Even if you don't know who Steve Jobs and Patrick Swayze are, you can appreciate the very difficult and gut wrenching decisions they have had to face, and the fact that they have both turned to their own hearts to make them.

A difficult diagnosis is life-altering. If you have ever heard those horrible words like "cancer" or "alzheimer's" or "parkinsons" or even "heart attack" or "(fill in the blank) disease" -- then you know. You stop processing any of the words the doctor speaks after that, and you just.... freeze.

Once you get your sea legs back under you, and begin processing those fateful words, then you begin making decisions. You may decide to fight. You may decide to learn. You may decide to give in. Maybe you'll do all of it -- but take it from me -- the one thing you realize is that it's your OWN prerogative to handle it however YOU choose to handle it.

Patrick Swayze chose to go public right away, and fight with every fiber of his being. We have to admire him. He kept working. He interviewed with Barbara Walters. He continues to fight.

Steve Jobs kept everything very quiet for awhile. Recently he announced he would take a leave of absence. We'll hope to hear soon that he's strong enough to take whatever next steps he chooses.

My personal choice was to keep my diagnosis quiet, because I was self-employed, and didn't want my clients to hear my death sentence and choose to stop working with me. But later, when I spilled the beans to some friends, it was making it public that led me to the second-opinion oncologist who helped me prove my misdiagnosis.

Bottom line? There are as many reactions and choices to bad diagnoses as there people who get those diagnoses. It's a time for the rest of us to simply respect both Patrick's and Steve's choices and perhaps to offer up a prayer or two to make sure they live the rest of their lives in whatever way they way they choose.

And don't stop with just these two gentlemen. That advice goes for anyone who must face health difficulties. Offer support, be present, but give yourself, or your loved one, the space needed to make the decisions that must be made.

Godspeed, Patrick. Godspeed, Steve. We wish you all the best.

..............................................
Photo � Getty Images

My friend Susan, an anesthesiologist, was the first doctor to bring this concept to my attention:

Patients lie. They lie to their doctors because they think their doctors will pass judgment on them. Put that way, it should seem silly.

Patients tell their doctors they don't smoke (when they may be smoking, even if only infrequently.) They tell their doctors they have taken all their medicine (when they may be splitting pills or forgetting doses.) They claim they get their 30 minutes of exercise three times a week. They pretend they are avoiding saturated and transfats. They claim fewer sex partners than they've really had....

You get the picture. Is it a picture of you?

Newsweek brings us an excellent article that points out the real detriments to our health if we aren't completely honest with our doctors.

As patients, and in pursuit of the best care we can get, it's our responsibility to be honest with our medical practitioners. Being dishonest is asking them to do their jobs with wrong information. How can we expect them to help us based on bad information?

It's not the doctor's job to judge us. Does it happen? Maybe. But does it matter? You can worry about judgment, and get sicker. Or you can forget the fear of judgment and be healed, cured, or at least get better.

Hmmm.... Which way makes more sense to you?

The article also makes us realize that our doctors are really on to us. Here's the problem I see.... so what about the patient who IS completely honest? Is the doctor making adjustments that are wrong?

..............................................
Photo � domin_domin. iStockPhoto.com

There's nothing better than learning from my readers, and today we have a perfect example.

A reader named "Genmark" posted in the Patient Empowerment Forum about her discomfort -- even irritation or annoyance -- at the fact that as she waits in the waiting room to be called for her doctor appointment,

"out comes a 22 year old just out of medical tech school to call a little 85 year old lady on a walker Emily. Me, I am not agreeable, call me by my given name & I will ask you politely, have we met before? I don't remember asking you to address me personally. "

Those of us of a certain age knows what she's talking about. And it's no different with our doctors. We sit on those exam tables, half nekkid, bright lights in our eyes, feeling totally vulnerable, and in strides the doctor with a "Dr. Smith" label on his/her white coat -- calling US by our first names.

Have you had that experience? Did it bother you?

Well along comes Abbey, another forum visitor, who suggests that there's more to this than meets the eye. In fact, the explanation for the respect / disrespect disconnect may be HIPAA!

HIPAA, of course, is the federal law that is intended to protect our privacy. (This is not the time or place to argue whether it works the way it should.) The point is, most doctors don't really understand the law in detail, except that they do know they can be fined, slapped and otherwise chastised for divulging any personal information about any patient to anyone they shouldn't divulge it to.

Abbey suggests, then, that the reason the receptionist or nurse or anyone who calls out your name in public, in a waiting room, uses your first name so as not to give away your last name, which is much more easily identifiable. She also suggests that when you sign in at the doctor's office, and you see the other names above yours with dark marker lines through them so you can't read them, it's for the same reason -- so no one can identify the people who have stopped in to see your doctor that day.

It makes perfect sense. Even if we don't like it, we can see where the practice might have come from.

But just so you don't think Abbey's logical response was the only good that came from this question.... You'll enjoy Greg's response, too. He suggests that maybe doctors' offices should begin using those blinking, vibrating notification buzzer gizmos that restaurants use for patrons who are waiting to be seated.

Gotta love it! As long, of course, as the pharma companies don't begin using those gizmos for advertising.

Thanks to all three of you for posting, and helping all of us learn.

..............................................
Photo � visi.stock - Fotolia.com

Seems the FDA has been busy, and frankly, they muddy the waters, too.

In yesterday's post, I told you about the FDA's research into melamine-tainted baby formula. It seems they've tested 89 different formulas, including all those well known names like Enfamil and Similac, and found trace amounts of either melamine, or its trigger toxin, cyanuric acid in a handful of them. However, despite the findings, they are not requesting recalls or asking manufacturers to stop including those ingredients in the formula. They have their reasons, whether or not we might agree with them.

A few weeks ago, I alerted you to their list of contaminated, dangerous, and probably counterfeit diet drugs. At the time, the FDA had listed 28 different drugs that you can buy, over the counter, that may not only NOT help you lose weight, but may make you sick or even kill you.

Now the list has been expanded. There are 61 drugs on the list, and some of the names even sound like those we see in infomercials and newspaper ads. If you've considered taking a drug to help you lose weight, or if you have been taking a drug, or even have weight loss drugs in your medicine cabinet, you'll want to learn more about them and check the list. They are dangerous.

So -- why the FDA confusion? It's a lack of consistency. Approvals and disapprovals, warnings and no warnings, testing and lack of testing -- it leads to inconsistency that confuses and makes us wonder -- which information can we trust?

And that distrust, or at least those questions about trust go to the core of the FDA's work. It's supposed to protect us.

And personally, I find it more than a little disconcerting that when the manufacturers involved are American companies, like the melamine ingredients in baby formula, then those are OK. But if they are Chinese companies involved, like last fall's baby formula with melamine, or this most recent diet drug alert, then those aren't OK. Is it possible that the American companies are getting a pass, simply because they are American?

Melamine is melamine. Contamination is contamination. Danger is danger. Is this a question of politics? or Safety?

As smart patients, it's up to us to protect ourselves. And our babies. The problem is knowing when, how and who to believe.

In this case? I'm avoiding the diet drugs, and warning my daughter-in-law about the formula. I have a grandbaby to protect, and -- with appreciation to the FDA at least for this part (more confusion!) -- there are many formulas that don't contain melamine.

..............................................
Photo � FDA