Going Against Medical Opinion

I just read this summary of the recent case of the mother who didn’t want her son to have radiotherapy after brain tumour surgery. SUCH a tragic story and I wish them all well. There is no doubt that the parents and the medics all believe that they were acting in the best interests of the little boy. It is so hard this, though, isn’t it?

On a much smaller scale, of course, I see this kind of struggle every day in my clinical life. There is a dichotomy between what the doctor or consultant says to do and what the patient wants in many cases. It comes down to a negotiation.

Two examples:

Today, I was contacted by one of you who is has a ‘high’ cholesterol reading of over 7 and who is determined to avoid statin therapy.

We agreed to see if diet change would help and to do a detailed cardiovascular test to check if anything other than high cholesterol showed up as a problem. I referred her to read more about statin therapy and about the so-called ‘cholesterol myth’, where even the chap whose research formed the basis of the current cholesterol thinking has actually changed his mind. Unfortunately, once a medical paradigm is set, it takes at least two decades to change it. It IS changing, I think, albeit slowly. I have had many more doctors recently take the ‘is there any other risk besides cholesterol, let’s wait and see approach’ instead of blindly giving statin therapy until both patient and doctor deems it necessary. This, to my mind, is good strategy.

In this particular case, no other risk apart from high LDL turned up on the test results. The patient has chosen to spend 3-4 months on specific natural therapy to reduce the LDL and, only then, consider statin therapy if still needed. This is a considered strategy by someone trying to avoid taking meds for years and I can’t say I blame them.

Some meds are absolutely vital but some simply aren’t. My advice is always to try and change a lifestyle and use a more natural approach and only turn to the more aggressive medication if that doesn’t work. It will for some and won’t for others, but at least then you have tried and have made the decision to use meds in a considered way rather than just because they’re offered.

Obviously, if this is a serious situation, the advice can be to get on the meds asap, which I agree with of course, and often some side effects can be offset: giving CoQ10 with statins for example, or using a natural approach combined with less statin drug, which can work well.

I must have this conversation weekly. Some doctors are very supportive and agree with a trial natural approach (most I am sure just expecting it to fail, when actually it rarely does) but other doctors can get pretty aggressive and cause a lot of stress when their clinical decision is questioned. It’s tough to go against medical opinion, isn’t it, and yet we are constantly being told to take more responsibility for our own health? We are not always right, but neither are doctors. As I say, negotiation should be open on both sides.

The second example happened to me just yesterday. As many of you know, I have severe multiple food intolerance caused by gluten damage when I wasn’t diagnosed properly as coeliac in my early twenties. Thanks for that :(.

Because of those sensitivities, I find it very difficult to take any form of medical treatment. I can’t tolerate painkillers or usual meds because of the maize starch, lactose, grain alcohol etc in them. Yesterday, I had to see my dentist – one of the target tissues for gluten is gum and mine are in a shocking state. They can’t give me usual treatment so actually we spent my appointment discussing what options I had.

It ended with them saying they will do whatever I ask them to do to help me manage things. Now, that’s a refreshing approach. I confess to feeling a bit low that, yet again, I have to be the one to work everything out and manage it – it would be SO nice sometimes to have someone take the decisions for me – but at least I have control. Can you imagine some health professionals agreeing to that? No, nor me.

Anyway, enough rambling on. My advice? Do your research, get advice, talk to your doctors – they are just like you and me and WANT to help. If they won’t negotiate with you, stand your ground if you feel strongly, find some area of compromise – I often find asking for a 3 month trial and then reviewing is a good strategy. Or, if necessary, find a different health professional who is more amenable and open to debate. Easier said than done sometimes, I know. We need to have equal respect for each other, to be able to listen to the other’s opinion and be able to chat through and come to a mutual decision. The days of blindly following any health professional’s advice, including mine, are long gone.

Anyway, my good wishes for a successful recovery goes to the little boy in the story, and my understanding goes to both the parents and the doctors in such a tragically difficult case.

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