These three stories may help save your life someday and I hope they will help you make the best possible medical decisions.

Gall Bladder Surgery

12 years ago at age 25, a doctor diagnosed me with gallstones and she recommended that I have my gall bladder removed. The first inaccurate thing they told me was that the procedure was safe. It isn’t. They didn’t tell me that 1 in 50 patients have an injury that results in serious complications like death or lifelong pain. They also didn’t tell me gallbladder surgery increases the chance of colon cancer. And they didn’t tell me that over 1 in 10 patients are not satisfied with the surgery. Is that the doctor’s fault? No, some of this stuff they didn’t even know in 1994. It was my responsibility to ask more questions and do more research about the procedure. I should have asked – What does low risk mean? What exactly are the possible complications and how would they affect my life? Is it possible there are long-term complications with this procedure that nobody knows about yet?

The day of my gall bladder surgery, they wanted to perform an ERCP to remove a stone from my bile duct. The ERCP was in addition to my gall bladder removal surgery. It involved inserting a tube down my throat while I was conscious and rooting around in my bile duct. ERCP risks are high – 1 in 5 cause pancreatitis, which can result in death or lifelong pain. Just before I was about to have the procedure done, I asked the doc, “why do you think there is a stone caught in my bile duct?”

He said, “because your liver tests indicated it.”

I asked, “what else could give you that result?”

He said, “alcohol consumption.”

I asked, “how much?”

He said, “anything more than two beers.”

I said, “I had six last night.”

He said, “Six beers would give these results”, and he called off the procedure. I avoided a 20% chance of serious internal injury by asking questions!

My gall bladder removal surgery was flawless and I am grateful for that, because three years later my brother’s gall bladder removal did not go so well. The surgeon nicked his intestine and it leaked bacteria causing septic shock. He nearly died. He would have left two children under five behind. After several weeks in ICU he snapped out of his coma. A doctor told him that 70% of people with septic shock die.

Kidney Stones

At 4 A.M. Thanksgiving morning 2006 (a few days ago), I awoke to a searing pain in my lower left back. An hour later, I landed in the ER. They diagnosed me with a kidney stone, told me it was one of the most painful sensations know to man (renal colic), shot me up with narcotics, and gave me a CAT scan. The scan confirmed I was passing a kidney stone. They sent me home with a bottle of painkillers and told me it would take a few days to pass. Thank God for opiates. The ER doctor and staff were fabulous.

The ER doc referred me to an urologist, but it took five days to get an office visit. During this visit, I asked him what I could do to prevent kidney stones from forming in the first place. He said I could eat less calcium in my diet, but other dietary changes would have no effect. I said, “what about pop, coffee, or water?” He said that stones were genetic and changing my intake of those items wouldn’t have an effect. He was wrong.

Many medical researchers believe calcium deficiency causes kidney stones not a calcium surplus.

People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. But recent studies have shown that foods high in calcium, including dairy products, may help prevent calcium stones. Taking calcium in pill form, however, may increase the risk of developing stones.

From: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/#the

Reduced calcium diet is an old inaccurate preventative treatment:
http://www.ccjm.org/pdffiles/HALL1102.PDF
My urologists information was out of date.

Diet does affect risk

Foods and Drinks Containing Oxalate

People prone to forming calcium oxalate stones may be asked by their doctor to cut back on certain foods if their urine contains an excess of oxalate:

  • beets
  • chocolate
  • coffee
  • cola
  • nuts
  • rhubarb
  • spinach
  • strawberries
  • tea
  • wheat bran

People should not give up or avoid eating these foods without talking to their doctor first. In most cases, these foods can be eaten in limited amounts.

From: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/#the

Water intake does affect risk:

A simple and most important lifestyle change to prevent stones is to drink more liquids—water is best. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period.

From: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/#the

He doesn’t return my calls, goes on vacation without a backup, and gives dated advice. It’s time to find a new urologist.

Arthritis

Three months after our second child was born my wife began to develop pain in all the distal joints on her left hand. She was 35 years old. After several more months, the pain increased and her joints began to swell. She visited a doctor. He told her that is was Osteoarthritis and modern medicine couldn’t help. She’d just have to live with it. She believed him for the next year as her joints became worse and the disfigurement progressed.

Then it began to spread to her right hand. After Googling arthritis, my wife and I discovered that Osteoarthritis generally did not progress this fast. This time she skipped the whole HMO referral process and went straight to a top tier rheumatologist. This doctor was better and more empathic than the first doctor was. He did tests to ruled out Rheumatoid Arthritis. Then he guessed it might be Psoriatic Arthritis (a rare form of progressive arthritis that can be disabling within five years) and put her on several medications. One medication was Methotrexate – a chemotherapy drug with significant life altering side affects. After taking this drug for several weeks, she returned to the doctor telling him that it wasn’t working and it made her sick.

Then she got a third opinion. This doctor determined that she had DJD (degenerative joint disease) which is another name for Osteoarthritis and put her on a NSAID drug that seems to be working. But the truth is not one of them knows what is happening in her hands. They are all guessing. It was up to her to tell them what was and wasn’t working. It was up to her to question their diagnosis. It was up to her to get second and third opinions.

The second doctor encouraged her to do her own research on Google and learn as much as possible about arthritic conditions. He was wonderful. He admitted he didn’t know what was happening and recommended the third opinion.

Owning her own health care decisions and challenging the doctors saved her joints from further destruction and saved her from years of life threatening side affects from Methotrexate. Her current NSAID treatment seems to be working well.

Remember, ultimately, you own you own health care. You are the decision maker. So ask a lot of questions.

Read the 10 part series on the 10 things I wish I had never believed:

#1 Why People Believe Money is the Root of All Evil
#2 Why Getting a Good Job isn’t the Best Way to Earn Money
#3 The Secret Great Leaders Know About Emotions
#4 Success is 99% Failure
#5 10 Tips to Secure a Management Position without a College Degree
#6 Always Question Your Doctor - Three Stories Why
#7 How the Public School System Crushes Souls
#9 Give Me 3 Minutes and I’ll Make you a Better Decision Maker