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5 things I learned from my patients

Listening to their stories has sometimes improved my health

Consumer Reports magazine: January 2013

Listening to my patients’ experiences has been a unique privilege of being a physician and is one of the principal reasons I love my job. Hearing their symptoms helps me reach a diagnosis (and talking with me can be cathartic for patients). It also helps me expand my medical acumen and make better treatment decisions. And it has often led me to make better choices in my own life. Here are five things I’ve learned.

1. When it comes to exercise, respect your limits. The “no pain, no gain” mantra couldn’t be farther from the truth. Just ask the 70-year-old retired administrator I saw recently. He said he lifted hundreds of pounds while striving for a senior weight-lifting record. The strain had dislocated his shoulder blades, creating a “winged” appearance and resulting in months of excruciating pain. Likewise for the 28-year-old whom I diagnosed with nerve damage from doing side crunches while wearing ankle weights. So common are these tales that although I exercise every day, I now know to avoid adding excessive repetitions, weight, or resistance just to prove I can. See our advice on home exercise equipment.

2. Listen to your body. Many patients can recall nascent symptoms that they ignored, thinking that they would go away. One of my earliest lessons came as a resident when I saw the father of a colleague who had ignored several weeks of heartburn. When he arrived at the emergency room with severe abdominal pain, his chest X-ray showed a perforated ulcer, a life-threatening condition. He had been self-medicating with antacids but didn’t mention the symptoms to his doctor. I’ve learned to heed early symptoms so that they don’t develop into worse problems.

3. Don’t try to treat yourself. I saw a schoolteacher with migraines and fatigue recently who was shocked when I told her she’d been consuming about 700 milligrams of caffeine a day from her daily use of Excedrin Migraine coupled with her latte habit. She had made her headaches worse and had developed insomnia, conditions that went away when she reduced the caffeine and was properly treated with prescription migraine meds. Doctors are notorious for self-medicating, and I was no different. Battling a chronic sinus infection, I once took three consecutive courses of antibiotics and ended up with pseudomembranous colitis, a gastrointestinal condition. Of course, most patients can’t write themselves a prescription, so they rely on the plethora of over-the-counter treatments available.

4. Just because it’s over-the-counter doesn’t mean it’s safe. Last month I saw a 30-year-old landscaper who had taken a body-building supplement and ended up in the emergency room with blurred vision and a severe headache. He was diagnosed with a brain hemorrhage from dangerously high blood pressure. Everyday items in our medicine cabinets can cause problems, too. Too much acetaminophen can cause liver damage; sleeping pills and allergy drugs can cause over-sedation. I use nonprescription drugs sparingly, if at all, and restrict my supplement use to vitamin D.

5. You can’t take care of others unless you take care of yourself. I often ask my patients, after they admit that they haven’t gotten around to finding a primary-care doctor, if their children have a pediatrician. The answer is always yes, which raises the question, “Don’t you deserve the same care?” Although we often take excellent care of others, when it comes to our own health we toss all wisdom aside, getting too little sleep, eating poorly, forgoing regular medical exams. As they say before takeoff, put on your own oxygen mask first. You’ll be of more help to others if you’re ready yourself.

Orly Avitzur, M.D.

Medical Adviser
Editor's Note: A version of this article appeared in the January 2013 issue of Consumer Reports magazine with the headline "What My Patients Have Taught Me."
   

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