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Second Opinion

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A lot of my patients recently are relating stories of having surgery that I regard as unnecessary. More charitably, these are surgical procedures whose chance for producing symptom relief is iffy at best.

Most of my fellow internists do believe that too much surgery is being performed, and that the symptoms people are hoping surgery will cure can often be handled by lifestyle changes instead.

Just this year, I have seen:

  • Several women with fibromyalgia undergo unnecessary and ineffective back surgery or joint arthroscopies (in which a scope is inserted into the joint).
  • Patients with irritable bowel syndrome have their gallbladders or their female organs removed. One woman had both removed, and her symptoms were unchanged.
  • No shortage of patients undergoing sinus surgery without first being tested for food sensitivities or treated for yeast (candida) overgrowth.
  • And one “tired” patient having surgery for sleep apnea–without any evidence of sleep apnea during sleep studies.

Now you might be thinking “These doctors are unethical,” but really, this isn’t the case. The problem is that doctors are trained to “fix” things and have a limited toolbox. They’ve got their ever-present prescription pad (use of pharmaceuticals has reached the level of mind boggling). And then there’s the operating room.

So here’s a piece of advice from somebody’s who’s been in the doctoring business a long time. If you’re not in an emergency situation and you’ve been advised to have surgery, get a second opinion. Obviously, don’t try this if your appendix has ruptured, your wrist is broken, or you’ve been in labor for days. But if you yourself are feeling worried and deep inside you’re questioning the wisdom of surgery, trust your intuition and get a second opinion.

I’ll anticipate your next questions:

  • You won’t hurt the feelings of your surgeon if you get a second opinion. They’re quite used to it.
  • If a surgeon acts angry about your independence, consider finding someone else altogether.
  • The doctor you use for your second opinion won’t be miffed if you return to your first surgeon. He or she will be paid (either by you or by your health insurance company) and generally doctors enjoy being consulted for their expertise.
  • Last, and certainly not least, health insurance companies almost always pay for a second opinion. They like the idea they might not have to pay for your operation.


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DIAGNOSE-IT-YOURSELF: COVID-19

Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.

ALLERGIES

• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

COLD
• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

STREP THROAT
• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

CORONAVIRUS-COVID 19
• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

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