Tag Archives: cancer

HEALTH in red capital letters

7 questions about health you need to ask now

What does “health” mean to you?

Health- flux and adaptation

Let’s continue exploring the heart of health by looking at a couple of interesting books. In a previous post we considered the WHO (World Health Organization)definition of health

“a state of complete physical, mental, and social well-being

and not merely the absence of disease or infirmity.”

Or you could also say

There's a Lot More to Health than Not Being Sick by Bruce Larson

“There’s a Lot More to Health than Not Being Sick”

So, what is “a lot more”? 

I’m introducing you to two medical writers who believe  health is multifaceted and not centered around the presence or absence of disease.

(Note: this post uses affiliate links to sites where you might make a purchase which will help fund this blog; your help is appreciated. )

Enjoying life to the fullest

Despite the author’s  impressive credentials, I was skeptical about a health book called “The Lucky Years”, as if health is just a matter of the luck of the draw or throw of the dice.  book cover- The LUCKY YEARS by David B. Agus, M.D.

The author is David B. Agus, M.D. , Professor of Medicine and Engineering at the University of Southern California , , author of two bestselling books and a CBS News contributor.

In The Lucky Years- How to Thrive in the Brave New World of Health Dr. Agus covers some hefty topics including

  • how the human body ages
  • Innovative cancer treatments with immunotherapy , DNA sequencing, and molecular targeting
  • The use of clinical trials to study new treatments for cancer and other diseases
  • How cancers metastasize (spread)
  • Potential uses for stem cells
  • New insights into the development of antibiotic resistance
  • Proteomics- study of the body’s proteins
  • The relationship of antibodies to common viruses to onset of chronic diseases

Rather than highly technical detail he offers a broad overview of these new technologies and how they may help treat and potentially prevent the main causes of death, that is cancer and chronic diseases like heart disease and diabetes.

He recommends patients understand and use technology to maintain and improve their health and not rely solely on their doctor to do so and to actively participate in the healthcare system.

He believes that health data will be used to prevent, detect and treat disease and to prolong life.

Large quantities of such data, organized in a secure database, will help us predict risk and recommend preventive measures, such as already done with

  • Colonoscopy to prevent deaths from colon cancer
  • Aspirin and statin use to prevent cardiac deaths
  • Management of low grade cancers conservatively, avoiding the use of surgery or chemotherapy

Health is in perpetual flux. 

I agree with Dr. Agus’ views on what health is, or rather what it is not.

“I don’t know what true health is, particularly on an individual basis.

For person A, health can be living totally free of illness and disability.

For person B, however, perhaps health means managing a condition well and enjoying life to the fullest despite some disability.

While we can certainly try to measure health in a variety of ways- weight, cholesterol, blood sugar, blood cell count, hormone levels, markers of inflammation, how you look, and how well you sleep, for example- none of those figures or generalizations will tell the whole picture.

And they won’t reveal how many years and days you might have left on this planet.”

He offers this advice –

“I encourage you to view your total health as a complex network of processes that cannot be explained by looking at any one pathway or focal point. Health is in perpetual flux.

The body is an incredible self-regulating machine. You don’t need to do much to support its health and optimal wellness.”

A constant state of healthy adaptation

Nutritionist Hailey Pomroy, author of Fast Metabolism Food Rx, recommends using food as “metabolic medicine.”  book cover- FAST METABOLISM FOOD RX BY HAYLIE POMROY

“Food integrates with your body to create health in a powerful way.”

She explains health using a formula E + M = H which means

Eating, Exercise, Environment  plus

Metabolism, metabolic pathways, Me  equals

Health, Homeostasis, Harmony

In this formula, E stands for everything we put into our bodies as well as everything around us, including people, your job, the weather.

M is what is inside of you, including your genetic makeup, and what happens when your body processes (or metabolizes) food, nutrients, toxins, medications.

“Health doesn’t always mean you are disease free, It means your body has created a homeostasis or internal balance, …is a constant state of healthy adaptation or flux.”

Considering their advice, think about what health means to you.

Use these questions to get started.

  1. Do you use any type of technology to manage your health and medical care? If so, is it helpful, or just more busy work?
  2. What is your relationship with your personal physician? Do you rely on your doctor to tell you what you should do, or recommend what you should do to stay healthy and treat ailments?
  3. Do you know what  medical conditions you are at risk for, and what you can  do to prevent them?
  4. What health measures are important to you, like blood pressure, cholesterol, weight, BMI, mammogram, and why?
  5. Are you “living life to the fullness” and if not, why not? What could you change to make that happen?
  6. How do you use food?
  7. What factors make up your E and your M? Do they add up to the Health that you want to create?

If none of these questions fit your answer, that’s ok, I want to hear your thoughts on health. Share your answers in the comments, or in a message if you prefer to remain anonymous, I will share and discuss them in a future post. Thank you.

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Do you know the best questions to ask about your healthcare?

I blog about healthcare communication because you need to understand your doctor better and  we doctors need to understand our patients’ expectations, concerns and obstacles.

Physicians should  use clear understandable plain language with patients. Patients should also be clear and specific when they talk to their doctor.

You may think your doctor knows exactly what you mean, but sometimes we are left trying to read between the lines of what you tell us.

Dr. Aletha talking to a mother and her son

Talking to a patient through an interpreter makes communication extra challenging.

You know it’s important to tell us details of your symptoms, medical history, family history, habits, and other medical facts.   But besides medical information about you , we need to know

Your expectations about your care,

Your concerns about your care,

Your obstacles to getting care,

You may wonder, won’t or shouldn’t my doctor ask me theses questions? Sure, we can ask and probably will, but by volunteering it , you start dialogue that gets you and your doctor communicating effectively much faster. Your doctor knows about disease, but you as the patient know the experience of the illness much better. 

Let me illustrate by giving you some examples. These are all statements patients say  to me in my daily practice. The original statements aren’t bad or wrong, but by rephrasing to add some additional detail they  give your doctor valuable information that will help provide you the best care possible.

The underlined words can be substituted for others listed in parentheses.  The exact words aren’t as important as the  message they convey. 

Hello doctor, I’m here because I want my thyroid checked.

(substitute heart, lungs, cholesterol, blood sugar, kidneys, etc.)

Instead try-

Hello doctor, I’m tired a lot, and wondered if it might be a thyroid problem or something else. What testing would help us find out what’s wrong with me?

It’s better not to limit your doctor to checking just one thing, when there are many possible explanations for your symptoms. You expect a thyroid check, but you’re open to other possibilities.

tubes used to collect blood samples in a lab

 

Doctor, I feel terrible and think I have  pneumonia. The last time I felt like this the doctor said it was pneumonia, so it must be that again.

( sub kidney infection, strep throat, sinus infection)

But if you say this

Doctor, I feel so sick. This illness is similar to when I was diagnosed with pneumonia and I’m afraid I have it again. I am concerned it’s pneumonia again so  I’m here to find out what is wrong, as I realize it may be something else.

You’ve told the doctor your concern about pneumonia but you’re not trying to diagnose yourself.

 

 

I have a family history of cancer so I want to have a mammogram.

(sub any other cancer, heart disease, stroke and other tests)

That’s good, but this is better.

Doctor, I’m concerned about breast cancer as it runs in my family. My grandmother was diagnosed at age 45 and now my sister has been, and she is 40. Do I need a mammogram or any other testing now?

Knowing who in your family had a disease and at what ages helps the doctor make an accurate recommendation. It also tells your doctor this may be an emotional issue  (concern)  for you.

Top 10 cancers in the U.S.

 

 

I need an antibiotic (anti-inflammatory, muscle relaxer, steroid, shot )  for this; I know because my previous doctor always gave me one for this.

Please try this instead:

When I had this before my doctor prescribed an antibiotic; I wonder if that would be appropriate this time?

This tells the doctor your expectation, but also that  you are open to different  advice/recommendation. (and avoid getting a medication you don’t need.) 

6 smart facts about antibiotic use

 

 

 

Will my insurance pay for this? How much will this cost me? Is this an expensive drug?

Patients may expect us to know about insurance and cost, but often we don’t. We can work with you on financial issues if we know more about your obstacle. Try asking-

I need to find out if this is covered by my insurance. Can someone in your office look that up, or help me find out?

I’ve had a lot of medical bills this year that have stretched my budget. I will need to find out what my out of pocket cost will be before scheduling this test. Can your office help me with that?

If there is a generic version of this drug that will work just as well, I would like it, to minimize my out of pocket cost. If not, is there another alternative?

 

 

Is this drug safe? (effective, good, best, dangerous, harmful)  

Few things are 100% safe. But what we can discuss with you is –

What are the risks and side effects of this drug? Is the benefit I get from the drug worth the risks? Are there alternatives that would be effective and less risky?

We always should be concerned about drug use, and safety isn’t the only issue. Don’t hesitate to ask questions.

medication capsules

 

 

 

 

 

How long will I be off work? When can I go back to work?

Here’s what your doctor needs to know –

My job requires me to stand and walk for several hours?

(sit and type; talk on the telephone; drive long distances in my car)

And here’s what you need to ask:

How soon should I expect my stamina to return so I can work part time? Full time?

When can I safely work without interfering with my recovery?

What can I do to hasten my recovery so I can return to work sooner?

Both  you and your employer, need to know when it is safe to return to work.  We have to balance health concerns with your financial concerns and what is expected and allowed by your employer and the law. 

If you are clear  with your concerns and obstacles  and flexible in your expectations it will be easier for your doctor to make the right decision.

 

 

These are just a few examples. I’m sure you can think of others.

Whenever you have a need to consult a physician, think ahead of what your

expectations, concerns and obstacles are before you make the visit so you’ll  be

prepared to share .

Here are  more tips on talking with your doctor-

How to talk to your doctor to improve your medical care

How to tell your doctor what’s wrong with you.

I invite you to follow this blog as we explore the HEART of health together.

 

Dr. Danielle Ofri’s book  What Patients Say, What Doctors Hear,

details the reasons doctors and patients don’t communicate well

and offers ways to improve our interaction.

What Patients Say, What Doctors Hear by Danielle Ofri, MD

written by Danielle Ofri, M.D.

(this is an affiliate link)