Sometimes even hypochondriacs have real diseases; reporter learns he has CVD while covering story on

Mark Fuerst

August 29, 2000

Tue, 29 Aug 2000 08:01:31

Newport Beach, CA - A health reporter with admitted "medical student's syndrome" tells the first-person tale of what it's like to "see" inside his body with an electron-beam computed tomography (EBCT) scan. Fast CT is no longer just for those in the fast lane, as average Janes and Joes now seek out these expensive, controversial tests to find out what their future health might be, according to a feature in the August 25, 2000 USA Today.

ONCE THE PROVINCE OF THE "WEALTHY, WORRIED WELL," EBCT NOW AFFORDABLE FOR MIDDLE-INCOME WORRYWARTS

"That little bulge on my aorta is the first tick of a time bomb," writes Robert Davis. "That's real," Dr Harvey Eisenberg (HealthViewCenter for Preventive Medicine, Newport Beach, CA) says, as he talks Davis through the EBCT scan. "He stops at the aorta, my body's largest blood vessel, and points out a nasty little bump that could very well be what ends my life. Eisenberg, a controversial radiologist, uses a CT scanner at his HealthViewCenter for Preventive Medicine here to peer inside healthy people's bodies in order to tell them what unsuspected health problems lurk there," writes Davis. "HealthView, one of the first such centers in the nation, initially attracted the wealthy, worried well. But as insurance companies pay for more of these scans, and the prices have come down, there are more average people in the waiting room. Critics say these unwarranted tests waste money, cause false alarm, and put a strain on the rest of the health system. But business is booming." He writes that people come not necessarily by referrals from physicians but because of "enthusiastic word-of-mouth."

 

"I came to HealthView to write a story about these inward explorations. And now, seeing my aorta bulge, I come to understand what people pay for."

 

Davis reports that the HeathView team has scanned 15000 people in the past 2 years at an average cost of about $710 per scan, mostly paid out of pocket by patients. "I came to HealthView to write a story about these inward explorations. And now, seeing my aorta bulge, I come to understand what people pay for. Eisenberg moves the computerized image up and down so that we can see the artery wall expand like a balloon and then constrict back to normal size in an unmistakable sign of vascular vulnerability," writes Davis. "There is some weakening," says Eisenberg, who is a former professor of radiology at both Harvard and UCLA, reports Davis.

 

"I feel a strong sense of control now that I know it's there. No longer is my family history of aortic aneurysm something that may or may not mean anything to me. From this moment forward, it is something that I know I have."

 

"That weakening will likely grow into a life-threatening aneurysm - the kind that my father's father had late in life - that one day could burst and kill me. I can barely utter a word as I sit with Eisenberg, seeing myself from the inside out. I'm spellbound and I'm also surprised, as he moves on from the aorta to view other parts of my body, that I am not bothered by this finding or by the other problems he identifies: an enlarged heart chamber, holes and a bone spur in my lungs, and degenerative back disease. I know I can deal with every problem he has found. The fixes for each one have gotten much better recently. By the time the weak spot in my aorta grows large enough to pop - if I can't heal it naturally through more healthful living - the repair will be an outpatient procedure," Davis writes. "More important, I feel a strong sense of control now that I know it's there. No longer is my family history of aortic aneurysm something that may or may not mean anything to me. From this moment forward, it is something that I know I have."

Davis reports that the availability of an EBCT has "created a buzz among the rich and famous." "It takes the mystery out and gives you a new perspective on your life," says actor Robert Wagner, 70, who heard about the scan from actor James Woods. "I became more aware of the fact that everything should be done in moderation." Davis reports that Wagner's scan found plaque in a leg artery.

EXPERTS UNIMPRESSED BY CELEBRITY ENDORSEMENTS; SAY MASS SCREENING NOT WORTH THE EXPENSE
 

"While we have these tools that do pretty impressive body imaging, we're not at the point where we can wave a wand over the body and find out what's wrong. Most of us don't drop dead early in life from something unforeseen, and these are expensive tests."

 

"Critics from the medical establishment say the dramatic, lifesaving examples are too rare to offset the money wasted by scanning hordes of healthy people. CT scanners should be used to examine those with known medical problems, they say," Davis writes. "While we have these tools that do pretty impressive body imaging, we're not at the point where we can wave a wand over the body and find out what's wrong," says Dr Robert Smith (American Cancer Society). "Most of us don't drop dead early in life from something unforeseen, and these are expensive tests." Heart specialistsalso agree that there is no convincing proof about the utility of EBCT. "There is not enough compelling evidence to warrant widespread use at this time. We would like to see some proof," says Dr Robert O'Rourke (American College of Cardiology).

 

"The realities are, with this level of information, I have yet to see a normal patient. It's a daily event for us to uncover unsuspected, life-threatening disease that is either stoppable, curable or reversible."

 

"Many doctors suspect that these screenings of healthy people often will be done without any measurable benefit. And when something suspicious but ambiguous is found, other tests that are riskier, more invasive, and more expensive must follow to determine whether the finding poses a real threat," writes Davis. But Eisenberg calls the criticisms by the medical establishment a "knee-jerk reaction" and "hypothetical," reports Davis. "The realities are, with this level of information, I have yet to see a normal patient. It's a daily event for us to uncover unsuspected,life-threatening disease that is either stoppable, curable or reversible," says Eisenberg. "In medicine, we're taught to sit and wait for people to develop symptoms and react. But that's usually a late stage. People think the body is this wonderful machine with bells and alarms that go off, but in fact, your body compensates." He doesn't believe that doctors should play "catch up" after a disease is diagnosed, which he says is "expensive stuff both in terms of morbidity and cost," reports Davis. "That isn't right. Medicine has to change its paradigm from being reactive toproactive. Crisis management doesn't work," Eisenberg says.

 

"Medicine has to change its paradigm from being reactive to proactive. Crisis management doesn't work."

 

"I grabbed the assignment to come get scanned at HealthView (at USA Today's expense) in part because I often think that I am dying. When a friend is stricken with cancer, I am pretty sure that I will be next. When I write about hepatitis C, I secretly prick a finger and send my own blood in for screening because the horror stories of millions of Americans who never suspected they had the disease remind me it could happen to me," writes Davis.

THE PAST COMES BACK TO HAUNT HIM

"Over the past few years, I've lost 90 pounds largely through exercising regularly, and I felt confident when I first volunteered for the story that my improving health would guarantee the absence of any life-changing discoveries. But that feeling of confidence lasted about 20 minutes. Immediately after making an appointment to get scanned, I began to worry about what might show up. Did my youthful days in Margaritaville trash my liver? Did a lifetime of obesity clog my cardiac arteries? Did those years of smoking a pack a day seed cancerous tumors?"

Before visiting HealthView, Davis reports that he went to his doctor for a physical, which he says was overdue. "I also wanted to pit traditional medicine against the new controversial screening. What, if anything, would (my doctor) miss?" he writes. Results of the physical show that Davis is in good health, with a total cholesterol of 144 and an LDL-to-HDL ratio of 2.7. Over the past few years, he has brought his blood pressure down from a dangerous 180/96 to a healthy 130/60, he reports, and "my heart now beats fewer than 60 times a minute. I have not smoked for more than three years, but I strongly considered bumming one from a friend one evening just before I went to HealthView. That isn't likely to happen again."

 

"Seeing exactly how I've damaged myself with food gave me new strength to keep the weight down. I've damaged my heart's primary pump. The left ventricle, the big pump of the organ that had to move blood through about 100 pounds of extra weight, has become thick from 30 years of overwork. Without such a scan I would not have known about this enlargement until the pump became too weak to perform its job."

 

Davis notes that he knows that obesity wrecks the body, but "seeing exactly how I've damaged myself with food gave me new strength to keep the weight down. I've damaged my heart's primary pump. The left ventricle, the big pump of the organ that had to move blood through about 100 pounds of extra weight, has become thick from 30 years of overwork. Without such a scan I would not have known about this enlargement until the pump became too weak to perform its job," he writes. "The most noticeable change in my health following the scan is in my hearing: My scan taught me to listen carefully to my body and to ignore my irrational fears. I feel more in control of my health because I have seen firsthand what my unhealthy behavior has done to my body. When (my doctor) told me through my fat years that being overweight could bring me heart disease, I found it easy to believe it wouldn't happen to me. But now that I've seen my enlarged left ventricle and my bulging aorta, I know better."



Related links

1. heartwire / Jul 14, 2000 /

2. heartwire / Jun 30, 2000 /

3. heartbeat / Mar 24, 2000 /

4. heartwire / Mar 10, 2000 /

5. heartwire / Nov 8, 1999 /

6. heartwire / Nov 22, 1999 /

7. mediapulse / Dec 22, 1999 /


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