Taking care of yourself

By Peter J. McDonnell, MD

Around the time you read this, your chief medical editor will be celebrating one of those big birthdays that come along every 5 years. (No, I am not turning 35 this year, but thanks to all loyal Ophthalmology Times readers who remembered my special day and sent me a card, a singing telegram, or fifth of scotch.)

To prepare for the celebration, I scheduled a visit with my internist to confirm that I was as healthy as I feel. With a low blood pressure, low cholesterol level, and low resting heart rate, and my only pill being a multivitamin three times per week (business lunches and dinners don't always include as much fresh fruits and vegetables as is ideal), I have not spent a lot of time in doctors’ offices. The last time I saw my internist, in fact, was 5 years previously for my last big birthday. To be perfectly candid, I don't like going to the doctor. And I don't like shots.

But I actually like my physician and, should I ever actually get sick, feel reassured that he knows me and could take care of me. If I ever need him, he tells me, I am to call and he will see me that same day.

The results of this checkup were the same as the one 5 years ago, i.e., everything was fine. The only problem was related to my reaction to a part of the exam that men my age have to endure. It is hard to maintain one’s dignity when gloved fingers are exploring one's body.

“Everything is fine,” said my doctor, after my examination. We talked about various health-related topics, including flu vaccination.

 “Yes, I have my flu vaccination every year,” I said. “What I wonder about is the varicella vaccine. Should I have that?”

Vaccine virtue

It turns out that a physician (non-ophthalmologist) colleague of mine had recently suffered a bout of herpes zoster. He developed lesions on the skin of his eyelids on one side and unfortunately, he had ocular involvement as well. But with prompt treatment, things resolved reasonably well for him.

My internist said he did think I should have the vaccine. In people 50 years of age or older, he said it reduced the risk of developing shingles by 70%, and the likelihood of developing post-herpetic neuralgia was also dramatically reduced. The initial recommendation was for people aged 60 and over, but he said it was now recommended by internists for people as young as 50.

“But the vaccine is expensive,” he said. “Some insurance plans don't cover it.”

I pondered the issue. Should I save a couple hundred dollars, and thereby do my part to bend the health-care cost curve and reduce my nation's spiraling health-care costs? Or should I splurge on myself and have this live virus injected into my shoulder?

What else might I purchase for the cost of the vaccine? According to an Internet search, options include a guinea pig, an iPod touch, or a Kindle Fire.

“You better give it to me,” I told my physician. “I am the chief medical editor of Ophthalmology Times, and if I get herpes zoster ophthalmicus my readers will laugh at me.”

We physicians are notorious for failing to get the regular medical checkups and preventive care that we require of our patients. I have ophthalmologist acquaintances that admit to not having their eyes examined in many years. So I take this opportunity to ask loyal Ophthalmology Times readers whether they should make it a point to see their doctors and invest in items for themselves like the shingles vaccine.