Commonly used arm positions can overestimate blood pressure readings: study

I am not a doctor and this is not advice. This is a standard medical test I have completely given up on any doctor to perform accurately. I do it myself at home once or twice a month. I do it with the same device, in the same chair, at the same desk, the same time of day, after I’ve ate and drank the same thing. Yes, I still let everyone take it because it’s typically a precondition of receiving care but my readings at home are completely different and give me a more accurate data point that actually makes me feel good about the progress I’ve been making on my health.

I’m actively looking for more healthcare I can do this way. I trust my data and it all coming together on the safety of my personal device. We don’t need doctors with extremely limited datasets to do this and try to find obscure correlations for us.

> typically a precondition of receiving care

I've achieved exciting results by flatly refusing vitals checks at each and every medical appointment. Especially psychiatrists. The PCPs always gamely admire my self-reported histories and graphs, commenting how nicely the trend line goes down, and then completely dismiss the results in their clinical notes.

However, I did lock horns with a particular chiropractor. I filled out the "pre-existing conditions" form with candor and honesty. I permitted a BP check. (His method was 100% manual sphygmomanometer.)

Then he informed me that he wouldn't touch me until my BP was controlled and normal. Yes, a chiropractor, not a cardiac surgeon. Geez.

In the past, I've tried to avoid submitting to blood draws and labs, because those are 100% fishing expeditions, and not actually attempting to diagnose a complaint or symptoms. (They love to misdiagnose hypothyroid or diabetes so they can begin destroying your endocrines.)

Unfortunately, clinics do these orders on a schedule, so if you avoid labs for a while, the orders simply pile up until they contrive to get them all done. I couldn't win. Still putting off colonoscopy: 2.5 years late, and counting!

>Still putting off colonoscopy

I hope you won't regret putting it off.

>They love to misdiagnose hypothyroid or diabetes so they can begin destroying your endocrines

Yes, my favorite pastime when I'm bored of treating "actual" diseases.

I fail to understand how a well-educated group of people (aka. HN) can be this against the scientific method.

If those involved are in the US, it’s a trust thing.

This isn’t the fault of medical professionals, but rather a system optimized for minimum risk and maximum billing.

For example, my adult son recently went through a bout of rectal bleeding. He sits a lot in his job and we assumed it was hemorrhoids.

It was a Saturday so rather than wait we met up at the local urgent care. They did an external exam and decided he needed to go to the ER. No, it couldn’t wait. We had to go right away.

So we went across the street to the ER and took up a bed for seven hours waiting for a CT scan and results. The CT scan showed no active bleeding or any other cause for concern.

At this point, it was 2AM. The ER doctor suggested we allow our son to be admitted so that they could accelerate a colonoscopy on Monday or Tuesday. Yes, that’s 2-3 days in a hospital room just so we could avoid outpatient delays.

Now, keep in mind, there are no other symptoms. He feels perfectly fine. The CT scan shows no active bleeding.

To us, admission seems like overkill. The doctor isn’t much help. They are mostly exhausted and also exasperated at “the state of health care in this country.” We try to be empathetic but more or less it feels like they are holding back.

So what to do? Well, my son made his own decision - we left. The next day, I called in a favor with a GI doc I know. We were able to get a colonoscopy 10 days later. Guess what? Internal hemorrhoids.

This is irritating enough, but what is even better is that we could have had that answer in 15 minutes if someone had pulled out an anoscope. Sure we’d likely need an colonoscopy as a follow-up but we could have been out of the system very quickly. We could have freed up that bed in the ER. Heck, we didn’t even need to be in the ER at all. Oh, and 10 days of needless worry would be gone.

I asked a hospitalist I know why no one thought to just have a peek. The answer? Oh, they definitely thought about it, but no one uses anoscopes these days. The preferred route is a colonoscopy. Why? Well, a colonoscopy is a better diagnostic tool, but frankly it also happens to allow for better billing.

And boy, oh boy is the billing good. For the hospital alone, we’ve got upwards of $6K in billing. Who knows what the colonoscopy will run. We have good insurance but to cover the deductible I’ll likely be out $2K.

Naturally, I’ve already called the hospital and asked them to conduct a billing review, which will be followed by a medical review. The result will likely be a claim by the hospital that all procedures were followed correctly, which is technically correct. They did it all by the book, wasted an enormous amount of time and money, and irritated all humans involved.

Anyway, this anecdotal story might explain why well-educated people are suspicious of modern medical practices (at least in the US).

FWIW, I’m in my mid-50s and I’ve not had a colonoscopy either, and I won’t be getting one. It isn’t that I don’t want to take care of myself but rather I can’t afford to actually know if I’m sick. In the end, squeezing a little extra life out isn’t worth the financial tradeoff for my family in the long run.