Should I postpone my annual exams because of covid?
August 29, 2020 5:26 AM   Subscribe

I live in Brooklyn. Our numbers are down here, but they are still high enough to make me nervous. My doctor's offices are in Manhattan and I've barely been inside any other places except my own apartment. I normally see my dentist twice a year and now that I'm in my 40s, I'm supposed to get an annual mammogram. Can I put these off until...things get better?

I saw my obgyn early this year, and she prescribed the recommended annual mammogram (I've only ever had this done once before). I'm 41, with no underlying health issues and no family history of breast cancer. No kids. Since covid happened, I've been staying in as much as possible and the thought of being inside makes me incredibly anxious.

I also go to the dentist every 6 months like clockwork. At my dentist, there are no windows. The rooms are small. The hygienist is extremely chatty. I really don't want to go, but it feels like now might be the window before a second wave. Should I wait?

Would it be ok to postpone these health visits until next year? I'm not even sure if things will be better next year. Both of these require being near a person in small rooms without ventilation.

Bonus, have you done these things this year, especially in NYC? How was the experience and did you feel that the staff took safety precautions?
posted by anonymous to Health & Fitness (28 answers total) 4 users marked this as a favorite
I did my breast mri and it felt very safe. Everyone wore masks. These things are important to your health and I felt I wanted to stay on top of it because this could all be going on another year or two.
posted by pairofshades at 5:28 AM on August 29, 2020 [2 favorites]

Hi -- I also live in Brooklyn and have gone to my primary care doctor and dentist in Manhattan since COVID.

Experience-wise, I felt good. I have been several times to my primary care doctor and have worked to get early-morning appointments, and two times the two of us have been the only people there aside from the receptionist. We both wore masks the entire time until I had to unavoidably take mine off, so she could examine me.

I have also had my annual dental cleaning, delayed a bit because the dentist's offices were closed from March to June. There, they asked us not to arrive until exactly the time of the appointment and gave us the option to wait outside if we did arrive early. The dentist who performed my cleaning appeared to be wearing a blue surgical-type mask over an N95-type mask and all other staff were masked. As usual, the worst people were the other patients, some of whom were doing the "nose out" thing -- I opted to wait outside until they were ready for me and went straight to the cleaning room.

If I were you, I would not wait. (Though I might try to do things like get appointments early in the morning.) I'm honestly surprised COVID numbers in New York have been so low for so long, and my expectation is that they will start rising again once the weather turns colder and people have fewer outdoor socializing options. There is also no guarantee that if you postpone one year that we will not be in a similar situation.

Finally, if one of those checkups turns out that there is something more serious that you should be aware of, I feel it'd be better to get that taken care of now while the healthcare system remains (relatively) unburdened before any COVID second wave.
posted by andrewesque at 5:41 AM on August 29, 2020 [6 favorites]

I went back to my dentist last week for a cleaning, and the routines had changed. Masks on everyone, handwashing mandatory before I even signed in, and shields and PPI for the hygienist, no pop-in visit from the dentist. Nobody else in the waiting room. In short, routines had changed, behavior had changed, and there was a serious tone among all the staff. I felt completely protected, and felt their PPE was protecting them. My dentist practices in a free-standing independent office, so the precautions they took were all within his control. It had been 8 or 9 months since I last saw them, so it was wonderful to have my teeth cleaned.

I also had a mammogram 2 months ago because I was overdue and a friend had just been diagnosed with breast cancer. I was nervous. Again, handwashing inside the waiting room, no more lockers but plastic bags to put our clothes in and carry with us, masks for everyone, PPI for the mamm tech, no more waiting around for the doctor to give results, all results sent by mail. I thought the mammogram precautions were not as extreme as the dentist (there were 2 other women in the waiting room, distanced and masked) but still adequate. In the past there might have been 10 women waiting both before and after the procedure. My mammogram facility is inside a large hospital, and there are 3 or 4 mammogram machines and a couple of ultrasound rooms.
posted by citygirl at 5:47 AM on August 29, 2020 [1 favorite]

The American Cancer Society does not recommend annual mammograms until age 45 and the US Preventative Services Task Force doesn't recommend until age 50 (both say it's optional starting at age 40, and of course if you have a high risk family or personal history the "usual" recommendations may not apply).

I am not in NYC but I did go to my dentist in June, and felt safer there than in nearly any other place I've been since mid-March. No waiting in the waiting room; call on arrival and they bring you straight back. Everyone was masked; the hygienist and dentist both had face shields as well. I paid my co-pay over the phone afterwards, instead of handing my card over. I would call ahead and ask what their safety procedures are. Dentists and dental hygienists are at extremely high risk, and the ADA has guidance on how to see patients safely.
posted by basalganglia at 5:47 AM on August 29, 2020 [7 favorites]

I’ve had a primary care doctor visit, a 6 month dental cleaning, and an annual gyno visit since this all started. I have my regular mammogram set up for Feb. These are basically the only things I’ve done aside from grocery shopping since March. I felt very safe at all of these. I did have early morning appts for all, which made me feel better. All offices had everyone masked ( at the dentist the hygienist was masked and wore a face shield), temps were taken at the door, some chairs were removed from waiting rooms for social distancing, bills were mailed rather than having people pay at the desk...
I was quite anxious before all of these (especially the dentist) but I felt very safe throughout. I also found it comforting to talk with my gyno (this appt was just yesterday) about how I was feeling about all *this* and have my feelings validated by a doctor (not sure how that might translate to a dental visit!).
posted by bookmammal at 5:49 AM on August 29, 2020 [1 favorite]

I live in NYC too and I am planning to schedule a bunch of check-ups soon because, while NYC is doing well now, the uncertainty around school openings and the approaching cold months may cause a resurgence here which could affect access to medical care again. I'm not saying this WILL happen but it easily could, so I plan to hedge my bets and get that stuff over with now, while it's still summer.
posted by showbiz_liz at 6:34 AM on August 29, 2020 [2 favorites]

Oh I would definitely skip the mammogram if you don't have risk factors. I'm 42 and I'm not intending to get them on the regular until I'm 50, regardless. I told my primary care doctor I preferred to wait and she didn't give me any hassle about it.

Likewise, dental exams can pretty much always wait unless you're in pain or have an underlying condition. Even my dentist says this!

I don't live in NYC and I'm probably less cautious than you in general (I've been to other doctors several times, I've been to Target and various drugstores, I voted early in-person at the Senior Center, I checked out a new fancy wine shop the other day) but I absolutely would not get a mammogram and I'd only get a teeth cleaning if I had some kind of dental problem or if I thought it would be a net positive experience (I do like that clean tooth feeling, and one of the hygienists at the practice I visit is a massage therapist and sometimes adds on a head and neck massage).

These are both procedures that can be delayed for *years* barring any other problems or symptoms developing. You would probably be perfectly safe to get either, but if it's going to stress you out feel free to skip them.
posted by mskyle at 6:38 AM on August 29, 2020 [1 favorite]

I‘ve had a dental cleaning, mammogram and seen my gyn as well as being referred for other treatment which requires monthly appointments. Everywhere I’ve been had implemented extra protocols far in excess of what was happening pre covid.

By far the greatest difference was the dentist with mandatory hand washing and temperature checks and questions about potential exposures on arrival, nobody else in the waiting area, the hygienist wore a face mask and shield and she used manual tools as opposed to the sonic ones, which I was told require water to be used and thus create more droplets.

I never felt unsafe for any of these things.
posted by koahiatamadl at 6:55 AM on August 29, 2020

I would skip the mammogram and do the dental cleaning, but ymmv. There is clear benefit to semi-annual dental cleanings, and much less clear benefit to annual mammograms for pre-menopausal women.
posted by ArbitraryAndCapricious at 7:29 AM on August 29, 2020 [7 favorites]

I'm a person who *needed* to have a diagnostic mammogram a couple of months ago. I did it, I'm glad I did it, and I don't think you should do yours right now absent any specific risk factors. Commit to doing a monthly breast self-check and postpone for a year.

There is literally no possibility of distancing during a mammogram. The technician is right there in your face, repeatedly. Their face will be one inch from your face. And at least in my experience, they were wearing a mask and there was no possibility of them wearing a face shield. They need to get to too close to you for that.
posted by BlahLaLa at 7:39 AM on August 29, 2020 [1 favorite]

Not NY, but NJ so I feel your reluctance. I've been knocking out appointments now so that when things get worse later I won't have to worry about going so long.

I had a mammogram and breast ultrasound in June to follow up on abnormalities found last October*. Everyone was very cautious, the spacing protocols for patients were fantastic. In my case, they had us waiting in the separate dressing rooms until our time and then sanitizing the dressing rooms after each patient. I wore a mask and the technicians wore masks and face shields. It turns out that with all of the "turn your head to the left/right and put your arm up/over" choreography, we were never in each others' faces!

I saw my primary care physician and was less than pleased. At one time there were 5 of us in the waiting room because they weren't spacing out appointments and the nurse was taking temps before we came back NOT when we entered the waiting room (she forgot me altogether). It all turned out okay, but it's 100% fine to wait outside if you don't feel comfortable.

*All benign, but I'm 47. Knowing plenty of women who had breast cancer found in their 40s by a regular mammogram so I have feelings about the 50yo recommendation being a little high.
posted by kimberussell at 7:45 AM on August 29, 2020

I would get the dental cleaning because it might be 6 months or more before it's any safer and preventative dental care is really valuable. I'm not in NYC and I haven't gone to the dentist yet this year but my dentist's office has sent emails detailing their enhanced safety procedures. Hopefully you can get that kind of info from yours too, which might make you less worried.

I would definitely not get a mammogram at age 41 with no family history of breast cancer.
posted by dogwalker3 at 7:45 AM on August 29, 2020

Call the dentist and see what they are doing. Do they ask you screening questions? Mine's a free standing office and they have you call from outside and see if another patient or patient group is still inside and if so, to wait until they leave. From my experience at that dentist, I would not hesitate to go. You hardly have a chance to bump into anyone. I was less comfortable at the orthodontist's because of the setup: more people having to funnel through one little door. If someone was being screened at the door and was turned away, they would have to walk right by you. Another time I would probably wait on going to a multi-patient practice like that.
posted by BibiRose at 7:52 AM on August 29, 2020

nthing the dental cleaning - I'm in OR, not NY/NJ, but I did one in July and felt completely safe. Similar to others' experiences, there was much handwashing, there were many layers of protective gear (my hygienist wore an N95 mask under a cotton mask under a face shield, and changed gloves about three times during the cleaning). They also changed up their regimen - they didn't use any of the usual cleaning/polishing machinery that would throw off a lot of splashes of water from my mouth, so it was a very manual cleaning with me rinsing from a paper cup (which was new with each rinse).

CIS male so I can't speak to the mammogram, but call your dentist and check what they're doing, and I think it'd be safe to go get a dental cleaning.
posted by pdb at 8:03 AM on August 29, 2020

People's first hand accounts will probably help you quite a bit. I'd say do what makes you feel calmer.

To the larger question of is it okay to skip dental cleaning and a mammogram, I say whole heartedly yes.

I'm not an expert, and have a cynical outlook, so take it for what you want. From what I have read, mammograms don't seem to affect overall survival rates . And plenty of people don't get regular tooth cleanings--practice solid mouth self care, it is certainly not a necessity.

That said, with strong PPE and social distancing, you will probably be fine if you go to these appointments.
Good luck.
posted by rhonzo at 8:12 AM on August 29, 2020

I would not skip the dentist. It doesn't take very long for a dental problem to develop which if undiagnosed can really change your life for the worse. (I was very VERY glad that I finally went for my cleaning when I did. And it was horrible by the way, because the interval had been longer than usual. Sure people used to go without regular dental care at all in the olden days; people also routinely lost their teeth.) You can call and ask about the office COVID protocols before you go.
posted by fingersandtoes at 8:13 AM on August 29, 2020 [3 favorites]

I'd recommend asking your health care providers what safety measures they're taking. I recently went to a dental cleaning where I very much did not feel safe (the crowded waiting room was the first sign of a problem), and I wish I had been more proactive in asking about their safety protocols before I went. However, if they'd been using the procedures described by citygirl, I would have felt totally fine. Finding out what measures they're taking in advance might help you make your decision.
posted by ourobouros at 8:24 AM on August 29, 2020

Because of the link between tooth plaque and heart disease and trying to stay as healthy as possible, I did my dental cleaning as scheduled in July, thinking that now might be my window before things get really bad where I live. I was very anxious about it but am glad I did it, and was overall reassured by the precautions. I would skip the mammogram, though.

Can you get to your appointments without taking public transit?
posted by stellaluna at 9:25 AM on August 29, 2020

I can't speak to mammograms other than this does not sound urgent to me, but I do not leave home either and I have caved in and gotten an eye exam, shots and the dentist. Medical professionals have the most protections around so that is as safe as it gets. Also this shit will not be ending so there is no point in postponing until it gets better. It'll be like this next year too probably.
posted by jenfullmoon at 9:33 AM on August 29, 2020 [1 favorite]

I am going to dentist and doctor appointments now. It seems like a good idea to get basic health maintenance out of the way before cold weather hits and the anticipated second wave arrives. Also, having medical professionals look you over and say "no need to worry about this [thing that you were worrying about]" is a rare balm in an anxious time. It is literal self-care.

I put those appointments off in the early days, first when offices were closed and later when there was so much uncertainty about best practices. Now my dentist is limiting the number of patients she sees each day, so a dental cleaning that I postponed in early June was booked for September 25, their earliest availability. My doctor is doing telemedicine 3 days/week, and spaced out her in-clinic appointments to limit waiting room traffic, so slots for in-person appointments are about ⅓ what they used to be. Rescheduling an appointment this month is betting that our pandemic situation will be better in December, and I don't like those odds.
posted by mumkin at 9:39 AM on August 29, 2020 [1 favorite]

I would not skip. I live in Louisiana which has had some of the highest rates and I have gone to my dentist and gyn exams as usual because a) my doctors' offices are meticulous (almost to the point of overdoing it) about spread prevention and b) it just takes a year skip for what could have been manageable breast cancer that would have been caught to turn into something much more serious.
Is the possible danger of catching the virus and then probably having a relatively mild case of it (assuming you have no underlying health issues) really worse than missing a screening that could potentially save your life?
posted by tafetta, darling! at 12:31 PM on August 29, 2020

If your teeth are in otherwise good health and you are good about brushing and flossing, I would skip the dental cleaning for now. Even if your hygienist and the dentist are all masked and PPE'd up, you and all the other patients who have been in that room are the ones who cannot have a mask on while you're in the chair. I had a cleaning scheduled for May, right after things started opening up in my state, and I asked them to push it 6 months out. I'm currently scheduled for October and I still am not sure if I will keep that appointment or reschedule. My almost-SIL is a hygienist (not mine as we are in different states) and she has told me that if she were in my position, she wouldn't be going to see the dentist right now unless it was an emergency.

For the other appointments, I would feel more comfortable going to those because I would be able to wear a mask during the appointment, provided that the office is doing screenings/not making you sit in a crowded waiting room before you see the doc.
posted by hetobeto at 1:05 PM on August 29, 2020

If you already did the dentist once this year and got x-rays, maybe you can skip it. I finally went back recently following the same thinking of everyone here (had my March appointment cancelled and hadn't been in at least 6 months before that), get it done now while it's safe, and they found a cavity that I need to get taken care of asap. So, I'm glad I did even though I hate the outcome.

I think if you postpone based on current fears you are probably postponing for a year-ish. It's unlikely things will be significantly safer before next summer-ish. But the incidence is very low right now, so if you think you're gonna want to do this any time in the next year, I would do it now.
posted by ch1x0r at 2:08 PM on August 29, 2020

I've been trying to get my appts in over the last two and the next two weeks. I started with my annual physical, which led to needing a follow-up thyroid ultrasound and an appointment with an allergist. I also have my dental cleaning and annual GYN check-up next. I'm in Brooklyn and in the first 16 weeks, I only left the apartment 3 times, until we left to spend a month in Michigan where I also only went into one store in a month, if that helps to understand my risk analysis. Three of the five appointments are in lower Manhattan, so I decided to walk to those. Those who are un- or improperly masked really bothered me on the first walk, but knowing that I was outside and only passing these folks made me more comfortable by the second walk.

My GP wasn't super concerned about my thyroid issue, but wanted me to move forward with the follow-up now before the Covid infection rates most likely get worse in the fall/winter, so I would say to take advantage of any appointments that you can book now.
posted by icaicaer at 2:41 PM on August 29, 2020

I live in NYC and would also skip the mammogram and do the dentist visit, as others have said. I have not done either but have gone in for routine bloodwork and got a COVID antibody test while I was at it. I also had to go to my dermatologist's office twice because I fell and sustained a cut that needed stitches. I felt very safe in that environment because it was an office that was only handling elective things for people who are not actually sick; I imagine the dentist office environment would be similar.
posted by bedhead at 3:50 PM on August 29, 2020

I wouldn't skip the dentist visit for the reasons mentioned above. Also, much of the risk for dentist's offices is actually to the dental hygienist, not the patient. I kept my appointment as scheduled and they had really upped the preventive measures (temperature taking, no waiting room, special oral rinse for me before they started working, no touching basically anything).

Unless my doctor recommends otherwise, I will probably skip my well woman appointment - I am not at higher risk for anything she's checking for and probably am not due for a pap. I'd definitely skip a mammogram without a bad family history.

I have kept my kids' in person well child visits for vaccinations, even though their clinic is inside of a hospital that was designated as the pediatric COVID center for our area.

If it would make you feel better, I suggest asking your doctor and explaining that you are anxious. We rescheduled our kids' dentist visits when things were ramping up here out of an abundance of caution, and they were totally understanding about it.
posted by peanut_mcgillicuty at 5:20 PM on August 29, 2020

Reading these responses makes me want to follow up and add a couple of things I forgot to mention about my NYC dentist experience in my initial response: my dentist was also wearing a face shield and they had definitely changed up the routine by using the "water spray thing" way less and doing more manual picking, in addition to giving me very specific instructions about how to gargle and dispose of the water, presumably to lessen droplets in the air.
posted by andrewesque at 6:25 PM on August 29, 2020 [3 favorites]

My grandma always said you only get one set of teeth, so take care of them. I wouldn't skip a dental appointment at this point. I went for a cleaning in July and felt perfectly safe (in Buffalo, not NYC).

You have to remember the percent positive in NY right now is something like .67%, which is basically zero - with the highest area being Western NY, not NYC. And the people getting tested are people who have reason to believe they should be tested. If we cannot resume leading our normal, albeit masked, lives now when community transmission is basically zero, when will we be able to? I believe we should not be foregoing preventative health care at this time because covid is not the only thing that can kill us. You have to decide your risk tolerance for yourself, but what happens if you put off your mammogram for this year and then next year because covid still isn't 100% in check, and you end up with terminal breast cancer because you didn't catch it early?
posted by DEiBnL13 at 9:20 PM on August 29, 2020 [1 favorite]

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