Wednesday, February 08, 2012

Refusing it.

This is nobody's favorite subject and I apologize, but when I'm angry and frustrated, I have to rant in my blog, so today, I'm afraid I have to explain why I oppose almost all routine precautionary radiation, and to do that I have to talk about melanoma.

There's high risk for melanoma. There's very high risk.  And then there's me.
I am Celtic fair-skinned.

Despite that, at age 14 I got UV acne treatments.

Also, despite the pale Celtic-ness, I tried repeatedly to tan when I was 12-16 or so, and had more scarlet, blistering, skin-peels-off-in-sheets, fever and woozy-head, sun burns than most people ever have.  They say even one of these deep burns skyrockets your risk.  I literally can't count my moderate -to-severe burns.

Also, three generations of my family have developed melanoma. NONE of whom ever had as much burn history as I've had.  My grandmother had 2 of them 30 years apart.  My mother had 2 of them, about 5 years apart.  My brother has had one, 12 years ago.

When my dermatologist recommended the UV acne treatments to 14-year-old me, only one of those cases -- my grandmother's first case -- had occurred and I'm not sure he even asked about that.  It was 1968.  I was miserable over my complexion and I did adore that gentle rosy glow I got every other week(!).

That I haven't had any skin cancers yet is practically a miracle.  It certainly defies science.  I take a lot of vitamins.

But I also avoid any more stupid radiation, especially on my face.

And for a long stretch, that meant no dental care at all.

It is possibly because of damnable insurance companies who create a one-size rule and demand that dentists perform endless dental x-raying to protect the profession from lawsuits.  Beats me.

But in the case of my dentist -- let's call him Dr. Z -- it seems to be an infuriating, yet genuine belief on his part that yearly x-rays are more vital than any mitigating circumstance .... well, mitigates.

It wasn't the case with dentists I saw 20 years ago.  They wanted the x-rays, you bet, and I had to endure the patronizing lectures about  What A Teeny-Tiny Amount!  of radiation it involves, and about How Vital It Was For My Oral Health!  to which I would listen politely, because that was my role in the negotiation.  I understood the bind they were in.  I understand that x-rays can reveal some hidden problem in early stages, a problem that would be much worse when it finally grew big enough to make itself known. 

I'd listen to the requisite lecture. Then they would have me sign a disclaimer absolving them from all culpability and they'd clean my teeth, and I'd pay them and everybody went home happy.

Apparently, now I may not make this decision for myself.  No matter how seriously I have thought it out.  No matter how entitled I am to make my own health decisions.  Dr. Z, who, I repeat, is a truly good and conscientious guy, seems to think that forcing my hand by refusing me as a patient is kosher.  It's so important to him, that the fact that having no dental care at all is hazardous to the health of my entire body doesn't seem to have any pull.

A year ago, because of that hazard, I gave in.  He took a set. I became his patient, and think highly of him, and decided that a one-off set of x-rays was a good trade-off, and we could argue about it again in 5 years or so.

That's where I discovered that something else has changed in the dental profession, because not only did I get to refuse x-rays 20-15 years ago, but my old dentist requested them only at intervals of several years.  Today, ONE year later, Dr.Z demanded more x-rays.  And he and his tech are telling me all the dentists do this now.  It seems that I will have nowhere to turn.

When I gave in a year ago, I had not been to dentist in 8 years.

If that seems incredible, I can only, sheepishly, confess that God gave me the Rolls Royce of teeth.  It's one genetic luck of the draw that I got.  Apparently from my grandmother.  I've had 6 cavities in my life; at ages 14 (4 of them. Bad eating, I guess), 23 (one cavity), and one last one, sometime in my 30's.  One of the 4 1968 fillings was replaced about 10 years ago, the others are all original.  Even without dentistry for those 8 years, I had no problems at all, and those x-rays he forced on me last year revealed .... not a gallblasted thing.

But here I am again.  I refused them today. 

If he denies me care on this basis, I 'll have to hunt and phone and research and try to find someone who will honor my wishes.  It's still an "if" because he let it go today.  Apparently we will discuss it in 6 months, and I pray that all my excellent reasons, especially my family history and personal cancer risk, will allow me to keep seeing him, because he is absolutely wonderful, and is doing it to out of (in my opinion, bizarrely rigid) conviction, not for revenue or any other sleazy reason.  That's the thing.  Finding another one would be a lot of trouble, but the fact that he's one of the best dentists, and best people, I know makes me hope we can work this out.

I don't know if routine precautionary radiation is another topic or not.  I utterly despise it.  Yet I also understand the many benefits it has had to a lot of patients.  Everything is about flying blind and weighing odds, and you won't convince me that it never causes a tumor and only detects.  I doubt if even the imaging industry would claim that, but they do insist that I play odds that their bean-counters post as beneficial to "the whole."   In some cases, and facial radiation is one of them, I absolutely will not do it.


Christy said...

Unbelievable. Surely there has to be a dentist who will allow you to forgo the x-rays! Surely...

Hyper Bueno said...

This is happening to me, too! I was refused yesterday at a "holistic" dentist!