A blood test is a typical part of a physical exam, but deciphering the numbers is anything but routine. Interpretation of the results is strictly the province of a medical professional. Science Times: Decoding Your Health
This webpage at NYTimes.com shows a typical blood count lab report, and allows you to click on any part of it for further explanation.
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Are patients swimming in a sea of health information? Or are they drowning in it?
The rise of the Internet, along with thousands of health-oriented Web sites, medical blogs and even doctor-based television and radio programs, means that today’s patients have more opportunities than ever to take charge of their medical care. Technological advances have vastly increased doctors’ diagnostic tools and treatments, and have exponentially expanded the amount of information on just about every known disease.
The daily bombardment of news reports and drug advertising offers little guidance on how to make sense of self-proclaimed medical breakthroughs and claims of worrisome risks. And doctors, the people best equipped to guide us through these murky waters, are finding themselves with less time to spend with their patients.
But patients have more than ever to gain by decoding the latest health news and researching their own medical care.
“I don’t think people have a choice — it’s mandatory,” said Dr. Marisa Weiss, a breast oncologist in Pennsylvania who founded the Web site breastcancer.org. “The time you have with your doctor is getting progressively shorter, yet there’s so much more to talk about. You have to prepare for this important meeting.”
Whether you are trying to make sense of the latest health news or you have a diagnosis of a serious illness, the basic rules of health research are the same. From interviews with doctors and patients, here are the most important steps to take in a search for medical answers.
Determine your information personality.
Information gives some people a sense of control. For others, it’s overwhelming. An acquaintance of this reporter, a New York father coping with his infant son’s heart problem, knew he would be paralyzed with indecision if his research led to too many choices. So he focused on finding the area’s best pediatric cardiologist and left the decisions to the experts.
Others, like Amy Haberland, 50, a breast cancer patient in Arlington, Mass., pore through medical journals, looking not just for answers but also for better questions to ask their doctors.
“Knowledge is power,” Ms. Haberland said. “I think knowing the reality of the risks of my cancer makes me more comfortable undergoing my treatment.”
Dr. Michael Fisch, interim chairman of general oncology for the University of Texas M. D. Anderson Cancer Center, says that before patients embark on a quest for information, they need to think about their goals and how they might react to information overload.
“Just like with medicine, you have to ask yourself what dose you can take,” he said. “For some people, more information makes them wackier, while others get more relaxed and feel more empowered.”
The goal is to find an M.D., not become one.
Often patients begin a medical search hoping to discover a breakthrough medical study or a cure buried on the Internet. But even the best medical searches don’t always give you the answers. Instead, they lead you to doctors who can provide you with even more information.
“It’s probably the most important thing in your cancer care that you believe someone has your best interests at heart,” said Dr. Anna Pavlick, director of the melanoma program at the New York University Cancer Institute. “In an area where there are no right answers, you’re going to get a different opinion with every doctor you see. You’ve got to find a doctor you feel most comfortable with, the one you most trust.”
Keep statistics in perspective.
Patients researching their health often come across frightening statistics. Statistics can give you a sense of overall risk, but they shouldn’t be the deciding factor in your care.
Jolanta Stettler, 39, of Denver, was told she had less than six months to live after getting a diagnosis of ocular melanoma, a rare cancer of the eye that had spread to her liver.
“I was told there is absolutely nothing they could help me with, no treatment,” said Ms. Stettler, a mother of three. “I was left on my own.”
Ms. Stettler and her husband, a truck driver, began searching the Internet. She found Dr. Charles Nutting, an interventional radiologist at Swedish Medical Center in Englewood, Colo., who was just beginning to study a treatment that involves injecting tiny beads that emit small amounts of radiation. That appeared to help for about 18 months.
When her disease progressed again, Ms. Stettler searched for clinical trials of treatments for advanced ocular melanoma, and found a National Institutes of Health study of “isolated hepatic perfusion,” which delivers concentrated chemotherapy to patients with liver metastases. After the first treatment, Ms. Stettler’s tumors had shrunk by half.
“I don’t like statistics,” she said. “If this study stops working for me, I’ll go find another study. Each type of treatment I have is stretching out my life. It gives me more time, and it gives more time to the people who are working really hard to come up with a treatment for this cancer.”
Don’t limit yourself to the Web.
There’s more to decoding your health than the Web. Along with your doctor, your family, other patients and support groups can be resources. So can the library. When she found out she had Type 2 diabetes in 2006, Barbara Johnson, 53, of Chanhassen, Minn., spent time on the Internet, but also took nutrition classes and read books to study up on the disease.
“I was blindsided — I didn’t know anybody who had it,” said Ms. Johnson, who told her story on the American Heart Association’s Web site, IKnowDiabetes.org. “But this is a disease you have to manage yourself.”
Tell your doctor about your research.
Often patients begin a health search because their own doctors don’t seem to have the right answers. All her life, Lynne Kaiser, 44, of Plano, Tex., suffered from leg pain and poor sleep; her gynecologist told her she had “extreme PMS.” But by searching the medical literature for “adult growing pains,” she learned about restless legs syndrome and a doctor who had studied it.
“I had gone to the doctors too many times and gotten no help and no results,” said Ms. Kaiser, who is now a volunteer patient advocate for the Web site WhatIsRLS.org. The new doctor she found “really pushed me to educate myself further and pushed me to look for support.”
Although some doctors may discourage patients from doing their own research, many say they want to be included in the process.
Dr. Fisch of M. D. Anderson recalls a patient with advanced pancreatic cancer who decided against conventional chemotherapy, opting for clinical trials and alternative treatments. But instead of sending her away, Dr. Fisch said he kept her in the “loop of care.” He even had his colleagues use a mass spectroscopy machine to evaluate a blue scorpion venom treatment the patient had stumbled on. It turned out to be just blue water.
“We monitored no therapy like we would anything else, by watching her and staying open to her choices,” Dr. Fisch said. “She lived about a year from the time of diagnosis, and she had a high quality of life.”
Dr. Shalom Kalnicki, chairman of Radiation Oncology at the Montefiore-Einstein Cancer Center, says he tries to guide his patients, explaining the importance of peer-reviewed information to help them filter out less reliable advice. He also encourages them to call or e-mail him with questions as they “study their own case.”
“We need to help them sort through it, not discourage the use of information,” he said. “We have to acknowledge that patients do this research. It’s important that instead of fighting against it, that we join them and become their coaches in the process.”
| If you're worried about BPA, there are two things you can do right away. BPA (bisphenol A) is the chemical found in food containers, eyeglass lenses and CDs, and this week researchers fear it may cause heart disease and diabetes. Researchers from the University of Exeter in the UK have found that people with the highest levels of BPA in their body were also the ones most likely to have heart disease and diabetes. While America's health regulator, the Food and Drug Administration (FDA), says levels of the chemical that enter our body are far too low to cause disease, they have come up with two ways you can reduce your exposure. FDA spokesperson Laura Tarantino suggests you avoid plastic containers that have the recycling number 7, as most of these contain BPA (advice that may apply only to the US), and don't warm up food while it's still in its plastic container as heat can help release the chemical. The Exeter researchers monitored the BPA levels in the urine of 1,455 adults; of these, 79 had suffered a heart attack, chest pain or cardiovascular disease, and 136 had diabetes. The average BPA exposure in the group was 20 micrograms a day, but a quarter of participants who were exposed to higher BPA levels of up to 50 micrograms a day were three times more likely to suffer cardiovascular disease than someone in the 20 micrograms group, and those in the higher group were also 2.4 times more likely to suffer diabetes. (Source: Journal of the American Medical Association, 2008; 300: 1303-10). |
Like most Americans, my attention has been riveted lately to the political storm stirred up by the upcoming presidential election. The past two weeks of Democratic and Republican convention watching has had my mind in a whirl.
But I have to admit that I am thrilled and proud to live in a country where the mixed-race child of a young single mother in Kansas; a couple of life-long politicians; and a relatively unknown woman stepping out of the shadows can all stand equally before the American public seeking the highest office in the land and one of the most powerful offices in the world.
That realization fills me with pride and gratitude for our founding fathers who had the wisdom and foresight to write such a possibility into our constitution.
However, as I have listened to the politicians speak and to the responses those speeches have warranted this past couple of weeks, I am reminded of the story of the troubled old man who was asked by his counselor what he believed to be the single-most source of his problems.
"Oh, that's easy," he at once replied. "I am always right and others are always wrong. But those foolish others will NOT, no matter how hard I try to convince them, admit that they are wrong and I am right."
Not pointing out the enormous egotism involved in such a statement, the counselor decided instead to try simple logic by asking, "But how is it possible for you to always be right and everyone else to always be wrong?"
"Ah, that..." said the old man. "That is one of the greatest miracles of all time!"
The moral of the story, of course, is that logic has never been much of a match for vanity, whether its one or one, or spilled across the boundaries of an entire political party. We humans like to be right, and even in those times when admitting an error might suit us better, we are loathe to admit we might not be as right as we'd like to think we are.
Which reminds me of another story: A Master was walking across a broad field one day with an eager student at his side. The two passed by an archer practicing his craft. When an arrow hit the target, the archer praised himself exceedingly for his great skill. When the arrow missed the target, the archer blamed a gust of wind.
"Do you see the nature of man?" the Master asked the student. "When things go right, he credits his own skill for having made it so. But when things go wrong, he quickly finds someone or something else to blame."
Over the next couple of months, we Americans are apt to hear a great deal of credit-taking and blaming. Our job as responsible, caring and progressive citizens, not only of this country but of the world, is to filter through all we will hear, and find whatever nuggets of truth lie buried beneath all the half-truths and contradictions.
Personally, I think the best way to do this is to refrain from judging and criticizing as much as possible and try blessing instead. It is my heartfelt belief that we can do far more good by blessing all of the candidates in this election and the leaders and future leaders of every country in the world, for that matter, than we ever can be condemning any.
Then, we can better make up our own minds based, not on what the politicians tell us or what our own egos demand be right, but upon our sense of personal guidance arising from within. Because what any politician tells us is going to come from his or her personal perspective, and no matter how altruistic or worthy their goals may be, their own personal agendas will naturally color their words.
We simply cannot know with certainty that what a candidate or a political party says is best is always best for all concerned.
When, however, we go within and ask that we be guided to choose the best candidate, not just to satisfy our own personal agendas, but for the betterment of all, then the wisdom that comes from within will be true to that request.
We don't just make our own lives better when we take the time to go within and get to know ourselves better. By learning to listen to our own inner wisdom, we make the world a better place to be.
Copyright © 2008 by Live More Abundantly Productions. All rights reserved.
