For Preventive Medical Care, Be Your Own Advocate

• You must be responsible enough to advocate for your own health existence, particularly when it comes to preventive medical care. 
• One nurse shares her experience contacting Medicare to receive preventive gynecological care based on her personal and family medical history. 
• Because of her advocacy, it’s now documented that she receive preventive medical care on an annual basis. 

My new mantra these days is this: If you do not advocate for yourself, no one else will.  

You must be responsible enough to advocate for your own health. You must stick up for yourself regarding procedures, testing, doctor’s exams and information concerning your health. I learned this last year when I contacted Medicare to inquire about information related to basic gynecological care, as I had turned 65. To my dismay, the gentleman I spoke to was not immensely helpful with answers to my questions.  

I thought, “This is my teaching moment.” 

I did not want to ask about his age, so I began by asking if he knew anything about DES, or diethylstilbesterol. He had never heard of it. I proceeded to give him a little lesson on what DES was, how it was given, and why. As I wrote in an earlier blog, DES was given to pregnant mothers in the 1950s to prevent a miscarriage. The issue was that no one truly knew how this medication would affect the fetus. I was a DES daughter, as they call it. Both my sister and I were affected by the administration of the DES while in utero. Colposcopies were performed to decipher changes in the uterus and cervix. The changes ranged from mild to severe. 

How I Advocated for Preventive Medical Care 

After the explanation to this young man, he still maintained that because I was now over 65, I was not allowed or approved for a pap smear exam or a mammogram for three years. To me, this was unacceptable.  

I felt I was being penalized for being older and, therefore, not allowed to have preventative care. It brought me back to when I was in my 20s and found, quite by accident, a palpable painless lump in my right breast. I was terrified! My husband was about to graduate professional school and here I was, scared of what I found.  

I immediately called my gynecological physician and relayed my findings but was told I could not get an appointment for six weeks. I told her I could be dead in six weeks. I was working in an Emergency Room (ER) that day and was quite upset. My co-workers saw this and tried to help. One of the surgeons was in the ER at the time and they told him what had happened. He took me into an exam room and did a quick needle biopsy. It was not straw colored, which would mean a cyst, but was bloody. We set a date for a biopsy in the Operating Room (OR), signing only for a lumpectomy at that time. The outcome was not a tumor, but a lipoma, which was a painless palpable breast lump that is soft and mobile. These usually do not turn into cancer. They are just an incidental finding either on palpation or on a mammogram. 

The Results of Advocating for Yourself 

I had just started with a new gynecological physician, and I mentioned that I am a DES daughter. I explained my dismay at not being able to get proper preventative care due to my age. She agreed that because I am a DES daughter, and having just turned 70 this year, age should not make a difference when you have a gynecological history. I should mention that my mother was diagnosed with vaginal cancer, which was the primary site, and lung cancer the secondary site.  

That is reason enough to get a pap test and mammogram every year. It is now documented in my chart and will be ordered yearly for preventative reasons. When I called the office to make sure that it was written in my chart, the secretary looked and said that it was documented for yearly tests. 

The Bottom Line

If you are going through this same scenario with Medicare and being told you CANNOT have preventative care due to your age, please advocate for yourself. No one else will stand up for you if you do not stand up for yourself. 

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