Entries for the ‘Health identities’ Category
Personal control… the ups and downs as illustrated by Dr. Oz advice
Wednesday, April 4th, 2012April 4, 2012
In the research I discussed in my last post, I noted that there are different styles, so to speak, for predicting how we might want to communicate about our health. The personal control folks believe that their personal behaviors determine how genes relate to health. The participants who fit this style did not want to much communicate about their health. In fact, they were least likely to want to talk about their conditions. Perhaps they believe they have everything under ‘their control’. But what if not talking means that they miss a chance to prevent a poor health outcome?
Here is an example. On Dr. Oz today, he was giving advice about reducing fat in various parts of the body. He advised in one case to use red clover tea. He did not add that it should NOT be used if you are taking Coumadin/Warfarin–a blood-thinning medication. It interacts with the medication and can cause excessive bleeding. Someone in the facebook exchange about the advice noted this important fact.
Others noted that no one should take anything suggested by Dr. Oz without first consulting a physician. And so, the idea of personal control does not mean we should NOT talk about our health. In fact, in trying to have control over our health, we need to be sure that the advice we think makes sense for us fits based on our pesonal health history and current medications and therapies.
What ‘style’ would you be?
Thursday, March 29th, 2012Maarch 29, 2012
That is the question posed in one story about some recently completed published research. Science Daily reported about the research on March 12th [see http://www.sciencedaily.com/releases/2012/03/120312114119.htm]. The report describes the finding that there are four ways of looking at how genes affect our health in the U.S. population that are rather equally distributed. For some, their beliefs form around how personal behaviors relate to whether genes affect out health, whether our social environments have any effect, and whether religious faith and spirituality play a role. For others, their beliefs form around confidence that our personal behaviors predict whether our genes will affect our health. For a third group, they convey uncertainty about how genes affect our health, neither agreeing nor disagreeing that personal behavior, social environments, or spirituality plays a role. Finally, a fourth group is quite confident that our genes are our genes, and how they affect our health has nothing to do with our personal behavior, our social environments, nor our spirituality.
It is the finding that we vary in our beliefs that led one reporter to talk about it in terms of our ‘style’ [see http://www.communicationstudies.com/matching-communicaton-styles-to-patients-beliefs-study]. I’ll talk about how that might be a good ‘fit’ for thinking about communication and health over the next few days.
’tis the season…
Monday, March 26th, 2012March 26, 2012
The members of the Centre County Canoe & Kayak Club return to the water, as seen in this video… It is a metaphor for the news of the day…the rocky and wild path of health care reform in the U.S.
Why we must know our health history…my sister’s recent experience
Saturday, March 24th, 2012March 24, 2012
In my book, Talking about health, I weave several themes through the book in a number of ways. One of these is: know your health history, know your family health history, and know what is ‘normal’ for you. My youngest sister had a recent experience that she thought would remind us of just why it is so important to do these things and to be our own health advocate.
First, let me say that my sister is trained as an intensive care nurse. I begin with that because her doctors know of her background, and yet even she feels that it is difficult to stand her ground and act on her own behalf in her own best interests sometimes. And she has a lot of medical education and experience to back her up.
Our family, as illustrated in Talking about health, inherited the factor five leiden mutation which increases risk for blood clotting. There are a number of other risk factors for blood clotting and we also have inherited some of these as well. In my sister’s case, she has a couple of factors contributing to risk, and she tells about them in her story in my book. Well, in the past several months, a gynecological finding led to the recommendation that she take Provera [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000688/ ]. Here are some highlights of what followed when she said that she thought that would not be a good idea based on her health history and…
“Well, in my case, the gynecologist did not have the written report from the hematologist about my having the risk factors…..just my verbal statement. My primary care doc that I see every year didn’t have it either because we were at the other hospital for my pregnancy and diagnosis of the Factor V Leiden Mutation and the positive antiphospholipid antibody results. Anyway, I asked my primary care doc about it last year, because I wanted to get the hematology verification so that I wouldn’t be in this predicament if there was ever an emergency. He said, ‘Sure, I can get that test. No problem.’”
“So, I proceed to get my blood drawn. After I got home, I received a call about two hours later from the doctor. He says, ‘Nope, you don’t have anything wrong. That level is normal!’ He had mistakenly run a Factor V Assay level…..which we all have Factor V within our blood and it was within the normal limits!!!”
“I didn’t know how to handle that, so I thought I would take it up with him again this year. Unfortunately, however, due to the problems I’ve been experiencing with my uterus, my gynecologist wants to treat me with Provera. When I told him I had Factor V Leiden Mutation, he wanted verification. I gave him my hematologist name from ten years ago, but she had retired and they couldn’t find my records. That’s when my gynecologist said, “Well, I’m sure it will be fine to take the Provera. It’s not very strong.” I said, ‘Well, I’m not comfortable with that, can I please see a hematologist! He said, ‘Well, if it will make you feel better about it, we can get an all clear from him.’ I felt as though he were just pacifying me, but I was glad he agreed to the referral.”
“I went to the hematologist’s office. They literally (I counted them) drew 13 vials of blood. After the results came back, he told me “NO” you may NOT take any hormones if you have the Factor V Leiden mutation, even if it is only the heterozygous. He pulled up the stats on the latest research about taking Provera when you have the Leiden V Factor. Something like 1 in 12,865 people will develop a DVT if you don’t have any genetic stuff and take the Provera. That’s not too bad. However, when you add the Leiden V Factor and Provera, you have (I think he said) 1 out of every 345 people that will develop a clot. He went on to say that when you start layering the different thrombosis criteria, like antiphospholipid antibody and the lupus anticoagulant, patients can be at a very high risk for a thrombotic event.”
“He went on to say that gynecologists often recommend ‘just a little’ hormone therapy, even stating that the topical form will be fine, but he warns it is not fine. He said NO HORMONES….NOT NOW…NOT EVER….is his recommendation for me. I will literally make a few copies of all this stuff this time and stick one of the copies in my fire protected vault so that I won’t have to repeat all of this in the future.”
“So…I had my follow-up with the hematologist and it has once again been confirmed that I do have Factor V Leiden heterozygous. He confirmed that I should not take any type of hormonal therapy. Even AFTER going to the hematologist, my gynecologist is stating that progesterone is not a problem. He says, ‘It’s the estrogen that creates clotting. I told him the hematologist was very specific that ANY therapy with either progesterone or estrogen should be avoided. He ended with telling me that he would call the hematologist and talk to him about it. He said that in the end, he would certainly heed whatever recommendations the hematologist suggested because it was such an advanced and tricky field.”
“It really is the case that you have to be a confident, assertive, and persistent patient to receive the holistic care that is necessary for a positive outcome, but it can certainly be a very exhausting process!”
She had surgery. Her results were fine… They put her on a blood thinner several days before the surgery and used special socks and a special surgical table to lessen any risk for blood clotting. Thank goodness she advocated on her own behalf!
An introduction
Thursday, March 15th, 2012March 15, 2012
I was asked to contribute a guest blog post to the University of North Carolina’s interdisciplinary health communication blog site–Upstream Downstream… I was happy to do so. You can read it at http://upstreamdownstream.org/2012/03/communicating-about-genes-and-health/
The homepage for the blog is at: http://upstreamdownstream.org/ Check it out!
Telling it like it is…communicating about end-of-life
Wednesday, March 14th, 2012March 13, 2012
A stark reminder to check your prescriptions…closely
Thursday, March 8th, 2012March 8, 2012
I heard the story about a pharmacy mix-up the other day that reminded me how important it is to inspect my medications closely before taking them. As the clip shows, a medication was given that looked the same in color and size, but very much was not the same. A cancer drug instead of fluoride tablets.
I found an error once. The pill was a different color than my prescription but the same size. So I looked closer and it wasn’t my medication. You can check your prescription by going to http://www.drugs.com/imprints.php and enter the number on your pill to be sure that it is what was prescribed according to the label.
‘AfterShock’–Jessie Gruman’s book….giveaway
Monday, February 27th, 2012February 27, 2012
I’ve enjoyed reading Jessie Gruman’s book. Not because the topic is one I enjoyed. It is about ‘what to do when the doctor gives you – or someone you love — a devastating diagnosis’. I like this book because it uses published research to reach concrete suggestions. Even the appendices are loaded with specific ideas about things to do. Things like ‘how do I start my doctor search?’ and ‘choosing a doctor’. The latter has a list of questions, including ‘does the doctor have the right expertise?’ and ‘does the doctor particpate in your insurance plan?’ and ‘at what hospital does the doctor have privileges?’
For anyone who hasn’t read the book and might like to, I am once again attempting to offer some of my library to others. Just let me know in the comment section that you are interested. I will randomly pick someone and follow up to get your information to mail it to you…
Here is what the reviews on Amazon.com have to say about the book:
A look at the Western Susquehanna
Friday, February 24th, 2012February 24, 2012
I am still thinking about the upcoming kayaking season as we get ready to join friends for the annual Juniata Clean Water Parternership dinner. We have been talking about wanting to participate in the annual Western Susquehanna river sojourn. [See http://www.paddlehappy.com/West-Branch-Susquehanna-Sojourn] Hope we haven’t waited too long to do it…
