Patterico's Pontifications

8/2/2012

Government Seeks to Eliminate Routine EKGs

Filed under: General — Patterico @ 7:28 am



More government health care = less health care:

On Monday an expert government panel, the United States Preventive Services Task Force, joined the call by recommending against routine testing with electrocardiograms, or EKGs, in people who have no known risk factors or symptoms of heart disease, like shortness of breath or chest pains. The recommendations, published online in Annals of Internal Medicine, made the test the latest addition to an expanding list of once routine screening tools that have fallen out of favor. Earlier this year, the task force advised against regular screening with the prostate specific antigen, or P.S.A., blood test, long considered the gold standard for early detection of prostate cancer. The panel has also come out against measures like annual Pap smears for many women and regular mammograms for women in their 40s.

Saves money! What could be the possible downside?

I’m aware of a case where someone showing no symptoms asked for an EKG because they watched what happened to Andrew Breitbart, and didn’t want it to happen to them. The EKG revealed a potential issue, leading to more testing. Ultimately, atherosclerosis was ruled out, but testing indicated an issue with cardiomyopathy.

Problems like this can be addressed . . . but not if you don’t know you have them.

Policies like failing to deport criminal illegals, or certain lenient criminal justice policies, or elimination of medical tests . . . these all sound great to certain crowds in the abstract. The only trouble is that they actually kill people.

P.S. If you’re over 40 and you are concerned you might have heart disease, get yourself checked out. Do it before ObamaCare makes it impossible.

71 Responses to “Government Seeks to Eliminate Routine EKGs”

  1. 8 years ago, I went in for a routine physical. I was given an EKG, which detected some abnormality. I had not had any pain or any other symptoms. A week later, I had a quadruple bypass done. If not for the EKG, I would have had a heart attack soon thereafter.

    Yeah, let’s not do routine EKGs so we can have more people die from heart attacks. Sheesh.

    Jim Armstrong (9ed3f4)

  2. obama kills people to where they’re dead

    and also unemployed

    it’s kinda his thing

    happyfeet (3c92a1)

  3. Idiots. Everyone needs a baseline EKG so that doctors have something to compare to should they later experience cardiac symptoms.

    creeper (849351)

  4. The PA told me, you don’t need a Pap smear this year, the gubmint said so!

    I said, Oh, the gubmint said so? Then I want one.

    She looked kind of surprised.

    Patricia (e1d89d)

  5. ‘death panels’ she said, now that’s just crazy.

    narciso (ee31f1)

  6. DEATH PANELS ! !!!!!!

    JD (cfef43)

  7. A brief discussion and a few different points (brief, yeah, we’ve heard that before, MD)-

    From a population point of view, as well as an individual point of view, “screening” for anything makes sense only if you can screen effectively for it, you can effectively do something about it once you know about it, you do not cause more harm by doing things to people who don’t need it, and finding the problem earlier through screening makes a difference in the long run.

    The PSA is a good example. As in many things, there is no exact point where a PSA is normal and there is no cancer and when it is too high and there is cancer, and a middle area where the prostate is simply getting larger with age or whatnot. What you have is a different probability for a cancer being present bit by bit as PSA levels get larger. To some degree it is a bit arbitrary (though based on probability) of who you say to “come back next year” and who you say to get further tests, including biopsies (sticking hollow needles into the prostate to take “core samples”). The based on those biopsy reports, which also are not 100% good or bad, people go on to surgery or radiation therapy, which also doesn’t always work.
    So, by going by the PSA, many people get biopsies that are negative, worse, some get biopsies that show something funny and go on to surgery where no cancer is found. Meanwhile, the surgery can have side effects like incontinence and impotence.
    Last, it has not been shown that finding and treating prostate cancer before it causes symptoms does anything in reducing the overall mortality of it. In autopsies of men over 60 many have prostate cancer but they die “with it” not “from it”.

    The United States Preventive Services Task Force has been around much longer than discussion of ObamaCare, and they do address important questions as to what is the “best” course of action for many things. However, I think among some people there is a bias to “don’t do it until you have proven it works” which is a bit extreme and blind to the uncertainties of life.

    On the other hand, one of my teachers in residency was fond of saying that “even if something only happens ‘one in a million’, if you’re that one it is 100%”. An example being the person who wanted an EKG because of Breitbart.

    I believe in malpractice law where a doctor deviates from accepted norms may be a bigger issue at times than what the doctor actually did. I don’t know if an official recommendation like this protects the individual doc from a lawsuit in the event someone drops dead of a heart attack while jogging when their doc told them that an EKG wasn’t necessary. Because to the degree the issue is cost savings, docs aren’t going to listen to recs. if they can still lose a malpractice judgement.

    Believe it or not, I think most docs want to do what the patient needs and not do what they don’t without being strong-armed by third parties.

    MD in Philly (3d3f72)

  8. Once we find out what’s inside the bill, we’re all going to have heart attacks.

    Elephant Stone (65d289)

  9. Pretty soon there will be nothing left of government but tax collectors, bosses-of-me and pensions.

    Kevin M (bf8ad7)

  10. Strikes too close to home for me. Didn’t know I had atrial fibrillation until the anesthesiologist saw it during cataract surgery. It was confirmed with an EKG during a subsequent visit to my PA, with zero other symptoms. Skip it, my a$$!

    Methinks I’ll be getting regular/annual EKGs for the rest of my life.

    Red County Pete (225704)

  11. FWIW, a fib usually can be detected by a person listening to your heart or taking your pulse. Of course, I don’t know if machines that take pulses these days are programmed to catch it.

    MD in Philly (3d3f72)

  12. Annual paps really do not confer much medical benefits, and they do harm as well. The annual pap is a money-maker in that the idea that one needs one every year brings in a steady stream of patients who would not otherwise appear.

    There are even physicians who will not prescribe birth controls unless the patient submits to a pap, though there is no medical reason to connect the two. Its more of “discipline” measure to make sure the patient must appear.

    SarahW (b0e533)

  13. Of course, given the amount of time docs are spending paying attention to the latest recommendations from some muckety mucks it is increasingly difficult to find the time to take care of patients…

    MD in Philly (3d3f72)

  14. Yes, as SarahW points out, even if a woman does have an abnormal PAP smear, it takes much longer than a year to go from normal to abnormal to cancer. More can be said, not know.

    MD in Philly (3d3f72)

  15. So I can’t get too excercised about routine annual paps.

    PSA testing has been controversial for a LOOOOONg time. Calling it a “gold standard” test is very misleading. It’s a crap test, not very specific at all.

    SarahW (b0e533)

  16. ____________________________________________

    To some degree it is a bit arbitrary

    There is a damned if you do, damned if you don’t nature to much of this.

    I know that some patients, certainly the sue-happy ones, will file lawsuits against a doctor if they believe a lack of enough testing allowed a problem to be — in their mind — mishandled. But if the Obamabots are so concerned about the nation’s healthcare system, then they should focus on tort reform and deal explicitly with the issue of how the cost of medical care has been ratcheted up by the medical community due to a fear of ambulance-chasing trial lawyers.

    BTW, here’s another thing to consider when it comes to healthcare and rising costs:

    wired.com: From 2001 to 2006, the percentage of new products cut from development [by the pharmaceutical industry] after Phase II clinical trials, when drugs are first tested against placebo, rose by 20 percent. The failure rate in more extensive Phase III trials increased by 11 percent, mainly due to surprisingly poor showings against placebo. Despite historic levels of industry investment in R&D, the US Food and Drug Administration approved only 19 first-of-their-kind remedies in 2007—the fewest since 1983—and just 24 in 2008. Half of all drugs that fail in late-stage trials drop out of the pipeline due to their inability to beat sugar pills.

    The upshot is fewer new medicines available to ailing patients and more financial woes for the beleaguered pharmaceutical industry. Last November, a new type of gene therapy for Parkinson’s disease, championed by the Michael J. Fox Foundation, was abruptly withdrawn from Phase II trials after unexpectedly tanking against placebo. A stem-cell startup called Osiris Therapeutics got a drubbing on Wall Street in March, when it suspended trials of its pill for Crohn’s disease, an intestinal ailment, citing an “unusually high” response to placebo. Two days later, Eli Lilly broke off testing of a much-touted new drug for schizophrenia when volunteers showed double the expected level of placebo response.

    The fact that an increasing number of medications are unable to beat sugar pills has thrown the [pharmaceutical] industry into crisis.

    ^ Meanwhile, notice how the food industry — with little uproar or sniping from the medical industry — still promotes the idea that fat!!!, and not sugar, is a big problem. So even today food products still tout “low fat!” or “non-fat!,” while saying nothing about the amount of sugar in the ingredients.

    And all of this from the same human species that contains more than a fair number of those within it who love promoting the idea that man-made CO2 is a horror!, an environmental disaster, a cause of global warming!

    Mark (70c729)

  17. Don’t treat herds. TREAT PATIENTS.

    My view is most patients should be understanding the risks and benefits of common routine tests as they apply to themselves, and doctors should focus on care of individuals and their very individual goals, risk profiles, risk tolerances, and, pocketbooks.

    Most routine care and screening should be self-pay. It annoys me no end that people will be resorting to paying penalties taxes to get nothing, since they cannot afford plans larded up with mandates, when that money could go instead to a tax-sheltered HSA.

    SarahW (b0e533)

  18. This is totally the point of rationed health care.
    Save money by killing off people.
    The antithesis of do no harm.

    john b (33d124)

  19. People just don’t appreciate how good Obama is trying to be to us and all the freedoms he has created for the American people.

    Reducing routine healthcare screenings to save on the high cost of medical care.

    Forcing GM to produce external combustion engine Volts in the absence of any demand.

    Raising C.A.F.E. standards so automakers produce lighter cars nobody wants and increase highway fatalities but help save us from the scourge of nonexistent AGW.

    Discouraging or shutting down the domestic oil exploration business on federally controlled land and water again supposedly in our best interest.

    Forcing the domestic coal industry to shut down or adopt costly new technology or shut down based on bogus scientific findings for our own good.

    Expanding federal bureaucracies in the environmental, healthcare and financial sectors to help Americans cope with everyday life, because without those additional agencies and bureaucrats, everybody knows, we are too dumb to survive.

    Is this a great country or what?

    daleyrocks (bf33e9)

  20. Hillary care prohibited mammograms for females under age 50. There is currently a recommendation to substantially reduce mammograms for younger women because of the low detection rate at that age (primarily due to the low incidences of breast cancer at that age). Major steps in cost cutting.

    However, I would like to point out this means a death sentence for those younger individuals with breast cancer.

    A female employee in my office age 33 had her annual mammogram (no known indicators of higher risk). They discovered an aggressive form of cancer requiring almost immediate surgery & chemo.

    Under both hillarycare and obamacare with the likely cost cutting (due to use of “smart medical usage” also known as rationing), this individual would be dead in 3-5 years.

    Just a real world example.

    Mark (a00dc1)

  21. Where’s the reference to money in any of this?

    “For people at higher risk of heart disease, the panel found there was “insufficient evidence” to determine the benefits and harms of screening with the EKG test — either at rest or during exercise — and advised that it be considered case by case basis. In those instances, said Dr. Michael L. LeFevre, a vice chairman of the task force and a professor of family and community medicine at the University of Missouri, patients should discuss with their doctors their medical histories and circumstances — including age, blood pressure and cholesterol levels, and lifestyle — to determine whether an EKG test might make sense.

    The usefulness of the stress test has been questioned for some time, and in April, a group of nine medical specialty boards included it on its list of 45 common tests and procedures that doctors should perform less often. Their reasoning, like that of the task force, was that problems associated with the test can outweigh its benefit in many people, perhaps even leading to unnecessary harm.”

    still sleeeeepy (b5f718)

  22. If we don’t cut out this stuff for regular tax payers, how are we going to afford to provide healthcare, food, education, housing, etc, to the illegal alien population?

    Where is your compassion?

    Jim (748bc6)

  23. “Where’s the reference to money in any of this?”

    still sleeeeepy – Are you a moron?

    “In a move likely to alter treatment standards in hospitals and doctors’ offices nationwide, a group of nine medical specialty boards plans to recommend on Wednesday that doctors perform 45 common tests and procedures less often, and to urge patients to question these services if they are offered. Eight other specialty boards are preparing to follow suit with additional lists of procedures their members should perform far less often.
    The recommendations represent an unusually frank acknowledgment by physicians that many profitable tests and procedures are performed unnecessarily and may harm patients. By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States.”

    http://www.nytimes.com/2012/04/04/health/doctor-panels-urge-fewer-routine-tests.html?_r=1

    daleyrocks (bf33e9)

  24. It’s not just saving money – there is also the argument these tests bring positive harm, both because of the stress of the test itself, and because of what doctors do after they get the results.

    Sammy Finkelman (ce5e39)

  25. The recommendations represent an unusually frank acknowledgment by physicians that many profitable tests and procedures are performed unnecessarily and may harm patients. By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States.”
    Comment by daleyrocks — 8/2/2012 @ 10:32 am

    daley- what we need is an unusually frank acknowledgment by lawyers that doctors order a lot of tests and expenses to protect their butts from getting sued.

    MD in Philly (3d3f72)

  26. Yes, Sammy- I made that point above that cost is not the only issue involved. But it seems to me that the bean counters are the ones who get most excited about such things.

    MD in Philly (3d3f72)

  27. Comment by Mark — 8/2/2012 @ 8:55 am

    The fact that an increasing number of medications are unable to beat sugar pills has thrown the [pharmaceutical] industry into crisis.

    I wonder what else is in these “sugar pills” Calcium?

    Sammy Finkelman (ce5e39)

  28. If health care is a “right,” as the kooky lefties assert, then why would they cavalierly take away my “right” to an EKG ?

    Elephant Stone (65d289)

  29. MD #7,

    You make good points and I agree that most doctors put their patients’ interests first, but I think you are overlooking the degree to which institutional changes can impact future decisions and behavior. Specifically, the more the government decides which tests are needed (and which tests should be paid/reimbursed), the more it will impact how doctors make decisions, what decisions they make, and the minimum standard of care.

    DRJ (a83b8b)

  30. The government should not be making these decisions, nor health insurers. People should pay for their own routine care. Once upon a time, when medicine was a profession and not a technical career, physicians used their mad skillz to treat YOU, not the public at large. Studies on the usefulness of this screening or that – the benefits and harms conferred in general – should guide professional practice. Patients ought to have sense enough to know that testing has downsides and sometimes with limited benefit.

    SarahW (b0e533)

  31. _____________________________________________

    Policies like failing to deport criminal illegals, or certain lenient criminal justice policies, or elimination of medical tests…

    Not to mention the imposition of Daylight Saving Time by the geniuses in Congress. Such tinkering with the clock apparently not only doesn’t really save any or much energy, but it’s known to trigger an uptick in heart attacks upon its introduction each year. Moreover, a lack of people getting enough sleep is as big a health problem as any other, and screwing up natural biorhythms doesn’t help matters. Yet the brilliant minds in our government deal with that aspect of human health by forcing everyone to wake up one hour earlier.

    I guess politicians want to heighten the sense that time is flying by faster and faster, because we all joyfully want to race to our grave.

    Mark (70c729)

  32. “doctors order a lot of tests and expenses to protect their butts from getting sued.” And that is one of the last best protections from the government picking and choosing your care for you. The doc needs to be on the hook for the help and the harm of such testing.

    But frankly, a lot of testing = revenue stream, not mere posterior-covering.

    SarahW (b0e533)

  33. DST, TSA… PSA… it’s really hard to undue useless things even when they confer no benefit or cause more harm than good.

    SarahW (b0e533)

  34. SarahW,

    I generally agree that doctors should treat patients, not herds, and most doctors who have a long-term relationship with patients are able to provide tailored care. But for the average patient — such as patients who don’t regularly see doctors or patients referred to specialists — don’t doctors start by picking the diagnoses and treatments that are statistically most likely for patients presenting with particular symptoms? In other words, isn’t medicine designed to treat patients as herds?

    DRJ (a83b8b)

  35. “daley- what we need is an unusually frank acknowledgment by lawyers that doctors order a lot of tests and expenses to protect their butts from getting sued.”

    MD in Philly – I agree, but if our liberal Obamacare overlords begin rationing care, including limiting routine tests and adverse consequences arise which otherwise could have been detected or prevented, I think our liberal overlords should specifically immunize the medical profession against liability for such consequences or pass some form of tort reform. Unfortunately, I don’t see that in the cards.

    daleyrocks (bf33e9)

  36. And vaccines are obviously based on treating patients as herds.

    DRJ (a83b8b)

  37. “But frankly, a lot of testing = revenue stream, not mere posterior-covering.”

    SarahW – My internist added a very modest retainer fee arrangement several years ago assist with revenue stream issues.

    daleyrocks (bf33e9)

  38. Placebo pills: More than just Sugar

    Placebo pills are often custom made – and sometimes designed to have the same bad side effects as the medications they are being tested against! (that’s called an “active placebo”)

    I think most drugs have a harmful effect on the liver – they are anti-nutrients – so some of the placebo effect can be from not getting the medication.

    Even when something does good, it also has deleterious effects in general, so the question would be is it counter balanced by what good it may do.

    For instance an antibiotic may do a great deal of good, but also something bad (like killing good bacteria)

    Sammy Finkelman (ce5e39)

  39. There won’t be money for a lot of things. Not less, just none.

    Last Friday the Market ran up 200 because the ECB mouthed ‘Rescue’.

    Today it ratchets back down because nothing happened.

    Doom.

    gary gulrud (dd7d4e)

  40. _______________________________________________

    I think our liberal overlords should specifically immunize the medical profession against liability for such consequences or pass some form of tort reform.

    But, of course, we’ll probably end up with reduced testing and, at the same time, no limits applied to ambulance chasers. So doctors will be cajoled into rationing the tests they hand out — which by itself may not necessarily be a bad thing — but still will be vulnerable to getting sued by unhappy patients because of the existence of such a revision in policy. Truly a Catch-22.

    Makes me think of the very liberal 9th Circuit Court which recently ruled that Disneyland must consider allowing handicapped visitors the use of not just wheelchairs (which have been available until now) but also Segways. So if liberal jurists have their way, Disney will be required to give people the option of zooming around their park in rather bulky mechanical devices, which may accidentally hit another visitor, causing that visitor to, in turn, sue the Disney Company for negligence.

    Catch-22: The pride and joy of the left.

    Mark (70c729)

  41. “Believe it or not, I think most docs want to do what the patient needs and not do what they don’t without being strong-armed by third parties.”

    The medical associations have pretty much been taken over by government panels and many members of faculties compete to get named to a panel of “experts” so they can collect a nice salary for doing nothing.

    The literature on “screening” is getting unreliable as it is influenced by the panels and their masters.

    Basic things like an EKG is a baselines unless you are having symptoms. If the symptoms are worrisome, an EKG is not enough. We need to get to a model where intelligent people have the option of private care with a doctor you know. That will NOT be via an “exchange” or other government entity. In fact, those entities are hostile to private care because, as was the case in Canada, they do not want comparisons made.

    I have some firm ideas on what a good system would look like. If anyone os interested, you could start here.

    Mike K (326cba)

  42. “We need to get to a model where intelligent people have the option of private care with a doctor you know.”

    Ummm … when they pay for it?

    Random (edf1d2)

  43. You make good points and I agree that most doctors put their patients’ interests first, but I think you are overlooking the degree to which institutional changes can impact future decisions and behavior. …
    Comment by DRJ — 8/2/2012 @ 10:50 am

    I agree with you 100%. What I wanted to emphasize was that most doctors (hopefully) don’t need someone looking over their back to poke and prod. By all means institutional factors play a part and already have for at least 15 years or more in my own experience. In the early and mid 90’s it was usually easy to get approval for a medication or test just by having a nurse call in and say, “Yes, the doctor really wants ‘X’!” Then it became, “The doctor wants ‘X’ because of what I just faxed you.” Then it became the doctor on the phone convincing the medical director to allow it. Then it became the doctor filing out forms, and more forms, and waiting, and having the nurse call to find out the status, and…. maybe sometimes getting it, finally…maybe.

    MD in Philly (3d3f72)

  44. I think our liberal overlords should specifically immunize the medical profession against liability for such consequences or pass some form of tort reform. Unfortunately, I don’t see that in the cards.
    Comment by daleyrocks — 8/2/2012 @ 11:09 am

    Agreed and agreed. If they could get away with it, they would allow malpractice to get so high that no doc could afford it unless they worked for the government… and then all of the malpractice lawyers would have to get govt. jobs on some kind of review panel.

    MD in Philly (3d3f72)

  45. daleyrocks – there have been attempts to pass tort reform in the past, which have tended to be shot down federally by the party bought and paid for by the Association of Trial Lawyers … Ooops, sorry – the “American Association of Justice” …

    “Loser Pays” would go a long way to allowing more to be spent on health care and less to be spent on CYA …

    Alasdair (81fcf1)

  46. One of the arguments made in support of Obamacare was that since insurance companies were out to make a profit, they both gouged premiums and denied coverage. Not withstanding the threat of lawsuit.

    Of course the Government wouldnt deny coverage – not withstanding that the government employees have qualified immunity.

    Mark (a00dc1)

  47. mr. yuk is mean mr. yuk is green

    happyfeet (a55ba0)

  48. ” “We need to get to a model where intelligent people have the option of private care with a doctor you know.”

    Ummm … when they pay for it?”

    Of course. When you get something for free, it is worth every penny. Obamacare contains provisions that will make such self paid care illegal. Don’t believe me ? Read this. The writer has spent years studying insurance company policies and Obamacare. I don’t do it because I can read his work.

    Mike K (326cba)

  49. Alasdair – loser pays isn’t really an option in malpractice cases. Frivolous claims go nowhere, easy cases settle at once, with the most egregious cases capped – and where there is a real question of malrpactice or liability, it often takes discovery and depositions and expert reports to get the lay of the land. Loser gets nothing is quite enough.

    SarahW (b0e533)

  50. Maybe these tests are not necessary. But that’s not the point. I don’t want the government to decide! I don’t want medical organizations paid by the government to decide! I want the information and the choice.

    Patricia (e1d89d)

  51. The CYA is vastly overplayed. For one thing, it can even be malpractice to order dangerous and unecessary tests and procedures and a source of liability all its own.

    Pressure to milk sources of revenue and pressure from insurers to block that pursuit and pressures to treat patients appropriately have the physician squeezed from all directions. I would not in the current climate, however, allow the last barrier to a physician’s accountability directly to the patient, to be stripped away, if I were you.

    SarahW (b0e533)

  52. Patricia – damn straight. You do NOT want the government dictating priorities in patient care.

    SarahW (b0e533)

  53. The CYA is vastly overplayed. For one thing, it can even be malpractice to order dangerous and unecessary tests and procedures and a source of liability all its own.

    Yes, you can’t win. I’m currently on a jury in a med-mal case, and one of the plaintiff’s claims seems to be that one of the defendants, a doctor three months out of her residency, called for a consultation before deciding that a procedure was necessary; the plaintiff seems to think that had it been done immediately it might have had a better outcome. But if she hadn’t called for the consult, and had decided on her own to operate, what are the odds that we’d be right here in the same courtroom, with the same defendant, hearing that she shouldn’t have relied on her newly-qualified judgment and should have got a second opinion from a specialist?

    Milhouse (15b6fd)

  54. “Yes, grand-nephew, I remember when the most screwed up thing about the American medical system was the way we paid for it. Now eat your pink slime before it gets cold.”

    htom (412a17)

  55. There’s nothing wrong with “pink slime”. It’s perfectly healthy meat that some anti-meat activists have given an ugly name to.

    Milhouse (15b6fd)

  56. I think EKG’s will still be given to Democrat members of Congress.

    AZ Bob (1c9631)

  57. hey we should have EKG Appreciation Day next Friday who’s in?

    happyfeet (3c92a1)

  58. Hope the AARP and AMA are watching … oh, and Olympia Snowe for letting this out of Sub-Committee.

    Rodney King's Spirit (aeda60)

  59. Oh, and EKG don’t pay much to MDs. $19? Navel gazing as usual. Much like PSA. Navel gazing.

    Rodney King's Spirit (aeda60)

  60. … this is what happens when you leave Health Care Economic Models to navel gazing practitioners and accountants.

    Penny wise, pound foolish.

    Rodney King's Spirit (aeda60)

  61. Much like PSA. Navel gazing.
    Comment by Rodney King’s Spirit — 8/2/2012 @ 8:03 pm

    Umm, not quite.

    MD in Philly (3d3f72)

  62. #61, I am simply saying the concern over spending on low cost tests like PSA and EKG is navel gazing and a great example of penny wise and pound foolish.

    Rodney King's Spirit (aeda60)

  63. #61 .. unless of course you take the “correct view” from a pure economic perspective that Preventative Care as a whole is a gigantic waste of money.

    Also, smoking Cigarettes is a great way to eliminate health care and entitlement spending for those pesky 65 to 100 year olds who don’t produce but simply consume.

    Rodney King's Spirit (aeda60)

  64. U3 at 8.3% in July with August orders on every damn thing falling thru the floor.

    Stick a stake of driftwood thru his chest into Oahu soil.

    gary gulrud (dd7d4e)

  65. Comment by Rodney King’s Spirit — 8/2/2012 @ 8:30 pm

    Yes, and you’re right. I was just trying to be funny, noting that the navel is not the part of anatomy that the PSA relates to.

    According to my wife I have now said 3 things that have been funny (up from 1), but I don’t think she or I can remember any of them.

    MD in Philly (3d3f72)

  66. MD #11: The nurse doing preop noticed something odd, but this was a day surgery center usually dealing with more-or-less healthy patients. I was asymptomatic 2 weeks previously, but events (sleep apnea untreatable due to an overnight power outage, among other things) set off my heart.

    I know there are portable a-fib monitors. Haven’t investigated them yet. Seeing a cardio doc in a few days.

    Red County Pete (a5225d)

  67. Comment by Red County Pete — 8/3/2012 @ 1:55 pm

    Thanks for the additional info. Makes sense. I hope all goes well with the cardiologist.

    MD in Philly (3d3f72)

  68. PSA screening saved my Dad’s life. He’d gone in for his annual physical, nothing abnormal with digital exam, oh, we’ve got the new machine ready? Yup, just need blood to test! So they took a big sample and ran all of the tests, to watch it work. PSA came back with some huge number, I don’t remember what. They thought that test was broken somehow. Took another sample to the lab across the street; same huge number. A week later Dad was in the Mayo Scottsdale, getting the same results, and the same “nothing wrong” from the finger probe.

    I wish I knew the name of the Doctor who glared at my Dad and said “all of these tests can’t be wrong. Why can’t we … I know. Bring him.” Off they went to the OBGYN lab, where they used the ultrasound equipment to examine his prostate. There the tumor was, the size of a tennis ball, sitting on the top of the prostate where it couldn’t be felt. Fast growing Stage III.

    Must have been fifteen years ago now, maybe twenty (the PSA test was very new then.) Dad’s still a cancer survivor.

    htom (412a17)

  69. An opposing view from the FDA. http://www.youtube.com/watch?v=BOyebcrVWb4&feature=fvwrel May not be safe for work at fast food restaurants.

    nk (875f57)

  70. Yeah, let’s not do routine EKGs so we can have more people die from heart attacks. Sheesh.

    Well, clearly, Jim, if they have heart attacks, it’s not the fault of not getting an EKG, it’s because of obesity, and clearly, that means we need more laws telling people what to eat and how to behave.

    I mean, come on. Get With The Program, MAN!?!?!

    ===

    This is all about more laws, not more health care!

    Smock Puppet, Like... Duh? (8e2a3d)


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