MGordon_MD
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Jul 23, 2008, 9:37 AM
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By Dr. Michael Gordon
“What do you think of this?” the patient asked. It was another newspaper report on the risks of a standard medication that the patient was using. It reminded me of the time the potential risks of Hormonal Replacement Therapy (HRT) came out in the media that I was called in a panic by a family member asking what she should do. She had been on HRT for more than 4 years but could not see her doctor for a week and was terrified because the media’s report of an increased risk of heart attacks in users of the medication was interpreted by her and many thousand others as a medical emergency – a heart attack waiting to happen.
The actual results of the study revealed that the incidence of disease per 10,000 women on combined HRT in one year was: Seven more cases of coronary heart disease, 37 on combined HRT versus 30 on placebo plus some other negative and some positive outcomes. For many people the actual difference of 37 compared to 30 cases in 10,000 women per year may have seemed like a lot. For any individual taking the medication the increased risk from the medication was very low – much lower than many other risks that individuals routinely take when they drive, for example. But the impact was monumental in terms of general usage and the discontinuation by most physicians of HRT in most individuals. Some gradual return of use for short periods for defined symptoms is occurring but not the large scale use that was common before the news report.
The question is not whether that report was interpreted fairly by the media. It is whether the almost daily research outcomes of many drugs and foodstuffs should be taken at face value and lead to dramatic or urgent changes in usage. During the past few years medications such as anti-depressants, major tranquilizers, anti-inflammatory drugs, and over the counter cold medications have been reported as potentially dangerous. Recently the issue of whether coffee or red wine is good for you, or bad for you or both good and bad for you depending on how much and what kind you consume can make the medical profession and the consumer dizzy. It often leads to uncertainty and skepticism about medical science and medical recommendations.
What is sometimes forgotten is that medical knowledge is an ever evolving entity. Throughout human history medical knowledge developed, often slowly because of the nature of medical science which exploded during the 20th and current centuries. Medical research world wide constantly addresses questions and challenges today’s knowledge to either fortify or refute it. Eventually what is initially information, gets translated into solid knowledge which ultimately ends up as medical wisdom as physicians learn how to use the knowledge they have in individual clinical situations – that is part of the art of medicine which is required to balance its scientific base- which is always evolving and changing.
The key for the consumer is to take each media story with a bit of skepticism and if you or a family member are computer savvy to explore in greater depth just what was actually reported and the basis of it and look for commentaries from reliable sources on what was reported. You should discuss with your doctor before any drastic changes are made in treatment as most of the reports, as the example of the HRT are not urgent in terms of long-term decision making, but must be considered with all the risks and benefits and geared to the special situation of you as an individual.
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Dr. Michael Gordon is Medical Program Director, Palliative Care Baycrest Geriatric Health Care System in Toronto, Canada and Professor of Medicine, at the University of Toronto. He is co-author with Bart Mindszenthy of Parenting Your Parents.
Parenting Your Parents is available in bookstores and online at: Indigo-Chapters, Amazon and Barnes & Noble. It is available in a US edition: Parenting Your Parents: Support Strategies for Meeting the Challenge of Aging in America.
For bulk orders email info@dundurn.com. Call: 416-214-5544 or Fax: 416-214-5556
Dr. Gordon is the author of the engaging memoir Brooklyn Beginnings: A Geriatrician's Odyssey, published by I-Universe.
Brooklyn Beginnings is available in bookstores and online at: Indigo-Chapters, Amazon.ca, Amazon.com, Barnes and Noble and I-Universe
Visit Dr. Michael Gordon's website.
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