At a certain age, would you say NO to certain medical treatments?

[clifffaith]

My 85 year old dad has said NO to more colonoscopies.
My 83 year old mother has said NO to more mammograms.

My soon to be 80 year old husband and I are pondering at what point certain dental procedures should be stopped. And quite frankly money, not discomfort, is the big issue. Last month he had two 15 minute/$600 each plane & scale appts, without need of numbing, with our long time periodontist. Today he had a re-check for $75 to check his dental pockets (to me that should have been a free followup after the planing and scaling). She now wants to do a $3600 slice and dice with bone graft, on the lower left same place she's done at least once before some years ago.

His dad made it to 93, I'm counting on Cliff making it to 95. I said no to the treatment when they called me to look at the calendar. We are going to get second opinions from one, possibly two others to find out what they recommend, how much they charge, and what the prognosis is for letting it be for the foreseeable future. I'm starting to feel that 4 times a year cleaning (alternating dentist and periodontist) and taking care of cavities should be enough at the age of 80.

 

[AwayWeGo]

Heart doctor thinks maybe I ought to start taking cholesterol pills unless a repeat blood test shows my cholesterol is already below some magic number that it was bordering last time I had the blood test.

I'm all in favor of low cholesterol, but don't those cholesterol pills have worrisome side-effects of their own? If so, maybe I'm better off taking my chances with borderline cholesterol.

Only reason I have a heart doctor is that I went to a cardiologist instead of family doctor to get EKG clearance for cataract surgery. That's because last time I had surgery (& the time before), EKGs done by family doctor showed some irregularity (which did not get me blackballed from scheduled surgery). My thinking was that a heart doctor could not only clear me for cataract surgery, but also get to the bottom of the EKG funny business, which turned out to be something called sinus arrhythmia with premature heartbeats. Scary as that sounds, the heart doctor said it is not serious, not a problem, not heart disease, & I don't need to worry about it. But I need to come back in a year just to make sure. Plus, there's the lingering cholesterol issue. (It's always something.)

-- Alan Cole, McLean (Fairfax County), Virginia, USA.​

 

[VacationForever]

The balance has to be quality of life vs. cost/inconvenience. I know I do not want to spend my final years having gum or toothache. Ask the treating doctor on what if the procedure is not done and how will it affect quality of life.

 

[Talent312]

... She now wants to do a $3600 slice and dice with bone graft, on the lower left same place she's done at least once before some years ago.

Count me a bit suspicious of periodontists and the need for those procedures.
17 years ago, a periodontist told me I needed the same thing or I'd start losing my teeth.
I never went back. I never lost any teeth as a result (a recent implant due to tooth decay).

The guy who did my scaling and implant last year never said I needed any of that stuff.

.

 

[Passepartout]

At some point, testing for diseases that take a long time to do their damage is counterproductive. I think I'm scheduled for one more colonoscopy at about age 75. And that only because of family history and my own past polyps. Same thing with PSAs. I'll be dead of something else before they can get me. I suppose dental procedures in order to hold down infections and discomfort may be something we won't outlive the need for.

Alan, I take a lipitor and my doc seems to feel that just about every human on a 'modern' diet will have lower cholesterol and less artery plaque with a statin. They are cheap and I've not been aware of ANY side effects. Except he wants me to take it i n the evening, and I tend to forget.

Jim

 

[VacationForever]

Alan, I take a lipitor and my doc seems to feel that just about every human on a 'modern' diet will have lower cholesterol and less artery plaque with a statin. They are cheap and I've not been aware of ANY side effects. Except he wants me to take it i n the evening, and I tend to forget.

Jim

One of the things that I notice about PCPs is that in general they look at total cholesterol instead of total cholesterol/HDL ratio.

Total cholesterol is no longer as relevant as Total Cholesterol/HDL with less than 3.5 as healthy. My total cholesterol looks somewhat high due to high HDL because I exercise alot. My friend who is a marathon runner has consistently very high total cholesterol because her HDL is well over 100. Her ratio runs closer to 2.5 and less. Her triglyceride is around 30 and her LDL is within normal range. Her PCP said she needed to get her total cholesterol down. I just pointed her to mayo and other website regarding looking at ratios as opposed to total cholesterol.

 

[clifffaith]

Alan, I take a lipitor and my doc seems to feel that just about every human on a 'modern' diet will have lower cholesterol and less artery plaque with a statin. They are cheap and I've not been aware of ANY side effects. Except he wants me to take it i n the evening, and I tend to forget.

Jim

I kicked myself earler this year when my GP wanted to change my statin because she didn't like my numbers. Just had her send the new Rx to ExpressScripts. Bottle came with a $230 bill compared to something like $6 for my old pills. I took that bottle because I had no choice at that point, but made her find me something else.

 

[clifffaith]

Count me a bit suspicious of periodontists and the need for those procedures.
17 years ago, a periodontist told me I needed the same thing or I'd start losing my teeth.
I never went back. I never lost any teeth as a result (a recent implant due to tooth decay).

The guy who did my scaling and implant last year never said I needed any of that stuff.
I found that implants are 1/2 the cost in Mexico (there are U.S. dentists w/Mexican offices),
-- but I didn't go.

.

I think our perio is extra cautious, and she also teaches at USC so she is always on the leading edge of new stuff. Two years ago she had a new contraption in her office that takes skull X-rays that could then be manipulated to see different things. She was concerned about something and $500 later we had this scan. Teeth turned out to not have a problem, but she showed me how my sinuses were blocked and sent me to an ENT guy. He wanted to do surgery to clear my sinuses and I'm saying hold on, I can breathe just fine. She was freaked out I didn't want to proceed and gave me another referral to a different guy who I never visited. I have NO SYMPTOMS of sinus issues, I'm not about to have someone putting a rotor-rooter up my nose and then have my nose packed with gauze for three days.

 

[WinniWoman]

Working in radiology I see it all the time- ex: a 95 year old with terminal cancer and they are doing a Cat Scan. The nurses just shake their heads. When my mom had terminal cancer- in her 80's- sometimes she would have an episode where she would faint/throw up- would take her to the emergency room and they wanted to do a Cat Scan- I refused the test (I was health care proxy).

Ridiculous. But a cash cow for the hospitals.

 

[WinniWoman]

At some point, testing for diseases that take a long time to do their damage is counterproductive. I think I'm scheduled for one more colonoscopy at about age 75. And that only because of family history and my own past polyps. Same thing with PSAs. I'll be dead of something else before they can get me. I suppose dental procedures in order to hold down infections and discomfort may be something we won't outlive the need for.

Alan, I take a lipitor and my doc seems to feel that just about every human on a 'modern' diet will have lower cholesterol and less artery plaque with a statin. They are cheap and I've not been aware of ANY side effects. Except he wants me to take it i n the evening, and I tend to forget.

Jim

I have read that statins are bad. I have borderline high cholesterol- probably because of the cheese and shrimp and potato chips (weekends only- lol!) I love to eat because I do not eat meat, except for the occasional turkey. I make two eggs per week. Salad for lunch every day and oatmeal/oatbran in the morning with ground flaxseed.

Despite my high fiber diet and no bodily function issues if you know what I mean, the PA I went to said to take one Citrucel at night before my dinner. She started me taking it a few times per day and brought it down to once before dinner. It helped lower it.

I also keep drinking my weekend wine.

 

[WinniWoman]

Also, I have a new dentist and this practice always seems to want to do something extra, even though the hygenist always remarks how great my teeth and gums are. I fell for an extra cleaning on my bottom molars- $75- a scam because they only do a 1/2 hour standard cleaning (covered by my insurance). Year ago the hygenist I used to go to always took an hour and did a great cleaning each time.

Last time the hygenist wanted to give me a $50 antibiotic because when she did my cleaning my gums were bleeding on one side near my older crowns. I asked he if I instead could just "work" on that area myself and she said yes. I bought those toothpik type Den Teks thingamajigs and its been fine. I brush with an electric toothbrush twice per day, and use floss and a waterpik once per day and then use a DenTek after every meal to get food out from between my teeth.

 

[artringwald]

High cholesterol is an indicator that you may have plaque buildup, but doesn't necessarily imply that you do. Before increasing my Lipitor dose, my doctor suggested that I get a CT calcium scan of my heart. It cost $100 (that insurance usually doesn't cover), but it shows exactly how much plaque buildup you have around your heart. Since I had 0 plaque, he took me off Lipitor.

If your doctor wants to put you on cholesterol drugs, ask if you can get a CT calcium scan to find out if you really need them. The scan doesn't take long, and doesn't use any dye, i.e. no needles required.

 

[Bucky]

Long term use of Lipitor can have adverse side effects!

I’ve been a heart patient for 25 years and just recently my liver numbers have shot up. The first thing they did was cut my Lipitor in half! I take another drug that also is considered a “nasty drug” and they also cut hat in half. Won’t know if this helped or not until Monday when I retest.

 

[rapmarks]

My mother was given a colonoscopy at age 93 because of bleeding. She never recovered from it. She became delirious and ended up hospitalized, rehab, and finally in a nursing home where she died. We should have said no to the colonoscopy, what would have they have done if they found something. She was 100 per cent mentally, and after the test, totally confused, hallucinating, etc

 

[Phydeaux]

My 85 year old dad has said NO to more colonoscopies.
My 83 year old mother has said NO to more mammograms.

My soon to be 80 year old husband and I are pondering at what point certain dental procedures should be stopped. And quite frankly money, not discomfort, is the big issue. Last month he had two 15 minute/$600 each plane & scale appts, without need of numbing, with our long time periodontist. Today he had a re-check for $75 to check his dental pockets (to me that should have been a free followup after the planing and scaling). She now wants to do a $3600 slice and dice with bone graft, on the lower left same place she's done at least once before some years ago.

His dad made it to 93, I'm counting on Cliff making it to 95. I said no to the treatment when they called me to look at the calendar. We are going to get second opinions from one, possibly two others to find out what they recommend, how much they charge, and what the prognosis is for letting it be for the foreseeable future. I'm starting to feel that 4 times a year cleaning (alternating dentist and periodontist) and taking care of cavities should be enough at the age of 80.

To answer your subject question, YES.

I believe your dentist is taking advantage of you & your husband, from what you wrote. Find a new dentist from a personal referral from someone that you trust. Meet with them first, before jumping into their chair. Ask questions.

You need to move on from this dentist.

 

[x3 skier]

Last colonoscopy, Doc said come back in 10 years. I said, if I'm alive, maybe.

If it's something for pain or repair damage like new knees, fine. If it's to prolong life from a terminal illness like some cancers, not happening.

Cheers

 

[Talent312]

Last colonoscopy, Doc said come back in 10 years. I said, if I'm alive, maybe.

Lucky. They want me back in 2 years. One nurse said I was a polyp farm... nice.

I think that dentists, -dontists, and and their ilk are lot like my mechanic.
He wants to replace anything that's worn and keep our cars in tip-top shape.
Well, sorry, the car is worn and will never be in the same shape it was.

Another thing: They both seem to think they can criticize our maintenance habits.
I'm not paying you to tell me that I don't change my oil often enuff or floss enuff.

.

 

[bogey21]

My 85 year old dad has said NO to more colonoscopies...

My soon to be 80 year old husband and I are pondering at what point certain dental procedures should be stopped...

My last colonoscopy was at age 75. Doc wanted to do another at age 80. I refused. Four reasons. First, genetic testing showed I was not carrying the colon cancer gene. Second, doc wanted me to go off my blood thinner for three days prior to colonoscopy. Scary with two strokes in my past. Third, at age 80 I am afraid to go under anesthesia unless facing something life threatening. Fourth, A perforated colon at my age could be fatal.

At age 82 I am currently resisting a dental implant to replace a missing tooth. Two reasons. First, the gap doesn't show when I smile. Second, I have no problem chewing. Dentist tells me if I don't have the implant, other teeth will move around and I will suffer bone loss. I can't get a straight answer how fast these things will happen.

George

 

[VacationForever]

I have been sitting on the fence about having a colonoscopy. When I was with Kaiser, annual FIT (fecal test) was standard, without a need for colonoscopy unless the doctor believes something else is going on or a positive FIT. I moved out of CA and my PCP and gastroenterologist have been insisting that I have a colonoscopy. My PCP seeing my resistance, prescribed Cologuard (not covered by my insurance) which tests for DNA etc. It is supposed to be good for 3 years. I just took one and was negative.

I know of several people who had perforated colon because of the procedure and a couple of them died due to complications - one discovered it too late and another could not heal due to her poorly controlled diabetes.

To do or not to do is the question.

 

[easyrider]

Heart doctor thinks maybe I ought to start taking cholesterol pills unless a repeat blood test shows my cholesterol is already below some magic number that it was bordering last time I had the blood test.

I'm all in favor of low cholesterol, but don't those cholesterol pills have worrisome side-effects of their own? If so, maybe I'm better off taking my chances with borderline cholesterol.

Only reason I have a heart doctor is that I went to a cardiologist instead of family doctor to get EKG clearance for cataract surgery. That's because last time I had surgery (& the time before), EKGs done by family doctor showed some irregularity (which did not get me blackballed from scheduled surgery). My thinking was that a heart doctor could not only clear me for cataract surgery, but also get to the bottom of the EKG funny business, which turned out to be something called sinus arrhythmia with premature heartbeats. Scary as that sounds, the heart doctor said it is not serious, not a problem, not heart disease, & I don't need to worry about it. But I need to come back in a year just to make sure. Plus, there's the lingering cholesterol issue. (It's always something.)

-- Alan Cole, McLean (Fairfax County), Virginia, USA.​

Statins not only reduce cholesterol but stabilize plaque in the arteries . Stabilized plaque in the artery doesn't break off as easy. When plaque in an artery breaks loose it often causes problems like heart attack and stroke. Over the counter pain medications can cause statins to loose their effectiveness which is what I think happened to me. Statins can cause muscle aches, which is why I frequently took otc pain meds. I have been on statins for over 20 years. After my heart attack I was prescribed huge doses of vitamin d to help with the muscle aches. This worked for me.

Anyway, my point is that if you are asked to take statins and your cholesterol is not too bad it is likely to stabilize plaque so you don't stroke out of have a heart attack.

Bill

 

[Suzy]

High cholesterol is an indicator that you may have plaque buildup, but doesn't necessarily imply that you do. Before increasing my Lipitor dose, my doctor suggested that I get a CT calcium scan of my heart. It cost $100 (that insurance usually doesn't cover), but it shows exactly how much plaque buildup you have around your heart. Since I had 0 plaque, he took me off Lipitor.

If your doctor wants to put you on cholesterol drugs, ask if you can get a CT calcium scan to find out if you really need them. The scan doesn't take long, and doesn't use any dye, i.e. no needles required.

Is a CT calcium scan of your heart dangerous? It sound like it would be, but the idea that it shows how much plaque buildup you have is almost convincing me to have one done.

 

[Phydeaux]

Is a CT calcium scan of your heart dangerous? It sound like it would be, but the idea that it shows how much plaque buildup you have is almost convincing me to have one done.

What danger are you referring to? CT calcium scoring is a non-invasive, diagnostic imaging procedure. I'll have to assume you're concerned with the ionizing radiation of this procedure, and thus, it depends.

Not all CT systems are created equal, is the bottom line. Further, not all CT calcium scoring procedures are conducted in the same manner, with the same software and post-processing methods, even when the base equipment is identical. A person could receive a substantially high dose, and another a relatively acceptable dose.

If considering the procedure, talk with your physician, and you may want to do some research proactively. Here's some light reading for you:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789203/

 

[lizap]

My last colonoscopy was at age 75. Doc wanted to do another at age 80. I refused. Four reasons. First, genetic testing showed I was not carrying the colon cancer gene. Second, doc wanted me to go off my blood thinner for three days prior to colonoscopy. Scary with two strokes in my past. Third, at age 80 I am afraid to go under anesthesia unless facing something life threatening. Fourth, A perforated colon at my age could be fatal.

At age 82 I am currently resisting a dental implant to replace a missing tooth. Two reasons. First, the gap doesn't show when I smile. Second, I have no problem chewing. Dentist tells me if I don't have the implant, other teeth will move around and I will suffer bone loss. I can't get a straight answer how fast these things will happen.

George

George, really depends on the tooth. I had to have the bottom last tooth (next to wisdom tooth, which I had removed years ago) extracted; my dentist recommends against an implant. Says I won't miss it, and so far, I havn't. Implants have their problems too. Know two people whose implants have broken.

 

[WinniWoman]

My mother was given a colonoscopy at age 93 because of bleeding. She never recovered from it. She became delirious and ended up hospitalized, rehab, and finally in a nursing home here she died. We should have said no to the colonoscopy, what would have they have done if they found something.

Very sorry. Yes- we employees always say this at the imaging center. The question to ask is- what is the end game of having the test? If it is positive, what would be done about it? If nothing- there is no point of having it.

Of course, for the imaging center- they love the more tests the better! That is how they make money!

 

[rapmarks]

My aunt had dental insurance but refused some needed dental work because of the expence. Her teeth got so bad she couldn't chew and had to be on a soft diet. She lived to 92