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My Future According to my Doctor

Bonnie

Veteran

I had an interesting session with my MD, Dr. Y. last week. He spent most our our time together telling us (my DH was present) the plot of a movie he liked after asking once again how to pronounce our last name and finding out it had celtic origins. I'd had labs six months ago and he told me then that all my labs were great and my liver was so good, it could probably last another 20 years. Since I'm 76 years old that was good news. This time, he again told me I looked great for my age. He got up to leave and I stopped him and reminded him that I needed a prescription for my yearly mammogram and this is how he answered. "Well, now you are past the age where you need one." I replied that my aunt who is six months younger than I was just diagnosed with stage 1 breast cancer. He said "Well, my patients really don't like hearing this but you are now at the age where you are most likely soon going to die from cancer or heart disease." Then he implied that I should just accept my fate. I was really shocked at his attitude and didn't know what to say but I finally managed to blurt out "Would you rather die from cancer or heart disease?" I got the prescription and because I'm moving soon, there is no question that I will be looking for a new doctor. He is very young and I'm wondering if this is what is being promoted in medical school?

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42 replies

Latest reply was from shiny

Inge

(website)

Bonnie, I'm appalled!!-((( I'm so sorry! What was that doctor thinking!!???-((( And good for you for insisting on that prescription and continuing to go for a yearly mammogram.

Good thing that you won't have to deal with him for much longer. I sincerely hope that this is not what they are teaching the new generation of doctors in medical school!!!

Tina

Veteran

Well first of all, he is right about one thing, you look great- always!
The rest leaves me shaking my head. Breast cancer is so incredibly treatable if detected early, why would a doctor not promote a test that does just that?! I really question what he sees his purpose as a doctor being.
I could go on and on about this. Age is not valued enough, nor the wisdom that goes with it. He clearly has much to learn.
I hope your mammogram comes back clear!

Inge

(website)

ETA: That navy is such a beautiful colour on you!

Angie

(website)

Fashion Stylist

OH MY WORD. Bad, bad bedside manners. Zero tact. And unfortunately not uncommon in the medical world. We all have similar stories, I'm sure.

Maybe the doc thought he was funny? You certainly didn't laugh! Still, that's insensitive and just. not. nice.

No one is perfect. Doctors have their off days just like us - and deal with a lot of stress. But they need to do better what went down today. I'm sorry you were the recipient of such insensitivity.

Oh, sweet bonnie. Bless your healthy body! GOOD NEWS about your liver and lab tests. LIVE your life and celebrate. You are beautiful inside and out.

FWIW, and I don't have mammograms anymore. My G.P. - who ROCKS and is a woman - agrees with me. They are quite ineffective, and bad for you. I've gone down the road of stressful breast cancer scares because of lumpy breast tissue and ineffective/ inaccurate mammogram results. I eventually saw a breast specialist who was a lot more precise than the mammogram machine. And the next breast cancer detection machine needs to be designed by a woman.

Bonnie

Veteran

Thank you Inge and Tina for your incredible kindness and support. I'm still feeling quite shocked and your words really help.

MsMaven

Veteran

To think I was miffed because I've had to go in for a mammogram every 6 mo for the last couple of years due to an area that looked mildly different. Was just in, nothing has changed. After reading your experience, bonnie, I'm sorry I was so irritated. Last month I asked my MD why I no longer get glucose testing--she put it on the list for my next thyroid test.

Nobody should be written off just because they are over a certain age.

Tina

Veteran

With regards to mammograms, my understanding is that they are not effective for women who are younger than 55 or so due to dense breast tissue. However, for those in the 55 and up catagory, they can be useful in detecting abnormalities. Has this been the experience of others? My mom had hers detected that way in her mid 60s.

Angie

(website)

Fashion Stylist

AND bonnie, you were asking about fab lounge pants back on the blog yesterday - I just got these are LOVE them:

I've also got the Boden flannel Pjs on their way to me - they've got doggies all over them.

Make + Model Make + Model Lounge Around Pants | Nordstrom

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Top Pick

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Make + Model Make + Model Lounge Around Pants | Nordstrom

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Cosy Woven Pajama

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Stagiaire Fash

Veteran

I don’t have a clue what they’re teaching now, but when he went to med school in the 50s & 60s, I think this is pretty much what my dad was taught (minus the poor delivery). It’s a classic triage approach of saving resources for those likely to live long enough to get the best/most use out of them. Lots of tests are no longer recommended after a certain age, because you supposedly aren’t worth it anymore.

My mom was diagnosed with breast cancer about 5 years ago. It was not picked up by a mammogram—my dad does monthly exams for her, and he found it. She is now 78 years old, and still on meds to keep it from coming back.

Glad to hear you’ll be finding a new doctor soon. Now you have one more question on the list of things to ask while interviewing potential docs.

May I suggest you find a few sites that review docs and let people know his philosophy of care and his manner of delivery?

texstyle

(website)

Veteran

I would never have guessed your age Bonnie - you DO look so much younger!

Not sure what was up with your doctor's lack of bedside manner, but I agree with Angie re: mammograms. I actually have never had one and never intend to have one. I think they are doing more harm than good. But that's my own research and opinion speaking of course and I am not a doctor.

Nebraskim

Veteran

I think evidence is on his side and the American Cancer Assn agrees that for most women over 75 or so, mammograms are not that necessary. BUT his tactlessness was terrible. And for women who are far more vibrant than their age, they are worth doing. My own mother had her second mastectomy at age 81 (her first was at age 42, in 1972). She died at age 86 of heart disease. The cancer found at age 81 were very tiny DCIS and the mastectomy "cured" it. She chose mastectomy over chemo or radiation. Like Angie, I no longer have mammograms as they seem worthless to me. BUT that is MY decision and others are free to do whatever is best for them.

Anonymous

I will faithfully have a mammogram annually until it is no longer sensible for me . The Canadian Cancer Society supports them , as do both of my doctors . I have a serious family cancer history to consider and believe mammograms to be effective in detecting abnormalities . I am horrified to hear of your experience Bonnie .

Jane

Veteran

A horrid experience and I’m so grateful you have shared it. I have a super doctor who has been kind and supportive. She took me under her wing a few years ago.

I hope that you find a new doctor who is similarly kind, supportive and technically sound.

You do look amazing!

rachylou

Veteran

Appalling. I have many things to say about this. But I will just say it’s very bad when a doctor doesn’t really see you and your personal medical and life situation. When I lived in the ghetto, I had a neighbor. Her schooling was poor, her medical situation one that exacerbated her confusion... I could go on. Needless to say, she couldn’t follow the printed instructions he’d give her, and ON TOP of that he prescribed her medications that did not play well with her other prescriptions. Knocked her kidneys out. Doctors need to think, not just follow singular given paragraphs in ‘the book.’

All right. I’ve said my peace.

Runcarla

Veteran

You are right to be outraged. What a dolt!

Anonymous

What an (expletive deleted)! I would complain about him to his supervisor.

Jules

Veteran

I know in Ontario they are scaling back on both yearly physicals and a lot of screening tests, because they haven’t been found to be effectively increasing survival rates, etc. My doctor tells me they are no longer even pushing breast self-examination. I think they are questioning the whole idea whether early detection is as valuable as they had assumed (again, statistically speaking). Cancers also tend to be slow growing in older people.
So he might be trying to communicate new guidelines or thinking, but he did an absolutely piss poor job of it and I’d be livid too.

Bonnie

Veteran

Angie:Thank you for your help, you are so kind to chime in. I've had breast scares, too, but I find it strange that a test that caused a lot of additional testing and procedures a couple of years ago is no longer needed because I've reached a certain age. Medicare still wants me to get them because of my history but it appears that my doctor, who probably hasn't read it, just goes by his group's age charts.

MsMaven: You are exactly right. People age differently and individual needs should be respected. When testing is no longer indicated, it should be discussed rather than just dropped with no explanation.

Tina: I still have dense breast tissue and I was told, until this year, that it was important for me to have mammograms because the denseness made is hard to check manually. I'm glad your mom got the care she needed.

Angie: I'm going to give those lounge pants a try and if the pjs had birds on them, I would be ordering them, too.

Fashintern: Thanks for chiming in. I'm happy that your dad found your mother's cancer and she was able to treat it successfully. My aunt, who is my age, thought something was wrong and went to her doctor who checked her manually and said everything was OK. My aunt disagreed and requested a mammogram which showed that she had stage one breast cancer. Different experiences with happy endings. Good advice on how to find a doctor. I'm moving back to a community where I lived from 2010 - 2013, so I have friends that can help guide me, too.

texstyle: Thank you, I don't feel my age either. I walk in the desert and hour a day and practice yoga for about 45 minutes a day. I don't get sick very often and had the flu for the first time in 30 years last spring because of the inadequate vaccine.
I think what bothered me most about this experience was Dr. Y's attitude that since I'm over 75, I'm going to die soon so why try to prevent it. What's wrong with dying sooner rather than later and it doesn't make any difference whether it's cancer or heart disease. I'm just wondering if this attitude is common among MDs today.

Nebraskim: I agree that people of every age should have the right to the medical care they need and should not be discounted because of their age.

lisp: Thank you so much for your kind words. You have expressed perfectly what is in my heart.

Jane: Thank you. I'm glad you found a great doctor. I have had wonderful doctors in the past and hope to find one in my new home. I know people who lived there that can help guide me.

Angie

(website)

Fashion Stylist

Sweet bonnie, doctors will vary greatly in their professional opinions, and so will doctors in different countries. You have to go with what YOU think is best after a bit of thought and soul searching. I hope you find a fab new doctor that makes you feel cared for, important, and listened to. Hope the new loungewear works. Good luck and much love to you. xo

Bonnie

Veteran

rachylou: Thank you and what an appalling story. I'm seriously thinking of seeing a NP rather than a MD because they seem to have more time to listen and make measured judgments.

Runcarla. Thank you - my opinion exactly.

suntiger: Thank you - good advice!

Jules: Thank you. Thinking that spending time and money on a person when they are statistically going to probably die soon negates the value of life. Piss poor job is right.

Bonnie

Veteran

Angie: Thank you. I have been less present on YLF recently for the following reasons. Last spring, we took a three and a half month trip in our MH up the CA, and OR coasts with a brief stop in Portland and then on to Yellowstone for three weeks. During the trip, we made the decision to sell our home so when we got home in late Aug. we spent three weeks preparing our home for sale. It was on the market for three weeks when the fourth person to look at it made an offer which we accepted. We had a five week escrow to find another place and pack up our belongings which we are still working on. In 12 days, the moving van comes and we leave for the CA central coast. A busy time but I follow YLF every day although I do not often comment. Not sure how long it will take to get resettled - there will be a bit of remodeling to do. Eventually, I'll be looking for wardrobe advice since our new weather will be totally opposite from the hot desert.

Suz

(website)

Veteran

Bonnie, you look far younger than your years! Vibrant is the word that always comes to mind.

Whatever the current research on mammograms, that doctor’s manner was rude and dismissive. A conversation about pros and cons would have been far more productive.

It seems you got the worst possible write off. His attitude seems to have been a contradictory mixture. You look younger, so no need to worry your pretty little head about your health. AND you are “old” so what’s the difference?

Ageism may be the last “allowable” discrimination. We are going to change that!

I do go for mammograms due to my family history but like Angie I have had some scares and false positives so I have very mixed feelings about it. The standard where I live is changing, as Jules said. Fewer and less frequent tests. I don’t go every year. It is debatable how useful these are at different ages.

It is true that most of us will die of cancer or heart disease. Many late life cancers though are very slow growing and will not kill us and don’t require treatment. There is so much in medicine that remains a mystery, particularly when it comes to aging. All the more reason for doctors to learn to discuss this respectfully and thoughtfully.

Angie

(website)

Fashion Stylist

WOW, bonnie. You have been busy! I remember your 3 month long vacation. An exciting new chapter, and good luck resettling. Thanks for your ongoing YLF support, and we are here if and when you need us.

anchie

Veteran

bonnie, I am so sorry that you had to experience this, and feel appalled but not too surprised. My mom is 72, she had stroke recently and she wants to get better. But her doctor’s attitude is that she has to accept her situation, that she had long and happy life and why she wants more. And that there are worst things at her age than stroke and she should be grateful .

rachylou

Veteran

I say what, Anchie? Like no therapy?

Bonnie

Veteran

Suz: Thanks so much for your kind, comforting words. I too, have a family history of cancer and I'd like to do all that I can to prevent it. Mammograms are easy for me and with my dense, lumpy tissue, the best way to detect cancer. If medicare thinks I need one then I want to get one. They know my history far better than my doctor seems to. I've only seen him this past year - the first time he yelled at me about my high blood pressure. He did prescribe an additional medication that has helped bring it down to normal. The second time I saw him, he was all smiles about my excellent test results. This is the third time and I'm not really sure why he asked me to come back in six months, because all he did was describe a movie. I brought up the yearly mammogram and that's when I got the lecture. I love that you are passionate about preventing Ageism.

Angie: Yes, this has been a stressful time. I am so happy that I will soon be having daily walks on the beach and cooler summers.

anchie: What a terrible, frustrating thing for your mother to have to go through. And what a terrible attitude her doctor has. It puts things in perspective for me. This is another example of ageism.

Gigi

Veteran

Bonnie, I'm so sorry you had to deal with this insensitive doctor. I'm glad you were able to still get your prescription for the mammogram.

I agree with Fashintern that I think that there is a push to try to conserve resources for those who are younger, and that may be what is ultimately behind this. But I think it shows a lack of discernment on the part of this doctor. Not everyone who is older is in ill health--it sounds like you are very healthy. The doctor should have taken that into account. Not all bodies are the same!

Flytigress

I know many women whose lives were saved by mammography. In my experience, a 3-D mammogram eliminates callbacks. (I have dense, cystic breasts.) I will continue getting yearly mammograms.

Here are the American Cancer Society guidelines:

Women with an average risk of breast cancer – most women – should begin yearly mammograms at age 45.

Women should be able to start the screening as early as age 40, if they want to. It’s a good idea to start talking to your health care provider at age 40 about when you should begin screening.
At age 55, women should have mammograms every other year – though women who want to keep having yearly mammograms should be able to do so.
Regular mammograms should continue for as long as a woman is in good health.
Breast exams, either from a medical provider or self-exams, are no longer recommended.

Anonymous

I have been hearing the same thing. My father had prostate cancer in his 90's. Doctors did not really want to even try to treat it. I have been told that I am too old for several exams and medications that I have taken for years. A lot depends on what Medicare supports, it seems.
Even the recent cataract surgery had its senior plan. They have, I am told, a very good "assisted living" model lense for older people. It is cheaper but will not allow night driving . I rejected that one because I still need to be able to drive at night but it made me feel really old to have this plan pushed.

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