"Old Person's Friend" - Your Thoughts?

First, for the young’uns: The term refers to pneumonia.

I was recently offered a vaccine for a range of bugs which can cause pneumonia.

As I am in failing health, I must confess, I have reservations about getting the second shot, which will take out another wide range of pneumonia-causing bugs.

Pneumonia is what finally killed my paternal grandmother. All I remember of her was a shrunken bag of wrinkles who smelled bad (I was 8 when she died - in our house).

In her case, it really was a kindness, ending what was a long downhill slide into dementia.

Q: Are these vaccines really a good idea? How certain can anyone be that they will never be one of those for whom pneumonia is a blessing?
For reference: I am male and have decided to ignore my prostate unless it develops symptoms. The risk of false positives resulting in harm and the risk of false negatives combine to make it a craps shoot - it seems that if I live long enough, I will develop prostate cancer. The odds also state that I will die with an undiagnosed prostate tumor, which will have nothing to do with my death.

Please get treatment! When you see symptoms, you will be beyond help and metastatic cancer is a really shitty way to die. Early treatment provides options including chemotherapy, radiation, and surgery. None are pleasant – except in comparison to non-treatment. I just (last May) had my own traitorous organ surgically removed using the DaVinci robotic procedure. I had some rare complications that kept me hospitalized for 12 days instead of the usual 1 or 2 but I’m thrilled to be rid of my adenocarcinoma.

I don’t know you from Adam but it’s still painful for me to see you considering a sort of roundabout suicide for something that is commonly successfully treated. Get a biopsy. If it’s positive, get another. If that’s positive, seek competent advice from a doctor you feel comfortable with. Please.

What cancer?

As I said:
“ignore my prostate unless it develops symptoms”.

So far, it is still in the “Ain’t Broke” column.

Kidneys and skeleton are in the “Busted” but still “watching” stage.

So far, no hint of cancer anywhere.

And as he said, when you see symptoms it may very well be too late.

What CannyDan is suggesting is that you get tested for it regularly even though you have no symptoms. Yes, there are sometimes false readings but the majority of times there aren’t. Plus second tests and second opinions can be used to weed out false results. The test results aren’t guaranteed but the odds are greatly in your favor if you get tested proactively rather than reactively.

It sounds like you’re asking about the pneumonia vaccine. Get it, why not?

I do kinda wonder though. In 2007, along with the flu shots, everybody in my office was offered a pneumonia shot, and we were told we would never need another one, that was it, good forever, blah-blah-blah.

This year, another pneumonia shot was recommended. I said, “Oh, I’ve had that.” The doctor–well actually a physician’s assistant–said, “No, this is a new one, like a booster, but THIS one is the last one you’ll ever need.”

Oh, okay…

I had never heard it called “old person’s friend.”

I don’t think pneumonia is a good way to go at all.

In addition to getting your prostate checked in whatever regular fashion is recommended these days, I’ll also chime in thoughts on pneumonia. Dying of pneumonia is basically drowning very slowly. It’s really not a way anyone would choose to go out.

This is reminding me of a discussion I had with my kid sister.

I was given up for dead one time. As in the “Is there anyone you wish to have present” question in the ICU.
When I mentioned this, she became upset: “You should have told me!”.

Ummm… so you can do exactly what? You were 2500 miles away and have no medical training. All you could do is worry.
So I get a false negative. What changes?
So I get a positive? Odds seem 50/50 that it will be a real problem.
Biopsy? OK, now what? Is surgery required/indicated? X% of surgeries result in death. Is that % greater than my chance of actually living long enough for the disease to kill me?

Realistically, I have, at most, another 15 years - and that presupposes that my kidney does not decide to quit on me or that “Kidney Replacement Therapy” actually works for me.

I was chatting with a person from way back - I asked about a mutual “used to know”.
Dead of kidney failure from the Chemo used to treat testicular cancer.
Would the cancer have killed him? We’ll never know because the “cure really was worse than the disease”.

Please have you numbers ready before telling me my bet on a medical crap shoot is wrong.

A person who has lost all mobility, has failing eyesight and has advanced dementia has no mechanism by which death is certain.

A healthy, mentally and physically active person will not need pneumonia - but for those who are as far gone as my grandmother, yes, I can see it viewed as a salvation.

So what you’re saying is that you don’t want the pnuemonia vaccine in case you might want to die of pnuemonia if you’re rendered feeble by the prostate cancer you don’t want to get checked for.

This does not sound like a good plan.

Unbelievable. It truly is taking longer than we thought to fight ignorance.

The Mayo Clinic is ambivalent on screening. They say it “can” help.

A panel of doctors recommends against it.

http://www.foxnews.com/health/2016/02/08/drop-in-prostate-cancer-screening-reveals-split-among-doctors.html

The CDC recommends against routine screening.

http://www.cdc.gov/cancer/prostate/basic_info/get-screened.htm

The American Urological Association is ambivalent, but in many cases recommends against testing.

https://www.auanet.org/education/guidelines/prostate-cancer-detection.cfm

And lastly, the doctor who invented the PSA test says that it’s being misused.

Thank you, Flyer.

Now, maybe some reflection on the question of deliberately precluding a disease widely regarded as a blessing within living memory.

I first heard the term “old person’s friend” from a nurse in the nursing home in which my mother died.
The term was NOT used ironically.

…Cite?

CannyDan here fails to mention yet another treatment option: Palliative care while letting the disease take its course. I get the sense that this is the option that usedtobe is really interested in. But as SeaDragonTattoo points out, pneumonia isn’t that.

I had the shot a few years back, and recently my doctor mentioned that there is a new vaccine (actually a series of two different vaccines, given a year apart, which sounds like the two shots that OP mentions), that should now be given. This agrees with Hilarity N. Suze, a few posts up.


I think the treatment that usedtobe should really be looking at is an Advance Health Care Directive, in which he can specify that in case of serious, debilitating, or painful terminal disease, that he would like the most aggressive palliative care possible and nothing else.

Side note on PSA screening: something that I didn’t get told until after I had already had a (very painful and disturbing) biopsy (negative) was that you should abstain from any sexual activity of any kind for 72 hours prior to the test. Sexual activity can and apparently usually does cause your PSA score to rise. Once I knew this, I never had another reading that caused any concern.

As to pneumonia, my father died in his sleep at 87 mostly of old age, he was active until the end but had an enlarged heart. But on the death certificate, pneumonia was cited as the cause of death. He was only in the hospital for 3 or 4 days*, so I’m not sure how that works. But I suspect that if you are old and already weak, pneumonia doesn’t have to progress very far or become very uncomfortable before it kills you. Perhaps this is what the OP is holding out for.

*He was taken to the hospital when he fell off his Segway while running errands and couldn’t get back up again, and the EMTs thought he needed to be hospitalized (not for injuries, he was not hurt from the fall). Perhaps they detected problems in his lungs when they examined him.

If you don’t already have a living will with a DNR order on it, getting one might do more than worrying about which vaccinations to get and which to avoid.

Make sure that your next of kin knows your wishes. I used to work for a hospital system, and some doctors there did not want to know what the patient wanted, and would treat aggressively (intubate, IV antibiotics, CPR, etc.) if the patient was not in a position to say “get the hell away from me”.

Why is that a worse plan than getting the vaccine so he can die of prostate cancer? I do not accept the proposition that “death is to be avoided at all costs”. I prefer another idea -

Regards,
Shodan

IF you’re feeble enough, some strain of virus, bacteria or fungus will induce pneumonia, and carry you away. There are thousands of pathogens that cause pneumonia, and a lot of them won’t bother you a bit while you’re healthy. But get bedridden and unable to clear your secretions, they rise up.

But the pneumonia vaccine can prevent a a lot of garden-variety causes of pneumonia from taking you out while you’re still relatively hale and hearty.

Get the shot.

As for the prostate, unless you’re in a high risk group, like certain ethnicities, or a family history of prostate cancer in father, brother, paternal uncle or grandfather, don’t get screened.

I argued here for not screening for prostate cancer being okay some years ago unless one was in a high risk group, and took a lot of heat for that position. But it has become the (more fuzzy than usual) medical consensus.

This.

The shot doesn’t prevent the “old man’s friend” kind of pneumonia. It prevents the kind of pneumonia that can kill you before you’re ready to go.

Getting screened for depression might not be a bad idea too.

Couple of different questions here - what you personally should do re: this one shot, vs what society ought to do about maintaining large numbers of decrepit elderly. I’m no doctor, but my WAG is that O2 and pacemakers likely sustain more significantly impaired elderly than pneumonia vaccines.

I think it was Ezekiel Emanuel who wrote in the Atlantic how he intended to decline various types of testing/treatment after age 75. Not sure how this particular vaccine would fit in his position.

You seem pretty sentient. If you want to die, why not figure out how to do it, rather than waiting to see in a particular bug comes along and kills you in an unpleasant manner?

You should definitely have the appropriate directives executed and distributed, and should look into palliative care and hospice.