On a happier note, now that your blood is no longer buttery, you'll be less attractive to vampires who want something to go with their lobster hemolymph.
"But 'mainstream medicine doesn't care about prevention.' Um, this is by far the most preventative medicine I’ve ever experienced!"
Mainstream medicine cares very much about prevention, but has administrative difficulty delivering this care to patients in ways that aren't needlessly confusing and patient-shaming.
I recently had an experience which drove home how different a patient's situation looks from the patient's versus doctor's perspective. From the doctor's perspective, there is simply a new standard of care for asthma of my severity in 2025, it includes -mab drugs, and he was not the doctor to treat my asthma (he had good reasons for thinking he shouldn't be).
From my perspective, access to the new standard of care, with its -mab drugs, is precarious. Patients can lose it any time medical staff or coverage changes (which is fairly often), and re-establishing access can take months of misery both from deterioration of the underlying condition and the managerial headaches. Both changes had happened to me, and this particular BigHospCorp doctor was the only one I could still reach who had anything to do, albeit tangentially, with securing my original access, plus his area of specialty was on the list my claims reviewer had given me. For me? Ideal doctor of the moment to re-establish my access! For him? Nope.
Plus, BigHospCorp had not made clear to me that the visit I'd had with his prescribing nurse a few days earlier was adequate to re-establish me in his practice. What I heard was that a nurse could see me quickly in the interim, but I wouldn't really count as current with the practice until a doctor's visit, which meant months of waiting, until BigHospCorp's automated scheduling service notified me of an immediate cancellation, and I took it.
For all I knew, getting the doctor's visit over with as soon as possible by taking the cancellation would secure my status as an established patient with as little fuss as possible. I can't know as well as a practice's medical staff do exactly which appointments one must have with whom when to stay in the practice's good graces, and I was nervous about somehow "not really counting" (to *some* gatekeeper – if not the claims reviewer, then BigHospCorp itself) as "established" until the doctor himself had seen me. From my doctor's perspective, I had wasted everyone's time with an unnecessary appointment, with nothing for him to do so soon after the nurse's appointment.
When I tried to make the best of my apparent waste of the doctor's time by picking his brains, including about stuff I could do to maybe not need -mab drugs to begin with (since, from my perspective, access to these drugs is so unreliable that I need a plan to do without if I can), he was just confused: –mab drugs are the new standard of care; why would I plan to avoid them? And he thought I was confused (which of course I was, just not really about the medicine!). We were confused in mutually incompatible ways because the system is confusing.
Yep, the "systems" and institutions and businesses of medicine are often what people actually object to in "mainstream medicine," as opposed to the medicine itself, or medical science. In some parts of the world, the institutionalization of medicine is downright nightmarish.
Good for you! That must be a nice feeling. I’m always happy for your wins!
My cholesterol has been rising since I had to stop exercising, or moving much at all. So I’m practicing my own cholesterol denialism by pretending it’s not happening because I refuse to take statins. All I need is another reason for pain.
How stupid is this reasoning? Way stupid I know. But dying earlier than I normally would, compared to this, wouldn’t be so terrible. It’s not terribly high, right on the edge I’m told…
How stupid is that thinking? I’m not sure. Have you heard of other people feeling the same?
Thanks Paul I have followed your salamander blog for yrs and now having high ldls and chronic, untreatable pain ,there is hope for me yet!
Great news, Paul!
On a happier note, now that your blood is no longer buttery, you'll be less attractive to vampires who want something to go with their lobster hemolymph.
"But 'mainstream medicine doesn't care about prevention.' Um, this is by far the most preventative medicine I’ve ever experienced!"
Mainstream medicine cares very much about prevention, but has administrative difficulty delivering this care to patients in ways that aren't needlessly confusing and patient-shaming.
I recently had an experience which drove home how different a patient's situation looks from the patient's versus doctor's perspective. From the doctor's perspective, there is simply a new standard of care for asthma of my severity in 2025, it includes -mab drugs, and he was not the doctor to treat my asthma (he had good reasons for thinking he shouldn't be).
From my perspective, access to the new standard of care, with its -mab drugs, is precarious. Patients can lose it any time medical staff or coverage changes (which is fairly often), and re-establishing access can take months of misery both from deterioration of the underlying condition and the managerial headaches. Both changes had happened to me, and this particular BigHospCorp doctor was the only one I could still reach who had anything to do, albeit tangentially, with securing my original access, plus his area of specialty was on the list my claims reviewer had given me. For me? Ideal doctor of the moment to re-establish my access! For him? Nope.
Plus, BigHospCorp had not made clear to me that the visit I'd had with his prescribing nurse a few days earlier was adequate to re-establish me in his practice. What I heard was that a nurse could see me quickly in the interim, but I wouldn't really count as current with the practice until a doctor's visit, which meant months of waiting, until BigHospCorp's automated scheduling service notified me of an immediate cancellation, and I took it.
For all I knew, getting the doctor's visit over with as soon as possible by taking the cancellation would secure my status as an established patient with as little fuss as possible. I can't know as well as a practice's medical staff do exactly which appointments one must have with whom when to stay in the practice's good graces, and I was nervous about somehow "not really counting" (to *some* gatekeeper – if not the claims reviewer, then BigHospCorp itself) as "established" until the doctor himself had seen me. From my doctor's perspective, I had wasted everyone's time with an unnecessary appointment, with nothing for him to do so soon after the nurse's appointment.
When I tried to make the best of my apparent waste of the doctor's time by picking his brains, including about stuff I could do to maybe not need -mab drugs to begin with (since, from my perspective, access to these drugs is so unreliable that I need a plan to do without if I can), he was just confused: –mab drugs are the new standard of care; why would I plan to avoid them? And he thought I was confused (which of course I was, just not really about the medicine!). We were confused in mutually incompatible ways because the system is confusing.
Yep, the "systems" and institutions and businesses of medicine are often what people actually object to in "mainstream medicine," as opposed to the medicine itself, or medical science. In some parts of the world, the institutionalization of medicine is downright nightmarish.
Good for you! That must be a nice feeling. I’m always happy for your wins!
My cholesterol has been rising since I had to stop exercising, or moving much at all. So I’m practicing my own cholesterol denialism by pretending it’s not happening because I refuse to take statins. All I need is another reason for pain.
How stupid is this reasoning? Way stupid I know. But dying earlier than I normally would, compared to this, wouldn’t be so terrible. It’s not terribly high, right on the edge I’m told…
How stupid is that thinking? I’m not sure. Have you heard of other people feeling the same?
Heard of it? I've felt it! And I’ve also heard of it. Quite a common feeling, I think. I wrote about this dilemma back in mid-2023:
https://www.painscience.com/blog/sign-me-up-for-mild-muscle-pain-the-statins-dilemma.html