The Winning Edge
When Merrie Clarke, 43, an architectural designer and mother of two young boys in San Anselmo, CA, was diagnosed with invasive breast cancer in August 2000, she was devastated. But instead of dwelling on her condition, she immediately started practicing the habits doctors associate with recovery.
Clarke logged on to the Internet and downloaded information about the best oncologists in her area, sought the counsel of her clergy and practiced yoga to fight the stress and fatigue caused by the disease. "Most important, I chose the best ways to spend my limited energy," she says. "I gave up my college teaching position for the semester, quit the volunteer jobs I'd committed to and spent more time reading to my boys, playing Monopoly and savoring everyday moments." Clarke, who opted for chemotherapy and a double mastectomy to treat the cancer that had spread from her breast to her lymph nodes, is now cancer-free.
Doctors have long believed that certain attitudes and behaviors seem to propel patients into recovery -- and scientific studies are now backing those observations. Here, the habits that help us heal:
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Habit #1: Take Charge of Your Condition
Your first task: to obtain copies of all your records -- blood work, pathology reports, MRIs -- and learn how to read them. Your doctor can show you how. "Ask your physician to put 'copy to the patient' on every test he or she requests," says Darol Joseff, M.D., a clinical assistant professor of medicine at the University of Southern California at Santa Barbara and co-author of Making Informed Medical Decisions (O'Reilly Publications, 2000).
Because medical care is decentralized among many specialists, your own personal folder -- and your ability to understand its contents -- ensures that no critical piece of information will be overlooked. Bring it with you to every doctor or specialist you see. Also, if you're researching your condition online, it's important to know the specifics of your case, as medical material can be highly specialized. When you're on the Web, start your medical research by determining who -- or what organization -- is posting the information and whether they have a vested interest in doing so, advises Joseff, who teaches a course called "Finding and Evaluating Health Information on the Internet" at Santa Barbara City College. For instance, drug company-sponsored sites may provide useful medical information, but be aware that they'll be positioning their product as a prime therapy. Also, check when the material was posted -- reputable sites will generally indicate this. Avoid sites that seem long on hype -- especially those proclaiming "cures" for diseases you know to be incurable. Always maintain a conscious skepticism that prompts you to do further research when data sound skewed.
If, in the course of your research, you learn about tests or treatments your doctor hasn't mentioned -- or, if your findings run contrary to the opinions he or she expressed -- don't be afraid to ask why, says Amy S. Langer, executive director of the National Alliance of Breast Cancer Organizations. And if your doctor recommends surgery or a treatment you don't feel comfortable with, get a second opinion. "The bottom line," says Langer, "is that you've got to be your own advocate."
Habit #2: Have a Positive Attitude
Common sense dictates that optimism is better for an ailing body than doom and gloom. However, achieving a positive outlook starts by accepting dark emotions. It's natural to feel angry and depressed when you're diagnosed with an illness, but "the worst strategy is to repress or deny these feelings. This only causes them to fester in the unconscious, where they can build and eventually lead to even more depression, anger and anxiety," says Larry Dossey, M.D., author of Healing Words: The Power of Prayer and the Practice of Medicine (Harper Paperbacks, 1993).
Numerous studies show that optimism boosts health. For example, researchers at Dartmouth Medical School, in Hanover, NH, found that elderly cardiac-surgery patients who had an outlook filled with positive spiritual meaning had significantly better survival rates than people who didn't. But, Dossey cautions, that doesn't mean denying the severity of your condition. "Optimism and positive thinking work best if combined with a realistic assessment of the situation," he says. "If honestly arrived at, they can be sustaining and empowering. But if based on denial, they are likely to fall apart when the going gets tough."
Habit #3: Tell Your Doctor the Truth
"Be honest with me," says Marianne J. Legato, M.D., founder of the Partnership for Women's Health and professor of clinical medicine at Columbia University College of Physicians and Surgeons, in New York City. "Open, frank dialogue" is the hallmark of a good doctor-patient relationship, she adds. For instance, a patient whose treatment is most effective if she abstains from alcohol, but who continues to drink anyway, should tell that to her doctor. "I'm not the police. I'm not making a moral judgment," says Legato. "I guarantee that whatever 'embarrassing' symptoms you're hiding won't embarrass me."
Full disclosure is also important when it comes to the use of herbal remedies. Some can interfere with medical treatments, says Legato. For instance, studies show that certain botanicals -- including ginkgo biloba and St. John's wort -- must be discontinued two weeks before surgery because they can interfere with blood clotting and intensify anesthetics, respectively. Unfortunately, as many as 70 percent of patients fail to report their use of alternative medicines to their physicians, according to the Journal of the American Medical Association.
At the same time, "Your doctor needs to be respectful of your choices, even if she doesn't believe in the use of alternative remedies," says Legato. If she isn't respectful -- and she fails to convincingly explain why she is against those treatments -- you might consider changing doctors.
Finally, during office visits, make sure your doctor addresses all of your concerns. The best way to do that is to "list your questions and present a copy to your doctor when you walk in, so that he or she can discuss them accordingly," says Darol Joseff. Ask whether your physician is willing to receive follow-up e-mails from you -- to report symptoms, for example. Some doctors may prefer electronic communication, says Joseff, because both parties can store a hard copy of the dialogue.
Habit #4: Reach Out to Your Friends
Researchers have proven that the support of loved ones can actually improve a patient's prognosis -- and even help prevent illness in the first place. Married women and men were significantly more likely to report that they were in good health than single people, according to recent research. And in a study at Carnegie Mellon University in Pittsburgh, women and men who reported having broad social networks -- family, neighbors, friends, workmates and members of religious and social groups -- were less likely to develop colds than those who reported less diverse relationships.
Merrie Clarke credits her friends with helping her recover. "One friend, Deborah, acted as my clearinghouse for everyone who wanted to help," she says. That way, support was given when Clarke needed it, rather than all at once. "The worst times were after my chemo infusions, so Deborah organized an army to bring dinner every night for a week after each of these treatments," recalls Clarke. "She also saw to it that my boys were invited on play dates in the afternoons and were picked up from school, or that someone took my husband on a golf outing to get his mind off of things for a few hours."
Habit #5: Be a Good Patient
Whether it's taking a full course of antibiotics or eating a low-fat diet, too many patients fail to do what their doctors prescribe. According to a recent Harris Interactive Poll, 22 percent of respondents said they had not filled a prescription due to the cost of the medication. Thirty percent either took smaller doses of the drug or took it less often than instructed. The National Council on Patient Information and Education (NCPIE) calls such noncompliance a serious health problem.
Often, patients stop taking their medicine because their symptoms disappear after a few days or because the drug causes side effects, says Jerry Avorn, M.D., associate professor of medicine at Harvard Medical School, in Cambridge, MA.
The NCPIE has an educational campaign to encourage doctors and patients to discuss all aspects of medication, including side effects (for more information, visit the NCPIE's Web site, www.talkaboutrx.org). "Doctors used to assume that whatever they prescribed was taken," says Avorn. "Now we counsel them to say, 'You're on a few medications. How are you doing with them?' which opens the door to problems patients are having."
An open dialogue between patient and doctor is also critical when dietary and other lifestyle changes are part of the prescription. Marianne Legato believes physicians shouldn't simply hand down a long list of orders that don't take the patient's life and preferences into account. For instance, a woman with heart disease might abandon all attempts at good health if she feels she's failed a too-stringent regimen. "If a patient doesn't like to exercise but enjoys dancing, I might suggest a dance class at a local church to keep her moving," says Legato. "The trick is to establish what she loves about her life, what can't be meddled with and what she's able to give up."
