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Critical reading skills for media reports needed to remain informed and make good decisions

A recent dangerously misleading headline and report on NPR does not accurately reflect the content of the story, and reinforces the need for critically reading media reports to skillfully taking charge of your own healthcare.  Don’t let the media mislead you.

The report is about a conference on how blood sugar metabolism in the brain might predispose people to Alzheimer’s disease.  The headline claims that controlling blood sugar could prevent Alzheimer’s disease. But it could be very DANGEROUS to try to lower your blood sugars without using great caution in how you do it.  

And simply lowering blood sugars using current methods, even just lifestyle change, has not been proven to help reduce your risk of Alzheimer’s disease.

Though the participants in the conference did discuss how “keeping your blood sugar in check could lower your Alzheimer’s risk.”, the key conclusion was that while their findings advanced the science of brain glucose metabolism, and found potential links between how the brain metabolizes glucose and how it could develop Alzheimer’s disease, no clear causal conclusions could be drawn.

Importantly, the current methods of controlling blood sugar were not tested for their safety and efficacy in preventing the development of Alzheimer’s disease.

A key disconnect in the data not mentioned in the report was that while Alzheimer’s disease only affects one percent of people in the US, there are many more diabetics than that who have poorly controlled blood sugars.  

Much work needs to be done before the interesting findings presented by these scientists can be translated into a safe and effective plan for treating diabetes to prevent it from causing  Alzheimer’s disease.

An important caveat was stated clearly in the article; Low blood sugar could cause problems that lead to Alzheimer’s disease.  That means exerting caution in how patients control their blood sugar to avoid low, as well as high levels.

Also of note, the apoE enzyme mentioned that normalized brain sugar metabolism and brain cell function in rats worked in rats with high blood sugars.  That suggests that the blood sugar itself is not the problem, but rather that how the brain cells handle blood sugar causes trouble.

We repeat, do not try to change your diabetes treatment plan without first talking to your doctor.  But by all means talk to your doctor about doing the best you can to keep your weight safely down and your blood sugar safely controlled.  As the report does mention, there are lots of reasons to do those things for yourself.

At Operam we help you learn how to ask and answer important questions about your health, and work well with your doctors to make the best decisions about your health care and disease management.  Call us at 203-692-4422, or email us at ajc@operamhealthcare.com for a free consultation.

Personal preparation for the time when advanced care can be as harmful as it can be helpful.

The critical importance of strong advanced care planning:

Our recent experience with a personal family illness revealed how easy it is for even seasoned professionals to become hesitant at a time when decisions must be made at a critical moment. Even a full understanding of benefits, risks, alternatives and unknowns wilts under the pressure of knowing how you or your loved one wants to live their life when living it will be under a compromise between quality and quantity.

It’s easy to personally value “quality” over quantity, but understanding the details of what that means for different levels of compromise can be overwhelming when there are many variables and unknowns to consider.

Don’t let medical technology overwhelm your personal identity, needs and and values when a health exigency or crisis occurs.

Doctors often make decisions that seem right based on expert guidelines or recommendations, but don’t account for your own personal needs, values or goals.

While individual diagnostic or treatment plans are often difficult to comprehend or integrate, the most important time for making fully shared decisions is when medical science and technology don’t offer easy solutions or certainty.

It is critical to be prepared for that time by having carefully examined and fully communicated your own or your loved one’s goals and values. When a crisis occurs for you or your loved ones you can then more effectively collaborate with your doctors or other caregivers. It is all too easy to become overwhelmed with the complex medical decision making that must occur in the chaotic environment of a medical crisis.

If you would like more information, education, coaching or advocacy to prepare for the time when medical technology cannot give you or your loved ones’ life back, but can take away your opportunity to live a dignified and peaceful life as life’s end approaches, check our website and email or or call for an introductory consultation about advanced care planning.

Navigating the unknowns of medical science requires strong collaboration

A teacher and mentor of mine once confided, “I want you to know that half of what I teach you is wrong. Unfortunately, I don’t know which half.”

We often write about the incomplete nature of medical science. New findings and recommendations about the use of aspirin to prevent heart disease reveal how difficult navigating such incomplete science is.

The authors of the study quote an expert who states, “Our findings show a tremendous need for health care practitioners to ask their patients about ongoing aspirin use and to advise them about the importance of balancing the benefits and harms, especially among older adults and those with prior peptic ulcer disease,” 

The expert is referring to those same healthcare practitioners who just recently routinely recommended using aspirin to prevent heart disease.

What is missing from all of these recommendations is a healthy recognition of the unknowns in medical science. A deep understanding and consideration of those unknowns is critical to making a medical decision that matches your own goals and values.

We can help you to navigate the unknowns by educating you on particular topics and coaching you on how to use your knowledge to better collaborate with your doctors.

Email us at ajc@operamhealthcare.com, or cal 203-692-4422 for a free introductory consultation.

New study illustrates why understanding the “unknowns” is critical for good medical decisions.

Stunning new data reveals a previous unknown disease mechanism that affects treatment decisions for millions of diabetics. The study published in June 2019 uncovers the massively incomplete science for all people with type 2 diabetes.

While the authors of this study separated black Africans from white Europeans to reveal the new mechanism, recall that there are many diverse genetic and physiological traits within the groups we traditionally identify as black or as white, so it is very likely that the new mechanism applies in many diverse patients regardless of their ethnic or racial identification.

None of the current expert guidelines for diabetes care account for this unknown mechanism, and thus deciding on the right medication for treating an individual’s diabetes must be done cautiously, and with careful consideration of their response to the treatment as ordered.

We can help you better understand your medical condition so you can ask the right questions and make good collaborative decisions with your doctors.

Call 203-692-4422, or email ajc@operamhealthcare.com for a free introductory consultation.

Do you need a lifestyle doctor?

We often discuss the importance of collaborative engagement with your doctors so your medical decisions account for how your own goals and values for with the benefits, risks, alternatives and unknowns of those decisions. Most of the time those decisions involve medications or medical technology. However, one of the most powerful and important components of our healthcare is our lifestyle; the behaviors we engage in for our nutrition, our exercise and our cognitive styles.

All doctors agree on the importance of lifestyle. But not all doctors are trained or have the time to engage patients to help them improve theirs. Many medical schools have begun to address lifestyle education in their training programs. Additionally, some doctors have organized into specialty groups such as the American College of Lifestyle Medicine, which applies evidence-based principles to the practice of lifestyle management.

Most insurers do not reimburse the practice of lifestyle medicine. They expect it to be part of the routine care patients receive in the course of their physician visits. While this may change as insurers embrace a wider approach to use preventive care for managing healthcare costs, for now, visits to lifestyle doctors are investments individuals must make out of their own pocket.

So is such an investment right for you?

If your own physician has the time and interest to help you engage in lifestyle management, then you don’t. However, if your doctors leave you feeling uncertain about how to best engage in lifestyle change, a consultation and followup with a doctor trained in lifestyle medicine may be very worthwhile, especially if they can also collaborate with your own physician.

Despite the obvious benefits of lifestyle change for your health, how you do it does have the same set of benefits, risks, alternatives and unknowns of any medical decision. We can help you evaluate the qualifications of a lifestyle physician you might want to engage with, and we can help you understand the benefits, risks, alternatives, and unknowns to consider so you can ask the right questions to get the most out of your engagement with your own doctor, or with a lifestyle physician you may choose.

Email us at ajc@operamhealthcare.com or call us at 203-692-4422 for a free consultation.