Dear Christine, Shocked in Saugatuck

  • Posted on August 21, 2017 at 8:38 am

Dear Christine,

I’ve been living with my wife for 20 years and I just discovered something. She just confessed that she hasn’t seen a doctor for a physical for over 10 years! This scares me! I love her and understand from family experience that prevention saves lives. Now she is afraid to go. How can I convince her?

Shocked in Saugatuck

Dear Shocked,

We think we know each other and all our secrets in marriage! But the truth is, there is so much we don’t know about each other! Interesting read about this here: https://www.nytimes.com/2017/08/18/style/modern-love-married-to-a-mystery-man.html? mwrsm=Facebook. I’m glad you and your wife had this discussion. Going for many years without any health care happens to a great number of people, and in my experience, more often with men than women. Most people have stable health and don’t really see the need to go to a doctor for an annual physical when they aren’t having any health concerns. And if you are lucky, you can go 10 years without needing any medical care. However, life is a pre-existing condition, and eventually, we all have something go awry, the flu, a sprained ankle, a car accident, a bursting appendix, a blocked colon, shingles… whatever. This is why so many Americans have taken to the streets, town halls and writing letters to their Congress people, to protect the benefits of Obamacare, particularly for those with low income or multiple health concerns. And, so far, Obamacare remains the law of the land. Encourage your wife to consider going to your doctor, assuming you like and trust yours. Or encourage her to make an appointment with a couple of different doctors and interview them about how they provide care. Do they listen? Do they follow up with tests or referrals if something doesn’t seem right? Will they explain what is going on in terms you can understand? You will feel it when you meet the right doctor for you: you will feel more comfortable and have that sense of being understood. Getting a physical is the opportunity for a primary care doctor to get to know you and what is normal for your body and health. Blood tests will show your risk of having anything from diabetes to cancer, to iron deficiencies. Having a baseline in blood tests gives the doctor the way to see when your health changes. No one is completely normal! For example, my body temperature normally is at least a half of a degree, maybe even a full degree lower than the 98.7 F. So, if I take my temperature and it’s 99.7 or 100, that might not seem like much of a fever to someone else, but it means I am fighting off some infection and need to really take care of myself. If it’s up to 102 F, it’s time to go to the doctor’s office or even the ER. A lot of people wear FitBits or other health gathering units on their watch or phone. You can learn a lot about your own health from this: your normal pulse, your sleep patterns, when you are getting enough physical exercise and when you need to step it up. All of this information is not yet available to our doctors, but that time will be coming. Meanwhile, the more you know about your own health and functioning, the quicker you can notice a problem and takes steps to reduce risks and increase your immune response. Being a woman, we get bodies that have reproductive organs that always seem to need to be checked: cramps and PMDD, fertility issues, pregnancy, birth and postpartum issues, and breast feeding. Even if you never choose to have a pregnancy, those organs still need to be checked to make sure you don’t get cancer. I have had a baseline of a mammogram when I was 50, but I particularly disliked the experience, so for the past 20 years, I get a thermascan of my breasts to check for any changes or possible cancer developing. Thermascans pick up the heat radiated from the body, showing where the “hot spots” are. Tumor development always starts with angiogenesis, meaning the tumor creates its own blood vessels

Tumor development always starts with angiogenesis, meaning the tumor creates it’s own blood vessels to feed its growth. On a thermascan, where there is nothing touching you, just a camera reading the temperature off of whatever is in focus, those tumors look like a city lit up at night as you fly over in an airplane. And thermascans can turn up tumors before a mammogram will, giving you the opportunity to intervene before cancer is diagnosable.

This weekend, I read an article from Dr. Atul Gawande in the New Yorker from January 23, 2017 about how very important primary care is in longevity and health. He writes about how he was drawn to the heroics of surgery, where the doctor gets to be the hero who saves a life with a few trained slices and clamps. This article is his reeducation about how primary care, though much less exciting, actually saves more lives and extends patients’ lives more than 10 years. Patients who go to a general doctor may not get any dramatic medication or tests, but a relationship is developed that allows the doctor to understand what makes you tick and what helps you get better. People who have a primary care physician are more likely to get something checked out early, rather than waiting until it’s clear there’s a grapefruit-sized tumor. Check out the article, as I found it illuminating. Our government needs to increase investment in this incremental care to get the most for its dollars, is what I took away from it.

http://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care
So, your wife may well be extremely healthy and lucked out these past 10 years, but aging is occurring and as human growth hormones and estrogen and testosterone wane, joints get stiffer, hair turns white, skin sags and memory moves a bit slower. And other problems with heart, brain, kidney, liver, and all the rest of us sometimes start acting up. Going to a doctor doesn’t mean that your wife has to start taking all kinds of pills, but it might mean that the someone she really trusts is there when one of those inevitable problems of aging hit. Encourage her to be proactive. Explore what her fears and assumptions are. Offer her unbiased, scientific information. Make the appointment for her and go with her. Hold her hand through the whole process if that’s what she needs. It’s always wise to have someone there with you when the doctor explains something, just to make sure you heard everything and correctly.

Good luck and may both of you have continued good health.

Christine Cantrell, PhD.

Psychologist

Christine C. Cantrell, PhD
1026 W. 11 Mile Rd,
Suite C
Royal Oak, MI 48067
248-591-2888

Click here to email Christine.

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