On The Fly: Hiding From Bad News

Ignorance, when it comes to your health, isn't bliss. It's trouble. It's taking unnecessary risks and missing out on less-invasive treatment options that are available only when there's been early detection. While I'm a firm believer that our bodies, if left to their own devices, will try to heal themselves, I also know that stuff like cancer doesn't cure itself.
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Years ago, someone told me about a phenomenon that developed as the death toll rose in the Vietnam War. When a U.S. soldier died in combat, the military would send a clergyman and a ranking officer to knock on the family's door and deliver the news in person. But the family, frequently, would not open the door to them.

Across the country, mothers and fathers and young widows would peek out from behind the curtains, see the uniformed soldiers standing on their front porches and simply refuse to answer the door. They knew why the soldiers were there. They knew what they were going to hear.

In a way, it makes perfect sense. If you can't control the content of the message, you can at least control when you have to hear it. For every minute that the soldiers on the porch were kept at bay, the family's loved one was still alive, still with them.

The messenger-soldiers would sometimes stand there for minutes, even hours. Their orders were to not leave until the news had been delivered and the family comforted as best they could. Sometimes, they tried to talk to the family through the closed door, pleading to be allowed in. The message had to be delivered face-to-face, not through a closed door.

I was reminded of this behavior the other day when I told a friend that I was participating in a company-sponsored health screening. I had my finger pricked, my cholesterol and glucose levels checked, and I stepped on a scale. I saw it as an opportunity to keep track of my "numbers," even though I regularly see a doctor who does precisely that. I believe that knowledge is power and I want to know everything that is going on with my body and health.

But my friend's reaction surprised me. "Why do you go looking for trouble?" she asked. "Bad news will always find you; no sense in going looking for it."

Frankly, I go looking for good news when I get screened for diabetes and heart disease, and I'm glad to report that I found it this time. But I get my friend's point and realize that she isn't alone in her thinking. Many midlifers are still peeking out from behind the drapes at the soldiers standing on the porch and reasoning that until they let them in, they won't have to deal with their clogged arteries, their diabetes, their pre-cancerous polyps that go undetected because they won't have colonoscopies.

Unfortunately, that's not how it works. Ignorance, when it comes to your health, isn't bliss. It's trouble. It's taking unnecessary risks and missing out on less-invasive treatment options that are available only when there's been early detection. While I'm a firm believer that our bodies, if left to their own devices, will try to heal themselves, I also know that stuff like cancer doesn't cure itself.

Why be in denial? I tipped my hat when actress Angelina Jolie not only had a preventative double mastectomy, but went public with it encouraging others at high-risk for genetically caused breast cancer to seek the tools necessary and not be afraid of the tough choices. I salute not just her courage but also her good sense. After losing her own mom to cancer at a young age, Jolie knew she didn't want her children to face losing her.

My friend, who watched her own mother battle aggressive breast cancer, doesn't go to doctors. She is committed to a healthy lifestyle, exercises and is a regular in the organic food aisles and health food stores. But she could never bring herself to submit to a health screening, let alone have an annual mammogram done.

We argue about this quite a bit. I tell her I think she is paralyzed by her fears and she says she has made a conscious choice that has nothing to do with fear and everything to do with the suffering her mother experienced -- not from her disease but from the treatment of it. And in the end, she said, her mother died a painful and debilitating death -- again from the treatment, not the disease.

If I argue that her mother's death might have been just as painful and debilitating -- and a lot sooner -- without medical intervention, she turns a deaf ear. It might have been less time, but better quality time, she believes.

As we age, our approach and attitude toward medical care changes. I accept the inevitability of death but don't accept the inevitability of aging declines or painful death. Those things I intend to fight tooth and nail. If my knee always hurts and always needs to be iced when I step off the hiking trail, I want my knee fixed because hiking is too important to me to be sacrificed. If my doctor says I am prone to skin cancers, I lather in sunblock and enjoy the beach from the shade of an umbrella. But I want a doctor to tell me if that suspicious spot on my back is something to have removed.

Midlifers who live like ostriches with their heads kept in the sand about the status of their health may wind up missing out on their best years. And our medical system, unlike the military messengers, won't stand on our porch until we are ready to hear the news. It requires we be proactive. And besides, it was just a finger prick.

Earlier on Huff/Post50:

12 Tests That Can Do More Harm Than Good
EKG(01 of16)
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Electrocardiograms, better known as EKGs, made the Choosing Wisely list. The painless test is "done routinely during a physical, even when there is no sign of heart trouble," The New York Times reports. (credit:Alamy)
Proton Pump Inhibitors(02 of16)
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These strong drugs prescribed for severe heartburn often make their way into the hands of of those with only a slight case of discomfort. "High doses of [proton pump inhibitors], and taking them for a year or longer, has been linked to an increased risk of bone fractures. Long-term use might also deplete magnesium blood levels, which, in turn, can trigger muscle spasms, irregular heartbeats, and convulsions," Choosing Wisely reports. (credit:Alamy)
M.R.I.(03 of16)
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When it comes to lower back pain, doctors shouldn't use M.R.I.s within the first six weeks of a patient's complaints unless "red flags are present," according to the American Academy of Family Physicians. (credit:Alamy)
Antibiotics(04 of16)
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That flareup of sinusitis -- an inflammation of the sinuses -- probably doesn't need a round of antibiotics for treatment, the report found. (credit:Getty)
Pap Tests(05 of16)
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"Women older than 65 who have had several normal Pap tests can stop having the test," according to Choosing Wisely. (credit:Alamy)
Echocardiograms(06 of16)
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Now doctors are advised to not use this test "as a routine follow-up for mild, asymptomatic native valve disease in adult patients with no change in signs or symptoms," according to the Choose Wisely report. (credit:Alamy)
CT Scans(07 of16)
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Getting imaging tests like CT scans for headaches are not terribly helpful. "Research shows that for people with a normal medical history and neurological exam, imaging tests are unlikely to reveal a more serious underlying problem," according to the Choosing Wisely report. (credit:Getty)
Bone Density Imaging(08 of16)
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If you don't have a high risk for weak bones (70 years old for men and 65 for women), you may want to demur if your doctor recommends bone density imaging. The test can lead to a diagnosis of osteopenia, a condition with risky drug prescriptions that can lead to side effects such as thigh fractures and abnormal heart rhythms, the Choosing Wisely report found. (credit:Alamy)
Exercise Stress Test(09 of16)
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Besides being expensive, an unnecessary exercise stress test "can produce inaccurate results that trigger follow-up tests that can pose risks," the report found. (credit:Alamy)
Surveillance Testing (Biomarkers)(10 of16)
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While this form of testing can help colorectal cancer sufferers, doctors are now advised not to use it on breast cancer patients who are being treated with "curative intent." "False-positive tests can lead to harm through unnecessary invasive procedures, over-treatment, unnecessary radiation exposure, and misdiagnosis," the report found. (credit:Alamy)
Chronic Dialysis(11 of16)
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"Kidney disease doctors are urged not to start chronic dialysis before having a serious discussion with the patient and family," The New York Times reports. (credit:Getty)
Acid Reflux Medicine(12 of16)
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"The American Gastroenterological Association is urging its physicians to prescribe the lowest doses of medication needed to control acid reflux disease," The New York Times reports. (credit:Alamy)
Chest Radiography(13 of16)
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If a patient isn't exhibiting any heart and lung disease symptoms, chest radiography should not be performed. "Preoperative chest radiography rarely provides any meaningful changes in management or improved patient outcomes," the American College of Physicians found. (credit:Alamy)
White Blood Cell Stimulating Factor(14 of16)
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For patients with neutropenia (a condition characterized by "an abnormally low count of neutrophils, white blood cells that help your immune system fight off infections"), doctors shouldn't inject white blood cell stimulating factor to stave off fever if they have a less than 20 percent risk for this complication. (credit:Alamy)
Colorectal Cancer Screening(15 of16)
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Patients don't need to have a "repeat colorectal cancer screening (by any method) for 10 years after a high-quality colonoscopy is negative in average-risk individuals," advises the American Gastroenterological Association. (credit:Alamy)
Endoscopy(16 of16)
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If a patient with Barrett's esophagus's first endoscopy reveals zero signs of cell change, doctors should only use an endoscope once every three years, the report found. "If these cellular changes occur, they do so very slowly." (credit:Alamy)

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