Doctor’s Orders is the first rung of your climb up the ladder because it is the starting point from which most of us base our personal efforts toward better health and well-being. Of course, the odds of a doctor’s advice working for you often depend on your trust in him or her. Having faith in your physician will not only help you maintain a positive attitude, but you will also be more likely to follow the prescribed treatment. So, if you don’t believe in your doctor, find another one!
In order for you to develop that comfort level with a physician, come to the visit prepared with a list of questions and engage him or her in a two-way conversation. If you read an article or have information related to your condition, bring it to his or her attention and ask if it is relevant to your care. If you are unable or uncomfortable speaking up, designate someone who will advocate for you. Or have a friend, relative, or caregiver go with you and speak on your behalf. Also, the person you bring to your appointment can help you remember and digest all of the information provided. The more you know, the more you will be prepared to make the right decisions. Trust your inner voice and then act on what it tells you; because even when you have confidence in your physician, you must still be your own health advocate.
In Control
What makes a person at risk for illness? Some factors, such as age, ethnicity, and family history, are out of our hands. However, experts believe that up to 80 percent of illnesses, such as heart disease and type 2 diabetes, can be prevented by lifestyle changes. In other words, while genetics may load the gun, lifestyle pulls the trigger.
Even if you are receiving treatment and taking medication for a condition, adding simple disciplines to your everyday regimen can help you achieve optimal health. Not only will healthy habits make your medication or other treatments work more effectively, they may reduce or eliminate the need for medication.
Ultimately, following doctor’s orders and adopting healthy habits are the best prescription for wellness. We can find examples of how that “prescription” works in nearly every condition. While we can’t possibly cover every ailment in this book, let’s look at the top six maladies, starting with cancer, which is where I first began my professional odyssey so many years earlier.
When it comes to illness and longevity, there are some people who seem to defy the odds. Take, for instance, someone touted as the world’s oldest person—she is a member of the Kaxinawá tribe, found in the Brazilian Amazon. At 120-years-old, she believes her longevity is due to her lifestyle. She eats no salt, sugar, or processed food, but sticks to Amazonian staples such as monkey, manioc, and banana porridge. (Try finding that mix at your local Trader Joe’s!)
The Big C
Cancer is the diagnosis everyone fears, and there is no single remedy for survivors. However, Jackie’s story has much in common with many of the survivors with whom I spoke.
“I noticed an unusual lump during a breast self-exam,” she begins. “Although I knew something was different, I convinced myself it was nothing and pushed away any lingering fears. After all, there was no family history of breast cancer.” Eventually, the nagging feeling that followed her as she went about her daily routine won out, and she called her physician who referred her for a mammogram. That decision, along with the care she received, probably saved her life.
Her doctor was concerned enough with the results to suggest a biopsy. Jackie, though, was aware of what can go wrong in medical settings. So she insisted on a DNA-matching test to confirm that the surgical biopsy samples being evaluated actually belonged to her and that there hadn’t been any mislabeling or contamination. She was still shocked to learn that she had stage IIA breast cancer, but knowing that the DNA matched eased her worry that it might be someone else’s result.
Jackie’s medical team recommended immediate surgery followed by a chemotherapy protocol. It has been a few years since her diagnosis, and she is now cancer free. Still, to lower the risk of recurrence, she will continue to take medication for five years, which also serves as a daily reminder that she is a breast cancer survivor. Additionally, she started following a ketogenic diet (low carbs, no sugar) under the supervision of her doctor and has returned to the gym. Given this second chance, Jackie is determined to live as healthy a lifestyle as possible so that she can be even better than before.
Jackie hopes that others will learn that it is always best to take that extra step when it comes to your health. “Whether it’s making an appointment with your doctor or requesting a test that prevents medical errors that can typically go unnoticed, you’re worth it. And it could be a matter of life—or death.”
To that end, I asked a group of leading specialists for their advice on how to start the process. Dr. Andrew Kenler, an assistant clinical professor of surgery at Yale Medical School who specializes in laparoscopic surgery and treatment of diseases of the breast, suggests: “Before you have a test or procedure done, understand what steps your doctor should be taking to prevent medical errors.” When a patient comes into his office to get a biopsy taken, many are unaware that a standard biopsy process includes more than 20 steps, with multiple individuals in different locations handling the specimen. He explains that, at each step, human error can play a role, but a patient’s own DNA can ensure this doesn’t happen. “A Washington University study that was published in the American Journal of Clinical Pathology found that specimen contamination and mislabeling occurs in 3.5 percent of all biopsies.”
Dr. Deanna J. Attai, the president-elect of the American Society of Breast Surgeons, who focuses her practice exclusively on the care of patients with benign and malignant breast conditions, recommends researching your diagnosis but making sure that you are conducting directed research. “Many patients make the mistake of looking up their disease online, but they don’t really understand their specific condition, rendering much of the information irrelevant. Ask your physician to recommend reputable references, and be sure that you have enough information about your condition so that you spend your time reading articles most relevant to your unique situation.”
The doctor also says to never be afraid to get a second opinion, even if it simply reinforces what your physician has already told you. Most physicians do not take it personally if a patient seeks one, especially when it involves a serious illness or major invasive procedure. Remember to get another opinion not only on the diagnosis, but also on the treatment plan.
We also owe it to ourselves to improve the success of any treatment by adopting healthy habits. There is an abundance of evidence to support the fact that proper nutrition, exercise, and relaxation techniques can help cancer patients both during and after treatments. (We’ll talk more about these as we climb the Ladder.)
The Shape of Your Heart
People may not fear heart disease as much as cancer, but the prognosis is every bit as serious. It is, in fact, the number one cause of death due to illness in this country. And it affects men and women alike, although men generally develop heart disease up to 10 years earlier. For females, the onset often comes after menopause, in part due to the lack of estrogen, which has protective effects.
So when The Lawyer with the three coronary stents announced to the waiter, “I’ll have the steak,” I was understandably upset, even though he asked for a lean filet mignon. Judging by the look of self-satisfaction on his face, he was obviously proud of himself for not ordering what he really wanted—the marbled prime rib.
I couldn’t resist responding, “While you’re at it, dear, why don’t you have cheesecake for dessert, just in case you have any arteries left unclogged.”
I would be remiss not to mention that The Lawyer, dietary deviations aside, is in very good shape for a man his age and is extremely aware of what constitutes a healthy lifestyle. (Thanks to me, naturally.) But that doesn’t always mean he makes the wisest menu choices when it comes to his heart. He, of course, swears that a genetic predisposition—and my constant nagging—are the primary culprits for his prior coronary clogs. Therefore, I frequently remind him (always in calm, constructive tones), that he is just plain wrong.
Dr. Gordon Tomaselli, former president of the American Heart Association