I write widely as a patient advocate and subject matter expert on public policy for the regulation of prescription opioid analgesics in pain medicine.
Like many people younger than myself, I also visit many social media platforms almost daily. I am active on these platforms to share recent health care news and to support hope among people who increasingly struggle to find clinicians and pharmacists who will treat their pain by whatever effective means necessary. The regulatory environment surrounding opioid pain relievers is truly horrific these days, and many clinicians are leaving practice, deserting their patients.
As I “cruise” social media, I see and sometimes respond to questions on a wide variety of subjects. On one such platform, the post of mine that was most “up-voted” concerned the question, “What was your scariest idiot-at-the-gun-range moment? What was the funniest?”
Don’t ask me to explain human nature.
I am careful to qualify any remarks that I offer on health care with two observations. First, I’m a well-read layman and health care writer who is kept honest by a network of practicing clinicians who look over my shoulder. But I’m not a licensed clinician myself. Second, anyone who acts on the healt hcare advice of anonymous strangers whose qualifications they cannot verify independently of social media is setting themselves up for serious trouble.
There is truth in the observation that “he is a fool who has himself for a lawyer” (or the internet for a doctor).
Recently, however, I ran into a question that had personal significance for me: “How were you diagnosed with cancer?” I’ve since heard from clinician colleagues that my answer rang true for many of them.
There are many forms of cancer, each with its own symptoms, and sometimes with no symptoms at all until they become very advanced or metastatic.
Ten years ago, my family doctor found red blood cells in my urine during a routine yearly health examination. He sent me to a urologist for evaluation and a CT scan. An 8-millimeter carcinoma was found on one lobe of my right kidney. I was promptly scheduled for minimally invasive arthroscopic examination and cryosurgery. I was admitted to a hospital overnight after a scope was inserted through my mid-back, threaded past my adrenal glands, and positioned to deliver a blast of liquid nitrogen to the tumor. I left the next morning with a band-aid over the small entry wound, and no need for pain relievers. I’ve had no recurrences.
In July 2023, my family doctor referred me to a dermatologist for routine yearly exams. The dermatologist soon removed chalky-looking moles from my left elbow and right eyebrow. A biopsy revealed that the “mole” on my elbow had become an active Stage 1 melanoma (skin cancer). I was scheduled for a nearest-lymph-node radioactive trace and excision, with a deeper surgical excision of the former site of the “mole.” No metastases were found, and minor neuropathic tingling in my left arm from the surgery has since almost disappeared. I will be seen quarterly for two years for follow-up exams.
These cancers illustrated for me the importance of having yearly physical exams, urine tests, and blood work evaluated by an experienced internist and a dermatologist. This may be particularly true for seniors, for women, and for anyone who has a family history of cancer in immediate relatives as I do. Metastatic melanoma killed one of my half-brothers.
I am 79 years old. Online life expectancy calculators tell me that with my health history, I’m likely to live past 100. I intend for those years to be productive and positive. And part of that productivity is reminding people in pain in the communities that I serve as an advocate (and people generally) that health concerns other than chronic pain also deserve their attention.
It’s easy to become “target-fixated” when you are in pain every day from multiple chronic conditions and struggling to maintain any quality of life. But target fixation can get you killed. If you haven’t had a “routine” physical examination in a year or more, accompanied by urine tests and blood work, then it’s time to schedule a visit. Today.
Richard A. Lawhern is a patient advocate.