I’m so sorry that you have the flu. I heard that it’s a real kicker this year. I hope you recover quickly and feel much better soon.

The Skeptical Cardiologist (Anthony Pearson MD) has a newsletter that I think you can still sign up to read even though he also publishes it on Substack where everyone seems to be going to these days. All the writers offer much of their information in their free subscriptions but there are options for paid subscriptions as well which gets you more. I just opt for the free versions or I would quickly go broke. I also only subscribe to a few people or I would spend all day reading about everything under the sun on Substack, much of what is just someone’s opinion about anything with the author’s hoping for a following and/or a few bucks. Pardon my skepticism, smile.

I worked for a health services research company (Altarum) for the last 18 years of my working life and had access to excellent information albeit much of it over my head. I pulled data for studies for analysts. So I miss having that ability to get the latest and greatest. Mandrola and Pearson do write at a level one can understand. Mandrola and the “Sensible Medicine” team of Vinay Prasad (a maverick - Onocologist), Mandrola (cardiology/electrophysiology) and Adam Cafu (Internest) post really interesting subjects on Substack.
Cifu can get very technical and I swear he is interested in all aspects of medicine. I never know what he will post next. He has an incredible mind.

We’re all a data point of one. What I like about the three physicians above is that they seem to recognize this and still appreciate tailoring processes to the patient. They all feel that the healthcare system needs fixing and agree that there’s too much medicalization these days with the “pre’s:” Pre-diabetes, Pre-heart disease with Pharma anxious to treat people in said Pre-XXX with medication. Well of course! I’m old enough to remember when the upper level of normal fasting blood sugar was 115. Working for a health services research company, we were offered yearly lipid and fasting blood sugar tests and if we came in okay, along with waist measurement and within a reasonable weight, they put money into our HSA’s. You had to ace 3 out of 5 to get the money. The year that they changed the fasting blood sugar normal limit to under 100, I lost that point every single year as my ‘normal’ fasting blood sugar ranges from 101-105. Then when they developed the A1c test to see if you are diabetic or pre-diabetic, I always scored high pre-diabetic. But when I test myself as if I was diabetic with 4 to 5 finger pricks a day that sends the reading to an app that will spit out a report, I can’t even get to pre-diabetes. Turns out that not all A1c tests are standardized and after spending a year and a half with a diabetes doctor, he finally tested my A1c in his office and it was normal. Six months later he tested again and again I was normal and was dismissed as “cured.” Every year, even though I tell whatever doctor I have (we have high doctor turnover where I live) that I test high in A1c which is proven wrong with finger sticks, I still end up finger sticking for 2 weeks after that yearly test and sending the app report to them that clearly says on it “no manual entries” and shows that aside from my fasting glucose # typically at 101-105 with an occasional 99, every single finger prick shows that I’m in the green range.

We have to advocate for ourselves. I’m the one who asked the diabetes doc if I could test myself as if I was diabetic to find out what I was eating that created a high A1c so that I could try lifestyle change first. And look what we discovered! Dr. Ruiz who initially wanted to put me on Metformin, expressed dismay that if he had, my blood sugar could have dropped too low and caused me some serious problems.

I’m not against medication when it will help me. Obviously I’ve been taking the extended release beta blocker and BP med for years. But I’m wary about having unnecessary tests and unnecessary medications prescribed so I ask for time and more discussion before submitting to either so that I can learn more about them from resources and sources that I trust.

Keep your inquiring mind and pay attention to your body’s signals, to the information you can find and hopefully to a good informed discussion with your doctor(s). Doctors are so overloaded these days I know it can be hard for them to pay deep attention to their patients. Some try harder than others but some choose the cookie cutter approach and something that will tick the box on their EMR that shows that they offered a solution or prescribed a known course of action. They are also judged by what they put on their EMR’s. If you have access to a patient portal and can read their visit notes you will probably discover lots of things they said they discussed that was never discussed. I’m always amazed at how many things are in my chart that if I hadn’t looked at it, would never know what I still don’t know despite it saying something contrary in black and white. Good thing that I have a sense of humor.

A last example is my colonoscopy this month. Doctor came to my bedside after the colonoscopy saying that 3 small polyps were removed and that I should come back for another colonoscopy in 3 to 5 years because I am healthy. ??? - if not healthy I guess it doesn’t matter???

The next day I get a copy of my pathology report and it says to come back in 5 years given my mother had colon cancer.

I then get the official letter from the doctor who did the colonoscopy saying that the pathology report showed no cancer so I should come back in 7 years except that I’ll be 75 in a year when colonoscopies are no longer recommended so I don’t have to have another colonoscopy unless I want to have one.

At least I have options, eh?

Sorry for such a long answer that strayed from Afib and ablations and into the confusing world of figuring out how to best manage our health with so much conflicting information out there. Mandrola is an excellent source, and once again, I hope that you feel better very soon!