Self-referred mammograms useful

Dear Dr. Gott: I am a radiologist responding to your statement that women should be able to order their own mammogram. I object. What does she do with the results? With whom should she discuss the interpretation? With whom should she talk about the lump she found?

Perhaps the patient should be under the care of a physician with whom she feels comfortable.

Dear Doctor: I’m going to stick to my guns on this one.

I believe that women who are due for mammograms should be able to self-refer or obtain the X-ray tests without a hassle. This is, in my view, exactly the service performed by mobile breast examination facilities.

In my community, no woman gets a mammogram – either in hospital or a mobile unit – until she provides certain information, such as age, address, insurance – and the name of her obstetrician or primary care physician.

In my practice, I routinely receive mammogram reports on women I haven’t seen in years, but I am the primary care physician. When I say to my office manager: “What is this? I didn’t order a mammogram!” She replies: “Don’t worry. Just report to the lady!”

So, in answer to your objection, the patient’s doctor gets the results and can (and should) perform follow-up over the telephone or in the office.

Dear Dr. Gott: I am 76 and active. I take medication for high blood pressure. The dosage was increased about six months ago.

For the past few weeks, I have been experiencing recurring bouts of weakness and fatigue that lasts from 15 minutes to a day, without any demonstrable pattern. I have learned to check my own blood pressure and have discovered that it runs about 102/46 during my episodes of weakness. Do you think this is too low? Could this contribute to my spells?

Dear Reader: Without question. In my opinion you are seriously over-medicated. I doubt that your physician would disagree with this conclusion. Call him, describe your sensations and share your home BP readings; meanwhile, cut back to your previous dosage – continuing, of course, to monitor your own blood pressure.

To give you related information, I am sending you a copy of my Health Report “Hypertension.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.