Wondering how to give solicited medical advice

April 25, 2014

There’s a big difference between giving solicited and unsolicited medical advice. I think I’ve got a handle on giving unsolicited advice, but now a friend is asking for help and I’m not sure how to respond.

When you’re consumed with health issues, it’s easy to see them everywhere you look. I spend so much time and effort on getting enough sleep, eating the right foods, getting enough exercise, avoiding bad foods, etc., that it drives me up the wall to see people with more choices doing unhealthy things. The thing is, if the person doesn’t ask for advice, then offering it can be off-putting. They may be insulted or simply choose to ignore me. They probably aren’t ready to hear the message anyway. So I respond by posting tips to Facebook, where my family and friends can choose to read them or not. I’ll make comments that aren’t directed at them, just to get them thinking, like “Isn’t it terrible to think how many hormones people get from the animals they eat? I wish the FDA would do something about that.” I don’t badger anyone. This has been working out pretty well so far.

But when someone asks for advice, those rules go out the window. I’m back to wondering, how much is too much? If I give her too much information, will it scare her off? And can I trust my own perspective? I want to warn her that many doctors won’t run the right thyroid tests or prescribe the best medications. I know this is true. I’ve experienced it. I’ve read books about it. But if I tell her this now, before she’s found a doctor, will I be saving her from years of problems or will I be unnecessarily passing my own bias on to her?

I know that my friend needs help. She emailed me her blood test results and her symptoms yesterday. I will be honest that I can offer some good advice on some areas, but I don’t know anything about others. That’s fine. She knows that, and it won’t lower my credibility in her eyes. And she knows I’m not a doctor and won’t hold me liable for anything I suggest, so there’s no worry there. But I do see problems with her test results and her symptoms. She’s turning to me because she’s not getting great medical care. I want to help her. I just need to figure out the best way to do that.

How do you help friends who ask you for medical advice? Do you give advice or not? How much detail do you give? Do you warn them about the horrors of dealing with the medical community, or do you hold back on that? What else do you think I should consider?

 


Speaking the CI language

April 11, 2014

I remember the first day of my last job. Everyone was throwing around acronyms I’d never heard before, and I had trouble just following the basic line of the conversation. I asked around for a list of these acronyms, but there wasn’t one. I immediately started creating a list of my own. When someone new was hired the next year, I gave them a copy of my oh-so-valuable list.

Every group has their own language. Whether you’re discussing race, illness, sexual orientation, gender identity, ethnicity, sex, a job type, a career type, an industry, or anything else, you use certain vocabulary that the general population won’t understand. You have your own terms and abbreviations. Sometimes they’re obvious and you’re aware of them. But sometimes they’re less obvious.

I often forget about the CI (chronic illness) language. Sure, my CI friends know that PT means “physical therapy,” or sometimes “patient,” but the rest of the English-speaking world doesn’t always make that association. We know what a spoonie is. We throw around SSDI (social security disability insurance) and LTD (long term disability insurance) as if everyone knows those acronyms. We talk about medications, insurances, different types of pain, and legal issues in our own vernacular.

It doesn’t happen overnight. You don’t wake up one day knowing these terms and phrases. But bit by bit, it’s easy to pick them up. Within the hypothyroid community I assume everyone knows about TSH, T3, Anti-TPO, and the other thyroid hormones and antibodies. It’s just assumed. At first I was confused, but now those terms are just as familiar as “dogs and cats.” We experience something unique to us, and it’s so useful to have the vocabulary to discuss it with others.

This struck me today. I was in a room of CI folks, with one non-CI person, and we were trying to explain how our lives have been changed to that one person. I noticed people using words that he didn’t understand, and I caught myself trying to change my terminology to be more mainstream. Later, when it was just us CI folks again, it was so great to speak however we wanted and to really understand each other. There’s something really awesome about that. It felt easy and familiar. It helps us to bond.

The language isn’t perfect, but it helps us to understand one another, and that’s what’s important. So the next time you have the chance, I highly recommend that you visit a patient group or check out the patient communities on social media (personally I’m involved on Facebook as me and on Twitter as @CIRants) to learn the phrases they use. Then enjoy it! There’s something great about being able to communicate with others in our group in our own way and we need to make the most of it.


Is remission possible?

March 28, 2014

I saw my naturopath yesterday and she surprised me with one of her goals. She said that she wants to get me to believe that once I’m better, I’ll stay better, and that I won’t relapse. That had never occurred to me. [As a side note, I’m very impressed that she picked up on this mindset of mine and chose to address it head-on.]

Several friends and family members keep insisting I’ll get better. I keep trying to explain to them that I’ll never be 100% healthy. I’ll always have some symptoms, and I’ll always have these medical conditions. These are lifelong diseases that won’t ever go away, and I’ve accepted that. The best I can hope for is to go into remission, which I’ve never really thought of as a possibility for me, though I know it’s a possibility in general. As for symptoms, my gastrointestinal problems are almost entirely better and my fatigue has been improving, but I think I’ll always be at risk of those returning, and I’ll certainly continue to have pain. Maybe the pain can be reduced, but no one has suggested they’ll be able to get rid of it completely.

I’ve accepted all of that. I’m ok with that. If we could just get rid of my fatigue, I’d be ecstatic! But what my naturopath said really stopped me in my tracks. This whole process has been so traumatic. The symptoms, their impact on my life, the insurance issues, the uncertainty over my future, have all changed me. There are some good changes, like a new appreciation for the little things in life, and a desire to keep my life simple, without the “busyness” that so many people take pride in. I’m glad to have come to these realizations.

But there have also been some bad changes, like more fear. I’m scared to spend money, because what if I can never earn money again? And even if I’m able to work, what if I get sick again and need it for that? I’m scared I’ll never find a life partner who can handle all of my health issues. I’m scared I’ll be a burden on my parents. I’m scared to make plans for anything big (tickets to a show, a small trip out of town, attending a wedding) because what if I have to cancel at the last minute? And if I do get better, what if I get sick again? Will I have the strength to go through this all again. And what if I never improve in the first place?

I think that all of these fears are natural. I also think I have to get rid of them. My naturopath is right: if I’m going to have a goal of feeling X% better, then when I reach that goal, I have to trust that I’ll stay there. I’ll need that mental attitude to propel me forward. Sure, I might have setbacks. In fact, she agreed that I probably will have them. Then medications will be adjusted and I’ll improve. But she thinks there won’t be many and that they’ll be short, just a few days or a few weeks; not months or years.

I want to believe that. I do. Really. But I can’t. Not yet. After the trauma I’ve experienced recently, I’m just not ready. But I’m working on it. I love the idea. I hope she’s right. So when I eventually get a therapist (I started looking for one recently) I think this topic will be at the top of our agenda.


The myth of a healthy youth myth

March 4, 2014

I can’t believe I had this conversation again today. The details vary, but it always goes something like this:

Me: I want to get healthy while I’m young enough to enjoy it.

Other person: Well, the “healthy youth” thing is really a myth. Not everyone feels good, and people get sick, and we’re busy taking care of kids so we can’t go out much anyway. And lots of older people feel great and are active, so maybe you’ll be one of those. Besides, we’ll all be feeling like you one day anyway, and then we’ll all be on the same page.

Yes, people really say this shit. Ok, let’s start with the first thing: the healthy youth myth. That myth idea is a myth itself. I’m not saying that people without chronic illnesses are healthy all the time. They might get the flu or headaches or whatever. Some days they just feel like crap. Sure, I get that. But the point is that they recover! They don’t continue to have the flu for the next 30 years.

Next, just because you use your energy-filled, pain-free days to do things other than jet off to Paris and go to fancy clubs, doesn’t mean you aren’t enjoying your youth. Do you have any idea how many of us would like to have kids but don’t have the energy to take care of them? So while you might say you can’t party because you have kids, others of us say we can’t party OR have kids. See the difference?

I’m not suggesting that every 20- and 30-something parties 7 nights a week. But I’m suggesting they can go to parties on Saturday nights. I’m suggesting they can attend a lecture on Tuesday evening. I’m suggesting they can take a shower and cook a meal without feeling like shit.

And yes, some older folks feel good and are active. But if I feel like shit at 30 and 40 and 50 and 60, do you really think I’ll be skiing and skydiving and traveling and going out with friends at 70 and 80? Do you know any of those active elderly? Maybe it’s just a coincidence (I really doubt it) but all of them were healthy active in their youth and in their middle age and then they continued to be active. You can’t expect an unhealthy body to magically get healthier as it ages. The chances that I’ll feel better at 80 than at 30 are really incredibly slim. And besides, at best I could feel good compared to a typical 80-year-old, but I’ll never get the chance to feel as good as a 30-something again!

And sure, maybe one day my friends will all be tired and in pain with arthritis. But they’ll have already had all of the experiences of youth! That’s the point! Yes, maybe one day we’ll all feel equally miserable. (Though to be honest, I think I experienced more pain and fatigue at 32 than my grandparents did when they were 80. At 80 they were still hopping on planes and traveling. Not me. They still went out with friends all the time. Not me. Just saying.) But when we stiffly sit in our chairs with our achy joints at 80, they’ll be surrounded by kids and grandkids if they chose to have them, and they’ll remember all of their fun adventures and activities from when they were younger, while I’ll remember days of my life seemingly wasted sorting through medical records and insurance forms, feeling lousy, watching tv and ready and missing out on parties and outings that I really wanted to attend. Yes, I’ll have fun times to remember, but not as many. Hopefully I’ll have let go of the anger and sadness of not being able to have children, but maybe not.

So to all of you out there who spout the myth of the healthy youth myth, I’m telling you it’s not a myth. Spend just two months pretending you have the flu. Leave your job, turn down every invitation you’re offered, don’t accept invitations. Now tell me if you feel like your old life allows you to be active or not. I’m guessing you’ll feel pretty damn healthy by comparison. If you’re tired because you stayed out at the bar too late, go to sleep earlier next time, but don’t pretend you have it so tough. At least you have a choice.

I was going to give an update today on the doctor planet orbit, but I was too upset. So please accept my rant as just that (a rant), and I’ll resume my normally unscheduled blogging tomorrow.