When It's Time to Give Your Bones the Boot

The older I get, the less patient I am as a patient. Here's what I'm doing about it.

It was the last straw. I asked Dr. M, my podiatrist, a direct question, and once again got a vague, evasive answer. We were looking at x-rays of my feet, which are like the rest of me, 69 years old and starting to show some wear and tear. I have a fair bit of pain. That's why I was seeing him.

A few minutes previously he had intoned, in that annoying way of Old Male Doctors Speaking to Aging Women, that I was "chronologically challenged." Not a bit of humor. Normally such a silly remark would have sent me into gales of laughter, but he was serious.

Really, doc? Why can't you just say I'm getting OLD? Because parts of me are getting worn out, worn down, and that is the honest truth. What, you can't speak truth to a serious athlete, who NEEDS the truth and a way forward?

This isn't a rant so much as a statement of boundaries, not only for myself but for anyone else within shouting distance of my age who is seeking competent medical care. The older we get, the more we need to find health partners, not just health care givers. Partners implies a working relationship of equals.

In a business relationship, if you noticed that your partner wasn't pulling their weight, and if anything was becoming an impediment to the company, you'd end the partnership. I would argue the same for our healthcare.

I'm going somewhere with this.  

As we age, you and I need to pay attention to our aches and pains in a different way. Some of them, if you work your body as hard as I do, can be indicative of joints that need maintenance work. I just had two surgeries of that very kind on my left shoulder.

The same surgery on the right gave me my shoulder back, full use and full strength, without the pain.

Some of those aches and pains could well be because we aren't working ourselves. That is a whole other topic, but this article address those of us who are active, and who want to stay active as we age.

I expect some deterioration, after fifty years of body building, some hard falls and horse kicks. A sense of humor helps me both manage the pain as well as the recovery process, which for this aging athlete is a lot faster than many of my vintage. I also know that there are going to be negotiations. I may have to change sports or change shoes, or some other accommodations.

What I need is solid information, offered as options, for me to make a competent, adult decision. You would want no less from your partner.

However, if a doctor doesn't take us seriously, in that we really want to stay in the game at the highest possible level, then that Bones needs to be booted.

Maybe Dr. M is tired. I get it. However, if that's the case, and he's irritated with other clients who expect him to wave a magic wand and fix everything, that's not my problem. It's his. For such assumptions that we're all like that muddy the water. So when someone who really is committed to health comes in the door, said physician can neither see nor hear them. They see the age, often the gender as well, and that's all they need to know.

That makes them worse than useless. It makes them detrimental to our health. At a time when so many folks are already overworked and under pressure, when a positive, focused patient shows up, you'd think that would be welcomed. I show up on time, do the work, do the research, am cheerful and happy and grateful for the care. It's been my experience that these things lead to my being welcomed in a medical office.

I guess it depends, doesn't it?

My new friend Chris, who is close to my age and another very serious athlete, tore her ACL a few years back. Her doc told her to go home and rest. She didn't. She agitated, as well she should, until said doc got the message that at sixty she bloody well had no intention of sitting the rest of her life in a recliner watching other people do what she loves: hike, bike, yoga, all of it. Just like me. She got the surgery and she's back in the game, as well as cleaning off her own roof, thankyouverymuch.

My kinda woman.

I've had left shoulder problems for some years now. Starting in Denver right up through last year, I interviewed a series of orthopedic surgeons to help me do the repairs to get that shoulder back to full movement.

I ended up firing eight of them after the first meeting. I'm not sure why orthopedics seems to be a magnet for MAGA types, but it sure was my experience.

In another article, I wrote  about the shoulder surgeon I ended up with, a great doc who is a combination of considerable skills, a sense of humor and great bedside manner. That's a surgeon worth fighting for, especially as he totally gets my commitment to health, recovery and returning to my beloved sports.

It's exceedingly fortunate that he is also my hand doctor. That goes a very long way towards supporting healing. Healthy hands aren't just about the sports. As a writer, this is my living.

When it comes to feet, however, this is a whole other issue. For I hike, bike, ride horses, all kinds of things that require healthy dogs. When those go, so do a lot of options. When x-rays showed deterioration on my feet, perhaps the result of uber- high arches along with a lot of abuse, what I wanted was a plan.

I can't get one. I can't get a clear set of options, dos and don'ts, whether there are better shoes to wear or if changing to a different sport would help. These are the kinds of discussions that you and I need to have at any age.

However, as we age past fifty, this becomes even more important. For example, if it turns out that hiking big mountains is going to accelerate the deterioration, then I might have to seriously considering giving up on that second Kilimanjaro summit. I have no issue with that. There are plenty of other wonderful things to do in life if that door gently closes.

Or, if switching to cycling, or using an elliptical, or investing in a different kind of shoe would make a difference, I would absolutely research any and all the options available. Then, one assumes, you and I can go to our physicians and discuss those options, and decide on a course of action. Knowing full well, of course, that time and degradation will do their thing, and course corrections will be necessary.

That's partnering. You and I cannot do that with ageist doctors. Or lazy doctors.

This doc gave me some different orthotics. They worked well for a few weeks. When I noticed pain returning I took a solid week, six different pairs of shoes, and tried out the orthotics in various combinations, surfaces, speeds and inclines and declines, wrote up the results and presented them to this podiatrist as information that might be useful.

He barely acknowledged the work I did, nor did he even bother to check out the shoes that I had schlepped in en mass for a discussion about what might work. Look, I can't speak for anyone else, but I would bet you a lot of money that most patients wouldn't go to that kind of trouble and research to try to get information, answers and ideas to discuss with the doctor.

I did the field work.

For most doctors, such initiative would likely be seen as a positive thing. Who knows what Dr. M thought. I know what I think. I requested a new referral to a different podiatrist this morning. He's booted.

Here's what I am using to make that decision these days:

1. Arrogance, impatience and an inability to listen. If these are obvious up front, walk away.
2. If the above appear over time, again, don't wait. Walk away. Any further investment is wasted.
3. Any ads plastered on the wall for prescriptions. Pharma already owns your doctor.
4. If your doc is famous for having pioneered some new test or device. All too often your doc will want to use it on you whether or not your particular condition calls for it. Happened to me more than once.
5. Impatience, disregard, condescension or patronizing language.
6. Ageist, sexist or racist comments of any kind. DONE.
7. Won't trust your word, your wisdom about your body. Respectfully, that does not included our overheated research on WebMD about symptoms leading us to walk in and tell them their business. Do the research, but do NOT assume that the data we gathered applies to us. This is why we have doctors, tests and validation.
8. Won't discuss or explain your symptoms in layman's language, educate you on what's up and what that means to you, and a clear set of actions you can take to get better
9. When you bring in what you know to be related, valid information concerning your condition and it's ignored.
10. The very second some doctor calls you "hysterical." Please refrain from realigning their pearly whites, but do walk straight out the door, write a formal complaint and commence shopping for a new provider. Meanwhile research the term and find out why it is so widely used and uniquely offensive to female patients.
11. Your gut tells you this is not a good fit. It isn't likely to be wrong, it also isn't likely to get better, and your instinct is there for good reason. It's called survival.

Ageism infects all levels of society and most certainly infects the medical community. It strictly limits not only what you and I can do as individuals because of someone else's laziness and limitations but also can cause us to throw in the towel long before we need to. Aging athletes are now a norm, and all kinds of products, services and supplements exist to help us stay in and play.

Dr. M is no spring chicken himself, which may or may not inform his behavior. All I know is that we're not a fit.

As a friend of mine said this morning, the clock is ticking on the time I have left to play. For some reason, perhaps because of the added stress of the recent move, quarantine and all the demands of big life shifts, I am noticing more changes now in my aging body than ever before.

That doesn't mean stop, it does mean to take stock, assess, regroup and refocus.

While it makes sense to ratchet back some of the intensity if my body shows too much wear, I am not giving up. I categorically disagree with one aspect of the Play Hard or Go Home meme. As you and I age, and as time and wear take their inevitable tolls on our bodies, playing hard may have to take a back seat to simply being able to play in the first place.

We don't stop playing when we get old. We get old when we stop playing. You and I may have to change how we play as we age, but we need providers who are just as committed as we are to ensuring that we can play.

You and I have every right to boot the Bones who isn't taking us seriously. It's your life. My life.

Let's go play in it.