Parent wants to mend broken family Cologuard test worth the risk is
Dear Amy: All five of my now-adult children were adopted. The youngest two are bio-sisters and came to us when they were four and five.
These sisters have always struggled, and we were in and out of counseling as they grew up.
They have accused abuse (not true).
They both have substance abuse issues, and have exhausted their brothers and sister, too, with their lies and behavior.
Amy, they refuse to even talk to us. My heart breaks for their hurt and I do not know how to help. How can we mend this torn family? — Hurting Mom
Dear Hurting: You seem to have given your all to your children. I hope you have something left for yourself.
According to information published by the National Institutes of Health, “Addictions are moderately to highly heritable. Family, adoption and twin studies reveal that an individual’s risk tends to be proportional to the degree of genetic relationship to an addicted relative.”
Your youngest daughters may have entered the world already marked for the struggles with addiction disorders that they are facing now.
Unfortunately, you may not be able to mend your torn family. Parenting at this point for your challenging younger daughters may mean establishing firm boundaries and supporting recovery, but not enabling addiction. You may have to train yourselves and your other children to learn how to lovingly detach from them. Therapy at this point should focus on your own coping skills, as well as exploring concepts such as codependency.
It might be time for you to surrender to your own powerlessness over your daughters’ addiction, and make a choice to focus on your own health and recovery. us of
Dear Dr. Roach: I am a 77-year-old man in good health. At my recent annual physical exam, my physician ordered a Cologuard kit to be sent to me to screen for colorectal disease. I have never had symptoms of disease or problems with any part of my gastrointestinal tract. I read the patient guidelines and learned that the Cologuard test could result in false positives and that there is an unspecified increase in the risk of false positives for persons over the age of 75. A positive result from the test requires a follow-up colonoscopy. Since I am in good health with no symptoms of any disease, I decided I did not want to risk a false positive result from the test. Did I make the right decision? — E.G.
Cologuard is a brand of test that looks at DNA in stool for evidence of cancer. Certain DNA mutations are highly suggestive of cancer. In addition, Cologuard does an immunochemical test looking for blood. Because it combines these two techniques, Cologuard is more sensitive than only a test looking for blood. Compared with colonoscopy, Cologuard is about 92% sensitive in finding cancers, meaning it will miss about 8%. With improved sensitivity comes a lack of specificity, which means you could have a false positive result. The Cologuard can say that you have an abnormality when a colonoscopy would indicate normal. For 45% of people with a positive Cologuard test, no abnormalities will be found upon colonoscopy.
There are two reasons that I think the Cologuard is still a reasonable choice. The first is that a normal Cologuard test prevents a need for colonoscopy, and a false positive would lead to the same colonoscopy you would have gotten anyway. The second is that a person with an abnormal Cologuard and a normal colonoscopy may be at risk for an abnormality that wasn’t found.