Are You Ageist?
Medical Indignities

Do As I Say, Not As I Do

category_bug_journal2.gif “Have they grown?” he asked for the thousandth time? That was my former husband speaking (about 40 years ago) in reference to several small, soft protrusions on his lower back.

That they had been diagnosed as harmless sebaceous cysts that, depending on whether they got in his way could be removed or not, made no difference in his hypochondria which included uncounted numbers of other imaginary health worries he plagued me with during six years of marriage. Hardly a day went by without several such questions.

I deal differently with bodily occurrences that might be health alerts; I ignore them. Or, rather, I note them and wait to see if they get worse. The few that do, in my case, almost always involve teeth which - I have learned the hard way - share a property with water leaks: they never improve on their own.

Aside from dental problems, I have lived 66 remarkably healthy years for which I am grateful. I hardly ever see a doctor which, when I think about it at all, I attribute to my impatience with physicians’ poking and prodding, medical tests of all varieties and my belief that bodies ought to just chug along supporting our psyches and selves until it is time to die.

You and I both know this is stupid. In my lifetime there have been astounding medical advances many of which involve sophisticated tests that can detect health problems early when they can be successfully treated.

Nevertheless, when a physician suggests these tests, I resist those that involve anything more complicated than blood letting or peeing in a cup. So I am surprised that somehow my new doctor here in Portland, Maine, convinced me to have my first-ever colonoscopy which I am undergoing today as some of you read this.

In the weeks since this exam - so invasive that it requires anesthesia - was scheduled, I have thought more about my health than during any comparable period in my life. I have

  1. examined my stupidity (without vowing to change)
  2. made several mental tours of my body to see if I detect anything out of the ordinary (no)
  3. wondered how my life will change if the results of this colonoscopy are anything other than positive (I don’t want to know)

That third item, I have decided, is what accounts for the first.

In past discussions of late life fears on this blog, an overwhelming majority don’t want to become burdens to their children or other loved ones. I share that and we do what we can in advance to avoid it.

But statistics show that 80 percent of elders live independently until they die, and the larger fear for me is becoming a professional patient, of remaining independent and capable of caring for myself while having to manage one or more diseases or conditions that involve continuing tests, treatment, multiple medications and all that poking and prodding doctors do that I dislike so much.

This is not a crippling fear and it rarely surfaces until, like today, I subject myself to something that could increase the amount of time I spend in a physician’s office, hospital or laboratory. I prefer to stick my head in the sand and avoid both doctors and tests as much as I can reasonably do without being more than about 75 percent stupid.

In my consideration, these past weeks, of this stupidity, I have decided that it is just a more subtle form of hypochondria than my former husband’s. Its saving grace is that, today’s post notwithstanding, I don’t inflict it on other people.

When I was a little girl, my father took me out one evening for Chinese dinner. He parked the car across from the restaurant and as he took my hand to cross the street in the middle of the block, he warned, “Don’t do this yourself. Do as I say, not as I do.”

In regard to healthy living, I suggest the same for you.

[At The Elder Storytelling Place today, Ronni Prior relates a personal Alfred Hitchcock moment in a true tale titled The Birds.]


Comments

I share some of your attitudes and there are select medical tests I do decline about which I will not elaborate. But, a colonoscopy is not one of them. I have had two or three and am not due again for a few more years. Polyps were found, clipped during the test while I was unconscious, and I emerged no worse for the wear. They proved to be non-cancerous.

My experience has been that the most unpleasant aspect of a colonoscopy is the preparation at home the night before the test -- drinking that "stuff." Could be worse, though.

My thoughts will be with you, knowing you'll soon be back home with Ollie. You may even be pleasantly surprised at how smooth the whole procedure is. I just sat around and took it easy as instructed once I was home. No problem.

In my case the colonoscopy was not under anaesthesia, just mild sedation and I got to watch! "I've got as far as your appendix" was the rather nonchalant comment from the doctor.

Apart from the generally undignified nature of what is going on, it wasn't too bad, although I second joared's comment about the 'stuff'.

"...my belief that bodies ought to just chug along supporting our psyches and selves until it is time to die.

You and I both know this is stupid."

I don't know that this is stupid. We could probably each think, without even trying hard, of a dozen situations where medical intervention did more harm than good. Recently I wrote about a new trend toward "evidence-based medicine." You read that right. It's a NEW trend. It leads me to wonder what the alternative is. You can read about it at Time or Wikipedia

That "stuff" is really awful. I have not been able to enjoy any lemon-lime type soft drink (7-Up, etc.) since having that procedure. My biggest complaint, however, was about the rules of the clinic where the test was done. When I made the appointment for the test the clerk told me it was required that someone accompany me to the clinic and be available to drive me home. I protested that I had no one to do that (that was true as I have no family in the area at all and I would not ask a friend to take off work). My plan had been to take a taxi to the clinic and back home. The lady said they could not allow that as the taxi driver might "take advantage" of me and the clinic would be liable. I thought that was ridiculous!

Ronnie, may the gods be kind… please let us know how the results turn out.

As far as “80 percent of elders live independently until they die”, does not mean that they are doing this without a great amount of care or assistance from others. In my grandparent generation, it was expected that the children would care for them in their last years. My parents’ generation wished, as you seem to, not to burden their children.

I’ve seen friends suffer greatly trying to respect their parents wishes for independence and, at the same time, insure they are receiving proper care. For, sometimes, “I don’t want to burden my children” is not accompanied with a well-thought-out, financially viable, openly discussed Plan B. Sometimes, “I don’t want to burden my children”, can also be “It’s none of your business” if fuelled by confusion or fear.

Our generation most likely doesn’t have the alternative of burdening our children to care for us. It doesn’t mean they should not be participants in the definition of our Plan B. We must include them and other friends and family members in an open dialog. We shouldn’t stick our heads in the sand on this important matter.

Both my parents had your attitude toward doctors (just say no!) and they lived til 87 and 90. Both died at home. Some of the last bits might have been made more comfortable by more medical attention, maybe. But I'm not sure more interventionist attitudes toward aging bodies would have improved their quality of life.

I'm also not sure of my own attitudes. I seem to admire their avoidance of the medical establishment, but I am also annoyed that my HMO refuses to do a colonoscopy unless there are other indications.

Hope all went well!

My mom had very few of the tests we now consider to be routine and lived to 85 where she died in her own bed, but her sister had colon cancer and had a very unpleasant end. So I do some tests and put of what I can. I had the colonoscopy last year, didn't really go to sleep for it, kind of a relaxed, twilight sleep where I still felt it and heard their talk but was pretty relaxed about it. I think tests like that and mammograms-- whether yearly or not-- are important as they catch things before they cause worse problems. But otherwise, I avoid the doctor's office as much as I can.

I had a colonoscopy without anesthesia about ten years ago and it wasn't fun. I hated drinking the "stuff" and have only had one minor colon exam since. I hope to never have another. Yes, I'm stupid for not doing so because my half-brother is dying from colon cancer that metastasized to his lung and liver. I guess the colonoscopy is the lesser of two evils so maybe I will rethink my reluctance to have another one.

This colonoscopy topic I have come to enjoy... Here's why. Jean, my beloved friend of forty years died a year ago of colon cancer. Witnessing what she went through 18 months, I made a note to have the exam (years past the recommended age!). Because my health care coverage is in Israel, I paid $12.50 for the procedure (including bus fare!). On hearing this, an American friend laughed that this amount was the cost of parking his car during his procedure (which cost more than $1K). After watching what Jean went through to live as long as possible (she left a husband and twin boys, age 13), I drank the fluids in prep for the exam as though they were elixirs. I had watched her drinking all manner of medicines, undergoing chemo — the works. I felt blessed to have an affordable test with great results. The Israeli clinic, too, ranted about my traveling round trip on the bus and unaccompanied. Though a friend insisted on coming w me, I, ever the "independent one w a vengeance," would hear nothing of it. Another topic.

Thanks for the post today, Ronnie. I love this blog.

By the time you see this everything will be over and I cross my fingers they'll find nothing! I had this test done back in May and blogged about it; strangely enough just sharing the fear in black and white helped, as did the email support afterwards. Mine turned out fine. Now I'm sure glad I had it done and can not think about it for about 4 years the doctor said. Hope that's what'll happen for you and I'll be thinking of you and waiting to read that everything's okay.

A few years ago I had a colonoscopy with anesthesia,I didn't feel or hear anything.

When it was all over they stressed fact that I should take it easy when I got home. "Do not drive - do not use the range, you may not be alert.

Well I was perfectly fine, didn't have any after effects.

The worse part of the experience was drinking that "stuff." It's time they found something that does the trick but doesn't taste so bad. They can land a man on the moon, why can't they make that "stuff" taste better?

How did you manage the ride to and from the hospital?

Hope you get a good report.

I hope your report is good, Ronni, and by now, you may also know that the prep is the worst part. I have had 3 or 4 colonoscopies. My best friend died at age 77 because she couldn't "afford" the test (as an uninsured Medicare patient, she couldn't afford it back then). After witnessing what she went through (and I was with her when she died), I vowed to ALWAYS get the test when needed, no matter how much it cost.

Hello Ronni,

I hope the test comes out just fine for you. I expect that it will because I seldom -actually never- have heard of anyone I know having the test and getting dire results. So enjoy the rest of today and know that we are all thinking of you.
You are always so kind in your communications with us. We want you to know we appreciate you and wish you the best.

I have had two of these already. Everyone says "The worst part is the prep"

If ONLY.

The first time I awoke in the middle of the test screaming in amazingly searing pain until I heard the words "give her some more!" sedation, I guess. I was told later I had a "kink" in my intestines and since I am a small person they could not negotiate easily OUCH.

The second time I got through the procedure ok only to begin a bout of vomitting and dry heaving for 12 hours until I nearly passed out.

"Routine" procedures are not always so "routine".

My experiences were uncomfortable but at least I came away with negative biopsies, and, I didn't have to wait to get my test, which is something I still appreciate about our current healthcare system, which admittedly, needs some fixin!

I have a question: if a person has decided they would not go through chemo, why get the test?

I have seen a parent go through cancer without the treatments, and die after 18 months. A friend had cancer with all the treatments, and died after 2 years. She spent much of the last 6 months in the hospital for a bone marrow transplant, and was every bit as miserable as my dad was (if not more.) Her motivation was different because she was 45 and had 2 kids still at home. My dad was 80 and widowed.

I am uninsured and know how expensive the tests are. Every time I get a mammogram, and then have to have a follow up biopsy, and then the bills for $$$$, I wonder what the point is. I have been told that I because I have dense breasts, I will always have this same situation, so I should have it done even more often. But nothing is ever wrong, and I don't think I'd do chemo even if it was.

Do others have this outlook?

An ice cube or cold water in the mouth dulls the taste of that "stuff." As for the test, heck, I would go again just for the drugs. Not only did I not know anything, I was so relaxed after that I got a great night's sleep. Just never let a friend with a wicked sense of humor drive you. She will bid you, "Have fun!" as you are called from the waiting room and the dear little man holding his wife's purse will almost explode holding in the laughter! Hope all is well and results are good.

Colonoscopy is not so bad, really. And, since they found extremely early stage small amount of cancerous cells in the squamous cells they removed when I had surgery to remove the HPV warts they found, it probably saved my life.

I've had one colonoscopy since then along with an endoscopy as part of my "supervision", as they call it, to check for any recurrence. They'll never be enjoyable, but for me, they're necessary.

I am going to chug along until I die. That sounds like a plan, to me.

Ronni, you say "I prefer to stick my head in the sand and avoid both doctors and tests as much as I can reasonably do without being more than about 75 percent stupid."

I've never before read a sentence that so perfectly describes my very own attitude about it!!

I SO appreciate your writing style and talents. Thanks!

It was like drinking salty plastic. (I think it was the unflavored kind.) Jacques was so stoical about it that I got competitive. It helps if you don't breathe while it's in your mouth.

That was 4 or 5 years ago. I had a few wee, benign polyps so I was supposed to do it again in three years. I've already missed that deadline.

Until now, I had my last mammogram in 1993. The reasons for not having another were absurd, having to do with not wanting to take the time to go fetch my old films from the other place for the new place (got married, insurance change). But I did feel my breasts routinely whenever I took a shower. In the last 3 months I've thought I felt something in the left one. It was a "now you feel it, now you don't" kind of thing -- sometimes I thought it was just a variation on a structure I felt in the other breast too, sometimes I thought it was disturbingly more distinct. I took my time trying to decide whether it was worth being worried enough about to go check. I do go to the doctor -- but only when I have to, when something requires attention. An ovarian cyst in 1993 (which I held off checking out until I'd married J for his health insurance, so if I had something horrible it wouldn't be a "preexisting condition" -- but it was nothing). Arthroscopy for torn cartilage in one knee.

OK, so finally this thing really got my attention and I went and got the mammogram. I was dead calm, imagining the change in my life if it had to be biopsied, excised, irradiated. (It was tiny, so I didn't expect it to need chemo, and I didn't think it would kill me; but I couldn't afford even the fatigue of radiation.) They marked the spot where I felt it with a sticker, squeezed hell out of my tit taking close-ups, and followed up with an ultrasound.

They didn't see a thing.

Candace: I also woke up in cramping pain in the middle of my colonoscopy. It felt like really really bad gas pains. The nurse squeezed me around the middle and they put me deeper under.

The last colonoscopy I had didn't involve drinking that disgusting stuff. I took pills and had to wash them down with a prodigious amount of water, but that certainly was better.

I have now had three different protocols for cleansing the colon. Two for colonoscopies, one for a barium enema and soon a different one in preparation for taking out my sigmoid colon. The second prep for a colonoscopy was the least offensive as it only involved a strong laxative and two days of clear liquid diet. For the barium enema procedure I had to take castor oil plus two days of clear liquid diet. I needed the barium procedure because they could not complete the colonoscopy because I had too much scaring and twisting from diverticulitis. I woke up during both colonoscopies and seeing my colon on the screen did not makeup for the waking up.
There are other colon problems besides cancer. In the past six months I have found out how serious diverticulitis can be. I feel like a walking time bomb just waiting for another attack or a blocked colon. The Doctors all tell me the surgery is necessary.

It was not in my plans for retirement to be needing major surgery. I thought I was eating a high fiber diet but it was not high enough to prevent diverticulosis. This issue was not even on my health radar. My previous colonoscopy in 2004 had not shown any problem. So this issue got really bad in only two years or the previous Doctor missed the signs of pending problems.

I hope that I can keep myself in good health after the surgery as I want to live at least as long as my Mother who is still going strong at 91.

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