Sunday, April 5, 2009

Systems Breakdown


There was a fascinating story in the New York Times this week: Treating an Illness Is One Thing. What About a Patient With Many?

The title pretty much tells the story: that treating a patient with a single illness requiring one or multiple medications, is hard enough; filled with unknowns and uncertainties, as compounded by doctors’ time restraints and 15 minute appointments, paper work and insurance pressures. 

But, what about treating a patient with multiple morbidities (multiple health, multi-systems problems), seeing multiple specialists, with complicated histories and 17” thick patient files, taking a cocktail of 10 to 20, or more, medications per day, with the same doctors’ time restraints, 15 minute appointments, etc? 

How can doctors even begin to ascertain what is best for these patients;  what is helping, what is harming, the risks verses the benefits of all, or some, of the medications; the negative impact and/or interactions of one medication with another, etc.? 

The answer is; they can’t. 

Instead of treating people, they diagnose and treat each disease entity (co-morbidity) separately, chasing vital signs, so-to speak: trying to lower cholesterol, blood pressure and blood sugar, while at the same time battling osteoporosis, gastric reflux and depression. Doing it all with drugs that were never tested, or approved, for simultaneous usage let alone, in a population with multiple morbidities; drugs with significant individual side-effects and, all-too-often, dangerous, even lethal, consequences

These chronic degenerative diseases are, for the most part, not curable and barely manageable. By definition, they are chronic and progressive.

Ultimately, what even defines successful treatment; progressive disease and disability, and diminishing quality of life? Prolonged death? Most of the time the patients die, while on the medications for the problems being treated; or, as they say in doctor parlance; the treatment was a success, but the patient died. 

Shockingly, the article states how common these chronic diseases and their misguided treatments are: 

Two-thirds of people over age 65, and almost three-quarters of people over 80, have multiple chronic health conditions, and 68% of Medicare spending goes to people who have five or more chronic diseases.”

You do not catch chronic diseases. Chronic diseases take decades of cumulative damage to develop. These multi-systems diseases begin with a lifetime of unhealthy habits starting in youth, with decades of declining health, leading to overt diseases that interfere with living and cut lives short. 

In essence, we are not living longer, we are dying longer. 

This is so common that we accept disease and disability as normal aging when, in fact, they are not.

The answer is too obvious for most to accept. You cannot get healthy by fighting disease. By then, for most, it is already too late. 

In fact, we never get healthy, we only become sick

Health is your body’s natural state, its’ most basic survival mechanism. Your body is always working to keep you alive by maintaining health (homeostasis), adapting as best it can, to the daily onslaught of toxins we eat, drink, breathe and apply to our bodies.

That people refuse to believe this is testimony to the power and effectiveness of the selling of sickness and the magic-bullet and hope of cure we have assigned to drugs. 

We instinctively know what we need to do be healthy

When I ask anyone to name three things they know that they can do to make themselves healthier: no one ever says they need more drugs or surgery. They all say “I can eat better, exercise more, and control my stress better.”  And when asked if doing those three things more consistently would make them sicker or healthier, they all say ‘healthier’. And when asked, why, they say ‘I don’t know.”  

The answer is: you are genetically programmed for health. If you give that genetic blueprint everything that it requires, in a pure and sufficient quantity, the inevitable result is improved health.

The answer is not in treating illness. It is in creating health.

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