Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
2 Jan

Second Opinions

iStock 000005591833XSmallSometimes I just think the world is collapsing under the weight of its own complexity. My water bill last month was twice its usual already-outrageous amount. Since we hadn’t (to my knowledge) taken any more showers than normal, I figured there had to be a leak somewhere. Duh, right? I did a cursory review of all toilets and faucets in the house. Nothing. I had my gardeners check out the landscape irrigation system. Nothing. So I called my plumber/golf buddy Ted who said he had a guy who did leak detection and this guy was the best there is. Twenty years in the business and that’s all he does. Leaks. So I told Ted to send him on over, because this hydro-hemorhhage was mounting up fast.

Twenty minutes later the guy shows up and immediately starts diagnosing. He turns off the main valve at the house and sees that the meter wheel stops spinning, so he figures since it’s not between the meter and the house, it has to be inside the house. That’s bad.

He goes to his truck and gets a bunch of fancy detection devices all neatly stored in separate anvil cases. One looks like a stethoscope; another like a fancier version of those metal detectors they use down at the beach to find spare change. He tells me, “Don’t worry, I’ll find that sucker. I do this all the time.” Loved his bedside manner. Miraculously, after listening to all the sink pipes on the ground floor, he determines that the leak is in the hot water system – definitely not the cold – and that it’s somewhere in the slab under the house. That’s bad.

After twenty minutes of further dousing for pipes under the slab and listening through his high-tech stethoscope, he assures me he has found the leak. It’s definitely “right here in the slab under the dryer but just beneath this bearing wall. We’ll have to jack-hammer up all your matching [expensive] travertine tile, remove the wall, reinforce it and replumb all the way to the water heater to be sure.” That’s REALLY bad. I ask, “you sure about this?” He looks at me like I’m an idiot and says, “Absolutely. This is all I do all day long. It’s right under here.” OK.

He leaves me with a bill for $300 and drives off. Nice work for 45 minutes. I didn’t make that even when I was a “trainer to the stars.”

I’m about to call plumber/golf buddy Ted and tell him to bring the crew and the jack-hammers over on Monday when I get a wild one and decide maybe I’ll get a second opinion first. I call another leak detecting service from the Yellow Pages who sends a guy right over. He gets out a similar assortment of detection equipment and spends 25 minutes putting blue tape all over the floor to mark where the pipes are before I suggest (wink, wink) that maybe it’s in the hot water system. Another 25 minutes passes and he says, “there’s no freakin’ way there’s a leak in your hot water system or inside your house. Have you checked your pool auto-fill valve?” “uh, no.” “Let’s look.” Sure enough, the autofill valve (it’s like the one in your toilet) was stuck, causing water to flow into our infinity pool which was, in turn, leaking water infinitely through an obscured underground drainpipe. Case closed. Since this guy wasn’t “the best in the business,” he only charged $250.

I tell you all this as an illustration of how easy it is to become enamored of “specialists” and “professionals” in a world that has grown increasingly complex. I could easily have gone and had my entire kitchen floor jack-hammered at great expense and disruption only to have the initial problem continue to drive me crazy for months. I find that this happens all too often in many other areas (tech support from Mumbai that has you defragging your disc or reinstalling your operating system when a patch or reboot would have done), but most notably in medicine. How often do we all hear stories of expensive surgeries undertaken because a battery of tests (that weren’t that solid to begin with) “indicated” that there was a problem that needed fixing? Many prophylactic mastectomies or prostate biopsies or quadruple bypasses are probably not necessary (in my humble opinion). Yet they can severely compromise lives forever if they really weren’t necessary or if a few lifestyle interventions might have done a much better trick. How about the prescribing of multiple drugs to address symptoms or bring a few “out-of-norm” numbers back into the proper range? And then prescribing additional drugs to offset the side-effects of the first drugs – all based on sketchy diagnoses. My knee surgery last year would not have been necessary had my doctor not hastily shot cortisone under my kneecap. Long story. But, hey, he only had seven minutes of office visit time to make the (wrong) diagnosis and, hey, he was my friend. Oh well, my bad. If anyone should have seen that coming it was me.

I tell anyone who will listen that lawyers, doctors and CPAs don’t have answers. They only have opinions and sometimes those opinions are no better (and often worse) than your own instincts. This is why we at MDA are on a mission to try to help you better understand how your body works, so you can make educated, informed decisions when it comes to matters of health. Armed with an understanding of what might truly be behind your problem, that little extra you pay for a second or even third opinion might just make the difference.

Further Reading:

My Knee is Killing Me… No Really.

Washboard Abs on a High Fat Diet, No Ab Workouts and No Cardio?

Health Engagment: Where Do You Find that Personal Touch?

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Thanks for yet another interesting post…and I’m glad you didn’t have to jackhammer your floor!

    Mara wrote on January 2nd, 2009
  2. second opinions… third opinions… fourth opinions… i don’t believe it looking until you get an answer you like, but i do believe in looking until you get an answer you think makes sense/is right… or better yet, until at least two of those opinions agree. especially on important health matters, always better to be safe than sorry.

    Jane wrote on January 2nd, 2009
  3. This post is a little unusual, which is why I like it. I’ve never really considered the value of getting a second opinion, but this post makes it abundantly clear. Thanks Mark!

    - Dave

    David at Animal-Kingdom-Workouts wrote on January 2nd, 2009
  4. Good story. I can’t imagine what the first “expert” would have said after having dug up your floor only to find no leak.

    What was really interesting though is how quickly the plumbers were able to get there. Must be a sign of these tough economic times!

    Dave wrote on January 2nd, 2009
  5. Mark,

    This post could not have come at a better time. I have a hypothyroid, and have recently put on some ponds to add to my my other pounds. My doctor tells me this week “you should have weight loss surgery.”

    The last thing in the world I want is surgery. To me, that is the easy way out. And as Tom Petty says, “There ain’t no easy way out.” Yesterday I started following your Primal Eating Plan.

    Wish me will power.

    Tee wrote on January 2nd, 2009
  6. I have had this happen to me twice. Both times was the same problem. I called the water company and their guy simply misread a digit on the meter.

    The SoG

    Son of Grok wrote on January 2nd, 2009
  7. It always pays to get a second opinion. So glad you didn’t have to jack-hammer the travertine. Ouch, that stuff ain’t cheap. Thanks for sharing Mark. Once again, a thought provoking post.

    Heather McD (Heather Eats Almond Butter) wrote on January 2nd, 2009
  8. Love the post. However, there is something a little unprimal about mentioning your travertine and gardeners.

    WendyWoo wrote on January 2nd, 2009
  9. Great post, great analogy. At the end of the day, I think that we just have to remember that experts are just people. No one knows everything; even if they say they do. ;)

    Fit Bottomed Girls wrote on January 2nd, 2009
  10. This is so true. I’ve had a number of physicians over the years tell me the wrong thing–continuing the same bogus treatments for the wrong diagnoses.
    In my case, it wasn’t until I talked to a naturopath with advanced study in integrative nutrition that I finally got my health back. Insurance, of course, didn’t cover it, but I thank my lucky stars I had the gumption to finally say enough is enough! I’ve been much healthier ever since!

    Jen wrote on January 2nd, 2009
  11. I like this post, very good analogy that you used as well.

    Jerry wrote on January 2nd, 2009
  12. Such a relevant post with regards to diet and preventative medicine, Mark! My doctors have mixed opinions regarding a low carb unprocessed foods plan. One even said that if I was eating fruits and vegetables, I was “doing it wrong.” Sometimes your instincts can save your life!

    Lauren B wrote on January 2nd, 2009
  13. accidentally, Barry Groves’s site is called so, I attach a link to it because it’s pretty apropos to your approach.

    http://www.second-opinions.co.uk/

    zbiggy wrote on January 2nd, 2009
  14. People often wonder why I do everything myself when I can. I just keep thinking of all the times I’ve been burned paying a professional only to have a bad job done. At least when I do something myself I know what (if any) shortcuts were taken, what might have been messed up when the work was done, and why something broke in the first place.

    I’ll go to a doctor – when I see a need to, which isn’t very often. My uncle cut a mole off that was bothering him, with just a pocket knife. I might go in for something like that, but I’ll know what is to be done and why. (I think I want some pain medication)

    Henry Miller wrote on January 2nd, 2009
  15. i tried your almond meal pancake recipe this morning… holy shnykies…they were awesome…i just had to tell you that!!!

    Troy wrote on January 2nd, 2009
  16. Good post Mark. I had a specialist tell me last year I definitely needed sinus surgery. Strange that his opinion is all that’s needed for him to profit from the public purse.

    I got a second opinion and he initially told me the same thing. I had a second session with this specialist and questioned him on the potential problems with the surgery and the likely success rate. In the end he admitted there were lots of potential problems and no great guarantee of success.

    I’ve since hammered my sinuses with saline spray – result = problem fixed!

    Jonny wrote on January 3rd, 2009
  17. Great post with a great point! But I gotta say I’m still stuck on the fact you have an infinity pool… ;)

    charlotte wrote on January 3rd, 2009
  18. Thank You Mark
    For sharing your experience with us. This shows that it is all important to get more than one opinion.

    I always say follow your heart to listen what your instinct is telling you. And follow your head to what common sense is telling you as to what just makes plain sense. I totally agree with Mark, it’s best to get a second opinion. If something just don’t sit right with you on the first opinion, don’t go with it. In the long run, it does pay to take a little more time to figure and not make hasty decisions.

    Donna wrote on January 3rd, 2009
  19. Amen and spot on. I’m going through my own knee issue (an overuse injury). A visit to a sports med facility elicited one response: “surgery”, as if Mother Nature wasn’t part of the equation. Yet, I just returned from Vermont after fairly hard skate skiing, snow-shoeing, and downhill skiing, and the knee held up well.

    Also, in a recent study, 85 percent of orthopedic people incorrectly interpreted MRI results (the injuries were known to the people implementing the study; they were analyzing the ability of professionals to correctly interpret MRIs). I cannot find the reference right now, but it was in Sports Injury Bulletin.

    In general, these guys and gals love cutting up knees. I’m going to give Mother Nature several weeks before I consider going down this road.

    Bruce W wrote on January 4th, 2009
  20. Hi all,
    Regarding second opinions, musculoskeletal health is a largely misunderstood field. As an example of recent scientific insights towards chronic tendon pain, I wrote the following article. Please enjoy.

    http://www.thestayactiveclinic.com/wp-content/uploads/2008/12/patellar-tendinosis-in-a-distance-runner.pdf

    Dr. Corey R. Duvall wrote on January 5th, 2009
  21. I stopped trusting doctors shortly after I started work as a personal trainer. Thought process went something like this: “I am working with this crazy system that is infinitely complex. I have only the most basic idea of what to do in a given situation. There’s no way I’m ever going to understand what’s really going on in the body; all I can do is make my best educated guess and try not to hurt anyone. Oh my God! What if all professionals in the health and fitness industry do that?”

    So I no longer trust doctors. The body’s just too much for us to fully understand. One of the things I love about your site is that you’re constantly challenging the givens re: health and wellness. Thanks for the reminder that we should take it all with a grain of salt.

    Even what you say, right? ;-)

    Jamie wrote on January 6th, 2009
  22. I’m with you, Jen Despite eating primal and avoiding the poisons and paying a daily nod to exercise, my health got worse over 5 years. A traditional naturopath was my answer to good health, too.

    And maybe we should rethink underground plumbing in Grok’s new world.

    heykapo wrote on January 7th, 2009
  23. As a doctor, when I suggest surgery, I will almost always also suggest a second opinion. I have been practicing for 20 years, and the more I know, the more I understand that I don’t know. It is always better to get a second opinion and a good physician will be okay with it.

    chip wrote on January 8th, 2009
  24. Funny thing that I read your story in that i am today waitint for a leak detector to come tomorrow. Yes, I had a plumber check out all outlets available, but unfortunately there isn’t a shut off valve on the hot water heater to see if IT could possibly be the cause of the escaping water that keeps my meter turning. And yes, my house is also on a slab and I do dread to hear the diagnosis that it somewhere under it.

    Wiletta wrote on January 8th, 2009
  25. I definitely see what your saying. But I feel this can unfortunately work in reverse also. Sometimes, including us bloggers, there is information on the net that may be misleading or just plain wrong. People tend to find a niche that confirms their already held beliefs and this can lead to mistrust or complete ignoring of common medical advice. Although it does pay to be cautious I would like to believe 9/10 that the medical advice I get is pretty sound. But some people may refuse to believe it and be far worse off as a result. What do you think? I think in some respects its good to have some faith that these professionals know what their doing its unfortunate that some examples like yours exist to discredit all the other good professionals.

    Dr Dan wrote on January 22nd, 2009
  26. As I began reading I thought, hey this sounds like what I just went through. I thought I had already check all of the possibilities, had even put food dye in all commode tanks with no leaks there. Yes, the plumber and leak detection fellow were prompt. I had an expensive leak that turned out to be that the bulb in the tank was allowing the water to conatantly run into the overflow pipe. I had been so afraid that the problem was also in the slab and the ossibility of the hot water system as we had experienced a hot water leak under the slab about 35 years ago and had to break up the slab to repair.

    I do also believe in second opinions, and then like someone mentions, go with your gut, too

    Wiletta wrote on January 22nd, 2009

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