… it pours! Such a cliche but it’s true, especially in family medicine. There are a handful of issues that family doctors see on a regular basis, what we call the “bread and butter” of family medicine – hypertension, diabetes, heart disease, chronic back pain, depression/anxiety. Sometimes the “bread and butter” are clumped together. Some days it’s one newly pregnant woman after another; some days it’s one newborn after another; some days it’s nothing but back pain, other days nothing but bladder infections. It’s a strange phenomenon.
Part of my job is reviewing blood test results. There are days when the results are boring, and others (like today), when almost every.single.one is abnormal and I have to deal with it immediately. For example, there’s the late 20-something new mom who hasn’t seen a doctor in 10 years, whose laboratory results show she is severely hyperthyroid. Then there’s the 50-something man being treated for bladder cancer whose hemoglobin has suddenly taken a nosedive for no apparent reason (ie, he’s not bleeding, has no change in bowel habits). And finally, a gentleman with human immunodeficiency virus (hasn’t seen me in 3 years), comes to see me for something completely unrelated and I note he needs a number of routine screening tests. He agrees to the prostate screening test, after much counsel regarding it’s limitations, and his level comes back today – it’s the highest I’ve ever seen.
Patient 1 needs to see an endocrinologist but she refuses because she wants her naturopath to handle it. Patient 2 gets referred to a gastroenterologist to rule out another malignancy. Patient 3 gets to see a urologist for a potentially painful prostate biopsy that may or may not be positive for cancer.
I’m glad it’s almost the weekend.