Word: stilles
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Even then surgery is usually out of the question. Many of our local patients are in their 80s and still working. Our patient Tony, 82, is a gardener. He looks like a root: strong hands, twisted by arthritis, five-feet-nothin' and bowlegged. He's been listening to me recommend knee replacement for 10 years, but would never have the surgery. He takes the arthritis pills I give him, but leaves my physical therapy prescriptions on the counter ("Don't need no exercise, Doc. I work."). At most he'll take an injection when it gets bad. Even when...
...problems go too long, especially the numb hands, but since the '90s he has refused every procedure. About four months ago, something changed with him too. He requested surgery - first a shoulder, then the hands. He's been having an operation a month since then, quite happily. He still has another scheduled...
...government plan, insurance companies, overseas surgery outfits, electronic medical records. Often, I enjoy it too. It can slow down office hours but it beats droning on about glucosamine. From many hours of chat with many patients like Tony and Ira has emerged one strong theme: "Get it while you still...
...expectations of America's medical future are now the rule in my patient population. Not with all the patients; the very well-to-do still show little concern for the future availability of care or what it will cost. But this group generally means business anyway; they've looked me up and are usually ready for an operation when they first come. The lawyers and teachers, similarly, don't seem too worried about losing access to my services anytime soon. And some fraction of patients always seems clueless about the world beyond the tips of their noses: they...
...patients like Ira and Tony, the younger HMO types doing well but working harder and harder, the aging professionals dealing with their first serious pains - they seem to be of a new mind lately. So do the unemployed who foresee the day their COBRA benefits will end, and the still fully employed whose company plans in 2010 entail higher deductibles, higher copays and reduced benefits. Whatever their situation, these patients are less interested in therapy and anti-inflammatories, or in just waiting to see if the pain stops by itself. (Quite often it does.) They are signing...