Serious illness is more than a crisis of the body; it is a crisis of the soul. Many patients react to a serious disease by becoming paralyzed by fear. Resistance quickly crumbles, and is followed by depression and despair. Yet others marshal the inner resources needed to overcome the crisis.
How can people be empowered to mobilize their innate resources for health and healing? The twin keys to unlocking the door are Comprehension and Communication.
Comprehension means first understanding that the outcome of most common diseases—cancer and heart disease—is rarely inevitable. Your illness need not be your fate. Every doctor has seen patients with a life-threatening illness make a miraculous recovery after they were thought to be beyond hope. But because medical science is unable to explain these extraordinary occurrences, their importance is often ignored. Medicine is so enamored of the apparent infallibility of science that it has become blind to other possibilities. Remarkable recoveries are dismissed with the derisive term, “anecdotal,” a code word for meaningless.
Countless times, I have observed two desperately ill patients lying side by side in the Intensive Care Unit, seemingly in identical clinical circumstances. At the critical juncture, one would start to show signs of improvement, and go on to live, while the other would go downhill, deteriorate, and die. The cause of that divergence has always been a profound mystery to me, and one of vital importance. Clearly, the importance of a patient’s state of mind is a critical factor in determining the outcome of a life-threatening illness. Self-empowerment is possible, and it does matter. Research has validated what doctors have always known: the will to live is as potent a force for healing as any pill or procedure.
Comprehension also means becoming learning everything you can about the disease afflicting you. Get online. Do the research. Becoming more knowledgeable is vital to becoming an active participant in your own care. Become informed. Educate yourself about your illness, using the internet, library and resources like the Library of Congress, American Heart Association and Cancer Society.
Communication begins with your doctor. Let him or her know that you plan to be an active partner in combating your illness. Ask questions. Find out about alternative approaches—their risks and benefits. And never hesitate to get a second opinion.
Communicating with your loved ones is also vital. Friends and family members are often skittish around sick people. They often tend to avoid meaningful interactions. This can reinforce a patient’s sense of loneliness and isolation. Open up to them about your feelings. Tell them how you would like them to be with you. Encourage them to express their heartfelt feelings by taking the lead and letting them know what’s going on within you.
Most importantly, communicate with yourself. Learn to use simple relaxation techniques as well as journal writing to re-enforce your self-belief, keep you centered and aware of what’s happening within you. Relaxation and/or meditation techniques are easy to learn. They simply involve becoming quiet and visualizing a beautiful scene from nature or, repeating a word or phrase that is meaningful to you such as God or Peace, or simply focusing your attention on your breath. Journal writing is a powerful way to express inner feelings.
If you would like to become inspired by patients with life-threatening illnesses who found the inner strength to combat their afflictions, I suggest you read my recent book, Courageous Confrontations. It tells the stories of seven patients whose will to live imposed new realities on their disease. Often they survived, not because of their medical care, but despite it. These wonderful people prove that all of us have the power to impose new realities on illness. Your crisis can be an opportunity to change the quality of your life, as well as your relationship with yourself and others.
Tuesday, June 5, 2007
Monday, June 4, 2007
Why I Prescribe Antibiotics
I am often asked why I prescribe antibiotics to my patients with rheumatoid or reactive arthritis, late-onset asthma, Crohn's disease, fibromyalgia and other so-called "autoimmune diseases". Before I prescribe any medication, I ask myself whether it will help or hurt. All of the "auto-immune" diseases cause severe disability. Conventional medications neither cure these diseases nor stop the progressive destruction that they cause. Doctors prescribe immune suppressives that sometimes have deadly effects. Antibiotics are far safer than the drugs conventionally used to treat these diseases. So, if antibiotics can be shown to help control these diseases, they should be used long before a doctor thinks of using the conventional immune suppressives.
When a germ gets into your body, you are supposed to produce cells and proteins called antibodies that attach to and kill that germ. These diseases are felt by many doctors to be caused by your own immunity. Instead of doing its job of killing germs, your immunity attacks your own tissue. If it attacks your joints, it is called reactive arthritis; if it attacks your intestines, it's called Crohn's disease; your colon, it's called ulcerative colitis; and if it fills your lungs with mucous, it's called late-onset asthma. I do not believe that your immunity is that stupid. Accumulating data show that all of these conditions can be caused by infection. Many diseases that were thought to be autoimmune turn out to be infections: stomach ulcers are caused by bacterium, helicobacter pylori and others; multiple sclerosis may be caused by HHS-6 virus; rheumatic fever is caused by the bacterium, beta streptococcus, group A; Gillian-Barre syndrome may be caused by the bacterium, campylobacter; Crohn's disease and ulcerative colitis by E. Coli, Klebsiella, Bacteroides or Mycobacterium avium paratuberculosis; and so forth.
Shouldn't We Be Concerned About Resistant Bacteria? The argument that giving antibiotics causes bacteria to be resistant to that antibiotic is reasonable, but it has no place in discouraging people with these diseases from taking them. First, these people have serious diseases that cause permanent damage and death. Second, the treatments that are available are toxic, shorten life, cause cancer, and have to be followed with frequent blood tests. On the other hand, I prescribe derivatives of tetracycline and erythromycin. These drugs are extraordinarily safe and do not require drawing frequent blood tests. If you were to become infected subsequently with bacteria that are resistant to these antibiotics, you would have lost nothing. No reasonable doctor would prescribe erythromycin or tetracycline for acute serious diseases, such as meningitis, pneumonia or an abscess, because tetracyclines and erythromycins do not kill germs, they only stop them from multiplying. Instead, doctors prescribe far more bacteriocidal antibiotics that kill bacteria.
Many doctors criticize my use of antibiotics, but antibiotics are far safer than conventional treatment, cost less, can be administered by a general practitioner, and often cure the condition, rather than just suppressing symptoms. I know that the most physicians who develop these conditions will treat themselves with antibiotics because they know that conventional treatments with prednisone, chloroquine, azathioprine and methotrexate are toxic, and treatment with erythromycins and tetracyclines is safe. However, treatment of many conditions with long term antibiotics is controversial and not accepted by most doctors; discuss your particular condition with your doctor.
How you can help to prevent antibiotic-resistant bacteria: Suffer through short-term illnesses. Don't ask your doctor for antibiotics when you have a cold, flu or other self-limiting illness. You may feel miserable, but antibiotics are useless against viruses.
Finish your prescription. If you stop taking a prescribed antibiotic as soon as you feel better, you encourage the development of resistant organisms.
Become a vegetarian. The bulk of antibiotics are given to animals raised for food. As long as humans demand huge amounts of meat, farmers will use whatever means they have to deliver their product economically.
Definitions: Bacteriocidal Antibiotics, such as penicillins and cephalosporins, kill bacteria. They are used to combat most bacterial infections, particularly acute, serious diseases such as meningitis, pneumonia, a ruptured intestine or an abcess. However, most bacteriocidal antibiotics are not effective against chlamydia, mycoplasma or ureaplasma, bacteria that have no cell walls. Bacteriostatic Antibiotics such as tetracyclines (including doxycycline and minocycline) and erythromycins (including Biaxin and Azithromycin) keep bacteria from multiplying. Your own immunity is then able to kill the bacteria and remove them from circulation.
When a germ gets into your body, you are supposed to produce cells and proteins called antibodies that attach to and kill that germ. These diseases are felt by many doctors to be caused by your own immunity. Instead of doing its job of killing germs, your immunity attacks your own tissue. If it attacks your joints, it is called reactive arthritis; if it attacks your intestines, it's called Crohn's disease; your colon, it's called ulcerative colitis; and if it fills your lungs with mucous, it's called late-onset asthma. I do not believe that your immunity is that stupid. Accumulating data show that all of these conditions can be caused by infection. Many diseases that were thought to be autoimmune turn out to be infections: stomach ulcers are caused by bacterium, helicobacter pylori and others; multiple sclerosis may be caused by HHS-6 virus; rheumatic fever is caused by the bacterium, beta streptococcus, group A; Gillian-Barre syndrome may be caused by the bacterium, campylobacter; Crohn's disease and ulcerative colitis by E. Coli, Klebsiella, Bacteroides or Mycobacterium avium paratuberculosis; and so forth.
Shouldn't We Be Concerned About Resistant Bacteria? The argument that giving antibiotics causes bacteria to be resistant to that antibiotic is reasonable, but it has no place in discouraging people with these diseases from taking them. First, these people have serious diseases that cause permanent damage and death. Second, the treatments that are available are toxic, shorten life, cause cancer, and have to be followed with frequent blood tests. On the other hand, I prescribe derivatives of tetracycline and erythromycin. These drugs are extraordinarily safe and do not require drawing frequent blood tests. If you were to become infected subsequently with bacteria that are resistant to these antibiotics, you would have lost nothing. No reasonable doctor would prescribe erythromycin or tetracycline for acute serious diseases, such as meningitis, pneumonia or an abscess, because tetracyclines and erythromycins do not kill germs, they only stop them from multiplying. Instead, doctors prescribe far more bacteriocidal antibiotics that kill bacteria.
Many doctors criticize my use of antibiotics, but antibiotics are far safer than conventional treatment, cost less, can be administered by a general practitioner, and often cure the condition, rather than just suppressing symptoms. I know that the most physicians who develop these conditions will treat themselves with antibiotics because they know that conventional treatments with prednisone, chloroquine, azathioprine and methotrexate are toxic, and treatment with erythromycins and tetracyclines is safe. However, treatment of many conditions with long term antibiotics is controversial and not accepted by most doctors; discuss your particular condition with your doctor.
How you can help to prevent antibiotic-resistant bacteria: Suffer through short-term illnesses. Don't ask your doctor for antibiotics when you have a cold, flu or other self-limiting illness. You may feel miserable, but antibiotics are useless against viruses.
Finish your prescription. If you stop taking a prescribed antibiotic as soon as you feel better, you encourage the development of resistant organisms.
Become a vegetarian. The bulk of antibiotics are given to animals raised for food. As long as humans demand huge amounts of meat, farmers will use whatever means they have to deliver their product economically.
Definitions: Bacteriocidal Antibiotics, such as penicillins and cephalosporins, kill bacteria. They are used to combat most bacterial infections, particularly acute, serious diseases such as meningitis, pneumonia, a ruptured intestine or an abcess. However, most bacteriocidal antibiotics are not effective against chlamydia, mycoplasma or ureaplasma, bacteria that have no cell walls. Bacteriostatic Antibiotics such as tetracyclines (including doxycycline and minocycline) and erythromycins (including Biaxin and Azithromycin) keep bacteria from multiplying. Your own immunity is then able to kill the bacteria and remove them from circulation.
Sunday, June 3, 2007
Online MDs
Doctors across the United States and around the world are making use of the latest technology and the convenience of the internet in a variety of ways. Whether it's better patient care or making their presence known in their communities, medical professionals have come to depend on web sites, web hosting, and databases. It is no longer a luxury, but fast becoming par for the course.
Better Patient Care
The internet is often used for transfer of all types of medical data. Particularly with respect to radiology, the technology now exists to transmit CAT or PET scan images over the web for analysis by physicians in remote locations, or to transfer patient information quickly whether it's across the country or around the world.
Unfortunately, this technology is seeing limited use and usually only in affiliation with larger, teaching medical centers. Transfer of individual patient information is constrained by the HIPPA regulations to the point that signatures are required for exchange of that type of data and tend to be transmitted in paper form or by fax. While some medical facilities maintain advanced databases for patient records, the information contained in them remains closely held.
Maintaining a database of patient records will make filing simpler for employees, free up office space that was once dedicated filing cabinets, allow for fewer mistakes on charts and quicker and more accurate retrieval and transfer by any medium.
Community Medical Listings
The most likely place to find a physician's name, specialty and location on the web is through the regional online service listings. There are probably half a dozen 'yellow page' ecommerce type services in most major metropolitan areas that have medical listings.
Additionally, there are the 'city search' type web hosted services that provide local information on entertainment, restaurants and local attractions - and will also provide legal and medical listings. There are dedicated listing services such as yourmd.com that are more comprehensive, providing specialty information and an area for the physician to provide comments on treatment focus and philosophy, but provide only a basic phone number and address listing. A small monthly fee is charged.
Personal Medical Websites
If a physician chooses to utilize online listing services, it would be of substantial value if those listings included a clickable web address for the individual doctor or practice. Any medical practice or professional listed online should consider establishing its own hosted web site, so that the browsing consumer can click to a dedicated page introducing the doctor(s) and the practice specialties. Post professional information: where you were educated, hospitals you have worked at, and information about your specialty. Allow potential new patients to contact through your website with an online form or contact link for email. Post a picture, your address, phone number, and hours. List all your services and what insurances you accept. Give as much information as possible.
Educate Your Current Patients And Attract New Ones
There are a couple of specialties that have recognized the value of using online presentation of information. One is sports medicine: many clinics for sports-related injuries have web sites that discuss rehabilitation philosophy as well as surgical options and the clinical backgrounds of the staff.
Another is pediatrics: a field where many group practices have established websites in order to create an introductory environment designed to put the browsing parent at ease. Brief biographies of the doctors in the practice may be found there, along with any specialties that apply.
Physicians that have established their own hosted web sites will often use them to provide basic information on common afflictions and links to more comprehensive sites about the diseases. Provision of this sort of information is often done with literature and usually with the physician walking the patient through it. For that sort of patient care, a hosted website can be a timesaver for the doctor. "Look it up on my website and call if you have questions" can be a timely and convenient closer for an office visit.
Thorough Patient Care
A doctor's personal website can provide alternative contacts and telephone numbers for weekend or off-hour care. It can route calls to information nurses or other personnel on staff; providing a service that otherwise is simply another phone message for the doctor to return. It can also provide an email link for inquiries about appointment times - a worthwhile service for an office with phone lines that are often busy. In the medical field, a hosted website dedicated to a single doctor or practice is more an introduction and information source than an advertising vehicle. If designed and utilized properly, a personal medical website can be an efficient and useful tool in the practice of medicine.
Better Patient Care
The internet is often used for transfer of all types of medical data. Particularly with respect to radiology, the technology now exists to transmit CAT or PET scan images over the web for analysis by physicians in remote locations, or to transfer patient information quickly whether it's across the country or around the world.
Unfortunately, this technology is seeing limited use and usually only in affiliation with larger, teaching medical centers. Transfer of individual patient information is constrained by the HIPPA regulations to the point that signatures are required for exchange of that type of data and tend to be transmitted in paper form or by fax. While some medical facilities maintain advanced databases for patient records, the information contained in them remains closely held.
Maintaining a database of patient records will make filing simpler for employees, free up office space that was once dedicated filing cabinets, allow for fewer mistakes on charts and quicker and more accurate retrieval and transfer by any medium.
Community Medical Listings
The most likely place to find a physician's name, specialty and location on the web is through the regional online service listings. There are probably half a dozen 'yellow page' ecommerce type services in most major metropolitan areas that have medical listings.
Additionally, there are the 'city search' type web hosted services that provide local information on entertainment, restaurants and local attractions - and will also provide legal and medical listings. There are dedicated listing services such as yourmd.com that are more comprehensive, providing specialty information and an area for the physician to provide comments on treatment focus and philosophy, but provide only a basic phone number and address listing. A small monthly fee is charged.
Personal Medical Websites
If a physician chooses to utilize online listing services, it would be of substantial value if those listings included a clickable web address for the individual doctor or practice. Any medical practice or professional listed online should consider establishing its own hosted web site, so that the browsing consumer can click to a dedicated page introducing the doctor(s) and the practice specialties. Post professional information: where you were educated, hospitals you have worked at, and information about your specialty. Allow potential new patients to contact through your website with an online form or contact link for email. Post a picture, your address, phone number, and hours. List all your services and what insurances you accept. Give as much information as possible.
Educate Your Current Patients And Attract New Ones
There are a couple of specialties that have recognized the value of using online presentation of information. One is sports medicine: many clinics for sports-related injuries have web sites that discuss rehabilitation philosophy as well as surgical options and the clinical backgrounds of the staff.
Another is pediatrics: a field where many group practices have established websites in order to create an introductory environment designed to put the browsing parent at ease. Brief biographies of the doctors in the practice may be found there, along with any specialties that apply.
Physicians that have established their own hosted web sites will often use them to provide basic information on common afflictions and links to more comprehensive sites about the diseases. Provision of this sort of information is often done with literature and usually with the physician walking the patient through it. For that sort of patient care, a hosted website can be a timesaver for the doctor. "Look it up on my website and call if you have questions" can be a timely and convenient closer for an office visit.
Thorough Patient Care
A doctor's personal website can provide alternative contacts and telephone numbers for weekend or off-hour care. It can route calls to information nurses or other personnel on staff; providing a service that otherwise is simply another phone message for the doctor to return. It can also provide an email link for inquiries about appointment times - a worthwhile service for an office with phone lines that are often busy. In the medical field, a hosted website dedicated to a single doctor or practice is more an introduction and information source than an advertising vehicle. If designed and utilized properly, a personal medical website can be an efficient and useful tool in the practice of medicine.
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