Written Sunday, October 22, my birthday

I have written before about the scarcity of doctors for older people. 

When we reach our seventies and older, the body begins to break down more and more. Some people can forgo those complaints if they have a great immune system, but as we age our immune systems grow weaker, just as when we were little children. Face it young folks, it happens to us all.

I can tell when my immune system is sick now by how badly my multiple chemical sensitivity is acting up. If I feel good, have no aches or pains, no headache or difficulty breathing when I go to the grocery store, I can shop, go up and down the aisles polluted with scented products on the shelves or by perfume worn by customers, and have no serious repercussions.

But today, my birthday, I had to go to the store. I was out of many things I use every day. Yesterday I was in bed more than I was up. I slept most of the day just as I did when I was a child with the flu, but I did not have the flu. Thankfully, all that sleep was healing and today I feel weak but much better.

My immune system is not acting properly and has not for some time. Diabetes is an autoimmune disease. Fibromyalgia is an autoimmune disorder and so are several other things that plague my life. From conversations I have with older women, I hear they have many of the same aggravating problems I have. Their doctors have no good resources for them. Symptoms are treated as well as the doctor knows how to treat them. 

Where are the geriatric doctors? 

With our population growing older and older, this level of medical doctors is dwindling. Doctors don't want to deal with old people. After all, they are going to die before too long, so no one goes into that field. But with good care, an older person can live in her home possibly until she dies, which is what most of us want. Of course that also depends on the financial situation.

A thirty-five-year old doctor has not a clue what it is like when an older patient says "I am too tired or don't have the energy to take a shower some days."

A young doctor will tell an older patient, "You need to just get out and walk. Start with 20 minutes, then add to it until you walk at least 30 minutes every day. You will feel so much better."

The older patient has trouble with his feet, his hips hurt after only a few minutes on his feet. He gets sharp shooting pains in his feet and his hips feel weak so he is afraid he will fall. His balance is not good anymore so he can't walk on uneven surfaces. But Young Doctor can't imagine being in that shape. He ignores the patient and continues, "Just walk some every day. You'll soon be enjoying it."

Give me a doctor who has watched his parents get old and saw what happened to them. Give me a doctor who has compassion for the older patient and listens, tries to understand what it would be like to have those physical symptoms.

I have seen how doctors treat older people, men and woman. Nurses have much more compassion and understanding. I wonder if we can educate doctors as to what they should look for and how they can help older patients. And would they want to learn and would they do it?

In my experience, doctors seem to think they know it all. But they make mistakes. One doctor told me I had colon cancer and even if a biopsy said differently, he was convinced. My biopsy showed no malignancy.

My husband was told he had osteosarcoma, but he did not. A biopsy showed he had lymphoma. His cancer doctor told him he could live five or more years with this but he lived one year.

A doctor gave my father a drug to calm him down in the hospital and my father went into respiratory arrest and died from that drug.

My brother-in-law was prescribed a medication on the phone by his regular doctor. He died within a day from side effects of that drug. With his medical history, it was obvious he should never have been given that particular medicine.

Recently I talked with people and we discussed how often a doctor even touches a patient today. They often do not, except to feel under the throat. I was told by a Gastroenterologist that they don't need to touch the patient. There are machines that do those tests. 

I still think it is important for a doctor to feel of the abdomen if stomach pain or discomfort is present and use their hands when necessary to look for tumors, swelling, or pain. When you have a physical exam, don't you expect more than some blood tests and a urine sample? I also think an older person should have an annual physical although some group said the annual physical is no longer needed. Really?

We need doctors who treat the whole body, not the part that hurts today, but the entire body because that pain could be coming from somewhere else.

And doctors need more than fifteen minutes with the patient in order to do that.

Elderly patients are often seen by four or more specialists. One treats the thyroid. Another treats the lungs. A cardiologist checks on the heart. A gastro doc prescribes for the stomach and that area.  Another works on the feet and another on the eyes and ears.

Each of them may prescribe a medicine to the patient. How many of those drugs interact with each other and how many more drugs are given for those side affects. 

It is no wonder older people are sick so often. I think the meds make them sicker than they were before going to the doctors. Cutting back on meds is often the patient's call. Doctors hardly remember what they prescribed for you nor why. 

I recently asked that my blood pressure medication be cut back. After some resistance, I was told to halve my once-a-day pill. My blood pressure is still doing well and I was told that new studies show people my age should not have their blood pressure too low. That could lead to falls which would be more life threatening.

No matter what kind of insurance our country finally settles on, I am not sure we will get better care in this country, especially the older population. 

What Your Doctor Won't Tell You About Getting Older by Mark Lachs, M.D.

Originally published as: Treat Me, Not My Age

 This is an eye-opening book. This is called a survival manual for outsmarting the health-care system.

Two things he says that I like:

1. Geriatricians stop more medications than they prescribe.

2.  If you are taking supplements or vitamins, don't be afraid to say. It is important for the doctor to know what you are taking. 

I like his idea, "If you have seen one eighty year old patient, you have seen only one eighty year old patient."

So many tell patients, "Well, you are getting older and that is probably your problem."  I hate that kind of remark. Dr. Lachs does also.

This book gives names of places to go to for more information on alternative treatments and he doesn't frown on using them, although he is a conventional doctor. 

I wish we had more geriatric doctors and that more people would see them instead of feeling ashamed to do so. We are all going to get old, so why not look for the medical care that fits our needs. Find a doctor who understands ageing. And read Dr. Lachs' book.