Doctor and patient at odds over hormone therapy

Q: In a recently published column, you stated, “As always, the decision belongs to the patient,” while addressing a concern about the benefits and risks of stopping a statin drug. Oh, really? Why is it then that no doctor will prescribe hormone replacement therapy to stop my debilitating post-menopausal symptoms once I turned 60? After suffering from menopausal symptoms starting at age 42, I was finally prescribed HRT at age 57.

If a patient asks me for a treatment that has been shown not to be effective and has the potential for serious adverse effects, I don’t prescribe it, but will work with the patient to find alternative treatments. For example, some nonhormonal prescription treatments are moderately effective for hot flashes and sleep disturbance, and topical estrogen is very effective for vaginal dryness.

Moreover, a woman’s entire health status should be considered when deciding whether to prescribe hormone treatments. In women with a history of an estrogen-dependent tumor , a history of a blood clot or a stroke, or a few other issues, the harms almost certainly outweigh the benefits. Otherwise, a wise clinician looks at the patient’s risk for heart disease, blood clots and other conditions.

Hopefully, your treatment will be successful and they will no longer need the port. Once that happens, the port can be removed surgically. Scars, for any reason, are often red in the first weeks or months after the incision. Over time, the redness usually fades, and the scar becomes more skin-colored, sometimes paler than the person’s normal skin.

Should I be concerned about my nocturnal readings? Do you recommend supplemental oxygen based on this one test, or should more data be gathered? I have no symptoms of headaches, shortness of breath or a racing heart. I wake up refreshed and energetic with no daytime sleepiness.The apnea-hypopnea index is a measure of severity of sleep apnea. It reflects the number of times a person stops breathing during the night, with your AHI meaning, on average, you stopped or slowed breathing 8.

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