A Tale of Excuses 3

" I did not seek medical consult when I started feeling bad because I was afraid I might have a disease and start taking medications. I thought it was just stress or I was tired."
" I don't have money for consultation with a doctor."


I hear this often from interviews with patients when I ask them why they did not seek consult when they were feeling something bad. I tell them we could have caught this early on when complications could have been prevented. But regrets always comes last. Maybe its the "mamaya na" habit of the Filipinos. Why did we get such a bad habit? Is it the environment we live in? Habits passed on from generation to generation just because people around us do it every time?

Majority of the patients I see already have target organ damage when they finally seek medical consultation. That is the time they feel exhausted, shortness of breath, easy fatigability, loss of appetite. In the extreme, the only time a doctor see them is when they already present with acute myocardial infarction, stroke and sadly sudden death, severe pneumonia. In short, they come to you when their disease state has "SEVERE connected to it."

I'm a cardiologist so most of my examples here are cardiovascular in nature. As a cardiologist, it would be nice if we get the patient in the early stages of their condition. In my opinion, it is much more fulfilling as a doctor when we could prevent complications of cardiovascular disease than to get them when they already have target organ damage. To know that we decreased the risk of developing complications. Notice that I said "decrease the risk" and not prevent. "Prevention" starts early in life by living healthy. As previously mentioned in my earlier blogs of finances being an excuse for not buying maintenance medications, the cliche ""an ounce of prevention is better than a pound of cure." (Please tell me if that is the right phrase). We could have saved the trouble of spending all that money for expensive medication. But nothing beats the genes (for now). Majority of the risk for cardiovascular disease in hereditary. The environment plays an important role in contributing to the risk.

These are the risk factor for cardiovascular disease:
1. age                          >45 years of age
2. sex                          being a male is a risk factor
3. Hypertension
4. Diabetes                  being diabetic is a coronary artery disease equivalent. Meaning your risk of having a heart attack even if you haven't had one is the same as an individual who is not diabetic but had a heart attack before.
5. Dyslipidemia            High cholesterol, high LDL, high triglyceride and low HDL
6. Smoking                  accelerates the accumulation of cholesterol in the arteries, disrupts the normal function of the arteries
7. Obesity
8. family history of early cardiac death or disease in the family <45 years f age.

Hypertension, diabetes, dyslipidemia are disease that are asymptomatic in the early stages. Common statements of patient "I feel fine even if I have blood pressure." Yes they feel fine but if it remains untreated, sooner rather than later you're going to feel something and when you do, it means you already have target organ involvement.

"I don't have money to see a doctor." in their quest, (if that is a quest) to save up money they put their health out of the priorities list. The initial consultation with a doctor will entail a certain amount of money because you will go through tests, routine test to evaluate your current health state. after that the least number of follow up is every month. If you feel better, every 3 months or more. You don't go to the doctor everyday. Compare that if you already develop the complications. You will have more medication to take and you have to buy them. In the long run it wouldn't be cheap any more now would it. "An ounce of prevention is better than a pound of cure.


Think about it.........