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Category: Health identities

How communicating about health contributes to the ways we answer the question, “Who am I?”

What Nutrition Can Do for Cancer Patients by Jillian McKee, Mesothelioma Cancer Alliance

July 17,2012

Guest Post by Jillian McKee [http://www.mesothelioma.com/blog/authors/jillian/] 

As a cancer patient, it is so important that you keep yourself healthy at all times. One way to do this would be to go for regular cancer treatments in order to cure the problem. While nutrition is not a cure for cancer, a healthy diet is another thing to incorporate into your life if you are currently dealing with mesothelioma treatment side effects or any cancer side effects.  Nutrition boasts a variety of benefits that can improve your life and your wellbeing on a constant basis whether you were recently diagnosed or are in remission.

Nutrition is incredibly important for all functions of the body. Fruits and vegetables, for instance, contain a number of vitamins and minerals that will help the body to heal and become stronger. You cannot get these nutrients from processed foods or fast food meals. Begin incorporating nutrition into your cancer treatment so that you can reap the benefits of good eating. The vitamins and nutrients you consume will help to pave the way for a healthier future.

Another thing that healthy eating does for the body is increase energy and add calories. As a cancer patient, you need to make sure that you consume enough calories in a day to support daily functions. You can easily get these calories from vitamin-rich foods like nuts, legumes, fruits, and vegetables. You will find that these foods give you a ton of energy that enables you to get through cancer treatments without dealing with all of the exhaustion. You will know how beneficial it will be for you to accomplish this if you are so used to feeling exhausted after you go for a certain type of treatment at the hospital.

Before you decide to make any changes to your diet, it is important that you speak with your doctor so that you can get recommendations and advice on what is best for you.  Only your primary care physician knows what you need in order to become healthier.  If you are already on a very strict diet set by your doctor, it is important that you ask the professional if you can make minor changes to it or add different types of foods for your own benefit.

Keep in mind that a healthy diet is not a cure for cancer.  You will still have to go for regular cancer treatment and screenings after you go into remission.  However, healthy nutrition can improve the overall functions of the body so that it can heal itself quicker and give the cells more energy each day. There is nothing more beneficial than being able to get through your cancer treatment with the right foods helping you along the way. The increase of energy and overall wellbeing that you get from the foods you eat will help you to feel more alive than ever no matter what type of cancer you are fighting.

 

Are you fearful of being labeled ‘difficult’?

June 12, 2012

I am trying to imagine how my medical doctors perceive me. I tend to ask a lot of questions. I even bring — surprise surprise — information to an appointment and want to discuss it. I find that asking questions and sharing information leads my doctors to use vocabulary with me that I don’t understand and have to ask to have explained. And I am OK with that. But I cannot remember a time when I worried that my doctor, or my childrens’ doctors, or doctors treating my husband would label me ‘difficult’ because I asked lots of questions. But others do have these concerns.

A study published in Health Affairs conducted by Dominick Frosch and collaborators used focus group discussions to learn what barriers limited efforts to share decision-making with their doctors. They learned that participants wanted to be more involved in considering treatment and care options, but concerns that doctors would label them ‘difficult’ kept them from doing so. This suggests to me that doctors may need to make more explicit efforts to invite participation in shared decision-making, thus reducing the perception that participation will make an unfavorable impression.

Read more at: http://content.healthaffairs.org/content/31/5/1030

Who told me about glutein for eye health?

May25, 2012

After a brief hiatus to complete those piles of undone tasks [which are still not all complete but I’m making progress!], I wanted to share how communicating about health in my family may have helped my vision. I use ‘may’ because it appears to be the case, but I am not a medical doctor and can only tell you my personal experience–with a focus on how talking about health worked in this case.

First, setting the stage, I have low vision. For those of you who have low vvision, you know what this means. For others,  it means that limits related to my ability to see are significant. For example, I cannot drive… I see a low vision specialist at least every six months and more often if I feel the need based on some symptom. At any rate, in addition to impaired peripheral sight in both eyes and practically no vision in the left eye, at the last visit–my low vision doctor announced that a cataract had begun to develop. And it was in my so called ‘good’ eye. When I told my parents, my dad asked me if I was taking Lutein. He takes it for his vision. So this  family conversation started me on a path.

 

I looked online at google scholar and found quite a few published scientific articles about cataracts and lutein. Here is a link to one example: http://www.nutritionjrnl.com/article/S0899-9007(02)00861-4/abstract I went to Wal Mart and found lutein in the 20 mg size with zeaxanthin…which some studies specifically mentioned as being important with lutein. I took it 3 or more times each week. And this week, my visual acuity was significantly improved and the start of the cataract waas reversed…not there. Hmm. Sure am glad I talked to my dad…

Interestingly, the doctor wanted to know what I was doing differently because the change was a positive and clinically significant one. I told her. And she said, ‘the National Eye Institute at the National Institutes of Health have found that taking lutein improves eyesight…” She went on with more details but I was lost in the thought that ‘she knew this but she didn’t tell me. My dad told me…’ I have several follow-up questions for the doctor but did not ask them at the time. Why didn’t she tell me? Did she doubt the results? Did she think I wouldn’t take the supplement? She could’ve advised me to eat more fruits and vegetables with the lutein and zeaxanthin. I do eat a lot of these though and probably wouldn’t have changed my eating habits. Brussel sprouts is included in this list, as well as some others. See   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722697/

But in the end, she didn’t say anything. I sure am glad my dad did…

Personal control… the ups and downs as illustrated by Dr. Oz advice

April 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?

Maarch 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.

Why we must know our health history…my sister’s recent experience

March 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

March 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!

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