Tuesday, January 6, 2015

Say What?!?


I had my yearly checkup last week -- I have an under-active thyroid and have to have a blood test once a year to make sure my thyroid prescription is the right strength. I'm very fond of my doctor -- we tell each other what books we've read recently and she always answers my questions. And she treats me like I'm a reasonably intelligent and informed person -- which I really appreciate. 

So, she began to review my health care -- shingles shot -- check, tetanus shot booster -- check, eye doctor - check, colonoscopy -- check,  mammogram -- check, pap smear . . . nope, haven't done that in a while.  As it happens, pap smears are not recommended for women over 65 who have previously had a history of normal pap smears (see LINK.) And I am almost 72.

"So, what about mammograms?" I asked her. "When do I age out of that? There's no history of breast cancer in my family."

She shrugged her shoulders. "Go on with those. . . until you reach a point where you decide that you wouldn't do chemo if you were diagnosed with breast cancer."

(Deep breath.) "Okay." And  then she continued on to ask if I had a medical power of attorney in place along with end of life instructions.

(Another deep breath.) "Yes, but it probably needs to be updated."

And we chatted some more about books -- I told her about ON IMMUNITY and she told me about her recent reads and then I had blood drawn and went home.

With quite a lot to think about. I appear to be in fine health, by the way. But . . .

Did we just have an end of life talk? Or, maybe, approaching end of life talk?

Yikes!  My reaction was identical to when I was in my early teens and my mother insisted that I needed to shave under my arms -- I'm not ready for that yet!


But, obviously I am. According to the Biblical three score and ten, maybe a bit past ready. And I truly appreciate my doctor's candor and the gentle reminder of my mortality. I have already thought a good deal about these things -- but it's a good idea to get stuff in writing and notarized.  

(Let me just say I would prefer to drop dead this minute rather than spend years and years in a dementia unit in a nursing home.  As for all the other dire possibilities -- it would come down to quality of rather than length of life.)

A few days after my chat with my doctor, I came across an article that really sums up my own feelings. It's called 'Why Doctors Die Differently' and you can read it HERE

But, will I schedule a mammogram for next year?

 Probably not.

Addendum: As June points out in the comments, a mammogram can detect lumps etc. treatable by surgery rather than chemo. . . she's right -- I will, after all, schedule that mammogram next year. As long as the insurance covers it.

13 comments:

Thérèse said...

Food for deep thoughts today with you Vicky!
Thoughts that we all (should) go through for peace of mind but when something not pleasant takes place the decision will be perhaps different from the one we chose before having to deal with it...
At peace with oneself and knowing that doctors will respect your will is of course something first on the list of wishes.
Thks for reminding us...

Ms. A said...

Someone in one of the groups I'm in, just posted that link. Pretty amazing that doctors don't want any part of the things they push on their patients. Also pretty telling.

June said...

Vicki, schedule the mammogram. You could find some ductal carcinoma in situ like I had. Caught early, it's completely remedied by breast removal . . . no chemo necessary. If caught early.
Was it you who recommended Hillman's book, "The Force of Character"? I just started it, have to take it slow. His point, from the few pages I have read is that there is a need to have elders and to be an elder. It isn't all about the biology . . . it's about your psyche. If you think of life in terms of how long you live after you stop being able to reproduce, you short change yourself.
I like your doctor too, but she's in the body business.

Sam Hoffer / My Carolina Kitchen said...

Sounds like you have a caring physician and to me that's important. I wouldn't necessary consider her conversation as an end of life one. I find that most doctors offices today (I visit several, seems like everyone's a specialist today) ask about a living will and if you have one, they want a copy to have on file. They all seem to be updating their records, some of which are often not up to date. It may be related to HIPA rules or the fact that doctor's offices are digitized now and most are linked to a medical center. I like the links and find it is really convenient to go into a new doctor's office or an emergency room and find they don't have to ask me a lot of questions because I'm on file. I am going to continue to have a mammogram and a bone scan as long as insurance pays for it.
Sam

Sam Hoffer / My Carolina Kitchen said...

Oops, I meant to add a thank you for the link to why doctor's die differently. Very thought provoking and one I will definitely pass on.
Sam

Vicki Lane said...

June -- I thought about that and you're right -- like Sam, I'll go on scheduling the mammogram as long as the insurance covers it.

Jim Egerton said...

Yeap, Don't want to linger on life support or flat of my back. It is well known I want to go quickly with as much dignity and peace as possible. Of course drugs help.

Thanks Vicki for the link. Very interesting.

Brian Miller said...

smiles. i guess it happens to all of us...i guess i would rather a physician will to have them than not as well....really any of us could be near the end and not know it...

NCmountainwoman said...

This post struck a chord with me. I feel so healthy that I simply forget how old I have become. Guess that's a good thing come to think of it.

Christie Campbell said...

I am just entering into the mamogram phase. I have just realized this. *snort*

To their credit, your physician is wise to bring up those items. My grandmother didn't really have much of that set in stone and it wasn't easy for Dad and his sister to make those decisions. There were many arguments and damage done to the relationships.

While it seems surreal and morbid, it's truly a God send for those that survive you. Should it come time to make that "decision" would they do so in your best interest and to your wishes? Having those documents on file and handy is not so much for your peace of mind, but more for theirs. It will be the last gift you can give your family.

Darla said...

Thanks for sharing your experience and thoughts -- a good reminder! I don't do doctors -- haven't been in about 20 years (I stick with home remedies and am trained in homeopathy) -- but I definitely need to update my living will, DNR, med directives, etc. So, THANKS!

Star said...

I hope your blood results come back well and that you will live for a good many years yet Vicki.
I prefer to live each day as it comes and not worry too much about the future (smile).

Vicki Lane said...

All blood results good! I seem to be in good health.