- Psychological Issues
The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet, and in the cause and prevention of human disease.
Something interesting happens when I take a family medical history from some of my patients. They will talk about their grandparents from Russia, or the Caribbean, or rural America — grandparents who often lived into their 90s. What’s more, they stayed pretty active and healthy into old age. Were they wealthy? No, they were farm people, or working people; they did hard physical labor all their lives. What did they die of? No one really knows. It seems they died of old age — simple as that.
But my patients’ parents, of the same genetic stock, are encountering all kinds of problems: they have cancer in their 50s or heart attacks in their 60s. They develop diabetes. The parents are usually better off financially than the grandparents. They haven’t had to work as hard, and they retire when they’re 60 or 65. Yet, they have more serious health problems than the grandparents, who perhaps lived through deprivation or poverty and perhaps never had the opportunity to retire. My patients are reflecting on this and asking, “What is it about my parents’ lifestyle that has put them in jeopardy?” This is a typical experience, and the only thing we can really point to is the American way of life: smoking; drinking; the high-fat, high-sugar diet; minimal physical activity; the habit of driving a car instead of walking; the whole suburban dream that has somehow gone awry.
It’s clear we need to take a closer look at some of the typical American health risks if we’re going to mount an effective campaign against decline and illness. Let’s look at some typical examples of how baby boomers can get into trouble and how they can get out.
I see a lot of patients like Ellen, who first appeared in my office complaining of fatigue, spaciness, mood swings, and occasional “shakiness.” She told me that she was hungry all the time and couldn’t seem to help putting on a few more pounds every year, even though she was trying to eat a healthy diet. Ellen had just turned 40 and did seem to be carrying some extra weight mostly around her waist, which is a tipoff for a metabolic imbalance we call Syndrome X. Her complaints were real, though she half-wondered whether she should be seeing a psychiatrist because of her mood swings, even though she had a happy, stable family life and enjoyed her work in publishing.
I asked Ellen what she thought a healthy diet was. She had granola with fruit for breakfast, a no-fat muffin and fruit juice in midmorning, and a light salad for lunch. By midafternoon she was starved and fatigued, but she drank tomato juice or ate crackers and forced herself to put off eating until dinner, when she’d usually have a big pasta dish with lots of whole-wheat Italian bread on the side. The fact was that although her fat intake was relatively low, she was eating exactly the sort of high-sugar, highcarbohydrate diet that would naturally induce food cravings and weight gain. She was flooding her bloodstream with high levels of sugar when she ate, which gave her immediate energy but then invoked her insulin reserves to lower the blood sugar levels. She would then have a crash — no energy, spaciness, shakiness.
I put Ellen on my Salad and Salmon Diet, and she soon began feeling better and gradually lost weight. Fortunately, we were able to arrest a process of decline that could have had some very serious consequences, including heart disease and diabetes. But not everyone takes the necessary steps in time. Ellen was in the middle stage of a syndrome I call sugar disease. This manifests itself in different ways in different individuals, and at different stages of life. In younger years, it often appears as hypoglycemia, or low blood sugar, which is marked by a whole array of shifting symptoms: spaciness, fatigue, mood swings, sugar craving, headaches, tremors, depression, hot flashes, abdominal pain, panic attacks, and even more.
In the middle stages, sugar disease progresses to Syndrome X, which is marked by weight gain, especially around the midsection; elevated blood pressure; elevated cholesterol and triglycerides; fatty deposits on arterial walls; immune suppression; and insulin resistance. This latter complication typically leads to the third stage of sugar disease: full-fledged adultonset diabetes.
Ellen’s sugar disease is one example of a medical concept called diathesis — a syndrome of decline that extends over years. It’s a way of looking at disease over the course of a lifetime and is a much more sophisticated way of understanding disease than to simply say that so-and-so “contracted” diabetes in her 50s. The idea is that you don’t have just a disease that suddenly strikes you, but an unfolding pattern of vulnerabilities that may manifest itself at various times as various diseases.
For example, an allergic diathesis might be characterized in childhood by infantile colic, which subsides, but is followed by childhood eczema, develops later into adult asthma, and perhaps later in life appears as chronic obstructive pulmonary disease, causing cardiac strain and ultimately death. This is a way of looking at the disease potential of an individual and what his or her weak spots are. genetic predispositions play a part in diathesis, but so do health habits and lifestyle. The great value of this concept is that we can be aware of these syndromes, offer early warning, and recommend changes in diet or lifestyle, or intervene with nutrient supplements to ward off the final-stage disease.
The concept of diathesis is given lip service in medical schools, but more often as theory than as a principle to apply in clinical practice. In the examining room, doctors are much more likely to say simply that you have a disease or don’t have one, or sometimes that you don’t have one — yet. You’re just auditioning for the part! Actually, the concept of diathesis is very much in line with the theory of some non-Western traditional medicines. A doctor practicing traditional Chinese medicine may examine a patient and say, “Ah, very weak spleen,” and this could be part of a life-long theme for the patient. It doesn’t mean that the spleen got kicked by a horse one day and all of a sudden became a problem, but rather that the person has a constitutional problem, which can generate many different difficulties. We can apply the same principle using the high-tech diagnostic techniques of Western medicine. In a new patient I look for the potential for a diathesis to occur, to see what kinds of genetic or behavior patterns might indicate one type of decline or another, and which preventive approaches we should take.
One of the great things about this approach is that certain basic adjustments, such as dietary changes, can affect a whole range of outcomes, from improving cardiovascular health to preventing diabetes and maintaining good vision.
We’re also learning that it’s possible to backtrack from high-risk health patterns, recover from behavior-caused illness, and arrest or slow physiological decline. I have patients in their forties who are savvier than they were in their twenties or thirties and as a result feel healthier and more energized than ever before. Some of my patients have made significant adjustments in their lifestyles to conquer illness or slow decline. I also have patients who are not in decline but come to me because they want to “optimize” their health; take a proactive, preventive stance; and build their energy and stamina to an optimal level. Both goals require a willingness to compromise, to pay more attention to the body and its needs, and to take a more active or proactive interest in developing a healthy, prevention-conscious lifestyle. It also means taking a more active, engaged, and responsible role in dealing with the medical system and in choosing treatments, physicians, and sometimes alternative caregivers.
More and more physicians, their patients, and even health insurance companies are subscribing to the philosophy that prevention is worth more than cure and that it’s a viable goal to optimize our physical well-being and energy levels, our longevity, and our physical performance.
Dr. Ronald Hoffman is recognized as one of America’s foremost complementary medicine practitioners. He is founder and Medical Director of the Hoffman Center in New York City, author of Intelligent Medicine : A Guide to Optimizing Health and Preventing Illness for the Baby-Boomer Generation and numerous books and articles for the public and for health professionals, and is host of the popular nationally-syndicated radio program Intelligent Medicine, and the Internet podcast of the same name. – See more at: http://drhoffman.com/about/about-dr-hoffman/#sthash.gNSMZWUO.dpuf