Most important health issues

Time and time again, I am hit with requests from patients to “check everything” or “do all the tests possible” in their quest to rule out all the bad (but rare) problems that may affect their health. Of course everyone (well, most everyone) wants to know if they have cancer, and wants to know as soon as possible. Me, too. Oddly, though, the general population has the impression that blood tests are the key to identifying cancer and all other diseases. Boy, do I wish! You know how easy my job would be? If I could guarantee that a panel of blood tests would detect any form of cancer, I could retire tomorrow.

Obviously, medicine is not that simple. But, health is simple. Instead of worrying about that 1 in 10,000 incidence of leukemia/lymphoma (10 per 100,000 men, 5.7 per 100,000 women per NCI) , or the 1 in 200 incidence of any kind of cancer, let’s face the real problem that is far more likely to kill you – heart disease, the most common cause of death for the past 80+ years.  The incidence of heart disease ranges from 700 per 100,000 men at ages 35-44 to 6,800 per 100,000 (1 in less than 15) at ages 85-94.  The comparable incidence for women is delayed 10 years.

What I’m really suggesting is that far too many people are so set on themselves having some strange disorder that they forget the most important aspect of health: fitness. I want to say to these people that I will gladly investigate their concerns once their weight, cholesterol, and fitness level are all in the ideal ranges.

Obesity and overweight represent the 2nd leading cause of preventable death in the US, per the American Heart Association, second only to tobacco use. That’s easy to understand – tobacco and obesity contribute to heart disease, and both are major contributors to cancer as well.

Another classic patient: the smoker who comes in for a cough, shortness of breath, sore throat, etc. Hey, if you want to pay me for the simple advice of quitting smoking, I’ll keep my door open for you. But don’t beg for an antibiotic when you know darn well you’ll have another cancer stick hanging out of your mouth as soon as you feel better. That reminds me – everyone wants to pat themselves on the back when they gave up cigarettes for the 1st 3 days of their bronchitis. [Me: Are you still smoking? Patient: Nope, I quit 3 days ago when this cough started] How stupid do I look?!?

Do yourself a favor. Turn off the TV, put down the Big Mac, and quit staring at WebMD to figure out what weird disorder you think you have. Go learn about fitness and make some changes in your life that will make you feel better, look better, and live better. If you are overweight and sedentary, your doctor will likely be pounding his/her head on the office wall when you develop a complex about detecting that rare disease you are so worried about when the real problem is staring at you in the mirror every morning.

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One Response to “Most important health issues”

  1. I feel your pain doc!!

    Personnal responsibility is the key to changing our society from sickness care into a true health care system.

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