The Real Cost of Putting Off Your Doctor’s Appointments During Covid

At first they told us not to come. Early in the pandemic, health authorities steered us clear of doctors and hospitals to help flatten the curve and relieve ICUs.

We may have listened too well. Emergency room visits for non-Covid reasons tanked by 42 percent between January and May 2020. And by the middle of the year, roughly 41 percent of U. S. adults had avoided some form of medical care, according to a study in Morbidity and Mortality Weekly Report. The figures were even higher for Black and Hispanic adults. Of everyone who skipped or couldn’t get care for a serious problem, 57 percent took a health hit as a result, per an NPR/Harvard/Robert Wood Johnson Foundation survey.

Today, going to the doctor may be safer than you imagine—and staying away more dangerous.

“If you’re still reducing care, it’s important to stop doing that,” says Alexander Krist, M.D., a professor of family medicine and population health at VCU. Here, some of the most common health situations that guys didn’t bother to deal with during the pandemic—and some tips on how to catch up.

The Situation: Chest Pain

When it comes to treating life-threatening problems, one of the biggest drops was for heart attacks. Emergency rooms saw far fewer cases, and procedures to view and clear blocked arteries (catheterizations) at nine major U. S. cath labs plunged by 38 percent early in the pandemic. As a result, heart attack deaths spiked nationwide.

The cost of delaying care for chest pain: Even if you do manage to survive a heart attack, delaying treatment can leave your heart wall weaker, thinner, and more prone to rupturing, says Santiago Garcia, M.D., an interventional cardiologist at the Minneapolis Heart Institute. Putting off treatment can also mean more heart damage and a greater risk of heart failure and arrhythmia.

How to catch up on heart care: You’re much more likely to die from an untreated heart attack than you are from Covid-19, Dr. Garcia says, so call 911 if you have chest pain or pressure that lasts more than ten minutes or difficulty breathing or you’re in a cold sweat. And don’t brush off other heart attack signs including a tingling arm, unusual indigestion, or feeling winded during light activity (see more signs here).

The Situation: You’re Overdue for Blood Work

Almost a third of adults have recently blown off routine medical care, such as an annual physical, where a doctor can detect or track problems with blood pressure, cholesterol, or blood sugar—problems that can also raise your risk of Covid or worsen your outcome.

The cost of delaying blood work: All off-track health numbers are important to keep an eye on, including cholesterol numbers. But unmanaged diabetes and yo-yoing blood sugar have bigger effects than people think. These can zap energy, strain your heart, raise stroke risk, and damage your kidneys, eyes, and nerves. If you have diabetes and a narrowing of blood vessels that feed your extremities, “you could go from a normal foot to a gangrenous foot in three to six months,” says cardiologist Foluso Fakorede, M.D., an MH advisor. That can mean amputations, which have surged during the pandemic, especially in rural and economically disadvantaged areas, where it’s often tougher to access care. Find out more about reducing the risk of amputations here.

How to catch up on blood work: Get it done! When you get your blood drawn to find out all your numbers (including cholesterol), Dr. Fakorede suggests asking for a fasting blood-sugar test or an A1C test, which provides a longer view of blood sugar levels than daily testing does. You can do the follow-up consult virtually, with your doc covering factors in addition to food and activity that sway blood sugar, such as stress, depression, and alcohol.

The Situation: An Overdue Colonoscopy

New research has found that from March to July 2020, colorectal cancer screenings dropped approximately 90 percent due to Covid. It’s estimated that as many as 18,800 cancer diagnoses were delayed or missed in just three months last year due to people putting off colorectal cancer screenings. As a result, more than 4,000 extra deaths are expected over the next decade, according to the National Cancer Institute.

Men at average risk should get colorectal cancer screenings regularly starting at age 45. (What “regularly” means depends upon your risk factors and on what screenings discover.)

The cost of delaying a colonoscopy: If you don’t catch growths while they’re still contained in the colon, the cancer can spread to distant organs, including the liver and lungs, says William Cance, M.D., the American Cancer Society’s chief medical and scientific officer. When that happens, “successful outcomes drop significantly,” he says.

Catch up on your colonoscopy: Anyone in your family (parent, sibling, child) ever have polyps or colorectal cancer? If so, mark this test urgent. Especially don’t skip it if you’re Black: The incidence rate of colorectal cancer is 24 percent higher for Black men than for non-Hispanic white men. A family history raises your risk for this cancer by 5 to 15 percent and may be grounds to get your first screening before age 45. And if you have blood in your stool or changes in bowel habits, experts recommend asking your doctor about a screening (even if you’re under 45). Don’t just worry in silence. See how men like Timothy Mitchell are making it easier to talk about colon cancer and its symptoms.

You can do an at-home colorectal cancer screening test: Buy a fecal immunochemical test at a drugstore or a FIT-DNA test (go with Cologuard, which you need to order through a doctor or on the company’s website). But you have to follow up abnormal results with a colonoscopy right away: A 2021 study found that people who waited more than a year were more likely to have late-stage cancer than those who got a colonoscopy immediately.

The Situation: Knee Pain

Scores of knee procedures got shelved during the pandemic—including roughly 300,000 total-knee replacements and plenty of less-involved surgeries.

The cost of delaying care for your pain: You can wind up with more damage or a longer, tougher recovery. For instance, people who put off ACL repair for three months were more likely to damage the meniscus in the knee than people who had it fixed within three weeks. If you’re putting off a knee replacement, the persistent pain of osteoarthritis (the reason for many of those replacements), can prevent you from moving around and lead to weight gain.

Catch up on knee pain care: Put yourself in “prehabilitation”—preventive rehab— with exercises like leg extensions and curls, to keep muscles such as your knee-supporting quadriceps and hamstrings strong, or with swimming, to maintain your overall conditioning, recommends Charles Nelson, M.D., at the Hospital of the University of Pennsylvania. If you need medication to keep moving, control pain with doctor-recommended doses of OTC painkillers, or ask your doc about pain-relieving cortisone knee injections until you can claim your surgery slot.

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