Sunday, January 13, 2013

Amusement at Form Letters

     Friday I received a form letter from the hospital which has been doing my mammograms since we moved to Troy.  I was sort of amused by it.  First, it was Dated Dec. 27, and it came in Jan. 11th's mail.  "Our records indicate that based on your screening mammogram performed on 1/116/2012, it is time to schedule a routine screening mammogram of both breasts."  Really? I wonder how they are going to find the missing one?  I am also amused by the "routine screening mammogram."  For breast cancer survivors, no mammogram is routine.    I also am somewhat annoyed by the fact that even though I have had breast cancer and am now at stage IV, the only thing that the insurance covers is "a routine screening exam."  In other words, a rather cursory look....a diagnostic mammo, they go over in more detail.

On the other hand, the letter goes on to say this:  "Be aware that many breast cancers do not produce symptoms.  Early detection requires a combination of monthly breast self-examination, yearly physical breast examinations, and periodic mammography according to your age and physician's recommendations.  Current American Cancer Society Guidelines recommend screening mammograms and clinical breast exams every year beginning at age 40."

So, some of this I like....especially the self-breast examinations.  Why? Well, because at one of the last times I took my daughter for her yearly physicals, the doctor said NOT to do self breast exams because "you often find false negatives."  Excuse my language, but WTF? I would rather have something checked out and find it was a false alarm than to have anyone go through the hell I did because I didn't know that at age 33 I was at risk of breast cancer....and my tumor was quite large and easily felt by the time I realized I wasn't imagining things.

Yes, I realize that it can cause concern.  Yes, I realize that following up can cost money.  But, I think that this hospital is to be lauded because it does point out that self-exams are still important.

I also think of my niece's experience. She is 30 and recently went in to have a breast MRI.  She had to fight for it, even though her mother was diagnosed with breast cancer at 45 and I was diagnosed at 34.  Why a breast  MRI? Because she is young, she has dense breasts and dense breasts make it difficult to see problems.  Her PCP bucked it. Her insurance bucked it....the oncologist she went to applauded her because she was doing exactly what she needed to to protect her health.

I am beginning to believe that the patient is often being left behind as the almighty dollar is what we are really protecting...or rather, the almighty insurance companies.  Remember, very few hospitals are charity hospitals anymore...most are for profit entities.  Insurance companies are not there to help us, they are there to make money.   I realize that this is very harsh and there are a lot of hard working men and women in the health provision field who do care about their patients and work hard to try to make sure that we live as long and as well as possible...but we would be ostriches to not look at the whole picture.

So...even if I can't seem  to find my left breast so that they can do a mammogram of it.....or maybe....maybe they want to try a mamm of my prosthesis...I still think that this reminder and the letter is a good thing...

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