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Michael Karp, M.D.
Ambridge Area Healthcare Services |
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Seven Habits of Healthy Effective Patients (With apologies to Stephen Covey)
While many health care professionals and vendors would like to sell you their exclusive programs for eternal health, we all know that there are no shortcuts to achieving wellness. I won't offer any no-effort, can't-lose, one-size-fits-all techniques, but I will lay out a rational plan that can lead toward a healthier future for people of all ages, including the elderly. I think that it is important to define some terms before moving on. "Elderly" can be defined as over 65, over 75, or five years older than the reader (which makes this a very loose definition!). "Wellness" means many different things to people, with the traditional definition being "the absence of disease." The problem with this definition is that it excludes anyone with a chronic medical condition, and therefore it leaves out the majority of elderly people. It is rare to get to age 75, for instance, and not have a chronic disorder such as hypertension, heart disease, prostate enlargement, incontinence, depression, or obesity. This definition also supposes that people without diseases are well, when in fact they may be brewing terrible diseases that have just not come to the surface yet. Can someone with cancer be "well?" Can a paraplegic achieve wellness? Should a ninety- year old work on good health habits? I feel that living a full life, despite even severe health problems, can allow a person to work toward wellness. Wellness is a process, and not just an endpoint. No one can ever be finished with their journey to wellness, but some are farther along than others. The following guidelines are my perspective on wellness, and can be used to help motivate you in your quest for optimal health. Please review your own health status with your family doctor. Enjoy the journey! DIET As a doctor, I often need to discuss my patients' diets, and to offer help for improvement. Many people seem to feel that this is a difficult subject full of subtleties and calculations, which can be a scary proposition. I think that it is more important to have a basic understanding of nutrition, rather than the ability to count fat grams and calories and micronutrients. My advice involves the "three F's" of Fiber, Fats, and Fluids. Everyone needs lots of fiber to stay regular and keep the bowels healthy, so foods like fruits and vegetables are important. I also find bran cereals are helpful, and many people can benefit from the use of fiber products like Metamucil, Citrucel, and Fibercon (or their generic equivalents). The general rule on fats is to minimize them, especially saturated fats. Avoid animal fats and tropical fats (coconut oil, etc.) whenever possible, while using more olive and canola oils. Finally, drink lots of fluids, especially water and juices. Eight glasses of water daily keeps the body hydrated and flushes the kidneys, unless your doctor has restricted your water intake. EXERCISE This does not have to mean buying expensive clothes and shoes and going to a health club, but rather can mean walking for thirty minutes three times a week. Any exertion that gets your heart rate up a bit and that you can sustain for thirty minutes qualifies, so talk to your doctor to get clearance for this and to discuss options for exercising. Exercising for shorter periods during the day has also been shown to have positive health results. Much of today's problems with elevated blood pressure, blood sugar, cholesterol, and stress can be helped by moderate exercise. If I could bottle the health benefits of exercise, I would have the cure for many of our worst illnesses. STOP TOXIC SUBSTANCES If you use tobacco, quitting is probably the single best thing that you can do for your health. Scientific research has shown that tobacco directly causes illnesses like many cancers, emphysema, and heart disease. It is hard to stress too strongly the health benefits of tobacco cessation, along with the obvious financial rewards of quitting. There are lots of ways of quitting, ranging from cold turkey to tapering to patches to gum to a new pill to "whatever it takes" for someone to quit. If you can quit on your own- Do it! If you have not yet been able to quit, talk about choices with your doctor. I also recommend no more than one alcoholic beverage daily for women and no more than two for men. This is all that the body can safely detoxify, and drinking more can cause many long -term health consequences. It is also vitally important to stop the use of any illicit drugs, including marijuana, because there can be severe and lasting effects that show up years later. UPDATE YOUR IMMUNIZATIONS We in America are very good at giving our children their pediatric immunizations, but we are less aware of our own adult immunization needs. Every adult should have a tetanus shot every ten years to help prevent lockjaw, a potentially fatal disease. Adults over 65 years old, and anyone suffering from a chronic heart, lung, or immune disease (including diabetes and asthma), should have at least one pneumonia vaccine (Pneumovax) and a yearly influenza vaccine, or flu shot. These immunizations can prevent severe illness and death from these respiratory illnesses. For those at risk, immunizations are available for Hepatitis B, Hepatitis A, and chicken pox. More vaccines are always being developed, so ask your doctor if your shots are up-to-date. WORK AT RELAXATION This may sound like an odd way to describe this goal, but relaxation is not a natural part of today's stressful world. Learning to relax is a skill like many others, and needs to be practiced. Get a hobby, find an escape, work at slowing down. Relaxing is not laziness; relaxing is allowing yourself to get recharged and ready to be even more productive. You'll never 'find' time to relax- you'll have to 'make' time for this important activity. CONSIDER DIETARY SUPPLEMENTS Nowadays, it is impossible to ignore vitamins and other food supplements. People are bombarded with enticements for surefire herbal remedies, amazing vitamins, restorative minerals, and over- the- counter cure-alls. Wading through this is a difficult task, and it becomes hard to know who and what to trust. I try to recommend only things that have at least some science behind them, rather than only testimonials. Vitamin C, Vitamin E, calcium, and folic acid all seem to be generally helpful. Taking any of these or other medicines should warrant a discussion with your family doctor, just as you'd review any new prescription. Drug interactions, even with common, over- the- counter medicines, can be very serious. PARTNER WITH YOUR DOCTOR One of the most valuable resources available in the quest for better health is your family doctor. In addition to relying on your doctor to help you when you are ill, you can also ask for guidance with your personal wellness program. Your doctor can factor in your own health status, providing you with a unique program tailored to optimize your health. Making this a two-way discussion allows you to be an active participant in your health care, and gives your doctor input about your unique perspective on wellness. Work with your doctor to coordinate the previous six steps to wellness, and you can expect a lifetime of rewards.
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