What’s more important than your physical and emotional health?  

NOTHING!!!!!

You might be wealthy, successful, have loving relationships, are engaged in your community and have a full life!  But if you have poor health and haven’t made your health your #1 priority, none of this will matter! Health is wealth! 

But, how do you take charge of health? 

You have to learn to be a strong advocate for yourself and at times question what you’ve been told if it doesn’t resonate with you.  You may also need to be very clear on what you need and not ask, but tell your health care practitioner to order the test or make the referral to a specialist that you know in your heart is necessary.

When I was in my early 20’s, my mother was diagnosed with breast cancer.  The specialist recommended a complete mastectomy.  My parents never questioned a doctor, and luckily for my mother, her female family doctor wanted a 2nd opinion.  The second opinion indicated that a complete mastectomy was not necessary and recommended a lumpectomy.  The lump was removed, and my mother never had to deal with cancer again.  This was the first time I had heard about “2nd opinions”, and I started to develop a sense that it was okay to question the medical profession.  

I respect medical doctors and am in awe of the determination and dedication required to complete their studies.  However, they don’t know everything and have a particular approach to diagnosing and treating illness, which doesn’t always work.   

In the past, I’ve had family doctors who never asked me any questions about my lifestyle and focused solely on treating my symptoms. In some situations, it was entirely warranted, but not when one family doctor’s response to my insomnia was to prescribe sleeping pills. When I was dealing with menopausal symptoms, the only thing she offered me was hormonal replacement therapy.  These treatments might have been precisely what I needed, but not asking questions or exploring anything else forced me to find a new family doctor.  BTW, I resolved these two issues with the help of a naturopath. 

During my search for a new family doctor, I met and interviewed a few. As soon as I mentioned that I believe in prevention and focusing on a healthy lifestyle, and seeing a naturopath, their response completely turned me off.  All of them said they didn’t believe in naturopathy and didn’t support my seeing one. 

Luckily, I found my current family doctor.  When I first met him for our “meet and greet “appointment, one of the first things he said to me was that he focuses on lifestyle and is only interested in prescribing meds when he feels it is absolutely necessary. He was okay that I saw a naturopath and was open to working with her to approach my health issues.  I was elated and decided right then and there that he would be my new family doctor.  I like and respect my family doctor. He is also knowledgeable, kind, compassionate and open-minded, and I feel like I’m in a partnership with him when it comes to my health, that my opinion and feelings count.  

There was only one time when I experienced some conflict with him.  A few years ago, I developed some cognitive challenges, and I was concerned because I have several risk factors for Alzheimer’s disease.  I repeatedly asked him for a referral to a specialist, and he refused and felt there was no need because he didn’t think anything could be done.  This was an unusual response from him.  I finally asked him if he expected me to sit back and passively wait and see if I would get Alzheimer’s disease.  He said no, and I finally told him, “I’m at the point where I’m no longer asking for a referral to a specialist, but I’m telling you to make the referral.” He made the referral, and now I’m being followed by two specialists and have access to brain scans and possible studies and drug trials.  

How to be Proactive and Advocate for Your Health

1)    Make sure that you have a good family physician.   If you are not satisfied with your family doctor, find a new one.  I realize that this may not be possible as there is a shortage of doctors and if you cannot change doctors, utilize your doctor in a way that works for you and try and find ways to work with them.  

2)    Ensure that you receive a complete physical each year.  Even when I had a doctor that I was unhappy with, I made sure that I had an annual physical, obtained all the screenings, and had blood work done.  

3)    Get your screenings done.  Know the screenings that you should have and make sure that you don’t miss the dates.  Check out Cancer Care Ontario.   My family doctor informs me when I’m due for a colon screen, pap smear or mammogram, and I also receive notifications from Cancer Care Ontario.  Colon, breast, cervical and prostate cancers are treatable and have excellent prognoses when detected early.  Don’t delay these necessary tests until you are feeling symptoms.  

4)    Keep records and maintain them.    Keep a symptom diary, so you have a reliable record of how you’ve been feeling. I have a large file that has copies of all of my medical records.   I don’t understand all of them completely, but these records have been helpful when seeing specialists.   I also have a word document that I periodically update with my experiences as I know it won’t take long to forget details.

I had one clinical note that contained utterly false information.  The next time I saw the specialist via zoom, I mentioned it calmly and professionally, and they profusely apologized. I asked them to make an addendum to the clinical note explaining the error.  They did this immediately after our appointment.  It wasn’t great that this happened, but I understood how busy they are .  If I didn’t see a copy of my records, I never would have known about this error, which honestly could have impacted future treatments.  

5)    Know your meds.  Bring a list of your current medications to all appointments, including the dosage you’re taking, and the number of times a day you take them. Remember to tell your doctor how often you actually take it – not just how often you’re supposed to. And don’t forget to include supplements and over-the-counter drugs.

6)    Be efficient with your appointment times.  Utilize your appointment time and come prepared when you see your family doctor.  I have a hard covered notebook that I take with me when I see my family physician.  I use it to make a list of questions or concerns before our appointment, and I take notes of anything that we talk about because I know I’ll forget if I don’t.  I firmly believe that my doctor appreciates this approach and most of my appointments are short because I’m so prepared. 

Be sure to share information about how you feel physically, emotionally and mentally, and what’s changed since your last visit. Make a list of your questions and concerns, with the most important ones first, and share them with your doctor at the beginning of the appointment.  This will help your doctor focus your visit on what’s most important to you. Avoid small talk to ensure the focus is on your concerns.  

7)    Be kind and patient.  Most doctors are overwhelmed and just don’t have the time they would like to have to spend with you.  They are bursting at the seams and putting out fires.  This is why you must take the lead on how you interact with your doctor.  Most of the emails that I receive from my family doctor are after 11 pm.  I know that he has a young family and has a hectic and demanding practice, so if he takes some time to get back to me, I cut him some slack because I know he is doing the best that he can.  

8)    Know your doctor’s limitations.  Doctors in Ontario are under constant scrutiny and have to justify why they are sending you for a particular test.  Please keep this in mind when your doctor doesn’t agree to a test or referral.  For example, if you’ve had a bit of mild back pain for a few weeks, an x-ray or MRI of your back may not be warranted.  However, if you’ve had the pain for ages and it has interfered with your functioning level, then obtaining some imaging will probably be required.   

9)    Be honest: Tell your doctor your medical history and your current lifestyle. How much alcohol do you drink a week? Are you under stress? Everything you tell them is confidential and helps them see the whole picture.

10) Do your research.  Research only reliable, professional websites, i.e., WebMD, Mayo Clinic, Johns Hopkins, etc. You can Google your illness but only go to foundations that are specific to your problem. Stay away from another patient’s alarming online story. It only adds unnecessary stress to an already stressful situation. 

11) Bring support.  Whenever I see one of my specialists, it’s via zoom, and I make sure that my husband and daughter are present for the appointment.  I prepare well for the appointments, but sometimes I feel overwhelmed and forget things.  I’ve noticed that one particular specialist takes their time and doesn’t rush me as much when my husband and daughter are present.  Having witnesses makes them more accountable.   

12) How to communicate.  Be ready to be clear about what you want help with. To avoid defensiveness, try not to diagnose yourself at first; just give the symptoms. So rather than — I have a sprained ankle, say “I’m here because I twisted my ankle and it hurts, I want to see what’s wrong with it and how to make it better.” Rather than saying — I think I may have arthritis, say, “I’m having pain in my finger joints; it’s worse in the morning.”  

I just recently had to ask my doctor for a couple of things that my naturopath recommended.  He’s always been open to this, but I’m still cautious with how I ask.  In this sort of interaction, I never tell him what to do; I let him know what my naturopath’s findings are and would he consider ordering the extra bloodwork, ultrasound etc. or whatever it is.  When I’ve approached him like this, he usually is okay with it.  Occasionally, he hasn’t always agreed to the blood work that she suggests, and when this happens, I ask her to order it and pay for it myself.  I do not get into an argument with him about it.  You can be clear and assertive but still, be calm and respectful.  If your family doctor and the support staff find you challenging and demanding, it could negatively impact your health as they may not want to deal with you and rush appointments.

13) Consider a multidisciplinary approach to your health concerns.  I have a family physician and naturopath, and I believe both approaches complement each other nicely.  They have different training and techniques, but I feel entirely comfortable working with both.  I provide copies of all of the bloodwork and specialist’s reports to my naturopath.  She interprets blood work results differently and becomes concerned about the numbers when they are sub-optimal, not when they have reached the area of concern.  I also have my yoga practice which assists my back immensely, but I also receive regular massages and chiropractic treatments.  I believe that you will receive the best results when you approach your health from different perspectives.  

14) Get a second opinion. If you receive a serious diagnosis, don’t hesitate to obtain a second opinion.  

15) Suppose you have been given a serious diagnosis.  All the above suggestions are even more critical.  Learn as much as you can about your diagnosis.  If you are seeing a specialist or speaking to your family physician about your diagnosis, ask them if you can record your appointments; if not, be sure to bring a support person willing to take notes and ask tough questions if you forget or find yourself too nervous.  

16) Educate yourself.  Beyond reading reliable sources about disease and medication, follow health care practitioners that are evidence-based and focus on prevention.  I’m a huge fan of Kris Carr. She’s a wellness advocate and has lived with a serious cancer diagnosis for more than 10 years.  She’s written books and has a fantastic website.  I also like Jenn Pike.  She is a holistic nutritionist and exercise specialist.  She’s also written a few books and has an amazing website and a podcast called “The Simplicity Sessions”  that is very informative. I also recommend  Dr. Mark Hyman is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. 

Times when I didn’t agree or wasn’t sure about a treatment plan:

In the early 2000’s I was on a mental health leave for depression and was being seen by a psychiatrist that I liked and trusted.  After a year on medication, I had to stop taking it because some patients had complex life-threatening side effects, and the drug was discontinued.  This psychiatrist wanted me to start taking lithium because he felt that I had bipolar traits.  I informed him that I was uncomfortable with this and wanted to see how I would do off of meds.  We agreed that if he became concerned about a relapse that I would reconsider.  I did not need medication again for 12 years.  

Shortly after meeting my current family doctor, I had a relapse of depression and asked him to start me on an antidepressant.  He was relucent and wanting to wait a few weeks to see if I was just having a rough time.  I appreciated that he wanted to take his time with a prescription, but I explained to him that I knew my symptoms very well and researched the medication and didn’t want to wait.  He changed his mind and prescribed that medication that I took for the next 7 years. 

In January, when I ended up in the emergency department because of excruciating hip pain, I was given an IV of morphine, which was the only thing that relieved the pain.  At that point, I hadn’t slept for 4 nights, and my family physician wanted me to continue taking morphine.  I was very uncomfortable and reluctant, but he convinced me that I needed to manage the pain, get some sleep, and be well enough to receive physiotherapy.  I took the morphine for 5 days, and luckily the pain had gone away. 

I’m seeing a specialist for some cognitive challenges, and they prescribed me a medication that I was reluctant to take, but I thought, I’ll try it and see.  My family physician, naturopath, and even the pharmacist questioned why I was taking it and its benefits.  After taking it for 3 months and feeling no change, I stopped taking it..  

It’s your body, so you have the right to decline any procedure or treatment plan.  You also have the right to be well informed and question advice, especially if it doesn’t feel comfortable.  Take control of your health and be a health warrior.

Be well.

Anita

Resources: 

1)    Arthrosurface