Doctor won’t prescribe treatment
Dear Dr. Roach: 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 postmenopausal symptoms once I turned 60? After suffering from menopausal symptoms starting at age 42, I was finally prescribed HRT at age 57. What relief I had, as it was the only remedy to alleviate my hot flashes, weight gain, lack of sleep and vaginal dryness.
MOON ALERT: There are no restrictions to shopping or important decisions today. The Moon is in Leo. HAPPY BIRTHDAY for Wednesday, June 21, 2023: You are intelligent, intense and focused, and you have many talents. You are sociable and like to be busy. ARIES (March 21-April 19) ✩✩✩✩✩ This is a wonderful day to socialize with others and enjoy playful activities with kids. (You’re very convincing today.) Tonight: Socialize!
TAURUS (April 20-May 20) ✩✩✩✩ Be open to entertaining friends and loved ones at home today. Any gathering at your home will be joyful. Tonight: Entertain.
The form of scoring can affect bidding decisions. At IMPs, for example, you want to be plus — plus anything — in partscore deals. At matchpoint duplicate, your goal is to outscore the other pairs who hold your cards — by any margin.
In the Platinum Pairs at the Spring NABC, East opened a weak two diamonds, an odd action with that suit. After two passes, North doubled, an answer to South’s prayers. After two passes, West questionably ran to two hearts. North doubled again.
Once I hit 60, I was ordered to stop the HRT, and no one since will prescribe it for me now. I am 66 now, suffer daily with hot flashes and have my sleep interrupted at least five times a night with terrible night sweats. I have tried just about every over-the-counter offering with zero effectiveness.
I will gladly trade the greater risk of heart attack and stroke, and the possible shorter life span, for relief from symptoms that affect my daily quality of life. Clearly, the choice is not mine. Why don’t I have that choice as a patient?
R.M.T.
GEMINI (May 21-June 20) ✩✩✩✩✩ You’re in a positive frame of mind today, which is why this will be a successful day for you. Tonight: Communicate!
CANCER (June 21-July 22) ✩✩✩✩ Trust your ability to negotiate financial matters in your favor, because they exist. Tonight: Protect your belongings.
LEO (July 23-Aug. 22) ✩✩✩✩✩ This is a powerful day! People in authority (including parents and the police) regard you favorably. Tonight: You win!
VIRGO (Aug. 23-Sept. 22) ✩✩✩✩ Your popularity is strong now. In addition to this, authority figures will listen to you because you
South was sure his side could make 3NT for plus 600 or more.
At IMPs, he would have passed; he could
Answer: A patient always has the right to refuse a treatment recommended from a physician. However, the physician is not obliged to prescribe a treatment they do not think is appropriate.
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.
In women with a history of an estrogen-dependent tumor (like many breast cancers), a history of a blood clot or a stroke, or a few other issues, the harms almost certainly are confident and convincing. Tonight: Solitude. LIBRA (Sept. 23-Oct. 22) ✩✩✩✩✩ This is an excellent day to study, make travel plans or give a speech. People will listen to you. Tonight: Be friendly. SCORPIO (Oct. 23-Nov. 21) ✩✩✩✩ People see you as financially capable and ambitious, yet charming and likable. Tonight: You’re high-viz.
SAGITTARIUS (Nov. 22Dec. 21) ✩✩✩✩✩ Go forward with your ideas to make travel plans. They will be successful. Tonight: Do something different. CAPRICORN (Dec. 22-Jan. 19) ✩✩✩✩ Issues at work will be easily resolved expect a sizable plus on defense. If he was plus 500, he might lose a little; but the penalty might be bigger, and if 3NT happened to fail or wasn’t bid in the replay, he would gain heavily.
But at matchpoints, South had to consider bidding: If he was plus only 500 on defense, he might get a “bottom.” The winning action was ... to pass. Two hearts (or two diamonds) doubled cost at least 800. DAILY QUESTION Youhold:S832HKQ DAQJ83CQ94.You open one diamond, and your partner responds one heart. The opponents pass. What do you say?
ANSWER: A bid of 1NT would promise a minimum opening bid with balanced pattern, which is what you have. Since your spade holding doesn’t suggest playing at notrump, at least not from your side of the table, to rebid two diamonds is tempting, but you would suggest a longer suit. Bid 1NT. outweigh the benefits. Otherwise, a wise clinician looks at the patient’s risk for heart disease, blood clots and other conditions. Women at a very high risk for heart disease should probably avoid estrogen; otherwise, using lower-dose estrogen by patch (rather than pill) is wise for women at moderate risk, such as those in their 60s.
I recommend you seek out an expert in menopausal treatments. today. Work hard, party hard! Tonight: Check your finances.
AQUARIUS (Jan. 20-Feb. 18) ✩✩✩✩ Even though things are unfolding beautifully for you today, be prepared to go more than halfway. Tonight: Be patient. PISCES (Feb. 19-March 20) ✩✩✩✩ Family discussions will go well today. You might be able to recruit the assistance of others to help you achieve what you want to do. Tonight: Work.