New doctor recommendations

[determined2bhealthy]

I haven't had an established relationship with a primary care doctor ever in my entire life. Being in my 50s, I decided it was a good idea to establish one. I just saw him for the first time, and he is recommending: flu vaccine, shingles vaccine, Hep C test, colonoscopy, and a mammogram. I didn't say a word to him about any of my reservations about any of it. I also didn't say yes to any of it. I feel a bit odd now, since I don't necessarily plan to follow up on any of his suggestions. I really just want a complete blood workup done, to establish a baseline for myself. I am not sure why it matters for me to have this relationship with him, if I am not going to be honest about my position on these things. I guess I am having mixed feelings. As I was sitting there in his office, I felt overwhelmed with the idea of sharing *any* of my thoughts with him.

The truth is, I don't want a colonoscopy or a mammogram, or a bunch of vaccines. At the same time, I was really sick this past year. I had a terrible, scary bout of the flu last January, and this June I got shingles. Obviously, getting a handle on this woe is crucial, but I feel more scared in general about getting sick than I ever have.

Sorry if this doesn't make sense. I'll appreciate any feedback on any part of this. Thanks.

[Grammy Ginger]

I didn't always follow the advice of my children's pediatrician. I rarely have seen a doctor myself during adulthood except for baby doc and even then they were usually midwives. I learned to keep my different views to myself, because they threaten the average MD. You don't have to do everything they recommend. It's ok. Doctors aren't perfect. Medicine is only part science. That's why they call it practicing medicine. I go for the less is more approach. Get your blood tests if that's what you want. Stay away from anything else that makes you uncomfortable. If the doc won't go for it, get a new doc. Trust your instincts.

[Lyndzie]

I haven’t had a primary care doc for years. I see a midwife for reproductive health, and visit urgent care when I have the occasional need for a doctor. So far that has taken care of my needs. I don’t get the flu shot, but if you wanted one, every pharmacy seems to provide them anymore. Not sure about shingles, though. I’m with you on the mammograms and colonoscopy. There are other less invasive tests that can be done if there is a concern.

[PJK]

Check out Dr McDougall short video on immunization...he generally recommends:

https://www.drmcdougall.com/health/educ ... nizations/

[John_B]

The UK NHS invite women over 50 for a mammogram without expressly recommending it, setting out the balance of risk and benefit (https://www.nhs.uk/conditions/breast-ca ... s-offered/) which is pretty blanaced according to the Chochrane review (https://www.cochrane.org/CD001877/BREAS ... ammography). Shingles rarely strikes twice so the vaccine seems a bit marginal, as does colorectal screening (https://www.ncbi.nlm.nih.gov/pubmed/27133893). Flu vaccines in healthy adults? Cochrane finds minor reduction in flu, and relatively minor side-effects (https://www.cochrane.org/CD001269/ARI_v ... thy-adults).

Dr McDougall is far more forthright in recommending us to steer clear of avoidable treatment than I can be without medical qualificaitons. He recommends some vaccines (not for flu) and does not recommend colonoscopy or (as I recall) breast cancer screening.

When I saw a cardiologist who mentioned possible treatment, I did not want to seem rude so I asked him, rather than trying to tell him, whether the evidence pointed to better outcomes in case of intervention. He said, 'it is a good question; it depends.' So if I were offered colorectal screening I would probably ask the doctor about its benefits for all cause mortality (answer: probably none), as well as for reducing cancer risk, and listen carefully to whether the doctor presented familiarity with the evidence and compelling arguments, or evasion.

Personally I would also not want the blood tests. If they find high blood pressure, or high cholesterol, or sugars, they might prescribe medication whose benefits are unclear at best. Famously, in the Helsinki Businessmens Study, the group who saw doctors (who did recommend healthy diet) had lower cardio-vascular disease but higher death rate than the untreated group. So you can take your pick of which risk you prefer to reduce: cardio-vascular disease or death. The following brief journalistic summary repays reading: https://www.sciencedaily.com/releases/2 ... 085917.htm. Its conclusion is much the same as the reply of the cardiologist (mentioned above): intervention might make sense for high-risk cases.

[determined2bhealthy]

Thank you all very much for your responses.

I appreciate the links and reminders from you and from Dr. McDougall!

I don't know *what* happens to me when I find myself in the medical environment. It's so odd. It is like being in an alternate universe and I lose my bearings temporarily...

I had to get a physical for an upcoming cataract surgery, and it was quite cursory really. However, when I was there, I found myself succumbing to the fear of contracting this or that illness! Suddenly, I felt like I needed to KNOW what my blood work says--even though what I KNOW is that I don't want to become a patient any sooner than I have to and that said blood work could easily lead me right to that status, like a horse to water. Suddenly, tests reveal X or Y condition and, before you know it, I'm on meds.

No no no. That is not the life I want. And I've been hanging around the plant-based community long enough to know this. I think other things in life are making me feel vulnerable and unsteady--like watching literally almost everyone else I know--either professionally or personally--become fat and sick from the standard American diet. It is so scary and sad.

Again, thank you kind people. I'm going to cancel my appointment, methinks.