PUMPING IRONY: Ignoring Doctor’s Orders

A visit to a new doctor reminds me how much western medicine relies upon numbers, which makes me nervous — and not very compliant.

doctor
Can you feel your blood pressure rising? I can.

I visited a doctor again last week. That’s twice in the last couple of months, which I know is nothing out of the ordinary for some guys my age, but it’s like binge-doctoring in my case. I’ll typically make the trip to my local clinic about once a year to have them irrigate my wax-filled ears — a simple procedure that has a salutary effect on me and all those around me who grow weary of repeating themselves. Last week’s foray, however, was more complicated, and measurably more stressful.

In a weak moment back in April, I agreed to have a full physical check-up at this new functional medicine clinic, a work-over I last experienced about 25 years ago. As far as I’m concerned, a complete health inventory is probably a good idea every quarter century or so, but this particular doctor was rather alarmed that I’d neglected to see what might be wrong with me for that many years.

It’s not that I dislike doctors, I explained. It’s just that I don’t have the level of curiosity or foreboding required to impel people to inquire regularly about their vital signs. If I’m feeling good — and I almost always do — I see no reason to mess with the status quo. This, of course, bends all the rules about so-called “preventive care.” But that’s another rant entirely.

I know that this visit was more stressful than necessary when the nurse, as nurses do, wrapped the blood-pressure thingy around my left arm, instructed me to uncross my legs (a relaxing posture, as far as I’m concerned), and pumped up the machine that measures the numbers that are supposed to determine what meds I pick up at the pharmacy on my way out. Those numbers, notwithstanding my uncrossed legs, were not good: 200-something over 90-something. The nurse just shook her head.

So did the doctor, who suggested some variety of pharmaceuticals designed to save me from cardiac arrest or stroke — or to save me from worrying about cardiac arrest or stroke, which I suppose would raise my blood pressure even further.

The doctor, a woman probably slightly older than my daughter, was just doing her job. There’s a protocol she was taught in med school and reinforced in residency and now in her early years of practice: blood pressure reading of X, patient’s age of Y, diagnosis of Z.

So I explained that the last time I had my blood pressure checked, less than two months ago at my other doctor’s office, it cashed in at around 140-something over 80-something. I’ve read up on this phenomenon: You find yourself in strange surroundings with someone wearing a white coat and wielding a stethoscope and, voilà!, your systolic rockets into the upper stratosphere and the next thing you know, the first responders arrive with a gurney and respirator, offering a ride you don’t get to refuse.

To her credit, she was not unaware of this particular syndrome and even allowed that my numbers could have been affected by the fact that I’d never been in this clinic before — though she still recommended some pharmaceuticals, which I declined.

So much of western medicine is caught up in numbers — blood pressure, cholesterol, PSA readings, and the like — but I think this is fear-based healthcare. Like my blood-pressure reading last week, these are just snapshots. If you’re generally taking care of yourself and listening to your body’s signals, you should be perfectly aware if anything is going awry. At that point, you can decide what changes you need to make to get back on track.

In fact, it’s perfectly normal for your blood pressure to rise as you careen past middle age.

This point was confirmed last year when the U.S. government released new guidelines redefining the definition of hypertension (which, I might point out, makes my 140-something over 80-something perfectly normal). As a result, almost 6 million Americans now no longer need to be on medication.

But that’s just another number, isn’t it. How many of those 6 million so-called hyper-tense individuals were diagnosed after a first visit to a strange doctor in a white coat after driving through rush-hour traffic on a short lunch hour during a tough day at the office? And how many decided to skip the pharmacy and instead quit smoking, started exercising more regularly, lost some poundage, and began eating a healthier diet? Just FYI: those are four of the biggest lifestyle changes you can make to lower your blood pressure on your way to avoiding doctors altogether and living a happier, healthier, less stressful life.

You should know that I did apologize to the poor doctor after declining blood pressure prescriptions, colonoscopy and prostate screenings, and a tetanus shot. She was very good-natured in the face of my oddball rantings about western medicine’s obsession with keeping us all hyper-tense about what might happen if the numbers don’t come out right. (Though she did chase me down in the reception area after the exam to see if I wanted to do a bone-density test.) Just doing her job, she explained.

And to be completely fair, I can’t say the visit was a complete waste of time, either. The nurse did a great job of cleaning out my ears. I can hear pretty well. Even if I won’t listen.

, an Experience Life deputy editor, explores the joys and challenges of aging well.

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