Should we keep putting Mom through rounds of tests? Or is enough, enough?

A fellow caregiver asked...

My 88-year-old mother has severe COPD, congestive heart failure, kidney failure, anemia and osteoporosis. It seems every time she complains to her doctor about "just not feeling well" we do a round of more tests. Chest x-rays, abdominal ultrasounds, pulmonary function tests and rounds labs with every test. I want good care for her but I with each new round of tests I ask, when is enough?

Expert Answer

Loutfi S. Aboussouan is a staff physician for the Cleveland Clinic's Respiratory Institute and Neurological Institute. He is board certified in internal medicine, pulmonary disease, critical care medicine, and sleep medicine and directs the pulmonary curriculum for the second-year class of the Cleveland Clinic Lerner School of Medicine.

I believe your question is whether your mother is receiving too many or perhaps unnecessary tests, and I understand your concern. This is a difficult question to answer in part because heart failure, a flare of COPD, a worsening of kidney function, and anemia, could all present as a feeling of "just not feeling well". Your mother's doctor may be trying to pinpoint the exact cause of her problems by doing several tests. The results of those tests may determine which treatments or medications will help her most. I would suggest that one possible way to narrow the possibilities is good communication back and forth with the physician, and a good physical exam. That way, if your mother's symptoms and exam on one visit are more consistent with a specific diagnosis as opposed to another, then perhaps testing could be limited, and treatment started more quickly.