From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med,can.politics,sci.med.cardiology
Subject: Re: the impatient patient, the angioplasty, and the doctors
Date: 2 Nov 2005 21:34:20 -0800
Message-ID: <1130996060.796286.305250@o13g2000cwo.googlegroups.com>

fresh~horses wrote:
> >From TheTyee.ca
> The Impatient Patient
> Link Address: http://www.thetyee.ca/Life/2005/10/26/impatientpatient
> Published: 2005-10-26 22:39:00
> By David Berner
> TheTyee.ca
> Pushing back at doctors has been good for me.

> About eight years ago, my family doctor (a good man and a good doctor,
> who is still my family doctor) told me that a recent blood test
> indicated that I had "hyperparathyroidism" and that I should see an
> endocrinologist. The endocrinologist confirmed, after yet another blood
> test, that I indeed had hyperparathyroidism, and that I should hurry
> across the street to St. Paul's to see Dr. Cutter (I made that up.) to
> schedule surgery at once.
>
> "Tell me about the surgery, Doctor."
>
> "Well, Dr. Cutter will open up an area just below your throat where the
> four little parathyroid glands are. He'll find that one of them has a
> benign - never malignant -- tumor, and he'll cut that out and in six
> months you'll be better."
>
> "Better than what?"
>
> "Pardon me. Better than what? I have no symptoms of anything. I am
> asymptomatic."
>
> "Yes...but when you get older, you could get osteoporosis."
>
> "Ha! Isn't that a definition of old age, Doctor, osteoporosis? I most
> likely will get osteoporosis if I'm lucky enough to 'get older.'"
>
> "Yes, that's true."
>
> "Now, look, Doctor. Let me lay some cards on the table."
>
> "Yes?"
>
> "In the two weeks between the first time I saw you and today, I went to
> the library and I did some research."
>
> "Really?"
>
> "Yes. And this is what I believe I learned. Tell me if I'm wrong."
>
> "O.K."
>
> "First, you don't really know how the parathyroid glands work, do you?"
>
> "Well...that's true. There's still much that we don't understand, yes."
>
> "And second, hyperparathyroidism or its signs could be caused by
> aluminum toxicity. Is that right?"
>
> "Yes, absolutely."
>
> "Well, for many years now, Doctor, I have been chewing 2 Gaviscon
> tablets before I go to bed for a reflux stomach. And Gaviscon is loaded
> with aluminum. (In the intervening years since this story, Gaviscon has
> now been re-formulated without aluminum.)"
>
> "Ah, I see."
>
> "So, what is the alternative to surgery, Doctor?"
>
> "Watchful waiting."
>
> "Which means?"
>
> "We take a look at you every six months or year and see how you're
> doing."
>
> "Now, you see, Doctor, you're talking to a middle-aged, fearful,
> neurotic Jewish man. 'Watchful waiting.' Now that's a phrase I can
> embrace."


COMMENT:

LOL. Well, maybe this middle-aged fearful neurotic Jewish man will
embrace it a bit less, after his bones fall apart. The "osteoporosis"
(osteomalacia) you get from hyperparathyroidism isn't a bit like old
age. It's much worse.

Somebody should (and many no doubt are) tell this guy the skinny.

1) Aluminum toxicty is very rare in people with normal kidney function.
And when it is seen in patients with normal kidneys, it's never from
oral aluminum. The reason being that aluminum is poorly absorbed from
the GI tract, and what little IS absorbed, is quickly gotten rid of in
the urine. Since aluminum is one of the more common components of dirt,
animals and people do this job pretty well. Thus, nobody with normal
kidneys gets aluminum problems from antacids. Period.

2) Even renal patients who DO get aluminum toxicty, don't get
hyperparathyroid from it. If anything, their parathyroids are damaged
and they get HYPO-parathyroidism. Obviously the opposite thing. And not
what Mr. Berner had, or nobody would be talking to him about
osteoporosis.

Thus, I can conclude that the story above is fiction, provided as
entertainment. Either that, or else Mr. Brener is indeed a pain in the ass
(as he writes) and a doofus besides, and is not reporting correctly on
what he (thinks) he heard his doctors say. Or, possibly, this
endocrinologist is a doofus. Perhaps all these are true.  However, one
thing is likely--- he got crappy care somehow, in this matter.

And had to work at it, too.

SBH