Caring Currents

Second Opinions: If in Doubt, Seek One Out

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Lois De Domenico isn't prone to dramatic pronouncements. So I'm all ears when she tells me matter-of-factly that a second opinion "saved her life."

Here's what happened: The slim, lively, octogenarian philanthropist -- a veritable pin-up gal for the AARP set -- practices yoga every morning, eats a healthy diet, and had never had a major illness. But in September last year the San Francisco Bay Area resident began feeling ill, particularly in the evenings, and found herself dealing with unexplained fevers and drenching night sweats that saturated the bed sheets.

She went to her doctor. He did a work-up, couldn't find anything wrong, and sent her home with the advice to take a couple of Tylenol if the symptoms persisted. Lois didn't get better, found herself reluctantly leaving a fundraising event on a Friday evening, and drove herself home. The following Sunday she called her physician's practice and the on-call doctor offered to send her antibiotics.

But something about the situation niggled at Lois. Call it intuition. A daughter begged her the next morning to go see her family doc, whom she highly recommended. Uneasy about the way her physician's office had handled matters, Lois made the call. She got squeezed in for an appointment that day and met with her daughter's doctor, who promptly took a CAT scan of her lungs. He called later that afternoon: She was gravely ill with a rare form of tuberculosis and needed to be hospitalized immediately. It was touch and go for several weeks -- the disease spread to her hip, which required surgery -- but after months of rehab she kicked the energy-sapping illness and returned to her normal, busy life.

Her advice for others who have doubts about how a doctor handles mysterious symptoms that don't lend themselves to a ready diagnosis? "Follow your instincts and get a second opinion," she says. " And don't be afraid to change doctors if you feel the need to."

Refreshingly, today many docs agree that folks should feel comfortable soliciting another's perspective. Even physicians seek out second opinions for themselves, according to a New York Times essay. Medical diagnosis is frequently a murky world, and oftentimes even experienced physicians aren't sure what's going on with a patient. That's particularly true in geriatric care.

Don't worry about offending your parents' regular doctor by seeking out a second point of view. The doctors who are worth sticking with generally welcome getting another physician's input. To paraphrase one physician blogger: Second opinions can provide a fresh perspective, new information, and draw on different clinical experiences so that a diagnosis may result and better medical decisions may ensue, especially in complicated or baffling cases.

A second opinion may do nothing more than offer peace of mind. Yep, Doc #2 agrees with Doc #1's diagnosis and plan of action. Sometimes a second opinion is conflicting or contradictory and so a third assessment may be warranted. Sometimes alternative treatment options emerge that are worth considering. It pays to be assertive and persistent to get to the bottom of things.

So don't be shy about taking the time, trouble, and often added expense to find out what's wrong. A senior's life, literally, may depend on it.

Next week: Strategies on how best to go about getting a second opinion.


Photo of Lois De Domenico by Sarah Henry.