Comment by smacktoward | Hacker News Reader

Comment by smacktoward | Hacker News Reader

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Or even if you're not experiencing any pain -- if you haven't been to the doctor in a long time... go to the doctor. Get a routine checkup! It can save your life.

I almost learned this the hard way a few years ago. I was in my late 30s, and handled going to the doctor the way I always had since reaching adulthood -- which is to say, I didn't bother with it unless I was feeling out of sorts. Routine doctor visits seemed like a waste of time. Why sit an hour in an office to have somebody tell me I was doing OK, which I already knew?

Then my glasses broke, so I went to my local optician's to get a new pair. They did a routine eye exam to make sure my prescription hadn't changed, and in the process noticed something odd about the little blood vessels in my eyes. That led them to take my blood pressure, which turned out to be high. Like, really high. The kind of high where the person giving you the test looks you in the eye afterwards and asks you, entirely seriously, how you are still alive.

I was a stroke victim waiting to happen. (See http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/W...) And I had no idea. And would have continued to have no idea, right up to the moment when my circulatory system strangled my brain to death, if my glasses hadn't broken.

I went to the doctor, they gave me some pills to handle the immediate crisis, we changed my exercise routine and diet a little to bring my blood pressure down for the long term, and now I'm fine. But I don't skip out on routine doctor visits anymore! And neither should you.

> Get a routine checkup! It can save your life.

There is no evidence that routine checkups lead to better outcomes.

http://www.health.harvard.edu/blog/a-checkup-for-the-checkup...

"But what are the true benefits of this practice? Careful reviews of several large studies have shown that these annual visits don’t make any difference in health outcomes. In other words, being seen by your doctor once a year won’t necessarily keep you from getting sick, or even help you live longer."

That seems unbelievable. Do the doctors _never_ find a heart attack, or get a patient treated for high blood preassure or skin cancer?

Of course not, it's just rare to find problems without symptoms. And going for a check up is not without risks. Sometimes doctors produce false positives. Sometimes you catch a bug in the doctor's office that you would not otherwise have gotten. Going to the doctor can be stressful. All of these things are small effects, and they all generally cancel each other out so that the net effect of going for a routine physical is a no-op.

What is a long time? I came to the US in 2012 and haven't been to a doctor since. Not going to lie, the $ sign is a deterrent.

But I am moving back to Europe this year so I will go to a doctor there and get all checked up etc.

The idea of a 'routine checkup' is an American thing as far as I can tell. I've lived in the UK and New Zealand and adults only go to the doctor when there's something wrong, or if you have known chronic conditions. You certainly don't have regular blood tests.

Yes, that is how I remember it as well.

How do they catch things like kidney disease early? I have stage four kidney disease and there are barely any symptoms. Stage five means dialysis. For me it is too late to properly fix it but if caught early with regular blood tests there are ways to slow it down. My feeling is regular blood tests are a necessity for many health issues.

I had a kidney disease while in puberty, specifically nephritis. Since then, I take a blood test every six months. It's a great habit because it can catch a lot of problems, for example diabetes, cholesterol levels, etc. Urinary tests are also very good because they can detect stones in your kidneys.

Isn't that rather expensive?

Where I live (Greece), it's like 40 euros.

A standard set of the most common 25 or so blood tests costs total $50 in the US. You can get it ordered online and go to a local lab to get it tested. They will post the results online and note if anything is out of range.

You can get a checkup every two years when you're 40+ (paid for by your health insurance). Also skin cancer screening.

Most decent insurance plans will fully cover the cost of a routine checkup, or at least only charge you a minimal co-payment. (They don't want to pay for a hospital visit for you any more than you want to have one.)

I'm no doctor, so I'm the wrong person to ask about how often you should see one. But if it's been five years, it's probably time.

"Wellness visits" under Obamacare are supposed to be covered in full, with no co-pay, but exactly what counts as a wellness visit (and not an office visit) is (probably intentionally) confusing.

https://www.usnews.com/news/articles/2015/12/10/confusion-su...

In Canada annual checkups by your GP are free. If needed, blood tests, x-rays, CT, MRI, whatever, free.

'If needed' is slippery slope. I had multiple visits to NHS with chest pain and got nothing but a blood check. I still don't know whats wrong with me, but its not looking good.

Part of what they're looking for is likely the chemical signs of a heart attack - if heart muscle is dying off, it's generally detectable in the blood. I suspect part of what they were looking for is BNP: "When your heart is damaged, your body secretes high levels of BNP into your bloodstream to try to ease the strain on your heart." (http://www.mayoclinic.org/diseases-conditions/heart-disease/...)

Sometimes a high BP is just a reaction to someone measuring your BP. One side effect of a high BP is that you hear the thumping sound of your blood pulsing.

I personally have my heart rate and blood pressure explode whenever anyone tries to measure them. So I was referred to a cardiologist who did some basic checks like an echo, found nothing wrong and wired me up to a device that measures BP continuously for 24h. My BP was perfectly normal.

The first thing that tipped them off was looking at the blood vessels in my eyes, not measuring my BP. This is an absolutely routine part of an eye exam, so I wasn't stressed out or anything like that while they were doing it.

High blood pressure will not always be accompanied by easily detectable symptoms like audible thumping. There's a reason why it's called "the silent killer." (See: https://www.cdc.gov/bloodpressure/index.htm).

An interesting thing I heard from my dentist and my optometrist is that dentists and optometrists often diagnose (or successfully refer for) a fairly wide variety of conditions that manifest as symptoms visible in the gums and eyes. A lot of stuff that can go wrong in the body can apparently mess up your gums or eyes in a way that an expert can notice.

Also, people who have excellent vision can still benefit from optometrist exams because they can catch early stages of eye problems, and even other kinds of medical problems.

I've been seeing the same doctor for nearly two decades. She does the same routine every time she takes my blood pressure: "So, (puts on cuff), do you have any trips planned? Anything fun coming up? (pump pump pump)".

I laugh inside at how consistent she is, so I guess it still works on me.

I'm similar, every time I get my BP taken, I have to ask them to take it one more time, because the sounds and feeling of the machine make me very anxious. The results are usually worrying the first time, and then perfectly normal on the second take.

In this case the solution is to measure your BP yourself at home.

You should definitely keep an eye on your blood pressure every once in a while because there no symptoms of high blood pressure until it's way too late (kidney damage for example). Even if you are too lazy to go to the doctor, at least in the US you can find blood pressure monitors frequently installed in the pharmacy area of your nearest Safeway, Walmart, etc. If it's been more than a few months and I run into one of these things I sit down and take my blood pressure just to see how it is. If it's a bit high on first read I will repeat the test two more times. This usually gives my body a chance to relax to make sure that I get an accurate reading.

If your blood pressure spikes a lot when you are stressed that's good to know too. For example I've found that when I drink coffee my blood pressure reacts to stress a lot stronger than when I don't drink coffee.

I probably haven't been to a doctor for years and years. Like most Americans I have pretty shitty health insurance, and it's mostly about avoiding unnecessary expenses. I don't have any burning desire to pay a doctor, a blood test lab, and all the other various administrative leeches, just for them to all tell me everything's good. If something happens and I get seriously ill, I accept that I'll be paying through the nose for it, but that's the case whether or not I waste time/money on "checkups".

Nope. The longer you wait, the worse are your chances and the more expensive it will be.

Thats a pretty bold conclusion. What evidence do you have to assert this? I'm not being a jerk, its just everything I've read in the past indicated that routine checkups do not lead to better health outcomes. If new contradicting evidence is available I'd love to know.

Every insurance plan in the US will cover an annual checkup with $0 out of pocket expense to you.

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