Monday, March 23, 2015

Second (and Third and Fourth) Opinions

     Decades ago, Dear Abbey's Abigail Van Buren recommended that her readers seek and obtain as many medical opinions as necessary until a satisfactory diagnosis and treatment plan is received because doctors are fallible (and some are less than honest, I might add). I've taken this advice to heart and through the years it's saved me much heart and pocketbook pain. 
     Dentists in particular have been my sometimes nemeses. It started in Seattle in the late 1980's when a dentist I selected from the Yellow Pages, who claimed to offer “reasonable” rates, cleaned and examined my teeth, remarked twice how nice they were, twice asked if I was Japanese (he was Korean), and said I needed fourteen fillings which would be a “big improvement”—despite my having had only four tiny fillings at that point (I still have only four) and I had been doing my diligent daily dental hygiene best, same as always. Not convinced, I asked him to write down which teeth 'cause I wanted to ask my mother who works in a doctor's office her opinion. He said in a doctor's office? I said yes. He nodded and wrote numbers (designating the teeth) on a Post-it note and gave me at my request the more than dozen x-rays he'd taken. 
     Only then did I do the smart thing (I was young) and asked my friend for a recommendation. He referred me to his dentist who worked down the street from where he lived in Laurelhurst. The dentist, who never recommended my friend do anything with his teeth, examined my teeth along with the x-rays, thrice commented how nice my teeth were, and asked could he see the list of suspect teeth because it might provide him clues? I said, Please draw your own conclusions first, then I'll show you the list. He went over each tooth and selected x-rays again and said he couldn't find anything wrong with any of them. I showed him the list and he went over the fourteen teeth plus some x-rays again, commenting as he went tooth-by-tooth on the health of each, then quipped, “your dentist must want a second boat,” which caused my heart to ache with longing to bless him. And he didn't even charge a fee for the over half-hour consultation. 
     A few years later, after I'd moved back to Honolulu, my regular dentist said she'd put in a small filling where I had some gum recession, the first of several that “will be a big improvement.” Yet she and her hygienist always complimented me for my “beautiful teeth.” Since I didn't feel the need for any fillings, I changed dentists to Doctor Franklin Fukuda, who to this day has never recommended a filling. 
     Twelve years later, our family's pediatric dentist said Braden needed two fillings due to tooth decay. I asked him to show me which teeth and he stuck a probe in and touched the chewing surfaces of two molars. (As a youth, I got a cavity once when I forgot to bring my toothbrush to a Boy Scout summer camp when I served on staff for several weeks. Doctor Atebara demonstrated the hard taffy-like stickiness of my tooth's decayed enamel by shoving in the needle point of a probe, then pulling away until it released with a sudden jerk. I wanted to see that happen with Braden's teeth (as proof). He was unable to do it, but rather jerked the probe to one side to simulate stickiness. I had him jot down the teeth in question, then brought Braden to see another pediatric dentist who said that he needed four fillings, but none of the teeth to be filled matched those of the prior dentist! (I didn't show or tell him about the list.)
     I then took Braden to Dr. Fukuda who said, All his teeth look fine. I can't find anything wrong with any of those six teeth. 
     God bless him for his honesty! 
     Finally, Pene's myopia has been progressing so her ophthalmologist, whom we two years ago changed to for reasons of convenience, recommended low dose Atropine eye drops inserted every night for months (or years) on end to help slow the progression and thereby reduce the risk of a retinal tear or detachment. She said studies in Asia showed that “it worked” but that it hasn't yet been FDA approved because “drug companies refuse to sponsor studies because the drug is already generic” (i.e. there's no profit motive). Because Pene and I felt so uncomfortable about the treatment recommendation; because Internet research listed very few studies, none of which were long-term; and because when I asked my ophthalmologist at my annual check-up what he though about the treatment, he said it's tough on patients and parents and the myopia could return once drops are stopped; we took Pene in to see our original pediatric ophthalmologist, who said she doesn't recommend eye drops to treat myopia; the Asian studies happened for two years, then stopped; there are no long-term studies; and the risk of retinal damage from even severe myopia is very low. She also mentioned that only one pharmacy in all Hawaii mixed the Atropine dilute, which I found suggestive of less than wide-spread acceptance or appeal. 
     So for now, we'll forgo the eye drops option, and instead follow the common-sense recommendations gleaned from multiple doctors and staff that Pene get lots of out-door exercise, take regular reading breaks, and read arm's length rather than nose-to-page. I'll pray as always for her health and trust what we cannot control to God, because He is always in control. And as He said, “I give you peace, the kind of peace that only I can give. It isn't like the peace that this world can give so don't be worried or afraid." (I tend to stress about such things...)
     By the way, the upside of all this regarding Pene is she loves to read (as do all our kids) and devours books like tiny bags of potato chips—it astounds me how fast she reads. Largely as a result, she's doing just fine in school—we couldn't ask for more.

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