What If You Don't Agree With the Doctor's Diagnosis or Treatment?

Caregiver, patient expert

I grew up in a generation when doctors were considered one step away from God. My parents weren't as blind to the humanity of doctors as some folks, but still, if the doctor said it, for the most part you did it.

Mom was ahead of her time with supplements and whole grains. About the only thing available for supplements was a little hard bullet you took once a day. Yet, I'm sure it was better than nothing, and we'd find a tablet next to our orange juice glass each morning.

We "had" to eat whole wheat bread when all of our friends "got" to eat that nice, new, gummy white bread. Well, Mom, um, thanks The doctors said the supplements were a waste, but you knew your skinny little girl with a poor appetite need them. You stuck firm to the whole wheat routine and lots of fruits and vegetables - which, I'm sure, the doctor's would have endorsed if you'd asked. You used your sound common sense to make educated choices.

Learning to Respectfully Question

When I was a young adult, I still followed doctor's orders for the most part. But, like my parents,  I did ask questions if I didn't feel quite right with their decision.

The defining moment that convinced me of the need to be  an actively involved patient  came  in my twenties.  My esophagus was going into painful spasms, likely caused by stress. I was prescribed a "mild tranquilizer." These were the days, mind you, when tranquilizing women was considered good medicine by most doctors. We were such nervous little creatures (don't gag, all you young women - that's how it was).

Long story short, after taking the  pills for awhile they no longer worked. I called the doctor to report this and he said, "take two." That didn't feel right. I should have gotten a second opinion, but being young and foolish, I just  dumped the pills.  I later learned that they were highly addictive pills right out Jacqueline Susann's then blockbuster novel, Valley of the Dolls. My pills simply had a generic name.

I learned my lesson well. Ask questions if I don't feel comfortable with the diagnosis or treatment. Respect the doctor if he/she treats me with respect. If not,  move on.

A Good Doctor Considers You a Partner

Medicine has come a long way since those days, and most good doctors expect the patient, or the patient's advocate, to be a partner in care. Doctors these days are so pushed for time that some aren't all that pleased to have  patients question a diagnosis or treatment. The time element isn't their fault, it's the fault of our medical system. However, many doctors can still make a patient feel listened to. It's worth the search to find one who does.

When we are the advocate, this doctor search becomes even more critical, since we are representing vulnerable people.  Early on, when I visited doctors as a caregiver for  my children and my elders, I was often brushed aside. The doctor knew far more than the parent or caregiver. True enough - medically speaking. But the parent or caregiver is the person who can see the results of the treatment. We need to be taken seriously.

I caught my son's penicillin allergy just in time to avoid an emergency. I also prevented a medication going to my dad that I knew he'd probably be allergic to. Yes, this allergy was on Dad's records, but this particular medication had a  generic name. I looked it up in my personal copy of the Physician's Desk Reference, and called the doctor's office. The prescription was changed before it did any damage.

Most of you reading this have been to the doctor with an elder. Many, if not most of you, have been with your elder as he or she has been diagnosed with dementia. You wonder about prescriptions given or not given. You may even wonder about the diagnosis itself. When that happens, please get a second opinion. Most doctors do a very good job. But they are human. They are rushed. They make mistakes.

Many family physicians are now diagnosing Alzheimer's. They are likely correct a great percentage of the time. But an Alzheimer's diagnosis is complicated. People can exhibit dementia  symptoms because they have an infection that is not being treated. The can exhibit dementia  symptoms because of medications they already take. Or, they make exhibit dementia symptoms because they have one of a variety of dementia types or mixed dementia.

If a family physician does a complete physical, well good, that should be done anyway. But then, if the diagnosis of Alzheimer's seems to fly out of her mouth too easily, and your gut  tells you that you aren't sure you agree, perhaps it's time to see a specialist. Get some more tests.

The first doctor may well be right, but if your gut tells you something different,   get a second opinion. A good doctor will welcome the chance to be proven right, or be humble enough to admit he was wrong. Regardless of the doctor's feelings, you are the advocate. If you are not confident about the first opinion, a second opinion is likely a good safety measure. Use your common sense to protect your vulnerable loved one.

For more information about Carol go to www.mindingourelders.com or www.mindingoureldersblogs.com.