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Old 07-08-2014, 03:12 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,997,381 times
Reputation: 6724

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Quote:
Originally Posted by brightdoglover View Post
I just talked to my last real relative, my 89-year-old aunt, who is in fragile but reasonable health in her own home. She says she regrets having chosen not to be part of the Soc. Sec. system when working for the state. Now, recently widowed, she is appreciating the loss of that income, being retired now for 30 years. She had an option apparently while working to turn over about $7k in past deductions and then be part of Soc. Security, and she declined. She also gave me a lot of support for the working I'm doing now with the idea that, in later years, I might wish I had worked more when it was available. (I am three years and nine months away from my pension, and every shift that I work increases that pension. I am hardly overworking for a normal adult- up to 40 hours a week, sometimes 48) but it is wearing me down with the shift work. I must remember that now is the time to do it, not later to regret not doing it).
Oh, and she's Christian and had colon cancer 20 years ago. I guess she's a mixture of my genetics.

When I visit in the fall, I'm taking her to look at some assisted livings/independent senior livings. It's very frustrating that she wants to hang onto her savings for her two sons rather than dip into them for housing that I think would suit her very well. Her one son will buy used BMWs, and the other will buy guitars.
That's a big area in terms of both bad (and good) decisions. Financial decisions. And there are literally dozens/hundreds of them (although all of us don't face all of them). My husband and I both took early SS. Because the break even point at the time between taking it early (at 62) and at normal age (age 66) was age 78+. We thought the odds weren't better than 50/50 that we'd live to 78+. Guess only time will tell.

As for your aunt at age 89 - I think the main question isn't whether she can live independently in her own house now - but whether she's enjoying herself doing it. We tend to live "closer to home" as we age - and - depending on our communities and our personalities - people can start to feel isolated. My remaining aunt on my father's side - always my favorite (now 94) resisted moving into an independent senior living place until she was about 91 because she didn't want to accept financial help from her 2 children (both doctors who were more than willing to help her). After she moved in - she said she wished she had done it when she was 85 . She loves being around people her age again (even though she lived in NYC - she was pretty isolated - because her neighbors weren't at all like her at a certain point). And to you for taking your aunt around to look at places (judging from your tone - reckon her sons aren't interested in doing it). Robyn
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Old 07-08-2014, 03:52 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,997,381 times
Reputation: 6724
Quote:
Originally Posted by anifani821 View Post
Latest info, already suspected by many clinicians:

Study shows annual mammograms don't save lives - CBS News

Largest Study on Mammograms Again Finds No Benefit

http://www.nytimes.com/2009/11/17/he...ncer.html?_r=0

Ultrasound Helps Breast Cancer Detection

Seattle Cancer Care Alliance | Ultrasound Is Better Detecting Cancer in Women Under 40

Study: Adding MRIs and Ultrasounds to Mammograms May Catch More Cancers | TIME.com

It has long been known that about 40% of mammograms end up producing false positives.

Also, in re: to Medicare coverage of diagnostics in general, again, folks are NOT advocating for their health if they rely on what Medicare will and will not cover. Sometimes, paying out of pocket to get the diagnostic test needed, in a timely manner, would be the better course, even if that means creating a financial hardship. Now, that is my opinion and it is based on 25 years of research, as a writer, on the subject.
Based only on my experience - and I'm only one person - I don't doubt some of this. But question whether that "some" is relevant/important. I had my first mammogram in my 30's after I had a total hysterectomy and went on HRT. And still get them annually since I'm still on HRT (and yes - I know that's controversial as well ). And - after my first mammogram - there were of course things that looked odd (we all have unique breasts ) - so I wound up having an unnecessary biopsy. After I had that first test/biopsy - everything kept looking the same. So I never had to have another biopsy.

Note that this was in 1985. Today - before doing a biopsy - a doctor might well order an MRI/ultrasound before doing a biopsy when a mammogram looks "fishy". That's actually the way the place I get my care now (Mayo JAX) works. If the mammogram comes back irregular - they'll do an MRI (or perhaps ultrasound) ASAP. Before even considering an invasive procedure like a biopsy.

I would like to see a study about how many unnecessary (in retrospect) biopsies are done after first mammograms.

In terms of myself - since I have no - absolutely zero - history of breast cancer anywhere in my family - I think I'm at pretty low risk - even with HRT. Still - mammograms are innocuous. So I'll keep getting them. At my age - after almost 30 mammograms - if there's a change - it would probably be significant.*

I agree with you 100% about diagnostic tests. Because I'm not a health care professional - and because I trust my internal medicine primary care doc at Mayo 100% - I don't prescribe things for myself. But I do get every test she recommends for me - even if she's hunting for possible "zebras" - and even if I have to sign a "Medicare may not pay for this waiver" before the test. FWIW - most of my out-of-pocket costs if Medicare didn't pay for these infrequent somewhat unusual tests would be on the order of < $25 (I don't know whether Medicare requires that the exact cost be on the waiver form - but Mayo has it on the waiver form). Peanuts. Robyn

*Caveat - I've lost about 15 pounds in the last 18 months. And my mammograms changed - a lot. Because - when you lose weight - you lose some of it in your breasts. My last mammogram didn't "line up" with the previous one because of this. So I had to get a few more pictures than normal. If you have lost/gained more than a couple of pounds - mention this to a mammograhy tech.

Last edited by Robyn55; 07-08-2014 at 04:04 PM..
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Old 07-09-2014, 04:39 AM
 
Location: State of Being
35,885 posts, read 67,320,855 times
Reputation: 22403
Quote:
Originally Posted by Robyn55 View Post
Based only on my experience - and I'm only one person - I don't doubt some of this. But question whether that "some" is relevant/important. I had my first mammogram in my 30's after I had a total hysterectomy and went on HRT. And still get them annually since I'm still on HRT (and yes - I know that's controversial as well ). And - after my first mammogram - there were of course things that looked odd (we all have unique breasts ) - so I wound up having an unnecessary biopsy. After I had that first test/biopsy - everything kept looking the same. So I never had to have another biopsy.

Note that this was in 1985. Today - before doing a biopsy - a doctor might well order an MRI/ultrasound before doing a biopsy when a mammogram looks "fishy". That's actually the way the place I get my care now (Mayo JAX) works. If the mammogram comes back irregular - they'll do an MRI (or perhaps ultrasound) ASAP. Before even considering an invasive procedure like a biopsy.

I would like to see a study about how many unnecessary (in retrospect) biopsies are done after first mammograms.

In terms of myself - since I have no - absolutely zero - history of breast cancer anywhere in my family - I think I'm at pretty low risk - even with HRT. Still - mammograms are innocuous. So I'll keep getting them. At my age - after almost 30 mammograms - if there's a change - it would probably be significant.*

I agree with you 100% about diagnostic tests. Because I'm not a health care professional - and because I trust my internal medicine primary care doc at Mayo 100% - I don't prescribe things for myself. But I do get every test she recommends for me - even if she's hunting for possible "zebras" - and even if I have to sign a "Medicare may not pay for this waiver" before the test. FWIW - most of my out-of-pocket costs if Medicare didn't pay for these infrequent somewhat unusual tests would be on the order of < $25 (I don't know whether Medicare requires that the exact cost be on the waiver form - but Mayo has it on the waiver form). Peanuts. Robyn

*Caveat - I've lost about 15 pounds in the last 18 months. And my mammograms changed - a lot. Because - when you lose weight - you lose some of it in your breasts. My last mammogram didn't "line up" with the previous one because of this. So I had to get a few more pictures than normal. If you have lost/gained more than a couple of pounds - mention this to a mammograhy tech.
Just some observations that I think are important for anyone who is reading the thread and trying to make up his/her mind about a particular diagnostic test or alternative treatment.

1. There are "zebras" out there and docs look for "horses." (For those of you who don't know this old medical school aphorism . . . "When you hear the sound of approaching hooves, assume it is a horse, not a zebra.") However, many of us are, indeed, the zebra and that is why forming a solid relationship with a good physician means so much, longterm, with our healthcare. A good doc who knows the anomalies we have presented in the past will take the time to think things through - and not simply assume we are part of the regular herd of horses . . . zebras are out there!!!!

2. Weight loss can change the composition of breast tissue, as can weight gain. Good idea to at least get a baseline mammo after significant weight loss.

3. I don't "prescribe things for myself" but I am always interested in finding out what is available other than standard treatments. If I need to run that by my doc, I will. Or, I may take my chances after consulting with someone who deals with alternative treatments. For example . . . I can't take Celebrex, as it causes gastric bleeding and no way I want to revisit that situation. But - I can use Turmeric, with even better results. So I will do my research on my own behalf (and that of my family). Some things are not feasible; some are not helpful for everyone . . . but things such as changes in diet or adding an herb . . . Yes, I will cautiously experiment.
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Old 07-09-2014, 07:06 AM
 
Location: in the miseries
3,302 posts, read 3,595,374 times
Reputation: 3810
Quote:
Originally Posted by brightdoglover View Post
I just talked to my last real relative, my 89-year-old aunt, who is in fragile but reasonable health in her own home. She says she regrets having chosen not to be part of the Soc. Sec. system when working for the state. Now, recently widowed, she is appreciating the loss of that income, being retired now for 30 years. She had an option apparently while working to turn over about $7k in past deductions and then be part of Soc. Security, and she declined. She also gave me a lot of support for the working I'm doing now with the idea that, in later years, I might wish I had worked more when it was available. (I am three years and nine months away from my pension, and every shift that I work increases that pension. I am hardly overworking for a normal adult- up to 40 hours a week, sometimes 48) but it is wearing me down with the shift work. I must remember that now is the time to do it, not later to regret not doing it).
Oh, and she's Christian and had colon cancer 20 years ago. I guess she's a mixture of my genetics.

When I visit in the fall, I'm taking her to look at some assisted livings/independent senior livings. It's very frustrating that she wants to hang onto her savings for her two sons rather than dip into them for housing that I think would suit her very well. Her one son will buy used BMWs, and the other will buy guitars.
Can you talk to her about spending her money on housing?
Her savings may be used for nah care and that would be a bad decision if she shrimps on assisted living.
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Old 07-09-2014, 07:08 AM
 
Location: in the miseries
3,302 posts, read 3,595,374 times
Reputation: 3810
Quote:
Originally Posted by anifani821 View Post
Latest info, already suspected by many clinicians:

Study shows annual mammograms don't save lives - CBS News

Largest Study on Mammograms Again Finds No Benefit

http://www.nytimes.com/2009/11/17/he...ncer.html?_r=0

Ultrasound Helps Breast Cancer Detection

Seattle Cancer Care Alliance | Ultrasound Is Better Detecting Cancer in Women Under 40

Study: Adding MRIs and Ultrasounds to Mammograms May Catch More Cancers | TIME.com

It has long been known that about 40% of mammograms end up producing false positives.

Also, in re: to Medicare coverage of diagnostics in general, again, folks are NOT advocating for their health if they rely on what Medicare will and will not cover. Sometimes, paying out of pocket to get the diagnostic test needed, in a timely manner, would be the better course, even if that means creating a financial hardship. Now, that is my opinion and it is based on 25 years of research, as a writer, on the subject.
You can negotiate on procedures if self paying. Doctors might even let you pay on time.
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