One of my favorite movies is Indiana Jones and the Last Crusade. One of the best scenes in the movie is where the old knight, guarding the Holy Grail, told the Nazi sympathizer to “choose wisely” from the many grails before him.
He did not. He “chose poorly.” He died.
When we become ill with a debilitating disease, from beginning to end, we are presented with many choices. Tests and results. Doctors and insurance. Medicines and caregivers.
It is important to know what medical tests are and what their results mean. It is important to know that doctors do not always agree on a best course of action for a patient. It is important to know that insurance has limits, that medicines have unwanted side effects, that caregivers do not always care.
When presented with choices it makes sense to listen carefully, ask questions, do research, ask more questions because your health is at stake.
Here is a personal example.
Reluctantly, I ventured to ER, a local hospital’s emergency room, on two occasions. Once before the ALS diagnosis and once shortly afterwards. Why? Breathing difficulties.
During the first ER visit, blood tests indicated higher than normal CO2. Carbon dioxide. Nothing else. That was a clue that was ignored. My third neurologist then recommended a trip to the Mayo Clinic.
During the second ER visit, a CT scan indicated that arterial blockage might be responsible for my breathing difficulties. LAD. Left anterior descending artery. The widow maker. Five doctors reviewed test results. Three doctors recommended an immediate angiogram to remove the blockage. Two doctors overruled them and said to wait to meet with my cardiologist (who had previously determined my heart was in excellent shape for my age).
What happened? Test results can be viewed differently by doctors.
Based on what appeared to be a blocked artery, one of the doctors prescribed medicine to reduce my cholesterol. Without doing a blood test to determine my cholesterol (perfect; triglycerides, too). I did not take the medicine.
In the end, my cardiologist said the only way to determine if LAD artery is blocked is… insert drum roll here… an angiogram. I had the angiogram and it showed no blockage. The breathing problems persisted.
My original pulmonologist recommended a tracheotomy to improve breathing; a drastic and invasive process. That recommendation was made without an examination of current breathing capacity.
See a problem? I found another pulmonologist.
Another doctor recommended BiPAP machine settings that were too high and caused additional breathing problems. How is that possible? A diagnosis based on incorrect information from test results.
Test results can lie. They are not perfect.
“Choose wisely” is a simple recommendation that requires diligence from the patient. Some doctors do not like questions from patients. Others are willing to explain everything in sufficient detail. In the end, the patient is responsible for what course of action to take.
The choices are yours to make. The results are yours to keep.