Q: I'm 64 and went to a new doctor about knee pain. He looked at my chart and then said, "At your age, you might want to think about scaling back your activities." I excused myself, stood up and walked out. I'm committed to staying very active -- I bike a lot and do yoga twice a week -- and the age discrimination was obvious. I think it's pretty common in health care. How can I stop it from happening to me again? -- Gracie M., New York
A: He's lucky you reacted in such a civil manner! Doctors who assume that lowered expectations and disability are normal for older folks are seriously out of step with everything we now know about healthy aging.
It's important to recognize age discrimination and fight against it, because it can lead to increased health problems. A recent study from UC San Francisco looked at data from the National Health and Retirement Study (2008-2012) and found that age discrimination in health care has seriously unhealthy consequences. Folks who said they encountered age-related health-care discrimination twice a year or more (and hundreds of thousands do) were almost 30 percent more likely to develop "new or worsened functional ailments."
So here are a few tips to help you decide on a new doc -- don't worry that you're being too demanding; insist that your health-care providers treat YOU, not your age.
When you go to an appointment, set the rules. It's OK to say, "I expect you to treat me like an adult, not an old fart." If the doctor doesn't respond well to that or continues to be condescending, find another doctor.
Take a list of questions to ask the doctor, so YOU get the answers you need.
Bring someone with you; reinforcements can help spot and deflect age discrimination.
Don't be shy about talking directly to your doctor about age discrimination (but we don't think that's a problem for you).
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Q: I just heard a report that some Type 2 diabetes drugs may make it MORE likely that I'll get heart failure! How is that possible? I'm on metformin. Should I stop taking it? -- Martin S., Clearwater, Florida
A: We're glad you bring this up, because people are once again being confused by the way an important new study is being reported. And don't stop taking your oral diabetes medication without first talking to your doctor; you can cause yourself a lot of harm.
Basic Type 2 meds such as metformin (the first med prescribed when treating Type 2 diabetes, and the most popular) are not the drugs this Canadian study is talking about. Metformin has been found to be reliable, and slashes the risk for heart attack by up to 69 percent.
So, what did this new research reveal? Reviewing multiple studies that included 100,000 people, the researchers found that some meds were associated with increased weight gain. For example, every 2.2 pounds (1 kg) of weight gain associated with taking medications such as PPAR agonists (thiazolidinedione/Avandia) and DPP-4 inhibitors (Januvia) increased the risk of heart failure by 7 percent. That's important news. In contrast, intensive glucose-control strategies (aiming for an A1C level of 6.5 percent to 7 percent) and intensive weight-loss strategies were not associated with an increased risk of heart failure.
So what's the bottom line for anyone with Type 2 diabetes? The best way to treat the disease is to upgrade your nutrition (no more processed foods or added sugars, lots of fresh produce and no red meat), lose weight and increase your physical activity (10,000 steps a day, no excuses!).
Medications for Type 2 are often enormously beneficial, and it's great that they're available. But it takes more than a med to give you a do-over. Talk with your doctor about formulating an effective lifestyle plan that will put you back in control of your health today -- and tomorrow. And check out Dr. Mike's "This Is Your Do-Over" for a plan to reverse Type 2 diabetes.
(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at [email protected].)