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Numbers Vs Symptoms

Hypothetical Patient Number 1:  The patient is a 55 year old male coming in for a routine physical examination.  He states “Doc, I feel GREAT and could not feel any better”.   I check the blood pressure and it is 220/130 (dangerously high).  I tell his this is basically a medical emergency, I need to send him to the ER to receive intravenous medication to get this BP down and he needs diagnostic testing right away.  The patient then says: “Whoo…wait a second Doc…I feel great, aren’t you overreacting?”  I inform him that despite not feeling any symptoms, this is a dangerous situation and he needs help immediately.

Hypothetical Patient Number 2:  The patient is a 46 year old male presenting for a routine yearly PE.  He states “Doc, I feel GREAT and could not feel any better”.  I check routine labs and find his testosterone level is 160 (normal is between 260-916).  When I call him to go over the lab results and specifically query him about any change in libido, energy and sexual performance, he once again states “Doc, I am doing GREAT”.  Despite the low testosterone level I do not start him on testosterone replacement.  The reason: Having a low testosterone level does not cause any “silent” damage to the patient.  Starting him on treatment would only make sense if he was experiencing the usual testosterone deficiency symptoms.

There are many other instances in medicine/health when despite feeling well, there could be dangerous abnormalities occurring in the body and conversely, there are times when simply treating “numbers” and not the patient’s symptoms does not make for good medical care.  Because there are sort of “silent” (no symptoms) issues that can be occurring that require early detection, it makes great sense to go in for routine checkups.  

It is important to distinguish the “numbers” in medicine that are clinically important and those that are not.  Seeing your primary care doctor regularly will help you evaluate these distinctions.

And here is an interesting number:  25.  Why is this interesting?  Well, ever hear of Max Martin?  I did not until, writing this post.  Apparently, he has written the most Number 1 songs (25) only behind Paul McCartney and John Lennon.  Here is one of his Number 1 songs…enjoy Travis Kelce’s girlfriend.

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