Friday, October 20, 2006
Not dead yet
…HA has a friend whose 90-year-old father had a hernia. The doctor blew it off, saying, “Why don’t we let God take care of it?”
…What the heck does that mean? When he dies it won't be a problem?
…The man had surgery and is fine now.
…There was also a story this weekend about how elderly women are often undertreated for breast cancer.
…HA always asks doctors if they treat a lot of elderly people before she commits to them for her mother.
…Writing in the New York Times (Oct 18, 2006), Jane Gross cites a case in which a 97-year-old was about to get some surgery, when a geriatrician noted that older people often don’t high fevers with infections and she might just have an infection. She did.
…Geriatricians are in short supply. They are paid poorly and don’t glom onto the glory in medicine (cardiology, oncology).
…Of 145 med schools in the US, only 9 have geriatrics depts.
…Geriatricians have to manage multiple ailments and multiple drugs in the same patient. Their dementia, so-called, can actually be treatable depression. This is not an easy specialty, yet one such said a pulmonologist he knew used to shake his head when passing him in the hall and say, “What a waste of a mind.”
…The appeal of the job is based on reimbursement in some cases. Gastroenterology became more appealing when Medicare began paying for colonoscopies. One geriatrician joked that they need a geriscope.
…In a lot of cases, the geriatrician‘s job is to not stress delicate systems with unnecessary, just-in-case testing.
…Some geriatricians think the best way to deal with the coming bulge of old people in the health system is to teach core principles to all doctors, because there may not be enough geriatricians to go around.
…HA’s mother was hospitalized once and the nurse apparently did not understand dementia and trussed her up in restraints like a Christmas goose.
…Uh, her catheter was in wrong and it hurt.
...What's more, she probably didn't need one in the first place.