Doctor Google

Are patients swimming in a sea of health information? Or are they drowning in it?

Are patients swimming in a sea of health information? Or are they drowning in it?
The rise of health-oriented websites and medical blogs means that patients have more opportunities than ever to take charge of their medical care. They have more than ever to gain by decoding the latest health news and researching their own medical care.
I dont think people have a choice,said Dr Marisa Weiss,a breast oncologist in Pennsylvania who founded the website breastcancer.org. The time you have with your doctor is getting progressively shorter,yet theres so much more to talk about. You have to prepare for this important meeting.
Whether you are trying to make sense of the latest health news or you have a diagnosis of a serious illness,the basic rules of health research are the same. From interviews with doctors and patients,here are the most important steps to take in a search for medical answers.

Determine your information personality
Information gives some people a sense of control. For others,its overwhelming. A New York father coping with his infant sons heart problem,for instance,knew he would be paralysed with indecision if his research led to too many choices. He focused on finding the areas best pediatric cardiologist and left the decisions to the experts. Others,like Amy Haberland,50,a breast cancer patient in Arlington,Massachusetts,pore through medical journals,looking not only for answers but also for better questions to ask doctors. Knowledge is power, Haberland said. I think knowing the reality of the risks of my cancer makes me more comfortable undergoing my treatment.
Dr Michael Fisch,interim chairman of general oncology for the University of Texas M. D. Anderson Cancer Center,says that before patients embark on a quest for information,they need to think about their goals and how they might react to information overload. Just like with medicine,you have to ask yourself what dose you can take, he said. For some people,more information makes them wackier,while others feel more empowered.

The goal is to find an M.D.,not become one
Often,patients begin a medical search hoping to discover a breakthrough medical study or a cure buried on the Internet. But even the best medical searches dont always give you the answers. Instead,they lead you to doctors who can provide you with even more information.
In an area with no right answers,youre going to get a different opinion with every doctor you see. Find a doctor you feel most comfortable with, said Dr Anna Pavlick,director of the melanoma program at the New York University Cancer Institute.

Keep statistics in perspective
Patients researching their health often come across frightening statistics. Statistics can give you a sense of overall risk,but they shouldnt be the deciding factor in your care.
Jolanta Stettler,39,of Denver,was told she had less than six months to live after getting a diagnosis of ocular melanoma,a rare cancer of the eye that had spread to her liver. I was told there is absolutely nothing they could help me with,no treatment, said Stettler,a mother of three. I was left on my own.
Stettler and her husband,a truck driver,began searching the Internet. She found Dr Charles Nutting,an interventional radiologist at Swedish Medical Center in Englewood,Colorado,who was just beginning to study a treatment that involves injecting tiny beads that emit small amounts of radiation. That appeared to help for about 18 months.
When her disease progressed again,Stettler searched for clinical trials of treatments for advanced ocular melanoma,and found a National Institutes of Health study of isolated hepatic perfusion, which delivers concentrated chemotherapy to patients with liver metastases. After the first treatment,Stettlers tumors had shrunk by half.
I dont like statistics, she said. If this study stops working for me,Ill go find another study. Each type of treatment I have is stretching out my life. It gives me more time,and it gives more time to the people who are working really hard to come up with a treatment for this cancer.

Dont limit yourself to the Web
Theres more to decoding your health than the Web. Along with your doctor,your family,other patients and support groups can be resources. So can the library. When she found out she had Type 2 diabetes in 2006,Barbara Johnson,53,of Chanhassen,Minnesota,spent time on the Internet,but also took nutrition classes and read books to study up on the disease.
I was blindsidedI didnt know anybody who had it, said Johnson,who told her story on the American Heart Associations website,iknowdiabetes.org. But this is a disease you have to manage yourself.

Tell your doctor about your research
Often patients begin a health search because their own doctors dont seem to have the right answers. All her life,Lynne Kaiser,44,of Plano,Texas,suffered from leg pain and poor sleep; her gynaecologist told her she had extreme PMS. But by searching the medical literature for adult growing pains,she learned about restless legs syndrome and a doctor who had studied it.
I had gone to the doctors too many times and gotten no help and no results, said Kaiser,who is now a volunteer patient advocate for the website whatisRLS.org. The new doctor she found really pushed me to educate myself further and pushed me to look for support. Although some doctors may discourage patients from doing their own research,many say they want to be included in the process.
Dr Shalom Kalnicki,chairman of Radiation Oncology at the Montefiore-Einstein Cancer Center,says he guides his patients,explaining the importance of peer-reviewed information to help them filter out less reliable advice. He also encourages them to call or e-mail him with questions as they study their own case.
We need to help them sort through it,not discourage the use of information, he said. We have to acknowledge that patients do this research. Its important that instead of fighting against it,that we join them and become their coaches in the process.
NYT