Friday, May 16, 2008

The mammogram question. At my last visit to the Dr. – and I didn’t even get to see the Dr., it was the P.A. – she said she had to prescribe a mammogram for me. It was required by law or the FDA or AMA or somebody and it was her sworn duty to prescribe it. She ended by saying it was certainly my choice to get one or not. I’m sure the intent of the whole conversation was to avoid a future lawsuit on my part, which I wouldn’t do anyway. I politely declined, pointing out that I have no risk factors and that my family history leaves me more concerned with monitoring my heart health. Additionally, it’s not what I want to spend my money on right now.

The PA left me and the attending nurses came in and proceeded to get on the phone to schedule me for a mammogram. I said, “You can make the appointment if you want to, but I won’t be going in for it.”

They both looked at me as if my hair was on fire. “Why not?!” one of them said. I repeated that I had no risk factors and was more concerned with avoiding heart disease than cancer. They can test my cardiac health any way they want to, but leave my boobs alone. She made the appointment anyway and I asked for the telephone number I would need in order to cancel it. She handed it over grudgingly.

Another conversation of a similar nature took place with the receptionist.

Now I’m well aware of the choice I am making when I choose to forego the mammogram. I’ve heard the phrase “every woman over forty should get a mammogram” at least a million times.

Let me point out a few other things they said “every woman” should have:

Back in the 50s, it was thought “Every pregnant woman should be on thalidomide for depression and morning sickness.” Several months later, women started giving birth to hideously deformed children. Many of these children were abandoned and gave rise to “Thalidomide orphanages” and then it was, “Oops! Sorry, ladies. Thalidomide wasn’t such a good idea after all.”

And then there was the miracle drug Sibesterol (sp?) thought to prevent miscarriage. The only problem was that when daughters born to women who had taken Sebesterol grew up, a huge percentage of them developed cervical cancer. “Oops! Sorry, ladies.”

In the 60s, they thought “It should become routine to monitor fetal development and every pregnant woman should have an X-ray.” The consequences of this were nearly as devastating as the thalidomide debacle. “OOPS! Sorry, ladies.”

Then in the 70s, it was said, “Every young woman should be on birth control pills, not only to prevent pregnancy, but to maintain regular menstrual cycles.” Several years later, young women (by young, I mean age 30 or less) started having debilitating strokes and wound up partially paralyzed. “Oops! Sorry, ladies. Maybe not every woman should be on the Pill.”

In the 80s and 90s, “Every woman should be on Estrogen hormone replacement therapy (HRT) in the form of Premarin.” Okay, do you know what Premarin is made from? It stands for PREgnant MARe unrINe. I’ve seen pregnant mare urine. I don’t want to ingest it. (And don't even get me started on the mare urine farms.) And then women on this HRT started developing tumors, cancers and heart disease. “Oops! Sorry, ladies, maybe not every woman should be on Premarin.”

And now we have the mammogram. I know of at least three women who had regular mammograms and died of breast cancer anyway. What are we? Lab rats?

And what is going to happen to my personal choice in this matter if we socialize health care?


Ralph said...

You hit a real nerve with this one. We are trying to centralize medicine where it is one size fits all and there is a pill for everything. Coupled with the fact things change every other month on what you should and shouldn't do. Only ones that are winning are the health care organzations and pill dispensers.
On a positive note, your previous post made me bust out laughing.

Sue said...

To have or not to have is your choice. Just promise you will do the self exam every month. It doesn't cost anything.

cdroses said...

(yes, Mom, I do.)

Mary Connealy said...

Here's where Universal Health Care will explode.

In Britain where you have to get in line and, often a long, long time for surgery, exams, tests, their system of legal recourse is very limited.

My mother in law knows a man who had to wait far, far too long to have knee replacement surgery--after a doctor decided it was called for, as his health deteriorated in other ways. He finally got the surgery and died of a heart attack right afterward.

Now, as things stand in America, that doctor, honestly whether the doctor had really done anything all that wrong or not, would get his sox sued off.

Well, if we end up with a socialist style health care system and someone has to wait a year for a colonoscopy after symptoms begin worrying him and then has advanced untreatable colon cancer.

What happens? Do the lawyers win a lawsuit on that one?
If they can then those tests will have to be done fast, if we have to do things fast the cost will go through the roof, and make what Canadians and Britains pay look like chump change.

Something will have to give.
I predict a disaster.

Mary Connealy said...

I duck those mammograms like crazy, too. I probably shouldn't but I just keep dragging my heels and oops, has it really been TEN YEARS???

I have none of this in my family either.

Scarlet said...

I hear ya. I'm even starting to wonder about pre-natal vitamins. So many babies we know are born with acid reflux disease (my son had a severe case of it) and I don't recall this being such an epidemic in the past.

You might be on to something here. At least you're given a choice and I think it's wise to weigh the pros and cons, to be informed, and to have the freedom to choose without being frowned upon. Good for you for doing what you feel comfortable with and not getting suckered into routine procedures.

Mary Connealy said...

What do you think about childhood immunizations causing Autism? Is it possible? Man some people swear it's true.
It makes you wonder if they should maybe ease off of some of these immunizations for things that are so rare these days like Typhoid and diptheria. I mean, I'm not fooling myself that those aren't terrible diseases but how likely is a child to really catch them. And what's the treatment for them.

I've heard the treatment for Scarlet Fever is antibiotic.

If the other diseases are so simple to cure it might be a good idea to stop doling out questionable immunizations.

Janell said...

Ralph - Don't forget the malpractice attorneys.

I'm glad I gave you a good laguh for the day.

Sue - yes the self exam is done monthly.

Mary;I agree with you about the forthcoming disaster.
Keep duckinh those mammos.

Scarlet; this is the first I've heard of a conncetion between prenatal vitamins and said reflux, but the timing daes look suspicious.

Mary;I wonder about the autism/vaccine connection, too. Someone said it was the small amount of mercury (as preservatice) in it that was the culprit. I wonder if there could be determined an "at risk" goup who should get vaccines and the rest of them meaybe.

LaDawn said...

Mary - I live in the uK and have never had to wait for important stuff, ie broken legs, emergency c-sections, etc. As long as it is not a routine visit to the doctors office we are treated very well. And as far as our choice of treatment being taken away, well that has never happened. I can still say no and I can still request 2nd opinions. I do subsidise my nationalised care with private care provided by my employer to get quick access to specialists. But at least everyone gets access to care and treatment without going bankrupt. and whilst corruption among doctors still exists it is no where near the collusion you find in the USA. Nationalised Health Care is the only option for you to take care of your citizens basic health. But don't expect the world from it. Your fellow citizens are paying for it with their tax money. They are agreeing to pay from your treatments so don't expect costly miracles. No, we'll leave that to the Americans and let them go bankrupt.

And don't get me started on the invalidlity of that one study which linked MMR to autism. The people who did the study have now come out and said the study sample was so small that it was invalid. In the meantime the rate of mumps soared and children died. It was fashionalbe for caring mums to not to the vaccine and now they have all rushed off to get it realising this was a furor fanned by the media to sell papers. Lift up the covers and read the details people!

Janell - You know your body better than anyone, yes, even better than your doctor. Your right. Your call. Watch that heart, darling. We want your wisdom and strength with us for a long time.

Jamie Dawn said...

I don't see any harm in having mammograms, but I do not think anyone should be made to have one. Unfortunately, you are right about mammograms not being a sure way to find breast cancer. It doesn't always work.
You are so right about the many "lessons" we've learned the hard way over the years with various medications and treatments.
We cannot avoid all health problems, but you are smart about knowing your family history and taking steps to prevent those illnesses which are more likely to happen to you.

Jim said...

Hi Janell -- If we get to vote, my vote it JUST DO IT!!!!!

Mrs. Jim does that every year. She worked at M.D. Anderson Cancer and Tumor Hospital too long for any foolishness.

A hint, around here we have mobile mammogram vans that only charge about $75. That is cheaper than our co-pay on insurance. Mrs. Jim doesn't use those mobiles though.

How do you feel about the colonoscopy? I just had mine for the fourth time. The first one had polyps to be removed, none since. The doc did order a biopsy this time on a suspicious place, it came back as benign.

We have a very good friend who waited until her 60s to have hers, she had to have a section of her colon removed.

The bad part is that she has cancer of the liver and in her lungs. None of that can be removed, she is terminal, just a matter of time.

Her husband died of colon cancer also, less than two years ago.

Cliff said...

The weakling at the cash register had me laughing too. Great story.
You make some very good points here Janell.
And besides. I know of several farmers who will perform the exam at no charge.
I didn't say that outloud did I?

Anonymous said...

Paul said...

I'm with you on this. One of our grandson's has autism and guess when it started? Don't get me started.

You know that old saying: "An apple a day keeps the doctor away." We should listen up. Ben Franklin never had a colonoscopy and he lived to a ripe old age. In fact, millions of people did.

There's another saying that is sprouting up: "I don't wanna talk about religion, politics or health issues."

Pharmaceutical companies are demonic. That's how I feel.

Paul said...

Oh, yeah. I enjoyed the grocery store story. Good one.

Joe B said...

Sorry I missed this one...
My first observation, LaDawn and Janell both had boob posts in the same week.
"and whilst corruption among doctors still exists it is no where near the collusion you find in the USA." Last I checked, UK is nearly bankrupt as a result of nationalized healthcare.
The more fortunate people in the UK, yourself included, generally subsidize their healthcare with private insurance.
IN the US, broken legs, etc, are covered. If u don't have insurance, break a leg, go to the ER and they are required by law to treat you free of charge.
We pretty much cover everyone not covered by private insurance. We have Medicare (Old People), Medicaid (dis-abled, less fortunate) and SCHIP (Children).
I am going to post an article I saw on Healthcare showing how a free market can drop prices. When governments are involved, they prices can only go one way and quality will generally deteriorate.
Free Markets generally drive decreases in prices and higher quality care.
I'll site my sources.
Great Post Janelle...

nora said...

Took the afternoon off to get my annual exam and catch up on blogs. Timely.
Just had big conversations with my nurse practitioner (who I adore) we decided that I just need a pap every two years. She's really conservative and I feel very in-control of my health care decisions.
That said I scheduled my first ever mammogram (my maternal grandmother had breast cancer).