Empowering patients includes men tooWhen it comes to men, who are used to being in control, the health system seems particularly inadequate. By Alexandra Glorioso
We've been getting a handle on my husband Lawrence's health since his dad suddenly passed at age 63 from heart disease in February.
What we've discovered is that Lawrence likely has the same problems with which his dad struggled, but that they're also treatable. Since Lawrence is dealing with these health issues early, he's much more likely to survive them.
Like his father, Lawrence has a bicuspid aortic heart valve. That means the largest valve of his heart only has two flaps, as opposed to three, like normal. This puts more pressure on the existing flaps, and can lead to a slow calcification of the valve, narrowing the passageway for blood to flow from his heart.
On Tuesday, we got the preliminary results of his echocardiogram — an ultrasound of the heart — which showed some slight leakage of the valve, but nothing to worry about, yet.
Right now, we just need to monitor the valve. Eventually, Lawrence will need to replace the valve, probably through surgery. The procedure is common, his doctor told me, and there isn't any way to prevent it.
Lawrence knew he and his dad both had bicuspid valves, but they weren't aware that his dad's valve had major problems. His passing has prompted Lawrence to return to the doctor for regular heart checkups — something he admits he was avoiding addressing. He didn't even tell me about his heart condition until his dad passed.
That doesn't surprise me.
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Men have a harder time than women in addressing their health before a crisis. Along with a propensity for greater risk taking, and worse habits, studies show men's aversion to the health system is one reason why they tend to die earlier than women.
One silver lining to what happened with his dad, is that Lawrence got a glimpse into a scary potential future. And, as a result, he is becoming more proactive about his health.
Since February, he's gotten a physical, a prostate exam, a referral to a podiatrist, an EKG, an echocardiogram, his cholesterol tested and his ears cleaned.
But the system doesn't make it easy.
While he's been treated with more respect than I have, our physician's assistant also forgot to give him a physical, which is critical to establishing a baseline for his health. (We only caught the oversight because I, thinking it was a double standard, objected to the fact that I was required to get a physical but he was not).
The primary care clinic staff then forgot to send the results of his EKG, a basic heart test, over to the cardiologist to whom they referred us. He signed up for his cardiologist's text-message service to remember appointments, but the service has already failed to alert him to one of his appointments.
And, he simply couldn't believe the wait-times or that the records he requested from his previous cardiologist arrived in the mail, instead of being sent electronically.
I am heavily emotionally burdened by this stuff, and often write about it, but Lawrence more quickly begins to question the operation's overall competence when these things happen. And the administrative barriers combined with silly mistakes just make it easy for him to delay his care.
"I'd be more likely to take control of my health if my health information was on my iPhone," he says. Like a lot of men, Lawrence loves gadgets and devices. "The medical system is a lousy product."
Because of Lawrence's privilege as a tall, white male, he's just got higher standards, even higher than mine.
Well, the health care system sees those standards and disappoints them every single time. In a weird way, the system is geared toward women, because we have a higher tolerance for taking orders and for not having control over a situation (see: women existing in the patriarchy for thousands of years).
So when it comes to men, who are used to being in control, the health system seems particularly inadequate. And I think it contributes to men not taking their health seriously.
I ran this idea by Lawrence on Tuesday afternoon, when we were on our way to the hospital for the second time that day, for his echocardiogram. We had made a mistake about his appointment time, thinking it was in the morning, and it was just so unusual — two journalists getting an appointment time wrong — that I homed in on it. Making the matter more confusing, this was the second appointment time we had gotten wrong at the cardiology center !
"I think when it came to your health care, I was just so concerned about getting us from point A to point B that I really paid attention," Lawrence said as he was looking for parking at the medical center. "But, when it comes to my stuff, I'm not really present."
How could he be? He's a healthy male in his late 30's. And like a lot of men, he's under enormous pressure to create financial security for our family while he's young, and capable.
And so, I hover in the background, trying to catch details and times spoken through masks directly to Lawrence, who is a bit hard of hearing, and most importantly, who is trying to get out of the building as fast as possible, so that he can get back to work.
But, at some point, Lawrence will become a middle-aged male. And the health problems that seem more like myths will shift into focus.
By then, for some men, the learning curve in getting up to speed on their health is too high, and the pound of flesh they have to fork over for care, too great.
This health care revolution is for men too.