A recent study showing that men-particularly those who are "devoted to traditional beliefs about masculinity"-are far less likely to visit the doctor than women or pussy-ass metrosexuals was not exactly a surprise to anyone, but it hit home personally and caused me to reconsider my own longstanding aversion to having a medical professional look me over and tell me to stop doing everything I enjoy and start doing everything that I don't do already because it's boring or might cause me to sweat. I mean, let's be honest: I am not getting any younger, and the damage I've been doing to my body lo these many years is beginning to take its toll. So I bit the bullet and made an appointment.
Fortunately, the guy was booked solid for two months, so I've got the best of both worlds right now: I can tell everyone who keeps hassling me to see a doctor, i.e. my mom, that I have scheduled a check-up, but I don't have to actually do it until November, which is so far in the future I can't even process it! That said, if I should actually survive long enough for the dreaded event, I have a serious question that I am hoping members of the Awl community will be able to answer: What's the current calculus on the percentage of how much you drink and smoke that you reveal to your practitioner? I haven't had a check-up in seven years. Back then I recall the standard acceptable fiction being about a third of actual consumption. Has the ratio changed? I mean, if I'm going through the trouble of attending this thing I'd hate to get my lies wrong. Thanks in advance for all your help!
This is the same reason I don't go to the doctor ever!
But I seem to recall reading somewhere that they just automatically double whatever you tell them? Does that help?
Well, this is where the math comes in! I want to give him a rough estimate of how much I drink and smoke, but nowhere near the actual amount. So if I assume he's going to double the amount I tell him, should I tell him a third of the actual figure to give a little cushion and save myself from the liver enzyme tests?
I... guess?
This, by the way, is why I always drink about 3 liters of water (and take a multivitamin) before taking any blood tests. It may not allow the doctor to actually "treat" what ails me, but hey. What I don't know can't kill me, right? RIGHT?!
Shit.
If you're in your 30's and you say anything other than "I've haven't smoked or had a drink since my Rumspringa 20 years ago", they'll do the liver enzyme tests as a matter of course.
Oh sack up and get the tests. It probably won't be as bad as you fear. The gin-soaked and (now formerly) chain smoking mr. oudemia sucked it up and went to the doctor for like the first time in a decade and he was mostly ok. (And the guy's a fucking philosophy professor! All he does is brood and drink and drink and brood.)
I however lie like a cheap rug to the doctor.
If you're 30s, the liver is the least of your worries. You should be thinking pancreas and/or some form of alcohol-induced diabeetus. Almost nobody in their 30s gets booze liver.
Wait ... You mean Oudemia is a dude? Doudemia? (But then that should be Doudeis.)
Tulletilsynet is very cheeky. I am a lady. And "mr. oudemia" is my ÀÃŒÃιÂ. (A+ on your declensions, though!)
Man or woman, your little avatar is still my favorite, oudemia. (Little My!)
CLAPPING EXCITEDLY.
"I mean, let's be honest: I am not getting any younger, and the damage I've been doing to my body lo these many years is beginning to take it's toll."
Are you kidding me, Balk? Man up! Bourbon is the elixir of Life.
The bourbon alone would be fine. I'm more worried about all the vodka-and-diet-Sprites I drink when I don't want anyone to know I'm consuming liquor.
Ruh-r'oh!
I tell him straight up. Mostly because I wanted the no-bullshit AA-moralism-free answer on what amount of alcohol I could consume in a week given my lifestyle and not worry excessively (his straight up answer was about 20oz -- which was more than I was expecting to hear, and allowing for some good doctoring discounts, figures to put me at 30oz, which is maybe four decent nights out). You smoke, so you will get spend the entire time being hectored about that and losing 25 lbs. The drinking will probably fall further down the chart when you find out you have larger than normal red blood cells (which are a result of drinking). It's not like they actually test your liver. They just see that shit after you topple from cirrhosis.
Could I offer to lose the 25 lbs by smoking more, do you think? And should I lowball my smoking estimate in that case?
Ha. You guys are old.
@fek: Let's see how hard you're laughing after you take the Real Age test, young'un.
I'm 25.2! A difference of 4.8! That's not too bad is it? I think a lot of that had to do with my astigmatism.
I have a doctor who uses words like "pee" and "poo" instead of the clinical terms, and likes you to call her by her first name, Mandy. With a physician that chill, I found it very liberating to tell her the straight goods about how much booze and marijuana I consume*. I've also referred countless friends to her with great success... maybe the secret is to find a doctor you don't want - or need - to lie to (*other substances don't count because they're only occasional)! After all, only Judy can judge you, right?
You're paying this guy and presumably want accurate information, so why not tell him the truth? Since he may multiply that amount, tell him that you realize that he normally may increase the amount(s) that patients reveal, but that you are being honest, so don't use the multiplier.
You don't have to do what he says or ever see him again.
Seriously. It's not like he can court-order you to rehab. And an honest answer might help him account for that pesky pissing blood thing.
My dad has told me the three people you should never lie to are your lawyer, your doctor, and the IRS. I don't have a lawyer, but I think a little bit of fibbing is fine with the latter two.
For the doc, I generally just say "a pack lasts me a few days" (generally true) and shave the drinking by half.
Go in there drunk. That'll show him.
Sign in as Choire and tell Doc the truth.
"Now, Mr. Sicha, as a sexually active gay man, you probably won't even notice this next part of the examination, heh, heh, heh..."
This pussy-ass non-metrosexual says: tell the doctor the truth. You can even preface this by saying something like, "You know, doc, I was going to shade the truth on this a l'il bit, but you I feel like I can trust, so here goes..." The doctor will be so delighted and amused at the novelty of having in his office an adult male who actually behaves like an adult that he'll probably tell you to up the alcohol consumption or something. Having leveled male to male, you then have the option of following his advice or not. It's not like he's your mom, going through your desk looking for cigarettes.
"an adult male who actually behaves like an adult"
You do know you're talking about Alex Balk here, correct?
My doctor knows my penchant for honesty and know pretty much everything and everyone I do. In fact I think he looks a little too forward to it everytime I visit. (Did I mention that he's gay?)
MEANWHILE: I was in the ER last week for "something" (quotationalized as it is still in diagnosis phase). The CAT and MRI were fine, but I have to go to a neurologist. I CANNOT FIND A NEUROLOGIST THAT TAKES MY INSURANCE THAT WILL SEE ME UNTIL OCTOBER. I could be dead and my carcass consumed by my cat by then. When all of you funemployed fucks gets insurance the wait will be even longer.
Anyway, go to your doctor and tell him the total truth and let him know that you're an honest fuck. And by all means, I hope you have a straight male doctor. Likes should go to likes, I say.
After having a headache for over a month, I saw a neurologist that listened to my head with a stethoscope, glanced at my MRI charts and told me to chill. I live in Australia so this may be one of those crazy socialist sub-par medical practices y'all so scared of. Then again, at least I got to see one before I died from worry.
Doctor's are soooooo lazy they're tired from all the school and Godfoolery. LIE. Quote a fifth and make them take a proper medical history and order the exhaustive battery of tests. Otherwise they'll stop at doing no harm. Also, put some unisom on it.
A doctor who will stop at doing no harm would stop at nothing.
Okay, now that I'm done clapping I can type properly: LIE. LIE ABOUT EVERYTHING. Because when they call up your medical records to determine your eligibility for life insurance? YEAH. That one cigarette you copped to back in '93? Up goes your premium. The time you sauntered into the ER complaining of chest pains back in '07? DENIED.
1000% true.
Call me a "carpe diem" fetishist if you will, but isn't it more important that to receive adequate medical care during your lifetime than to leave whomever a fat check once you're dead?
Or am I reading this wrong? It seems like jolie is implying that if you have chest pains you shouldn't go to the ER?
This is all assuming of course that Balk is insured, which may be something of a leap, I admit.
No. ER stuff is actually fine (as long as they don;t find something chronic). it's the lifestyle "choice" stuff like smoking and drinking heavily that go on the record. But then, your health insurer may also have access to your credit card records which is why even if you lie at the dr. office, be sure to ALWAYS pay cash at the liquor store. (many places you cannot buy smokes with credit so....)
And while jolie was referencing life insurance. I'm talking more health insurance in general.
I got life insurance a few years ago and they didn't call up my medical records. They had me fill out their very detailed medical questionnaire/history and sent a nurse to my home to test my blood pressure and take blood samples for testing.
The key is to downplay the smoking as much as possible. Those white-coat -lung fetishist will never be like, "just cut down to X amount" . Instead, they'll be all like, "here's a pamphlet on how to help you quit" which is why none of the metrosexual have your respiratory fortitude, Balk. Furthermore, upsell the drinking. This will act as healthy counterbalance to your lies about smoking. And I feel like, drinking inspires people to be less judge-y than smoking?
Don't tell him about the huff dusting, though.
Oh Balk, a good doctor just sees the checkmarks on your input sheet for "Yes-Smoking" and "Yes-Drinking", and pays zero attention to whatever quantity you put on there. He should know better and he won't lecture either. He will just run every test needed for someone suspected of near-term simultaneous liver-lung failure, and treat accordingly. So lie your ass off, if it really makes you feel any better. And my quota of memoirs by alcoholic-depressed-cancer-ridden New York writers (fat might be interesting though) is completely full for at least the next 3 years, so don't plan on just earning your way out of this shit.
Milk thistle, which you can find at Wal Mart, makes the enzyme test think that even I am temperate. I am not.
For milk thistle to do any good, he'd have to start on it at least 6 months prior to the test, no? I was under the impression that it works on your liver over the long term AND that it's more a preventative measure. And yes, I take some every night.
I started taking it after an enzyme test came back bad many years ago. I don't know how long it takes to work but my subsequent tests have all been normal. I don't imbibe like I used to, though.
Yes. the long term is my understanding as well. though I think it's a bit of an "enabler" for heavy drinkers. "2 bottles of wine? Oh, fine b/c i take milk thistle!" And again, everyone always focuses on the liver when that really shouldn't be a young person's concern. nerve damage. pancreatitis. all, much more common.
Someone's too good for leeches and linament oil.
My doctor checks the bumps on my head to see if I'm a sociopath, then he extracts some of my black bile and I'm good to go.
My doctor keeps having to pin down my wandering uterus.
Jesus, you guys are making me more concerned than I was in the first place. Maybe I'll just cancel.
Which is why you posted this to begin with. Aaaaand the circle is complete. Hakuuna Matatta.
Shut UP, my mom reads this!
@Balk: Will the lies never end?
You know what you could do? STOP FUCKING EATING ONCE YOU'RE FULL, take longer drags, and occasionally hop on a treadmill.
God, you're such a man sometimes.
Seriously, it's better to go. Whatever the worst case scenario you've been running over and over in your head is, the reality isn't even going to be a tenth as bad as that. You probably have higher than normal cholesterol, and high triglycerides (from the drinking, mostly). But the doctor, and he's a million percent right about this, isn't even going to discuss that stuff with you until you quit smoking. Smoking is where any discussion about your health begins and ends. Look at it this way, this is the first step towards real adult life, pretty soon you'll be at the stage where you finally go to the dermatologist and have that funny looking mole checked out.
Also, if you need a motivator, despite all those silver-fox Clooney lookalikes in the commercials, smoking/overdrinking/overfattening is a key way to be in need of cialis/viara in 12 years. A drug that itself disallows drinking too much. Which leaves ypu with the pathetic paradox of needing booze to hook up but needing to be booze free to get the boner to hook up.
Shut up, CHICKS read this.
Oh go. And Abe and Lionel are exactly right. The doc will tell you to stop smoking. Your triglycerides will be too high. (mr. oudemia's were nearly 600 -- for real -- when he went. He quit smoking, hopped on the exercise bike and not so long later they were 85. It's fixable!)
I'm not buying your Mom's book about you either. So tell her to forget that money train. Also, a good doctor's visit is like chatting with a friend for awhile. Skip that and you go to the hospital, which is some kind of torture dreamed up by the death panels.
That's how I found out. She e-mailed me right after.
Just tell him you never wear shorts.
What if he's some kind of shorts evangelist? He'll send me for all sorts of unnecessary tests.
I think there's a much more important issue at stake here, Alex.
He'll be giving you a prostate exam, I presume? I mean, you've reached THAT age by now I'm guessing ...?
Ok, so, once you get naked and the doctor does that to you ... well, what's the point of being coy about anything with this guy? I mean, by that point, you'll have already shared more intimate moment with him than you're going to with most of the rest of the rest of people you're ever gonna meet in your life anyway ...
Fuck no, I'm telling him I'm 28.
Now why didn't I think of that?
Men don;t really need a prostate exam before 40. Barring some freaky family history.
I plan to lie about that too!
Alex: If you want to start an unhealthy men's health and alcoholism Shadow-Editors-like thing... you have my email.
Alex: A series of Dominican, black, Puerto Rican and Asian women will come into the exam room after long wait--which was preceeded by a longer wait in the waiting room. They'll draw your blood, give you a cup to pee in, weigh you, ask you ten times how much you smoke and drink, how often you fuck men, how often you fuck women and then they'll leave you alone with your thoughts.
After another half hour, the doctor will enter the exam room, probably without knocking or saying hello. He will remain in the room for a grand total of 4 minutes and 33 seconds. For most of that period he will be either staring at an electronic doo-dad that looks like Kindle Mark IV or doing the same to an old fashioned clip board. He will say, "Uh huh. Yep. Uh huh." He will look at your face intently. He may or may not touch your balls and stick a finger up your butt, depending on how close to 40 you are. He'll tell you to call in a couple days for your cholesterol numbers. Then he'll give you the Irish goodbye, exiting the room without telling you that the exam is over.
You will sit there for a few more minutes, not knowing if you should leave. You'll peak your head out the door. One of the nurses/nurses aids will say, "Oh, Mr. Balk. You're still here. You can get dressed now. Be sure to see Veronika before you leave."
The rest of you: You're all fucking liars. You haven't been to see a doctor since Carter was in the White House. Doctors don't give you a hard time about lifestyle choices anymore. They just give you drugs to countermand the side effects of poor lifestyle choices.
Backslider, regularly seeing a psychotherapist doesn't count as a Dr. visit in this context. Your run-down of what it's really like is straight out of a 4th woody allen film going through its 4th re-write.
Actually, I was thinking that his description accurately describes every hospital experience I have ever had. Like, to a frightening degree (minus prostate check, as I am a laydee).
Regular doctor visit, not so much.
i think that's probably a condition of this blog's readership demographic. I persoally know a number of GPs and OBYGYNs and they regularly complain about being overbooked because everything is scheduled for 15 min. but always runs much longer because of all the questions. This would lead me to believe these experiences are "user error as much as unengaged medical pros.
Sure. Again, that's only been my ER experience, with the nurses doing all the work and the doctor showing up for the last few minutes, looking over his clipboard and talking more to himself than to me.
My regular doctor always spends a good amount of time with me, and I'm a fucking hypochondriac, so that says something. SOCIALIZED MEDICINE 4EVA!111
Oh, ERs. I guess I missed that specific point. The ER docs I know are really only "locums" so.. for what it's worth. They're interested in what the particular patient has to say but ultimately they are not long-term caregivers and, barring some input from the patient that is highly influential, they simply treat according to the stats/tests etc. (In fact, ER patient input is often misleading, intentionally so - E.g. Most drug seekers are ER visits.) But yeah, ERs can be cold places.
Abe, this is true. ER patients are exceptionally misleading when detailing the events leading up to any foreign objects lodged in their anus.
The correct answer is "too much." When the doctor asks, what's your idea of too much, just tell the truth: you can't remember how much, exactly, you had to drink. Because you're always having too much fun to count!
Then move on to colonoscopies.
Oh please Balk. Just tell the truth.
There are too many drugs or procedures that are contraindicated with smoking heavily or drinking.. You want your doctor to know the truth so he or she doesn't overprescribe (um, sound familiar?) or otherwise do more damage than good.
I always tell a doctor the truth. That's what they are there for. Granted, I am Jewish. Maybe we are a different breed. We certainly don't have priests and confessions, so maybe doctors are our substitute.
If this is only about not wanting to hear whatever lifestyle prescriptions you think this doctor will dispense, I'm guessing you are not going to get more than a raised eyebrow and a "you might want to cut back." If you are lucky. If there is a longer lecture, you can always stick your fingers in your ears and say La la la. As others have suggested, I think it will be more cursory a visit than you are expecting.
I don't know about the other homos in the house, but I confront this issue of what to disclose to my doc when it comes to HIV testing. I used to always go to a clinic for anonymous testing, but lately I've just been having it done at my internist's office. My thinking is that if I am positive, I'm going to get treatment from my doctor anyway, so why not just do it the easy way? While it's unbelievably scary getting these kinds of tests, I think it's better to know the truth and deal with it rather than remain in a constant state of uneasy ignorance.
I've had a physical once a year for many years. The doctor seems to care most about changes from one visit to the next, so (s)he may reserve judgement on some things until next time.
There are some absolutes: smoking, certain recreational pharmaceuticals which they will tell you have no safe level and you should cut out.
There are some relatives: try to lose a little weight, drink less, exercise more. However, "too much", "too little", seem to work as answers.
Be prepared to try and remember when last you were innoculated against tetanus, Hep-A, etc. You might need boosters (which could entail no drinking for a couple of days!)
Turn your head and blog.
Internists are all alcoholics anyway. They don't make enough money to be happy. My doc used to bum smokes off of me. If the appt took you 2 months to get, it's a physical and Mr. MD will talk to you for a bit. We talk about boys. You will get scary tests. You will panic until the results come. You will be fine.
I have been admitted to the hospital for appendix cancer (the stupidest cancer ever) and a stroke workup in the past few years and none of it came from my physicals. It was all things that no one in their right mind would look for.
Internests are safe - specialists are the crazy ass ones that will keep you waiting and never give you a straight answer. Stay away from them and any university medical system (I cannot recommend Northwestern, they have too much of my money, god damn grubby rich people without anything better to do than make my chart bigger and ruin my credit).
Good luck with the appt.
If you take no other advice from this thread, hear this before you go: Buy new underpants.
STRONGLY AGREE
Be honest.
My vote goes with the milk thistle. It convinced my Dr. I'm dry after 1-2 months daily supplement and lots of water. Plus the Latin name sounds like "silly bum"... Cheap fish oil caps also go a long way to giving you a sleeker, shinier glossy coat and bright, clear eyes. :-)
Just print out these responses, bring them with you to the doctor, and ask which one he suggests you use.
amazing comment
Cigarettes, drinking, and drugs might hurt you one day. But entering your use of that stuff into your medical records will definitely keep you from getting certain kinds of life insurance, and it will definitely help your health insurance company drop you when you make a big claim. Yes, they're not "supposed" to have access to that stuff, but what is it about this world that gives you any faith in "supposed tos" like that?
ah crap
This has been so much more entertaining than any other news, like all summer!