Conflicting Medical Advice
Friday, 06 March 2009
Here is my belief about the health of our bodies: given reasonably good care – eating well and some moderate amount of exercise – a body should toot along without too many interruptions until time to depart this world.
Of course, I know that’s nonsense. Otherwise healthy people get all kinds of horrible diseases, conditions and illnesses every day. But I still think it should be that way and although I’m moderately interested in health discoveries from medical researchers, there are so many contradictions contained in them that it seems counterproductive to pay undue attention. I’m sure there must be a study somewhere that proves carrots will kill us.
So, I read the announcements with a degree of interest and then go on my way generally unheeding of their advice.
However, we are all different and a few days ago, I received an email from TGB reader, Linda Sandler, who wrote:
“This morning’s newspaper brought news of medical research that caused me to be both frustrated and anxious (with the anxiety winning out). Namely, the new finding that one glass of wine a day is correlated with a significant increase of breast cancer in women…Of course, I’ll stop immediately, but I can’t seem to get the new facts out of my mind.”
Linda is referring to the Million Woman Study in Britain, the size and length of which – 1.28 million women aged 50 to 64 over about 12 years – is the largest ever to examine alcohol and cancer in women:
“...just one glass of chardonnay, a single beer or any other type of alcoholic drink per day increases the risk of a variety of cancers…
“Even among women who consumed as little as 10 grams of alcohol a day on average - the equivalent of about one drink - the risk for cancer of the breast, liver and rectum was elevated, the researchers found.”
- - The Washington Post, 25 February 2009
It wasn’t so long ago we were told that red wine is good for us. And five days after the Million Woman Study was reported, WebMD published a story about the results of some other research showing that moderate wine drinking may help prevent a specific cancer:
“…findings from three newly published studies suggest that drinking wine in moderation may help protect against esophageal adenocarcinoma or a precancerous condition, Barrett's esophagus.”
You see the difficulty I have in giving much credence to differing health studies – there is no way to sort out what to do. It reminds me of the hysterical warnings about marijuana during the 1960s – that using it leads to hard drugs like heroin. I was amused when NORML (National Organization to Reform Marijuana Laws) pointed out that all heroin users also drank milk as babies, but no one was advocating banning milk.
Nonetheless, I concede that my breezy attitude toward health (which will undoubtedly sink me in the end since everyone in my family dies of one or another kind of cancer) is not necessarily held by others and Linda Sandler’s anxiety is to be taken seriously. Here is what else she said in her note:
”I’m wondering how other elder women deal with this type of contradictory medical advice, or if this is my personal and private angst. It seems that as I get older I feel more and more vulnerable to the vagaries and randomness of major illness.”
I am curious too not only about how you deal with confusing medical information, but if you have greater or lesser concern about your health as you’ve gotten older. And not just women. I think men reading this would also have some useful things to say.
[At The Elder Storytelling Place today, Alan Ginocchio has a rueful observation on Another Top 10 Senior Moment.]
The problem with most of these studies is that they are partial - they only look at one but of us or one activity. That isn't surprising or even unreasonable, but it does mean that they will appear to contradict each other.
So - wine drinking increases the risk of some illnesses, while protecting against others. What we need to know is the balance of risk - but we never seem to get it.
We are as a society very bad at handling risk it seems. A million to one chance of an adverse reaction leads to a drug being removed from the market, even though thousands would have benefited. The problem is that cost of compensating the person who suffers that reaction is borne by the drug company, while the value of the benefits is gained by a diverse set of people.
Maybe we should only do drugs testing on lawyers...
Posted by: ian | Friday, 06 March 2009 at 04:36 AM
I take these studies and reports with a grain of salt. Large studies like the million women one rely on questionnaires. Therefore, outcomes depend on what the respondents want to put down. There is no guarantee of accuracy or really any control.
Basically, I think the best approach is moderation and common sense in all things. It may be boring but it is less likely to lead to damage.
Posted by: flutterby | Friday, 06 March 2009 at 04:40 AM
Hmmm - I like the previous study that says that red wine is good for you . . . frankly, we're all going to die someday from one thing or another. If we worry about every doomsday study that comes our way, we'll die sooner. It seems to me that through the years, we've seen every kind of medical "advice" overthrown by another "study" only to be overthrown by another.
I agree that moderation in everything is probably the best medical advice - exercise, balanced diet, and red wine! (Also dark chocolate). Add to that, "gratitude" which lifts your spirits and may add years to your life.
Posted by: Lois | Friday, 06 March 2009 at 05:10 AM
My doctor called me last night to tell me I may have a bladder infection. She asked if I had noticed symptoms, I said No, and she seemed very conflicted about whether to prescribe an antibiotic or not. It almost seemed like she was asking my advice. After the call I looked this up on the internet and discovered that symptomless bladder infection is common in older women and the current medical advice seems to be don't treat it unless there are extenuating circumstances.
Reason I mention this is that in theory I am blase about all the conflicting medical research about what causes cancer and what doesn't, but in practice (admittedly a bladder infection is hardly on the level of cancer) I'm not blase at all, I want there to be an unconflicted straightforward answer, and I want it now!
I heard an excellent radio program recently on risk management and how we are subjected to pronouncements of statistical risk based on this or that study. These studies are all about statistical risk management. Having to make personal decisions based on a statistical estimate of risk is impossibly hard to do, and these studies really don't help us that much but are very hard to ignore. The program suggested that they only add another dimension of worry to our lives.
Posted by: anne | Friday, 06 March 2009 at 05:39 AM
I generally agree with you, Ronni, about medical studies. However, with one life-altering exception, I've enjoyed generally good health. However, there are times when a particular article will hit me very hard, as this one did with Linda Sandler. Then I'll wake up in a cold sweat of fear in the middle of the night.
This is the part of getting older that frightens me: the fact that I'm that much closer to getting whatever is going to kill me.
Linda, I cope with it by seeing a doctor when I start obsessing about something. But for the most part, my self-image is of a person much younger than I actually am. At the risk of being heretical on this blog ;-) , that serve me well when it comes to fears about illness. That's because it enables me to follow a bit of advice from Garrison Kiellor: "There comes a time when you just have to stand up to reality and deny it."
And, in the interest of honesty, I have to add that being a person of faith makes a big difference. It's not so much becaue I believe in a hereafter--my faith is a source of strength, support, and perspective in the here and now.
A friend who is in his 70s helped me recently. I was agonizing about my new puppy (of all things!) and how I'd be in my 70s if the puppy lives to be 15, and will I be able to take care of him, and if not, what will happen to him. My friend said, "You can't think like that. You have to take each day and enjoy it."
That's how I cope.
Posted by: mary jamison | Friday, 06 March 2009 at 05:53 AM
Someone should - not me - create a clearinghouse for all of this data as a public service. A place where the public can see ALL of the data and make informed decisions on their health care, instead of reacting to the latest headline. The way it stands now, we're all very wary of anything we read and tend to discount it all.
And no, it shouldn't be the government...
Posted by: Steven | Friday, 06 March 2009 at 06:09 AM
My husband always says if you wait a few days, you'll read of a study that refutes the last one you noted.
I still believe in moderation in all things.
Posted by: kenju | Friday, 06 March 2009 at 06:20 AM
In medical advice as in all advice...look to who is paying for the research and who is collecting for therapies and follow the almighty dollar.
Some of the best and easiest solutions for good health are FREE, and are just common sense and so, therefore are not in 30 second ads on television touting your new cure-de-jour.
Did you know that 20 percent of breast cancer GOES AWAY ON ITS OWN? Yes, indeed...and that's because believe it or not, your body actually has the ability TO HEAL ITSELF WITHOUT CHEMICALS.
We have given the power and independence of our own health (as so many other things...sigh) AWAY TO OTHERS because we want to be "taken care of". We want to pop a pill to solve even our smallest of problems.
If you are on the medical merry go round these days you have given your health over to BIG PHARM, because they are the ones who are educating your doctors and putting ever new symptom masking drugs into their hands and therefore into YOU.
PROPERLY dispensed and prescribed RX drugs kill 100,000 people a year and cause 2 million serious side effects. (JAMA)and are the prime reason for almost 30% of hospital admissions. (AMA)
The leading cause of death and injury in this country is the American Healthcare system itself.
Here is a good book for all to read, its called "Water Cures: Drugs Kill" How Water Cured Incurable Diseases by F. Batmanghelidj MD.
Posted by: candace | Friday, 06 March 2009 at 07:10 AM
Yes, i read the study and thought about it also because I do drink red wine. I wondered if women in France had the same results. Might it be something else in the diet of the English women that interacted with the wine (or any liquor)? I wondered what percentage of increase was significant to the study? Remember our actual risk of getting something is usually pretty small and a significant increase might still make it pretty small.
Then I considered all the studies that wine helps prevent heart attacks.
I thought about my enjoyment of wine in the evenings or with lunch and I decided I had to die somehow and wasn't going to let this study impact what I drink. I do however take Vitamin B and a folic acid supplement and have for quite awhile as many things, in particular alcohol, leach them from our bodies.
When I was raising my kids, these kind of studies could drive me nuts. Spank. Don't spank. The end result is a long time ago, I felt I had to use my own commonsense. It's what I believe about the alcohol. I might be more likely to get cancer, less likely to have a heart attack, but I definitely know I enjoy that glass of wine at night and moderation is the key to anything.
I cannot avoid all risks anyway. One of the worst is stress and who can avoid that these days!
Posted by: Rain | Friday, 06 March 2009 at 07:10 AM
I quit paying attention to statistics long ago. I try to practice moderation in all things and always have. Nonetheless I have added 15 pounds to my girth and I can't seem to care. I know I would be healthier if I lost them, but I agree with Mary Jamison - you have to take each day and enjoy it. I do not enjoy diet days.
Posted by: Darlene | Friday, 06 March 2009 at 07:16 AM
I've decided that the object of this exercise called life is to live it as best I can in the physical environment I was given to live it in. The outcome is a given, and that will happen when it happens regardless of my struggles against it. My "to do" list is to try to do better today.
Posted by: AlwaysQuestion | Friday, 06 March 2009 at 07:22 AM
Sychronisity, Ronni, I wrote a post about the woman and alcohol study yesterday. When I first heard about it I was spooked but as kenju's husband said if you wait a few days you will find a new study that refutes the study you read about earlier. My short post gave a link to an article,
http://www.spiked-online.com/index.php?/site/article/6316/
that explains why the study is flawed.
So many so-called scientific studies are flawed. I remember when a report came out saying hair dye caused cancer in rats and therefore should be banned.
It turned out they were injecting the rats with ten time the amount of hair dye that the average woman would use in her lifetime. Did you catch that injecting part of the study? They were not putting the dye on the rats, they were putting it into the rats.
A couple of doctors at the University of Colorado Medical Center were so disgusted by the lack of real science behind this study they decided to preformed their own experiment and inserted dimes under the skins of rats. When the rats showed symptoms of tumor formation they released a study urging the government to ban dimes.
As to concerns about my health as I've grow older- no change. I see the doctor and dentist for my regularly scheduled check-ups and go on my merry way. Of course I may be living in a fools paradise with this attitude but it sure makes life easier.
Posted by: la peregrina | Friday, 06 March 2009 at 07:25 AM
I agree that both common sense and moderation are the way to go. Studies can make interesting reading, but I don’t buy into them. I don’t remember when I started wondering what will get me in the end no matter what I do or don’t do. However, having lunch with a couple of women my age yesterday probably was a huge plus health wise. We were reminiscing about things done in our youth. We laughed so hard and so much that our sides hurt. More, much more of laughing until one’s sides hurt can only be a good thing.
Posted by: Claire Jean | Friday, 06 March 2009 at 07:28 AM
What Kenju said. In the meantime, everybody's gotta die of something and I'm of the mind that I'm going to keep on keepin' on as usual no matter what these studies say. When my leader calls me home, I will answer. I real feel no burning desire to live forever and everybody's gotta die of something.
Like most elders, I hope it's old age but I'm not about to worry about these studies. Living day-to-day is tough enough without worrying about dying. And after the week/month I've had, a glass (or two) of wine sounds damned good -- studies be damned!
Posted by: Kay Dennison | Friday, 06 March 2009 at 07:29 AM
Agree except on one thing: The marijuana we knew in our youth is not today's marijuana, and today's experts have decided it is both a gateway drug and, on its own, one of the chief reasons people end up in treatment houses. Heard a good NPR program on this recently, in reaction to state initiatives to de-criminalize various drugs. Until I heard the show, thought it sounded like a good idea.
Posted by: Mary Davies | Friday, 06 March 2009 at 08:14 AM
Answer: Yes, as I get older I worry more about illness and am I doing "it" right(whatever that means).
It does drive you nuts to find out that what you've believed for awhile is now not true.
I told my older sister about some fish that was considered unsafe to eat too frequently. Her response was that she was 70 and loves fish and she's going to eat fish. Makes sense.
Posted by: notdotdot | Friday, 06 March 2009 at 08:23 AM
Your question is very thought-provoking. I think I worried much more about death when I was younger because several friends died in their 30s and 40s. Now I have had four different cancers--all caught early, luckily. I experienced a deep reorientation process that after that. It has been reinforced by my work with old people (over 75) as a personal historian and church visitor. I have a stronger awareness that I will die eventually, but instead of making me afraid, this awareness turns me back toward the day, the moment that I really have, now. Yesterday on the way to visit an elder from our congregation I saw a coffee company's delivery truck. On the back was painted: Savor the moment. That summed it up for me.
Posted by: Peg Thompson | Friday, 06 March 2009 at 08:26 AM
So much information conflicts. My doctors are always nebulous too. I try not to bother them with every little concern-just keept he ticker and the lungs going.the earlier generations in my family were sort of hypochondriacs with the result that my syblings wouldn't go to a doctor unless we just couldn't get to work.
I'm finding the same problem with foods and go crazy with the dilemmas. My doctors say they can't tell really, how much I need attention because I never complain and always make light of my illnesses.I've learned that even that causes a contradiction. If I tell them, they send me for a round of tests. If I don't tell them, they send me for a round of tests to find out for themselves.
What to do. what to do.
Posted by: Charles Berry | Friday, 06 March 2009 at 08:45 AM
I agree about good sense and moderation. And I think we should remember that risk is a relative word. I heard a commentator on the radio some time ago on the subject of risk, and he said that people are afraid of new risks that they have just learned about. Every time you ride in a car you are taking a big risk, and yet we all get in cars all the time. The risk from drinking wine (if there really is one) is tiny compared to car riding, and yet if you just learn of it it's scary. So I think I'll keep on drinking wine and I'll get used to the risk.
Posted by: Anne Gibert | Friday, 06 March 2009 at 09:12 AM
We need to take all the studies with a grain of salt (or a glass of wine). Another one says that wine has been found to impair short term memroy, as reported in Elaine McGee's blog The Recipe Doctor: www.silverplanet.com/blog/recipe-doctor/think-you-drink-it-may-be-hurting-your-memory/6287. The memory loss seems more immediate!
Posted by: Andre | Friday, 06 March 2009 at 09:25 AM
Unfortunately, we still don't get much emphasis on numeracy (and literacy) in the US. Statistics aren't difficult to understand and provide a means to examine the news, etc. However, it takes practice to spot what exactly is said in the studies and to apply your analysis.
Alcohol is shown to increase the risk of breast cancer by nearly all controlled studies. However, the risk of breast cancer is extremely small, I think less than 8% of those even with family history. So multiply the increased risk from alcohol times the risk of breast cancer and the result is still a tiny number.
Note that the beneficial aspect of red wine is the grape skin, not the alcohol (otherwise straight grain spirit would work). So, for those concerned with increasing their already small risk of breast cancer, drink Welches Grape Juice.
Smoking, overweight, and driving without a seatbelt are still bigger killers and maimers. Choose your poison.
Posted by: vuee | Friday, 06 March 2009 at 09:50 AM
The best discussions of the difference between the headlines and the actual study results are often found at junkfoodscience.com They're not just for geeks either, but for anyone who appreciates clear writing, sound logic, and science with their science! Here's links to the posts about wine:
http://junkfoodscience.blogspot.com/2009/02/in-vino-veritas-part-one.html and http://junkfoodscience.blogspot.com/2009/03/in-vino-veritas-part-two.html
Both are worth the effort to read and mull ; ) over.
Posted by: Ajay | Friday, 06 March 2009 at 09:57 AM
"If it feels good, it must be bad."
Eustace McGargle says mix the lime with the coconut, toss in a little Purple Bart's Sarsaparilla, and call him in the morning.
I personally find it most soul satisfying to defy the Gods and will raise a glass of red Chianti in toast to Dionysus this evening, no doubt.
Posted by: Cowtown Pattie | Friday, 06 March 2009 at 10:28 AM
That study was bullshit and not scientifcally conducted. If you look at the actual results, the cancer rate was actually HIGHER in the non-drinkers. Also, the drinking was self-reported, which makes it almost entirely non-scientific and inaccurate.
Drink up, moderately, and don't worry about it, really!
Posted by: DW | Friday, 06 March 2009 at 10:31 AM
Oh, and if you suspect a bladder infection or UTI, have some cranberry juice for a few days. The acidity should clear that right up.
As to all these studies, don't buy the newspaper reports, look at the study itself. The headlines won't give you accurate information, that's for sure.
Posted by: DW | Friday, 06 March 2009 at 10:36 AM
Note to DW, as I said in my original comment, I didn't suspect a bladder infection, there were no---zero---symptoms. Unfortunately this is rather common for older women, and some don't discover it until it reaches their kidneys.
Also, the amount of sugar in most commercially available cranberry juice pretty much negates the benefits of the acidity.
Posted by: anne | Friday, 06 March 2009 at 12:12 PM
I really started getting concerned about my health when my husband died as I felt that I had to stay alive until my daughter was in her twenties. But I must say I hate taking drugs, and I choose my doctor(s) among those who prescribe few of those. I would say that I trust my nose ;) and only when I trust a doctor do I follow what she says.
I am more concerned now that I have reached that third part of my life as I want to feel reasonably comfortable for as long as I can.
Newspapers report one thing one week and the opposite the next, so how can you trust them? And since I am not able to read complicated medical reports, I just rely on the people I trust AND common sense as I see it.
Posted by: Claude | Friday, 06 March 2009 at 12:23 PM
Another BRITISH STUDY that was published recently is about front facing strollers for children. It seem this study found that infants and children in strollers that face forward have slow language development because the children cannot interact with their caregivers or see their faces
I say..GIVE ME A BREAK..and several letters to the editor in the NYT today agree.
"While hundreds of thousands of children face death every day from preventable diseases and starvation, we are now being asked to worry which direction our infant strollers are facing.
When did staring at the glazed eyes of their parents every minute take precedence over interacting and learning about the world?
Both my older children uttered their first words while strolling in the park and watching total strangers pass by with objects that caught their attention — a red hat and a tail-wagging dog. And while I may have pushed them in forward-facing strollers, they somehow managed to learn a word that will serve them well in our current child-rearing climate: ridiculous."
------------------
Methinks the British have too much time and money on their hands for pseudo scientific studies.
Posted by: chancy | Friday, 06 March 2009 at 12:42 PM
Living is inherently risky and, while it's possible to reduce this risk somewhat by avoiding known killers (smoking for instance) and doing things in moderation, you can't eliminate risk entirely. There are always unknown factors at work to interfere with "the best laid plans of mice and men..."
So, my advice is to take reasonable precautions in health matters, live in the present, and enjoy yourself while you can. For the final reality is that nobody lives forever; we are all going to be dead for a long, long time.
Posted by: George P. | Friday, 06 March 2009 at 01:57 PM
Well, my oncologist told me that the current thinking is that moderate intake of any kind of alcohol is anti-carcinogenic. He's a lot smarter than I am, and it is nice to hear something about health practices that I want to hear!
Posted by: Citizen K. | Friday, 06 March 2009 at 08:27 PM
one of my friends was VERY upset by that study. she loves wine. then maybe a week later, the same online resource that published the putative wine-cancer link said that caffeine can protect against cancer. since my wine-loving friend also drinks a starbucks double short americano (that's TWO OR THREE shots of espresso in one cup--enough to kill me), i told her she had a good program and not to mess with it.
Posted by: m.e. | Friday, 06 March 2009 at 08:50 PM
Re: "symptomless bladder infection is common in older women and the current medical advice seems to be don't treat it unless there are extenuating circumstances."
I have experienced the same thing and also looked it up. I read different advice: that it's always worth treating: "any older person who is a bit anxious or confused, always test their urine - it may be a symptomless infection and should be treated."
I had been feeling generally low, and the antibiotic treatment did the trick and my energy came back. I'm in my 70's and always say to the doctor "Older age is not an illness and if I don't feel right I'd like you to assume something's wrong until you find otherwise."
Posted by: joanna howard | Saturday, 07 March 2009 at 02:34 AM
To DW -how about some cranberry tablets? Then you pass up the sugar problem! To everyone of you other wonderful people I have news, we are all terminal. We go to such extents to deny death that we warehouse our elderly in nursing homes, supporting "Big Pharm", with no quality of life. We can either enjoy our lives or agonize over every study and advertisement we read and see. As a mortician for 22 years I came to the conclusion that we should probably be crying when people are born and laughing when they die..This is just a single dimension that we are viewing in this life that we live...I am with "Norm" on"Cheers"......"Pass the beer nuts"
Posted by: Diane | Saturday, 07 March 2009 at 05:23 AM
I'm 61 and never expected to live this long, for a variety of reasons. So, since I AM still living :) I find that the older I get, the more careful I get about what I eat, etc. I have, at least, come to grasp the notion that the most important thing in relation to my aging is my health.
However, when it comes to the wine controversy (which you would think by now the scientists and nutritionists could figure out once and for all), until there's a definitive answer -- ain't no way I'm giving up my glass of wine each evening!
Life is too short!
Posted by: Nikki | Saturday, 07 March 2009 at 11:47 PM