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View Poll Results: [See scenario below] I'd prefer if my doctor...
said nothing to me about the finding of cataracts. 3 2.80%
told me about them, and educated me on the likely course and future options 102 95.33%
told me and advised surgery at my soonest convenience 2 1.87%
none of the above (please explain in a post) 0 0%
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Old 07-15-2009, 02:25 PM   #41
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Let's say it were something serious -- say a genetic test that shows that in 10 years I'm going to get a serious debilitating disease which will cause a lingering death with a lot of pain. It would be nice to be ignorant of that for a few years at least, but I'd sure want to know so that I could up my withdrawal rate in that situation.
We're all so different. If I knew I had only 10 years (even moreso if I were younger), I might well forego some delayed gratification such as retirement saving, full- v part-time work, insurance, living near kids - whatever, in order to optimize the things I cherish in those last 10 years. Personally, in most scenarios I can envision, I'd rather know.

Genetic counselling is a little different, but that's for another thread.
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Old 07-15-2009, 02:30 PM   #42
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Genetic testing for a disease that you can do nothing about? I wouldn't do the test. What's the point.

I recently heard part of a public radio program. A guy was talking about what to tell and not Alzheimer patients. Not about their illness, but about other things. For example, do you tell he person that their spouse died when they are not going to remember it 15 minutes later? The guy gave a sensible answer. You tell them once. They have the opportunity to grieve. But if they ask about their spouse later, you don't tell them again, you lie if necessary. Why have them live the death over and over?

If I had Alzheimer disease, I would want to know that I was getting the disease. But after things got bad I would want people to lie to me. If I think I am a happy foreman in a factory (as a friend's father thought), don't tell me I am in a nursing home. Play along a little.
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Old 07-15-2009, 02:43 PM   #43
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I recently heard part of a public radio program. A guy was talking about what to tell and not Alzheimer patients. Not about their illness, but about other things. For example, do you tell he person that their spouse died when they are not going to remember it 15 minutes later? The guy gave a sensible answer. You tell them once. They have the opportunity to grieve. But if they ask about their spouse later, you don't tell them again, you lie if necessary. Why have them live the death over and over?

If I had Alzheimer disease, I would want to know that I was getting the disease. But after things got bad I would want people to lie to me. If I think I am a happy foreman in a factory (as a friend's father thought), don't tell me I am in a nursing home. Play along a little.
I couldn't agree more.

When DH's father was in the last stage of Alzheimer's, he would ask for his mom and dad. My MIL would tell him they were dead. This would make him grieve just as much as he did when they died. It was new...and a shock to him. She didn't do this on purpose to hurt him...she thought she was doing the right thing.

I told her we should think about the fact that he is ill and perhaps we should not tell him negative things. So, when he asked for them again...and again...we would tell him they had already gone to bed, and we would see them soon...then he would be content.
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Old 07-15-2009, 06:20 PM   #44
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Genetic testing for a disease that you can do nothing about? I wouldn't do the test. What's the point.
You might not be able to do anything about the disease, but if you know you're going to die young you can adjust your spending accordingly (up your withdrawal rate).
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Old 07-15-2009, 06:47 PM   #45
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You might not be able to do anything about the disease, but if you know you're going to die young you can adjust your spending accordingly (up your withdrawal rate).
And, in the case of Huntington's and other genetic anomalies, decide if you want to risk passing it on to kids.
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Old 07-15-2009, 07:04 PM   #46
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This is a no brainer!
I was told 2 years ago I could be a glaucoma candidate down the road, and my doc is rigorously following up on that with annual tests. He told me if I experienced any vision or physical changes, come see him IMMEDIATELY.
I already know what my treatment options will be.
So far so good...
Yeah, me too on the glaucoma. It was discovered about 20 years ago that one optic nerve is a different size than the other. Doc says not a problem unless the odd one changes size. So far, it never has changed. I go an opthamologist for the checks but it is considered a medical problem and not vision. In addition to the regular type eye exam, he gives me a Humphries(sic) vision field test. Covered by my regular health care plan. He has never told me what the solution is to the problem. IOW, what do you do if you get glaucoma?
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Old 07-15-2009, 09:02 PM   #47
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IOW, what do you do if you get glaucoma?
Meds
surgery sometimes
give up caffeine

ta,
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Old 07-16-2009, 09:29 AM   #48
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This NBC News story was relevant (early testing for Altzheimer's risk -- "Would you want to know?"):

NBC Nightly News with Brian Williams: News and videos from the evening broadcast NBC Nightly News with Brian Williams: News and videos from the evening broadcast- msnbc.com
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Regular medical check-ups.
Old 07-16-2009, 11:12 AM   #49
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Regular medical check-ups.

Why do I have the impression that the majority of you guys go and get regular/routine medical check-ups? Not me. I only go when something PERSISTENTLY really is bothering me. And even so....
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Old 07-16-2009, 11:29 AM   #50
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Why do I have the impression that the majority of you guys go and get regular/routine medical check-ups? Not me. I only go when something PERSISTENTLY really is bothering me. And even so....
It's easier to take care of a problem that is just beginning than to endure the pain and procedures when the problem has elevated.
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Old 07-16-2009, 09:39 PM   #51
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As for Alzheimer's, why not read Thomas Debaggio? He wrote two books when he was diagnosed with early-stage Alzheimer's at the age of 57. I think he would've wanted to know as soon as a genetic test could have told him.

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By the way, what was that about inhaled steroids causing cataracts? I've used fluticasone about 6 months out of every 12 since 1994 - helps me cope with seasonal allergies. Nobody said anything about causing cataracts! I think I would have noticed something like that if it was mentioned in the package insert.
Same situation here with Flonase, so I went looking.

From this research paper:
Quote:
An excess risk with nasal corticosteroids was not apparent for severe cataracts.
It is concluded that, among the elderly, even low doses of inhaled corticosteroids are associated with a small but significant excess risk of cataracts requiring extraction. Such an excess risk was not observed with nasal corticosteroids.
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Old 07-17-2009, 08:25 PM   #52
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Very few elements of the routine physical have proven value for patient outcomes. It is an American (perhaps North American) ritual. For example, of the usual items which have some value, one might include blood pressure, cholesterol every 5 years or so, some type of colon cancer screen (like colonoscopy every 10 years, maybe). Even checking blood sugar in this setting is lacking in evidence. Immunizations are generally good.

Note that this refers to folks who are healthy with no symptoms or signs of the target disease. Yet, I there might be value in repetitive lifestyle counselling, establishing a good relationship with your provider for future illness management, and just the feel-good effects of a so-called "clean bill." In this case, more is not always better and the $3000 "executive physical" filled with unnecessary tests does more harm than good, IMHO, with all kinds of false alarms, wild goose chases, and distress for no reason. Many don't like to hear that.
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Old 07-18-2009, 09:59 AM   #53
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That's very useful information, Rich, thanks.

Quote:
I only go when something PERSISTENTLY really is bothering me.
I'm in this camp too, because I'm a recovering hypochondriac. I used to go to the doctor for every little thing. I went because my neck clicked when I turned it. I went when couldn't line up my fingers after a long bike tour.

Now, something has to be "pain" rather than "discomfort," and it has to last a bit.

I'm not like Lance Armstrong, however, who didn't see a doctor until his testicle was the size of a grapefruit. [I know what you're going to say, REWahoo: "Isn't everybody's?"].
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Old 07-18-2009, 10:55 AM   #54
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Thanks Rich, good to know your views on annual physicals particularly since I have my "Executive Physical" coming up next week. I don't know how much it costs the company but I hate spending their money so usually only go every 18 - 24 months. The tests don't seem excessive and apart from blood and urine include hearing, vision, and lung capacity (spirometer). It always includes either a stress test or at rest ekg plus colonoscopy every 10 years once you hit 40. (The lung capacity is important as it is a chemical facility and for folks who actually work in the unit and/or labs they get one every 3 to 6 months).

In 20 years of doing this I only had the "feel good" factor of knowing I was in good health, although last year when I had my second colonoscopy they did remove a benign polyp.

This last few months I have noticed my bp is consistently high for me and I have been checking it myself at work on a machine. Yesterday it was 135/85 so I am interested in what it will be when taken professionally by a nurse.
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Old 07-18-2009, 01:24 PM   #55
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This last few months I have noticed my bp is consistently high for me and I have been checking it myself at work on a machine. Yesterday it was 135/85 so I am interested in what it will be when taken professionally by a nurse.
That'a a borderline number. One BP check is not as valuable as your observation of an upward trend. Ask if you can have a 24 hour blood pressure monitoring test. Meanwhile, think about things you can do to decrease your BP. If you are a business executive no doubt you eat out a lot. Restaurant and airline food is notoriously salty. Try to eat at home when you can, avoid processed food and sauces, and don't add salt to your food. When eating out, choose low salt options whenever possible.

I've been there and done that, and it works. I have my own BP meter and I bring the printout to my doctor.

Here is a report on the perils of excessive salt consumption:

Under pressure - The Globe and Mail
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Old 07-18-2009, 01:44 PM   #56
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That's very useful information, Rich, thanks.



I'm in this camp too, because I'm a recovering hypochondriac. I used to go to the doctor for every little thing. I went because my neck clicked when I turned it. I went when couldn't line up my fingers after a long bike tour.

Now, something has to be "pain" rather than "discomfort," and it has to last a bit.

I'm not like Lance Armstrong, however, who didn't see a doctor until his testicle was the size of a grapefruit. [I know what you're going to say, REWahoo: "Isn't everybody's?"].
I have to be careful not to complain in front of my wife. itīs not the first time she frogmarches me to the proper specialist. Like now, she has forced me into seeing the urologist.....
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Old 07-18-2009, 02:08 PM   #57
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That'a a borderline number. One BP check is not as valuable as your observation of an upward trend. Ask if you can have a 24 hour blood pressure monitoring test. Meanwhile, think about things you can do to decrease your BP. If you are a business executive no doubt you eat out a lot. Restaurant and airline food is notoriously salty. Try to eat at home when you can, avoid processed food and sauces, and don't add salt to your food. When eating out, choose low salt options whenever possible.

I've been there and done that, and it works. I have my own BP meter and I bring the printout to my doctor.

Here is a report on the perils of excessive salt consumption:

Under pressure - The Globe and Mail
Thanks for the info and link to the article. From the article:
Quote:
Recommended daily intake (amount of sodium adequate to good health), by age group:
Ages 1-3: 1,000 milligrams (less than half a teaspoon of salt)
Ages 4-8: 1,200 mg
Ages 9-50: 1,500 mg
Ages 51-70: 1,300 mg
Over age 70: 1,200 mg
We don't add salt to anything but, as you say, you don't really know what you are consuming unless you start taking notes. We eat a lot of salads and I just looked at the salad dressings in our fridge and they do vary a lot, plus it is deceptive since the daily recommended intake appears to be 2,500mg, well above the table from the article. I have no idea what the salt levels are in the salad dressings at work in the cafe.

I appreciate your advice and will immediately start tracking the amount of salt I consume to see how much I am actually consuming and then try and keep below 1,300mg/day. At work I will stop adding dressing, and these days travel has been banned so I rarely eat out on business (maybe the recession will provide some benefit after all )

I'll talk to the doc next week and see what he recommends. All other factors are good except for the glass of wine/day which I will hate to give up. I regularly exercise and am not overweight. Even after walking to the building to use the BP machine my heart rate was only 47 bpm (since I upp'ed my aerobic exercise dramatically a few years ago I saw my resting heart rate drop down into the 40's).

I've also considered getting my own BP meter - any recommendations?
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Old 07-18-2009, 02:12 PM   #58
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I have to be careful not to complain in front of my wife. itīs not the first time she frogmarches me to the proper specialist. Like now, she has forced me into seeing the urologist.....
That's exactly what my wife did to me 3 months ago. Now I am on Flomax for BPH, and when I had my BP checked it was borderline high so now I'm worried about that as well (see my post above)
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Old 07-18-2009, 02:20 PM   #59
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I've also considered getting my own BP meter - any recommendations?
You're welcome. The available meters probably differ between countries. I was advised not to buy a wrist one as they are less accurate, and to ensure that I chose one with the Canadian Standards Association stamp of approval. I like to record data, so I chose one with a data download function and software for my computer. I asked my doctor for a prescription so my supplementary insurance plan covered it.
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Old 07-18-2009, 02:34 PM   #60
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You're welcome. The available meters probably differ between countries. I was advised not to buy a wrist one as they are less accurate, and to ensure that I chose one with the Canadian Standards Association stamp of approval. I like to record data, so I chose one with a data download function and software for my computer. I asked my doctor for a prescription so my supplementary insurance plan covered it.
I wondered about that - I went to the dentist for a check-up a few weeks back and the hygienist took my bp with a wrist one - it was the only normal reading I've had since I've been checking it with the machine at work (where you put your arm in the cuff).
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