How to make the best health & wellbeing decisions?

Hi everyone,

I'm curious to learn how other people make important decisions for their own health.

Do you find yourself needing to research some form of scientific or empirical evidence?

[Hidden]

The present generation has a huge advantage. We have access to whatever evidence we need. But we also need to know what evidence is. It is not "it worked for me", it is what the science says. But that isn't always easy to assess. Personal example: I've had bisphosphonate treatment for osteoporosis, and my dentist says that will increase the risk of failure for my implants. My rheumatologist says the increased risk is minimal, and showed me the data. I still don't know who is right, but as I have had vertebral fractures and the implants are perfectly fine (X-rays confirm that), I am sticking with the treatment. The point however is that this uncertainty does not invalidate science. It is inherently uncertain, and it works to reduce uncertainty over time. This is not liked by the lay media, they want certainty. So do not make health decisions based on headlines in the Daily Mail etc. Sadly academia also feeds the problem, as university PR departments issue news releases that are simplistic and designed to grab attention. My personal example shows the need to dig beneath the hype, and to interpret the science in terms of what matters to you.

[hunter5582]

Educated and assertive patients receive higher quality care. Passive patients do not. If you do not understand the decisions you need to make, you cannot make good decisions nor advocate for the best care for yourself. I learned this lesson the hard way.

These are the guiding principle behind all of my treatment decisions.

Treatment goals:

1. Extend quality of life.

a.Protection of cognitive function is the single highest priority.

b.Protecting vision, hearing, other senses and mobility/physical abilities second priority

2. Extend length of life (only when QOL intact)

a.Philosophically – better to get less tx benefit and preserve QOL with any tx

b.My medical POAs have very specific instructions regarding my care and when to d/c all treatment.

Treatment Approach

1.Combine Western Medicine with alternative/complimentary healing methods

2.Rely on evidence-based practices.

3.Weigh the benefits and the risks of any treatment option.

a.Don’t make assumptions. If something can help you, it can also hurt you

b.Pay attention to how treatment approaches, medication/supplements interact

4.Look for underlying cause and links between medical issues.

5.Standard tx protocols are not always the correct approach for any specific person. Individualize tx based on individual medical profile.

6.Treat the whole person, not just the parts.

7.Use MPN-Expert Consultation to inform MPN tx & on other tx needs (e.g. surgery)

I make all of my medical providers aware of how I make decisions. I require that they respect my priorities and use them when setting treatment goals and in making treatment recommendations.

All the best

[Hidden in reply to hunter5582]

Much of what you say is sensible, except that 1 and 2 are not compatible. Why are some `treatments' considered alternative/complementary? Because they are not evidence based. Yes there are lots of anecdotes, but they do not make for robust evidence. That is why science has developed tools to mitigate against the bias that attends personal observation. The evidence that exists for alternative/complementary remedies is not good. Cancer patients who choose them instead of proven effective treatment die earlier:

academic.oup.com/jnci/artic...

[hunter5582 in reply to Hidden]

You are quite correct to distinguish anecdotal evidence from research using standardized scientific methodology. Anecdotal evidence can be useful from a heuristic perspective, but does not constitute solid evidence. There are some complementary health approaches for which there is evidence. Curcumin and N-Acetylcysteine have solid evidence regarding their use as anti-inflammatory agents. Nutritional based interventions such as Magnesium and Vit B/Folate are also supported in evidence, but typically considered complimentary since many conventional Western-trained physicians ignore these issues.

Looking for evidence also means 3.a - if something can help you it can also hurt you. Whether conventional Western or complimentary medicine, there is always the potential for adverse effects with any biologically active agent. In evaluating any treatment options, it is important to look at the evidence for for benefit and harm.

I would not support reliance solely on complementary health approaches. There are very effective treatment options in Western medical approaches. There are also effective interventions that can be found in complimentary health. I believe in combining the two. In doing this, it is also important to understand how the agents interact. Another point of evidence that needs to be explored. (e.g. Fish oil potentiates aspirin significantly - combination is contraindicated).

Evaluating all research requires an understanding of the basics of scientific methodology. Looking at the reliability and validity of the data, evidence of researcher bias, and for conflicts of interest are an important part of reading the literature. Published research cannot always be taken at face value. There are methodological shortcomings and bias in what appears to be scientific approaches that must always be evaluated when looking at any research.

I would note that I am using a pretty broad definition of complimentary health. Solid nutrition, a Mediterranean/anti-inflammatory diet, nutritional supplements to address identified deficiencies is a complimentary health approach. One that is well supported. I also practice a health/healing form of Qigong, which anecdotally I can tell you does help. There is evidence for this as well, but it is pretty hard to find. My own openness to these alternative approaches started when my rheumatologist suggested trying Curcumin for osteoarthritis. It works better than Meloxicam, Ibuprofen, or Lyrica. It was later that I learned the underlying support for the use of this agent as well as what you need to know to use it effectively.

Thanks for bringing up such interesting points. I think we all benefit from considering them.

[Hidden in reply to hunter5582]

I'm so pleased to hear you say "if something can help you it can also hurt you". Many people think that if it's natural it must be harmless. I would not regard lifestyle measures such as nutrition as complementary medicine. I take a quite rigorous approach to evidence. For example from what I have seen the studies on curcumin are mostly in vitro and to a lesser extent in vivo. The very sparse human studies have been disappointing. Hence there are no EFSA approved health claims for curcumin. I don't know much about Qigong, but controlled exercise seems like a good thing. What I do object to is this sort of thing being explained by inventing entirely fictitious notions such as vitalism, qi, meridians, chakras etc. Ironically, vitalism was killed by biology decades ago.

[hunter5582 in reply to Hidden]

I would not take Foxglove or Hemlock bust because they are plants. That would not turn out well. The same thing applies to all botanicals or synthetic meds. Some of the synthetics used to treat cancers and other diseases are quite toxic. They also have to be used with caution and an eye towards the risk/benefit profile.

We do have to take a skeptical view of all of the research, but be open to what is out there. Despite the varied results with Curcumin, I know from personal experience how will it works IF you use a bioavailable formulation. Personally I am willing to try something provided there is not undue risk involved.

I do not believe any of the pie in the sky promises we see with most every intervention that is in "research." However, I am willing to learn.

All the best my friend. Hope you find interventions that work for you.

[oscarina in reply to hunter5582]

thorough assessments noted, one additional research is on the pyrolysis of N-Critolindole, very rigorous study with clear outcomes but not specifically applicable to any one variant of cancer mutations