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Avoiding Death
For the past year, we have examined the seven assumptions that drive excessive medical care, as described by Dr. H. Gilbert Welch in Less Medicine, More Health. This month, we review the very last assumption that medical care is all about avoiding death [1]. Welch states that most Americans desire to die peacefully in their own home with their loved ones without any medical equipment or alarms. Yet, hospitals are the most common place of death, according to the CDC [2].
Barriers to Nutrition Decisions
Humans make thousands of decisions every day. Decisions are not just life-changing choices we face, but also the countless small decisions we make almost automatically and instantaneously throughout each day. We decide at what time to get up each morning, what clothes to wear, how to brush our teeth, and the tasks we set out to accomplish until the end of the day. Part of our daily routine is the food we decide to put into our mouths. The choice of nutrition is one of the most important ones we can make for our body’s health. Yet often, these choices are the most difficult. Many barriers exist when deciding on healthy diets, including knowledge, busy schedules, and energy depletion.
The Glamour of New
The sixth assumption is that newer is always better [1]. One of the examples is the drug thalidomide. Created by a German pharmaceutical company in the 1950s, the drug was marketed as Contergan. Its function was to reduce anxiety and improve sleep. A few years later, an English company licensed the medication as Distaval, touting the drug’s safety and well-tolerance. Within ten years, babies were born to mothers who had ingested thalidomide. The most prominent finding was the missing limbs of these children, a devastating side effect of the drug.
Beyond Self-Identifying With a Disease
How often have you heard someone speak as though they are their disease? Common expressions like “my anxiety,” “my heart condition,” “my cancer,” or “I am diabetic” easily become part of everyday language. We have probably all said statements like this, even referring to a minor cold as “my cold.” However, self-labeling and self-identification of a condition may cause unintended consequences. When a health condition becomes part of one’s self-concept, coping and healing can be hindered. Research shows that coping strategies can play an important role in physical and mental health in the face of chronic disease.
The Value of Subtraction
Previously, we discussed the assumption that always treating is best when faced with a health issue. Often, a treatment provides a tangible solution for both patients and healthcare providers. Yet, treatment may not be in the patient’s best interest at all times. There may be value in simply waiting or doing nothing. As we will see, another option may be to subtract a root cause rather than add a new intervention.
Preventing Frailty in Older Adults
Frailty is a prevalent and debilitating condition that affects many adults over the age of 65. Approximately 21% of older adults living in a house or apartment experience a physical or cognitive decline that limits their ability to carry out activities independently. Consequently, those with frailty have a reduced quality of life and poorer health outcomes. Preventing frailty starts early in life, through measures that promote mobility, adequate nutrition, and strong social connections.
The Impact of Obesity in Atrial Fibrillation
Atrial fibrillation is an abnormal heart rhythm caused by quivering of the upper chambers, or atria, of the heart. Normally, the two atria receive blood from the lungs or the body. When the atria contract, blood flows from the upper chambers to the lower heart chambers, or ventricles. In atrial fibrillation, the quivering prevents blood from flowing properly.
The Issue With Always Treating
The author starts with a story about President Garfield. Garfield was shot in the back with a pistol in 1881. The bullet stopped by his pancreas, and miraculously, the president survived.
Stress and the Immune System
The body always seeks balance, or homeostasis. Cortisol is needed in just the right amount. The hormone is synthesized by the adrenal glands, which are small glands that sit on top of both kidneys. An area of the brain called the hypothalamus initiates a series of steps that ultimately causes the release of cortisol by the adrenal glands.
The Importance of the Patient Care Environment: Ventilation
Nightingale emphasized that the environment influenced healing. The core principles of the Environmental Theory, or canons, include ventilation, clean water, proper nutrition, natural light, minimal noise, and clean bedding. These canons highlight the close relationship among the patient, environment, health, and nurse.
When Medications Harm
Medications seem to work miracles when people are not feeling well or have a certain condition to treat. Have a headache? Pain? Nausea? Diarrhea? Diabetes? Depression? Urinary problems? Obesity? Arthritis? High blood pressure? Heartburn? Medications are advertised to help the symptoms of any ailment. Yet what happens when drugs that have been marketed for years are pulled from shelves due to medical harm?
Too Much Information
Returning to the discussion of health assumptions that drive too much medical care, let’s review the fourth assumption in Less Medicine More Health by Dr. H. Gilbert Welch. The fourth assumption is that getting more information is always the right choice.
Melanoma and the Importance of Sunlight
With summer fast approaching, people are inclined to spend time outside in the brilliant sunshine. Throughout many decades, caution has been heeded to avoid too much sun and apply sunblock for skin protection. Although a plethora of health literature gives warnings about the sun and its cause for melanoma, many research findings show evidence of the sun’s benefit for the skin.
Overdiagnosis of Melanoma
When health screening takes place, there should also be evidence that the screening leads to better survival. In the example of melanoma, the incidence of disease has risen over the past decades, while the mortality rate has remained stable. The issue is well-depicted by the National Cancer Institute website for Surveillance, Epidemiology, and End Results Program (SEER)
The Role of Inflammation in Obesity
White adipose tissue stores energy and regulates certain metabolic functions [2]. Metabolism describes the process by which the body breaks down nutrients to use for energy. Regulating inflammation is one of the functions of adipose tissue. Certain molecules are released that contribute to or inhibit the inflammatory process.
Choices With Screening
The third assumption is that sooner is always better. This chapter examines screening, which is defined as searches for abnormalities without any presence of disease symptoms
Factors and Considerations in Endometriosis
In endometriosis, the endometrial tissue that normally lines the uterus grows outside the structure. Common sites affected include the ovaries, fallopian tubes, and the gastrointestinal tract [2]. Other organs that may be involved are the lung, heart, and central nervous system. We will explore common symptoms, theories about the condition, and options when faced with endometriosis.
Fixing Problems Is Not Always Best
The second assumption is that fixing the problem is always the best choice.
Health Implications: The Lurking Quandaries with Dairy
Often people assume age or genetics are the culprits of health issues. For instance, “My mother was obese, and therefore I am obese.” Yet only rarely are these to blame for disease. Normal aging patterns should not cause sickness. Most conditions occur because of lifestyle habits, such as eating. Consuming an optimal diet of whole food plant-centered nutrition allows the body to thrive. Disease may be halted, prevented, and/or reversed. One of the biggest offenders of illness and weight gain in the Western diet may surprisingly be dairy.