Disclaimer

This blog is an accounting of my personal journey to find fitness. All the content on this blog should be read as a biographical piece of literature, not a medical resource. I am a physician, but I am in no way giving medical advice or establishing doctor patient relationships with my readers. I am simply keeping a diary. If you are starting a diet or exercise program or require medical evaluation or advice, please see your own family physician.

Tuesday, October 19, 2010

Tuesday. Wow you people know how to get riled up.

Yesterday was a good day. I ate well. I was under 1300cal. I didn't exercise. I miss it. Wah wah wah...moving on.

There is a hugely controversial subject being talked about today. There is passion on both sides. This gets people so riled up. It is emotional. I deal with this subject every single day. "Medical establishment" vs "natural therapies".  It is exhausting for me. That's why I didn't post anything when I read it. It's why I don't post much when I read about other controversial things I read on blogs. Things like people getting their spleen cleansed and such.   What therapy you choose is between you and your doctor.

That being said.....
Doctors are not in some collusion to get rich with the government or insurance companies.  Doctors are not getting paid by drug companies. We can't even be given pens because someone thinks that my getting a 1.50 ball point pen might influence me.  And I am certainly not rich driving a Toyota mini van that is 6 years old.  I am paid well and I am grateful. But, then I spent 11years training and I risk loosing it all with one stupid law suit everyday. Are there bad doctors? Yes. Are there good doctors? Of course.  Good doctors don't want people to get sick. We are not trying to make people sick so we can get your money. The fact is there is illness in the world and chronic diseases which need treatment.  We are doing the best we can with what science we have.  We should all be grateful that we live in the era of modern medicine.

And you think these "homeopathic" "doctors" or herbalists or "natural supplement" or vitamin companies  or chiropractors or whatever aren't getting rich? I get so tired of people thinking that "those rich doctors" are more about the money than getting people well.  There are good and bad people on both sides of this debate.


Cancer is a disease that is multi-factorial, meaning there seems to be many different things that play a role.   We do NOT know what causes cancer. We don't. We know there are genetic factors and environmental factors. We know somehow the genes for cancer get turned on in some people and not in others. I did my residency in Omaha, Nebraska at Creighton University and studied under Dr. Lynch who is one of the pioneers in genetic cancer research. He and his team identified the gene for familial colon cancer and helped with the research in identifying the genes for breast and ovarian cancer. Even he will tell you we do not understand why one carrier of the gene develops cancer versus another.

We do know that eating healthy diets lowers the risk for virtually all cancers. We know that avoiding known carcinogens is important. There is some truth to the fact that our food and water supply have contaminants. We DON'T know if that is a cause of cancer or to what degree it might be a factor in cancer.  We have to have real science to back things up. Studies done with good technique.  As a physician married to someone who works for the EPA, I can tell you we don't know enough yet about MOST environmental contaminants.

Science is about data. Data can be manipulated to look one way, when the truth is another. People can quote statistics and unless you know where that data came from, it may not be reliable.  Don't believe something just because it SOUNDS believable.

There are a lot of "natural" things out there that are not healthy. Cyanide is "natural".  Just because someone labels a treatment as natural doesn't mean it is better or safer or more effective. It generally means it hasn't been studied or approved by the FDA.  That being said...There are probably some good natural therapies out there. Some of these do work. We don't know how much the patient believing they will work plays a role. You can't just give someone a pill and if 3 out of 5 respond say it works. Unless there is a placebo controlled trial, it isn't good science.   Until these "natural" therapies are studied as rigorously as traditional therapies, we do not know how safe or effective they are. Some may be harmful.

Are there drugs we use that hurt people? Yes. Medicine is a balance of risks vs. benefits. Every decision we make is made in terms of this. There are a lot of people spending WAY too much money on unstudied stuff.   There are too many people taking advantage of patients who want to believe.  Most of the time if a patient asks me about a particular therapy, I tell them what we know about it. If I don't think it will hurt the patient, they can try. But there are some things out there that will hurt you that are branded as "natural" and are not.

A perfect example of this is ephedra or Metabolife being the most common brand.. How many of you tried this stuff for weight loss? Sold over the counter as a "natural" weight loss drug. Herbal. Safe. "All Natural".  Never studied. These people can put whatever they want in. They don't even have to prove that what they say is in there is true. If they call it a "vitamin" or "natural" that's all it takes. They aren't regulated by the FDA.
Ephedra killed people. Killed them. And not because those people took more than the bottle said. We had young healthy people who died taking this "natural" medicine.

Be smart about your health. Don't believe one thing you read on the internet or in a magazine or in a book. Don't believe one thing you hear from your Chiropractor or "herbalist" or even your doctor.  And for goodness sakes, don't get your medical information from snipets on the Today show or TV or Dr. OZ or a movie. They say some good stuff, but it is generalized and may not pertain to you.   Educate yourself on all sides when something is recommended. If the therapy is a prescription drug, it has been studied and approved by the FDA. This is not always perfect. But, at least you know SOMEONE did placebo controlled studies. 

Make sure you have a good primary care doctor who will talk to you about these things. Someone who doesn't immediately "poo poo" any idea you might have. Someone who will help you decide what treatment is right for you, "natural" or otherwise.

Cancer is now thought of as a long term chronic illness. I have patients who live for years with it. And others who are treated and "cured".  And others who are diagnosed and gone too quickly.  I have a lot of cancer in my family. I've lost people. The only thing we know for SURE, is that we don't know ENOUGH.  I've seen these miracle people where all hope was lost and they just get better. We don't know why these happen. We MUST do more research on cancer.   Spending tax dollars on this is absolutely necessary, just like spending money to clean up our environment. 

Medicine is not a prefect or exact science, but it is at least SCIENCE. 

If you or someone you love is diagnosed with cancer, I would hope that you would weigh ALL your options. Talk to an oncologist. Get the facts from a specialist. Talk to more than one until you find one you are comfortable with.  Make sure you understand the science and if you can't, find a physician you trust to explain it to you. Ask all the questions you need to until you are comfortable.  Then make a decision about treatment. But, don't avoid traditional medications out of fear or not being educated. Chemo, radiation, surgery- these things do work. Not all the time. Not for everyone. But, thank goodness, we're getting much better at it.

Prevention and early detection are key. Live a healthy life. Eat healthy things. Don't smoke.  Drink alcohol only in moderation. Get regular exercise.  Stay out of the sun and wear your sunscreen.  Do not use tanning beds.  Maintain a healthy weight.  SEE your doctor regularly. Get an annual exam. They really do work.

I have a 43 yr old young man, just diagnosed with colon cancer. Why? Because he said he had some stomach pain and we didn't write it off. We ran the tests. We got it out. He'll live now.

I have a patient who is now  57. I saw her 10 years ago and did a routine rectal exam which was positive for blood. She had a good sized colon mass. She had absolutely no symptoms Removed, treated. I saw her last week, she just had her first grandchild. Today she is cancer free.

I have a 52 year old patient that was in for a physical about 9 years ago. Normal prostate exam, but his PSA was high on his blood test. He had very aggressive prostate cancer. Treated he is disease free. Some people say not to do those tests because there are too many false positives. I do them because the one we save are worth all the others.

These are just 3 of them. I have so many more stories. Get your screening tests. INCLUDING Mammogram.

19 comments:

  1. Thank you so much for posting on this! I was reading all the posts last night and kept starting to reply and then stopping...it is such an emotional topic! Having a father who ate healthfully and still died of colon cancer but had several extra years with us thanks to experimental medical procedures and an aunt who just died from sleep apnea AFTER beating breast cancer...just left my head spinning with thoughts. I love the medical options available to us, in my mind - God gave them knowledge so he is working through them - but I am not going to sit by and eat like crap and then expect doctors to fix me either.

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  2. I concur, I tend to believe that doctors are people, thanks for weighing in and making sense. you're pretty awesome!

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  3. This was an extremely important post. Thanks SO much for writing it. I couldn't agree more with you on good Dr.'s vs. bad Dr.s and good and bad in every scenario. I wish you were my doctor years ago. I might a stopped chasing 'remedies'.

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  4. I have been waiting for your point of view... thank you!

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  5. Wonderful post, Dr. F...very practical, sensible, and realistic information from someone who knows what they're talking about. Thank you so much...

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  6. Finally, the voice of reason!

    I think we all need to be OPEN to all kinds of idea, but as you said, in the end it's between the individual and their doctor.

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  7. Great post!! Thanks for sharing with all of us!

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  8. Very well said, both you and everyone who commented before I did.

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  9. A wonderful, wonderful response, and I linked to it. THANKS SO MUCH!

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  10. Perfectly elocuted!

    I'm in the engineering field, and it's the same thing - we design the best we can with the science we have.

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  11. I agree, wholeheartedly. As a future doctor, I was offended by statements that some people made that we are trying to "keep people sick". I said this on someone else's blog, but really? I would not spend hundreds of thousands of dollars on medical school (while not working), work my ass off at subjects that most people cringe at the thought of (cell bio, organic chemistry, etc.), while knowing that my first few years as a doctor are going to have terrible pay and I will be knee-deep in loans, just so I can keep people sick. I want to become a doctor because I want to help people. So, I was offended greatly.

    Also, I'm all for natural medicine. I get acupuncture to help with my weight loss and take homeopathic medicine and it is a huge help. But it does not take away the benefits of a good diet.

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  12. Thank you. My sister had a mammo in March and found DCIS..she had 2 lumpectomies and radiation. She is doing well and on Tamoxifen. Thankfully, she tested neg for the breast and ovarian cancer gene. My brother and I sighed a collective breath of relief. Sadly, my other brother who I never met died of Leukemia in the 1950s. Modern medicine has come a long way and I am quite thankful

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  13. I missed all the hubaloo (not sure where the prior conversation was). You post is great, must have felt wonderful to get off your chest. I formally worked for a drug company, as a chemist. If people really understood how much effort it takes to get a drug on the market, they might be more understanding. We are talking 10 to 15 years and millions of dollars. FDA approved drugs are so extrememely regulated but it is that regulation that makes the drugs safe. Yes, there is some examples of problems here and there.

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  14. Very, very well written. This is what I believe. I think we need to be proactive in our health care also. I liked what you had to say and how you said it.

    It's hard to find a doctor, well for me anyway, that will listen AND act. I'm in a new town and of course have been asking others who they see. My problem is I live in a 55+ community here and the average age of my friends is about 70...maybe more. So, the type of doc I require, isn't what they require. I'm at a loss here. I am giving my doc one more chance on Nov 14. I'm not sure where to go if she doesn't pass muster this time. I have a lump in my breast. I can feel it. I can feel it from the inside out. Just sitting here, I can feel it. The mammo didn't show anything, nor did the ultra sound. It's there. I called to make an appointment and it was for a month down the road. That in itself could move me to another doc. I just know when I go in she's going to say it's nothing. Let's just wait until next year. Well, what if it IS something? What if a year is too long? I will ask her to refer me to someone else if she says that, but not sure where to turn if she doesn't. She thinks she can handle everything. Example is hubs ear. She's shaved a 'thing' off his ear twice. It was done in MI twice also. He went this year and she made an appt for him to come back and have it shaved off again. He mentioned seeing a dermatologist or some other specalist and she insisted she had dermatological training and was more than qualified. He made the appointment as that's how he is. He told me about it and I said no. It's just not right. It never heals, it looks awful, something isn't right. He changed docs. Went to an ENT who took it off. 15 stitches later, it was cancer. What if it was too late? It's so frustrating when you find a doc with an 'I can do it all' attitude. No, sometimes they can't. I need to find someone who will not only listen, but act. when I went for my yearly physical and she asked what was bothering me. I told her. I'm pretty sure it was in one ear and out the other. When I brought up how bad my knees, hips, and ankles hurt...she was writing and said 'Take Osteobioflex'. No questions. No exam. No feeling or hearing the crunch my knees make. Just 'take osteobioflex'. So, on Nov 14 when I go again, I'm going to tell her how I feel and see if anything changes. I just don't know where to go after that. I thought it was hard to find a good plumber...this is freaking impossible!

    Sorry, I don't know how that happened...I started out just wanting to tell you how much I liked what you said!!!!!

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  15. What a prefect post and I wish more people would have the chance to read it and learn!

    Thanks for taking the time to write it. Knowledge is power!

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  16. Yeah, sure, but my way was fun also....

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