COMMENT:DEBATING YOUR DIAGNOSIS

Diagnosis can take away from you one of the most precious things you have: your sense of well being, of trusting your body, of being healthy without having to worry about your health. A visit to a doctor mostly turns up something wrong. The doctor

Medicine today is so impersonal and technical. You are liable to be diagnosed by strangers in hospitals or large clinics. Since they don’t know you in a state of health they base diagnosis on an average. If something strange crops up in a test you are more likely to be misdiagnosed as sick. Or the reverse you may know you are ill but doctors don’t believe you because certain tests are “average”.

Thus unusual traces on the electroencephalogram (EEG) have led to vague diagnoses of organic brain disease in healthy but unruly children, turning them into medical cases and drugging them to their school desks. Similar fluctuations in the electrocardiogram (ECG) can start the coronary care colossus in motion with its traumas and uncomfortable tests.

Not only do the tests replace sound, sensitive clinical judgement, they are also wrong in an alarming number of instances. The Centers for Disease Control in Atlanta, Georgia, checked laboratories all over the US and found that wrong results were obtained in about one quarter of all tests.

Go into diagnosis with eyes open. It is not a risk free, take it or leave it situation.

Be sceptical about any diagnosis of illness or abnormality that you don’t already feel, especially if the diagnosis is based on lab tests. Ask for a repeat of any abnormal tests, if possible in another lab. Make sure to wait a while before taking the new test, to make sure it isn’t due to a passing phenomenon.

Remember that diagnosis should clarify symptoms you have, not make you look for those you don’t have.

Rely on an experienced general practitioner whom you trust, who knows your history and who knows you, more than on strangers, however qualified they may be. A good GP will carry out a series of tests when you are healthy so as to have a baseline in case you are sick. He should ask for repeats of abnormal lab tests as a matter of course.

If lab tests and diagnosis show that you have the beginnings of a health problem such as “pre diabetic” or “mild hypertension” treat it as a warning. Seek treatment from complementary medicine. Nutritional, natural preventive, traditional, herbal, homoeopathic and oriental treatments all work well at the early stages of disease, whereas conventional medicine does not. The drugs prescribed for these “pre conditions” carry much risk and little benefit.

Don’t be afraid to request a second opinion if your doctor advises more serious tests (such as laparoscopy or cardiac catheterization) on the basis of lab tests for a condition which you do not feel. Take the lab tests with you but respect the second opinion doctor’s wish to do his own.

Keep minor symptoms to yourself. Unless symptoms are serious, unusual, persistent or possibly related to some serious disease in the history of your family or yourself, don’t run straight off to get a diagnosis. Treat a tension headache with a hot bath, a sore throat with lemon and honey.

Don’t be continually diagnosed because you are worried about having a disease but there are no signs of it. Doctors can easily give you much more to worry about.

When you undergo an invasive test such as a biopsy or catheterization ask that you be shown the results and discuss them before further medical steps are taken. Do not sign a consent form to “other measures that may be necessary”. Only permit the test itself.

Stephen Fulder’s latest book is How to be a Healthy Patient (Hodder & Stoughton)