Forest, Trees, Hammer, Nail -- Insert Your Favorite Cliche Here

So I had to go to the doctor. A regular doctor, not the oncologist. 

When I changed my insurance at the beginning of the year so I could start going to the SCCA for my cancer I lost access to all my other doctors as well. And since I've only got so much mental energy for dealing with medical stuff, all of which is currently being consumed by cancer, I basically ignored that fact for as long as I could.

A few weeks ago I needed updated prescriptions for my insulin, which was a problem since the doctor who wrote them was no longer caring for me. The oncology PA was nice enough to cover the gap, but she made it pretty clear that this was a one-time thing and I needed to find a primary care doctor to deal with my non-cancerous health issues.

So on Thursday I saw my new primary care doctor, chosen on the basis that his was the open schedule at the clinic I chose for being a) covered by my insurance, b) more or less integrated with the SCCA so that it wouldn't be my job to move my medical records back and forth, and c) fairly close to my house.

I'd actually be interested to see another doctor at the same clinic if only because the doctor introduced himself by saying, "I'm Dr. _____. How can I make you feel better today?," and I just can't decide whether that phrase sounds more like something a slightly quirky doctor would come up with on his own or something one of the larger clinic networks in the region market-tested the hell out of and is now mandating as the prescribed greeting for all patients. I could see it going either way.

But actually, the doctor seemed a pretty nice guy in a really boring job. He asked me a few questions, poked at me a bit, but generally spent most of the time typing into a computer. I felt sort of bad that he had to go through some eight to ten years of school and training for the services he provided me. It seemed like serious overkill.

But in retrospect, I have to admit that I only really got one of the many things I was hoping for from the appointment: I got new scripts for my insulin. On everything else, the outcome was pretty much the opposite of what I was expecting. Specifically:

I've got these weird lumps in my arms that are driving me crazy and which I'd like to have removed. But per the doctor, the surgeons won't remove them until my cancer treatment is concluded. When I reminded him that my cancer treatment will never be concluded, he reminded me that the lumps are harmless. 

I explained that I'd chosen a general practitioner over an endocrinologist (i.e., a diabetes specialist) because I only had so much mental energy I could devote to health issues, and cancer was using it all up. A few moments later I got a referral to an endocrinologist, though at least to an endocrinologist based at the SCCA to make the appointments easier. So, yay!, more time at the SCCA. 

Then there was the message that came with my test results. In short, he suggested I talk to my oncologist to see if there was any objection to putting me on an anti-cholesterol drug and a blood pressure medication to counteract the possibility of kidney damage related to my diabetes. So I've got one condition with a median survival rate of two more years, and in addition to the eleven pills a day I'm already taking, this doctor wants to add two more to the mix to prevent problems that wouldn't likely arrive for another five to ten years. 

The movie theaters here in Seattle play these Geico commercials that revolve around the idea of "it's what you do." I was sort of reminded of those by my visit with this doctor. Got a patient with Type I diabetes, you send them to an endocrinologist. It's what you do. Got an elevated protein test? Prescribe blood pressure meds. It's what you do. Never mind the fact that I've got much bigger problems than cholesterol or protein.

I wouldn't care much about all this if it wasn't for the fact that I've seen way (way, way) too many people who were totally trashed by doctors trying to do too much. We're talking ten, twenty, or more pills a day. And I'm sure it was all well-intentioned, and started with the best medical knowledge available at the time, but it's always struck me as a pretty fast trip from "a pill for this and a pill for that" to "a pill for this and a pill for that, and this pill to counteract the side effects of that pill, and this other pill to offset the interplay between those two pills and this third" and suddenly cause and effect are all screwed up and you're basically running a biochemistry experiment within the confines of your body. I could be wrong, but to the best of my knowledge the FDA only requires drug makers to prove safety and efficacy, they don't require trials of every possible drug interaction before they grant approval. And I have no desire to be a test ground. 

Which is the long way of saying, I won't be taking any medications for blood pressure or cholesterol anytime soon. 

But at least I can get my insulin. I suppose that's something.