a) I have no primary care physician because I don't typicaly go to the doc for any reason
b) although I can afford insurance, it has an insanely high deductible and is very difficult to predict what I will be charged for
c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.
So I (like a lot of folks) don't go unless there is either an obvious emergency or a horrible, hard to live with long term problem.
So yeah, the advice is probably good, but the reason that I don't tend to take it has little to do with my willpower.
This is circular... you saying you don't go to the doctor because you have no PCP, and you don't have a PCP because you don't go to the doctor
> c) going to the doctor involves triggering an expensive and difficult to predict system that will possibly bankrupt me.
I'm having a hard time believing that a standard outpatient visit would bankrupt you. These are typically on the order of $100, and rarely more than a few hundred unless you're going in for specialized procedures, which you've already established you aren't.
Sure, if you go to the doctor, you might find out you have a more serious condition that would require future, longer-term care to address, and that future care may involve additional expenses and inpatient care which you may or may not be able to afford. But that's hardly a reason not to go to the doctor today and find out - at least you'd be able to make that decision on an informed basis.
In India, the process is very simple: you call the doctor in the morning, you get an appointment for the afternoon, you show up, get looked at, pay the cost of the visit (usually less than $10-15), and you're done. It's basically like any other business transaction. So even if I had a minor seeming infection, going to the doctor was the right and efficient move.
Here, I call the doctor's office, and might not get an appointment for another two months, if I'm lucky. At that point there is some opaque process involving my insurance, and it just seems like a much weightier event than a simple visit should be.
Of course, I'm guessing that an infection would speed up the process, but the psychological barrier is already up in my mind, and I'd rather just power through on my own.
But there seems to be some hope. Recently, my wife was able to go to an urgent care clinic to treat an infection, and the process was much more like what happens in India. Still, there is some intervention of insurance, though a bit more transparently so.
They did refer me to an orthopedist and I ended up being out about $450 dollars after they looked at an some imaging and decided it was a growing pain.
That was with insurance, but hey, not wholly unpredictable and because there was nothing treatable I wasn't bankrupted.
So I talk to the doctor and they say XYZ tests need to be run. Okay, now I know what I need exactly and get a price, right? Nope. I just get the run around and "It depends on the insurance" and "We will bill you later" and "No it's probably not $5000" and straight up "I don't know"
Oh, okay, so I need to call the insurance company then, huh? Nope, they won't tell me either. I've tried. They just say "It depends". Even when I know exactly what labs they are going to run. I can say "I understand it might change if they need to run more tests." Nope. No idea.
Sometimes they can give you a straight answer but very often they will not.
It's hidden on purpose. It is confusing on purpose. Insurance companies don't want you to know what's going on. The doctors offices don't want to share "cash-only" info publicly because insurance companies will demand that price. The insurance companies don't want to share the info because people will complain. Etc etc it is not that easy when you go to the doctor for more than the really simple things.
Because Lyme's disease is regional - almost exclusively found in the Northeast and Minnesota/Wisconsin - most doctors won't have had much experience with it. Lyme's disease also presents with a lot of different symptoms that are very difficult to differentiate from other conditions (including other tick-borne diseases), which makes it difficult for doctors in those areas to diagnose.
The trademark "bullseye" rash of Lyme looks striking in pictures, but in most cases, it's less heavily pronounced, and it's harder to differentiate from many other possible sources of a rash or irritation. This is actually a problem for people who contract Lyme's disease more than once - after you've had Lyme's once, you will always test positive for the disease, even though you may no longer need treatment, so it's hard to identify patients who have been reinfected.
EDIT: Fixed some incorrect information after I did some more reading on the specifics. Here's a full break down of it:
https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...
And here's the process of a tick attaching: http://phenomena.nationalgeographic.com/2013/10/30/heres-wha...
They feed immediately but it appears that it is contingent upon when the tick starts having to get rid of excess water. Until the blood meal has started to engorge the tick, though, the organisms are not activated in the tick's gut. So until you see that the tick has actually engorged a slight amount, it's apparently not enough for you to catch disease from the tick.
https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...
Again, sorry for the incorrect info initially!
Told my wife that I'm going to feel like crap because of 30+ hours of flying, but if I have a headache that doesn't go away, I need to go to the hospital right now. That was a fun conversation.
Not necessarily their fault (medical science is trying to debug a program that you don't have the code for, do not control/know all of the inputs to, and you risk killing them if it crashes) but they've failed me time and time again in diagnosis, effectiveness, and availability, and in the US they were a financial burden until I was fortunate enough to reach the point my budget could take a hit.
This has built a habit of assuming that if I'm not in intense pain, visiting a doctor would be a waste of time and money.
I got pneumonia once. When the cough seemed serious I asked for an appt, but it took several days and by the day of I was struggling to breathe. Ended up going to an urgent care clinic hours before my appt because I was genuinely worried I wouldn't make it to said appt if I waited. The clinic agreed, given that as I walked in to their crowded lobby they heard me rasping and bumped me to the head of the line. I had four people on me at once, giving me oxygen, taking vitals, and one entering the numbers into their computer. I could see the screen, and saw that a few entries triggered a "the number indicates a critical problem, is it accurate?" warnings. They told me later that at 1 percent lower oxygen (i was 92%, which apparently low) they would have sent me to the emergency room. I'm glad they didn't, as their care beat any ER visit I've had, and was only $100, which included lung xrays. An ER visit would have been worse just walking in the door. Still worth it when they can help me breathe, but it demonstrates one reason why one can avoid doctors for seemingly non-serious ailments and conditions, particularly with all the times they've shrugged.
I'm allergic to most everything that won't kill you (pollen, mold, dust mites, cats, dogs, even rats). I have a list of issues with this, mostly constant sinus production/drainage, but only learned it was allergies when I self diagnosed in my 30s and went to an allergist to confirm. Even then, the cause that was dramatic enough to clue me in (rats) was not part of the standard panel. I had to specifically request it...and then point out that they hadn't added it as they said they would. That ended up being so severe that the tiny scratch swelled to the size of a half dollar despite me being on benadryl (i had missed the instruction to skip such meds for the test) AND the calamine lotion they slapped on it almost immediately. Had I not asked for and checked for that test, the specific problem of the moment (my girlfriends pet rats) would have remained undiagnosed (I had a list of potential causes of an uptick in problems, not awareness of any specific one). Not one doctor growing up suggested an allergy test, even though I can now look back and see obvious signs. Not one doctor asked if my symptoms occurred at specific times or places, not one ever mentioned the high constant drainage or inflamed ear canals. (Though doctors offices are pretty allergen free. As a kid I joked that their ugly paint made you feel better, since by the time a doctor came to look in on me my worst symptoms weren't there...in retrospect the repeat experience should have been a clue to them and possibly my younger self) Instead they called it mild asthma (asthma test was negative, but shrug. My guess is that they called it that just to make me feel they had a clue)
Machismo is a problem, but it isn't the sole problem.
Then there is stuff they handle extremely well: broken bones, bacteria, and a variety of easily treatable ailments.
I have a few health issues I know I basically can get no medical help on. And then, on the other hand, I had MRSA, and went to the doctor ASAP to get that cured.
I'm just saying (with way too many words) that there are reasons other than stoicism or machismo that people avoid going to the doctor. Were I the OP, I too would have not gone to the doctor for seemingly mild symptoms, and would have suffered as he/she did.
Most of us have no good way of knowing which issues are medically treatable and which aren't.
But you got a point: they suck at preventing CVD, which is a shame.
You didn't have breathing problems when you asked for an appointment; you had a cough. Then when you had breathing problems, you sought out emergency care and had that taken care of. But you blame your original doctor for... not predicting your breathing problems? Or not giving you lung x-rays the moment you diagnosed yourself with pneumonia? I'm confused what you would rather they have done.
The missed allergy sounds like a legit failure, though, but I'm not a doctor.
Other than having more doctors in the world (thus higher availability) and/or lower prices, I don't think this is a solvable problem. My point was not that doctors are terrible, but that people may have decent reasons to suspect going to the doctor for a mild rash (as article had) would not be worth it. Reasons other than stoicism. When I have a cough now, I still don't go to the doctor because the last 4 trips have been "You have bronchitis, just wait it out". I've resigned myself to having a constant low-level cough between Nov-Mar every year.
I do think my allergies should have been detected, but at the same time I understand the reasons they weren't. My goal was not blame, though I can certainly see how my pity-party comment could sound that way.
i had step throat, they refused me antibiotics because although i had all the classic symptoms, the strep test was negative. a bottle of penicillin i had at home cured me pretty quickly.
i had pnemonia, i told them this was the sickest i have ever been in my life. my whole body was in pain and i had trouble breathing, especially at night. they told me to drink water and rest. after 2 weeks i got another appointment, i was in really bad shape. they told drink water and rest. 3rd week same, but i refused to leave. i reminded them i lost 40lbs, only then did they take a real look at me.
> "Not necessarily their fault" I do put the fault on them. i think there is something around 'white male, send them home' mentality.
Running to the doctor for non-issues is part of why our medical costs have increased so much the last few years. There's so much marketing to "ask your doctor" about this and that and the other thing these days. And when you go, of course the doctor is obligated to run a battery of tests to cover his ass.
So, learn to spot the symptoms, and go get it sorted with a doctor. Like you would with any parasite.
You are correct in that the longer a tick is attached the more likely you are to get Lyme. Mayo Clinic says it's unlikely to happen if it'as attached less than 36-48 hours. But some of the ones that can give you Lyme are about the size of a poppyseed and you don't notice them right away. You should always check for ticks after being outside and remove them ASAP.
More info on what to do: https://www.uptodate.com/contents/what-to-do-after-a-tick-bi...
I'm glad to hear you're on your way to a full recovery given the severity of Lyme.
Your advice to "go immediately to the doctor" is not only important with regard to ticks but to all manner of infection. Most infections have similar symptoms and distinguishing between something discomforting and something deadly is a matter for a health care professional.
Stoicism with regard to maladies is practically a cliché among strong-willed people (men especially). Always consult a doctor with unusual infections, and seemingly usual ones, too, if you can.