He had a big file tucked under arm when he came in. He said, 'all appears OK', 'What all appears OK? I asked. 'The tests, he said, pointing to the thick file that he had now placed on my desk.
Who asked for these tests? I asked as I didn't remember to have ordered any tests neither did I remember to have seen him recently.
'No doc. You didn't but I went and got these done on my own'. 'Why did you do it? I asked. 'Because I felt weak', he said in defense. Has your weakness gone after doing the tests? 'No doc, it is worse and that is why I have come, the tests all show normal values.'he stopped
I have another of these fools who have fallen prey to the advertisement blitz in the lay press and electronic media. He has spent over 7000 rupees [nearly 150 dollars] on tests with out getting any medical advice and wants me to advise him as to what he must do.
This has become a none too uncommon experience for me and my irritation continues to grow with each such incident of doing the tests and seeing the physician later episodes. Marketing their services whether needed or not has become common practice. Yearly tests have become the norm. Nine out of ten such tests are unnecessary but are done.
Coming back to this patient, I told him I will look at his glossy file after giving him a physical check. He readily agreed. Examination revealed overt anemia and no other cognizable illness. I had a look at his reports and found all were normal except borderline low Hemoglobin and red cell numbers. The possible diagnosis was recent blood loss yet to be fully registered in the tests. He gave no history of rectal bleed. Still I did a rectal check and it showed active second degree hemorrhoids [piles]
Did he not know he was bleeding from his piles? Possible. Unless one's bathroom is well lit it is easy to miss blood in the commode.
To exclude possibility of colon cancer a endoscopy was also done.
Finally it was proved that his tiredness was due to recent blood loss due rectal bleed. He regained normal health after stopping the bleed by a minor surgery.
The expensive tests didn't reveal his piles.
Moral of the story. When in trouble see your doctor first and follow his advise. It will save you time and money