What a few moles can tell you about your heart health
The electrocardiogram (EKG) was one of the great electro-medical discoveries of the 20th century. However, as with most things medical, it didn’t take long for it to evolve into one of the great scams of the century. Today, this test is being abused along with X-rays, lab tests, biopsies, and drug treatment. I’m picking on this particular “profit center” today because of a recent personal experience.
A few weeks ago I went to see a surgeon about having two moles removed from my face. My wife didn’t like them and worried about the possibility of malignant melanoma. (I didn’t care one way or the other.)
I sat there listening to a surgeon (who, to my mind, was still fairly wet behind the ears) tell me matter-of-factly that before he removed the moles he needed to order a handful of tests and scans–none of which had anything to do with why I was there in the first place. Why would he do such a thing? To get more money out of me, of course.
I guess it’s like an auto repair shop that advertises a dirt-cheap oil change. They don’t stand to make any money on the oil change itself, but the mechanics pray to the “gods of oil pans and impossibly dirty hands” that they will find something else wrong with the car that will warrant charging an arm and a leg to fix.
I don’t know much about cars, but I know more than your average Joe (and more than your average doctor, too) about medicine, and this rookie surgeon wasn’t about to pull a fast one on this old dog.
Here’s a snippet of our conversation:
The doctor examined the moles and said, “I don’t think they are melanomas.”
I replied, “No, I wasn’t concerned about that. I get plenty of sun and have an excellent diet, so I don’t think I will ever have a malignant melanoma.” I thought he would make some comment about my sun remark, but he didn’t fall for it. It’s just as well–you don’t want to start a controversy with someone who’s going to be cutting on your face. But completely avoiding controversy well, it isn’t exactly what I do.
He recommended blood chemistry tests–to which I agreed. Then he said, “We will also do an electrocardiogram. I have a colleague who is a well- qualified cardiologist, and he will interpret it for you and consult with you about your heart. (Aside: As an emergency specialist, I read EKGs for 20 years on a daily basis. I didn’t mention that to him, though.)
I responded: “Dr. X, there’s nothing wrong with my heart. I don’t think I need an electrocardiogram or a consultation with a cardiologist. You’re going to do the procedure under a local anesthetic, so what does the condition of my heart have to do with this?”
He quickly came back with: “Well, we use epinephrine in the Xylocaine, and that can affect your heart. Having an EKG is considered a necessary precautionary measure.”
“A normal electrocardiogram is not predictive of anything,” I replied. “You can have a normal EKG one day and a massive myocardial infarction the next. I would like to ask you two simple questions: (1) Have you ever had dental work done when the dentists did not use Xylocaine and epinephrine to numb the area? (2) How many times were you required to get an EKG prior to the surgery?”
He didn’t respond. I suppose I made my point.
Bottom line: Don’t let your surgeon or any other doctor bully you into getting tests or taking medications that you don’t need. Ask lots of questions, and if something seems fishy (like getting an EKG when you’re having a few moles removed), get a second opinion.
Incidentally, minus all the pocket-picking pranks, the surgeon did a great job, and my surgery went without incident. And most importantly, my wife is happy, and as any good husband will tell you, that’s all that really matters anyway.
Speaking of keeping your wife happy…