The Earwax Ball that Saved a Man’s LifePosted: May 21 in Obesity Medicine by Dr. Lazarus
Could it really be true? Could a ball of earwax save a man’s life?
A man came to see me complaining that he couldn’t hear out of one ear. It only took a few moments for me to remove the cerumen impaction and restore his hearing. This was my first visit with this gentleman (let’s call him Dan), but he had been a long-time patient of the practice. In getting to know him, like many 20-year old paper charts, his chart was a mess – I had some time, so did a quick medical history, made some front sheets with problem lists and a medication list, and while I was at it, checked his vital signs.
Low and behold, his blood pressure was a little elevated. Reviewing his chart, it had been elevated for some time – about two years. But since he was generally being seen for something else, it had not been addressed. I asked Dan if he’d like to discuss what this meant with me, or schedule back with his usual doctor. He agreed to discuss with me, and we decided to do an evaluation and come up with a treatment plan. I generally check labs (cholesterol, diabetes, liver, kidneys, etc.) and perform an electrocardiogram (EKG) if I make a diagnosis related to the heart. Imagine my surprise when I looked at his EKG and it was far from normal. This was his first EKG, and it was extremely alarming. He had a heart attack waiting to happen at any moment.
I didn’t let Dan drive home. We called his wife, and had him seen at the emergency room. The next day, he had a coronary artery bypass. The main vessel to the front of his heart was 99% blocked. It was a miracle he had not already suffered a deadly myocardial infarction.
I’ve stayed in touch with Dan – he continues to come see me play with the Littleton Symphony Orchestra 20 years later, always thankful that his heart is still doing well.
How is this relevant? Well, when it comes to obesity, it too is commonly overlooked. Patients present to their doctor for something else, and oftentimes the body mass index (BMI) is never addressed, even if it is in the risky range. We now know that an elevated BMI is associated with 236 other medical problems ranging from diabetes to heart disease. 13 of the most common cancers are largely attributable to an elevated BMI, and it is estimated that 40% of all cancers are weight-related. And, an elevated BMI can shorten the lifespan by as much as 6 to 8 years!
But like Dan, because patients are usually being seen for something else, the BMI is generally not addressed. And, if it is addressed, few health care providers have received training in obesity medicine, which teaches the proper evidence-based management of obesity. When it is addressed, they simply instruct the patient to lose weight. We all know that this is generally not an effective piece of advice. It’s like telling a patient with depression to think happy thoughts – hardly the best evidence-based approach to improve the depression.
If you suffer from obesity, it is not your fault, any more than it was Dan’s fault that he had high blood pressure and coronary artery disease. But you can do something about it. Dan went to the ER, had surgery, and has had long term management. This does not cure his disease – but it manages it and lets him live a long and productive life with his disease. Similarly, with obesity, we do not cure obesity. We treat it, try to make it better, and try to avoid the 236 related medical problems, 13 related cancers, and restore the lifespan.
We do not set a goal of “Normalizing” the BMI. We set a goal of reducing it as much as we can, and then trying to keep it from going back up. We use behavioral tools, medical tools, and like Dan, even use surgical tools.
Don’t focus so much on the number on the scale. Rather, success is managed by engagement in office visits, trying to follow the healthiest eating and physical activity routine that we can, and good medical management, both of the weight and also of the weight-related problems.
If you have been trying to decide when to get to work on your weight, now is the time. Don’t keep kicking the can down the road. If Dan had done that, it may have been a short road indeed. Remember, Dr. Lazarus is trained in both Family Medicine and in Obesity Medicine, and Heather Thomas, P.A.-C has 15 years of experience helping people like you conquer their weight problem. And our Registered Dietitian Nutritionists excel at helping you find the motivation to stick with it, provide support, and hold you accountable.
If it’s been a while since we’ve seen you, we would welcome you back to our office, and would love to pick up where we left off. And, if you are currently with us, congrats! We promise to do our best to help you enjoy a long life free to do the things you want to do. After all, isn’t that what this is all about?