Handbook for successful ageing - 9. - 9.1

9. Become responsible patients!
 

"Enlightenment is man's emergence from his self-imposed immaturity. Immaturity is the inability to use one's understanding without guidance from another."
-Immanuel Kant -
 

Preliminary remarks:
 

All references to doctors here include both male and female doctors.
 

Footnote 2 contains information about the type of ailments and the various phases of convalescence during which the vibration device Galileo™ Basic can help you.
 

Important additional information is available for women - unfortunately only in German - at www.frauengesundheitsportal.de.
 

Subjective assessment of your health has a considerable impact on your life expectancy. If you assess your health as being in a bad shape and believe that you are not able to influence your condition, you live less longer than someone who considers herself healthy and assumes she is able to do a great deal about it.
  

It is both in our own interest as well as in the interest of people close to us that we become mature patients. This can be done by - to link with the previous paragraph - encouraging these people, when necessary, to make a better assessment of their state.
  

When we live with others, we should, whenever necessary, consider the fact that they should also do everything possible to stay healthy or to become healthy again, particularly by regularly taking medication as well as diatary supplements prescribed to them ( refer to 1.9) and attend all medical check-ups.
 

9.1 Deal responsibly with your physicians, dentists and alternative doctors!
 

"Knowing your illness is the first step towards recovery"
- Spanish maxim -
 

"The patient himself is the true doctor. We doctors are nothing but his assistants"
- Paracelsus -
 

Please take note of the following information and use it whenever essential. To begin with, with the help of appropriate diet (refer to1.), reduce weight (refer to 2.), through exercise (refer to 3.) and protect your back (refer to 4.) to avoid visits to the doctor as far as possible.
 

Speak with your doctor about what you do to remain healthy and how you can contribute to aging in a healthy manner.
  

"Knowledge is the best medicine". This is true in real life as well: The more you know about your ailment, the better your family doctor kann advise you about it.
 

Our knowledge about ailments has increased rapidly due to the worldwide network. Certain family doctors are overloaded to such an extent that despite best intentions, they are not in a position to keep themselves abreast of the latest developments in all the areas of general medicine. Despite that, your family doctor is responsible for your "holistic" treatment. If he diagnoses an ailment, ask him about all the therapies that can be considered and the possible risks involved, if there are any. If he wants to prescribe a medicine, tell him which other medicine you are taking already. (see below, 9.2, keyword "interactions")
  

If you have an appointment with your family doctor, or if you are an emergency patient, he should take time to hear you out patiently, examine you carefully and should provide you detailed information. Ask him if you did not follow something, and note down everything you read on the Internet. Write down all the questions or apprehensions that you wish to discuss with him beforehand. If he is unable to provide you sufficient time because he has too many other patients, approach him boldly; if this does not help, look for another family doctor. The next preventive medical check-up offers, when it is available in your locality, a good opportunity.
 

Following a relocation, obtain information from your neighbours about which doctor is most valued. Marianne Koch, a former doctor, advises in her book "Körperintelligenz. Was Sie wissen sollten, um jung zu bleiben", Munich: dtv 2003, ISBN: 3-4232-4366-X: First, he should give you the chance to inform him about your previous medical history and should not let himself distract by phone calls. If you are at an advanced age already, it is even more important to know whether the new doctor respects the personality and the rights of elders or if he is one of the persons who think "that’s not worth it anymore" and perhaps withholds necessary therapies and expensive medicine from elder persons, to look after his budget. "How to find that out?", she asks, and continues: "Why don’t you set a little trap for him: ‘What kind of treatment am I entitled to once I get really old and rickety?’ Then you slowly silently count 21, 22, 23. By now, at the latest, he or she should say: ‘Exactly the same treatments as now, of course’ or ‘I do not understand your question, why should treatment be withheld from you at any time?’ But if he/she is hemming and hawing, laughing sheepishly or evasive, then you should be very mistrustful!"
 

Do not allow a possible disappointment about the lack of time of your family doctor to push you towards alternative doctors like acupuncturists, homoeopaths, chiropractors and phytotherapists. In general they may take lots of time to listen to you, but in return they charge a correspondingly high fee. Read the book mentioned at end of section 9.1 about this.
  

In case of a change of doctor, you are entitled to see all your documents available with your doctor and to have copies taken at your own expense. He can mail electronic copies of the documents either to you or to your new family doctor. He should preserve these documents for ten years.
  

If your doctor diagnosed a specific ailment, read about its causes on the Internet; you might be able to rectify them yourself! Also, read about the probable course, progress, possible therapies and any differential diagnoses. If your ailment is chronic, update your knowledge about the ailment. Should you still require additional information, please speak to your doctor.
  

In case of rheumatism, Diabetes mellitus and problems with the respiratory tracts, request your family doctor, as required in Germany, to temporarily recommend you to a rheumatologist, a diabetologist or a pneumatologist. If you suffer from forgetfulness, exhaustion, poor concentration, restlessness or other changes in your state of mind, request him to transfer you to a geriatrician, a geriatric centre or a medical clinic for the aged for permanent care, as with such ailments several family doctors in Germany have very little experience according to specialists. In other cases, transfer to a gastroenterologist (stomach-bowel ailments), orthopaedist and urologist would help. If your family doctor considers this transfer unnecessary, request him to explain the reasons in a comprehensible manner.
  

If your family doctor has X-ray equipment, he will naturally be inclined to recommend an X-ray examination for you, also when he should transfer you to a radiologist. You can however avoid unnecessary X-rays due to the side-effects. 2000 people are said to die each year in Germany from cancer caused by X-rays.
  

If your Doctor recommends you a cost-intensive or time-consuming treatment with a device which he is equipped with, please research on the Internet as to how good the prospects of success are, specially in your case, particularly in comparison with another therapy option, and perhaps discuss this with your doctor.
  

If you have been recommended a deferrable operation and you are not convinced that it is necessary, get the opinion of a second doctor and ensure beforehand that your health insurance covers the cost of it. Prior to meeting your doctor for a discussion, please note down all your questions and if possible take along a reliable person (four ears hear a lot more than two). Elderly people may be disorientated after an operation. In order to protect yourself from this happening you should train your memory before the operation (see above, 5.4), reduce the amount of alcohol you drink and the amount of cigarettes you smoke. In addition you should try to increase your physical fitness (see above, 3.3.2), since this reduces the danger of complications and accelerates the healing process. If you take anticoagulants (substances that prevent coagulation), you should ask to which point you are allowed to do this. Inform the anaesthetist about possible other illnesses and the medication you take against them.
  

Ask the gynaecologist, who recommends the removal of your uterus, and the specialist for HNO, who recommends the removal of tonsils for your child, as to whether he would make such recommendations to his own wife and child if necessary.
  

Remain just as sceptical about the advice to have your knee operated or about a suggestion to have the veins in your heart or neck extended. In such cases, it is recommended that you consult a second doctor.
  

If you suffer from vision loss and are unable to read the literature that your chemist makes available to you, search for magazines in one of your talking book libraries on a Daisy CD.
 

A thorough research on the Internet is however indispensible.
 

Claim all the vaccinations recommended below and all preventive medical checkups paid for by your health insurance. Please note down all the appointments for further checkups and immunizations and check at the beginning of each year as to what is essential for the year. The same applies for the examination of a pacemaker, if you have one.
  

"If you don’t take your time to take care of your illness, you have enough time to die."
- Ghanaian maxim -
  

If you are over 60 years old, suffer from a chronic illness, or suffer from a respiratory disease, even if it is just an acute on, or if you are pregnant, you should have yourself vaccinated against flu (influenza) by the beginning of October, if you don’t have a temperature at that time and if you are not allergic against chicken protein. The immunization against flu also helps prevent inflammations which can trigger a heart attack. Furthermore, medical and nursing staff as well as all those who work in organisations where they have much contact with other people, in schools or in nursery schools/ day-nurseries, should have themselves vaccinated.
   

If the epidemic breaks out, it may perhaps be too late. Please allow your doctor nevertheless to advice you in such a case. In the case of an epidemic, you should wash your hands more often and, if possible, avoid shaking hands and using banisters in order to reduce the risk of infecting yourself and others. In addition you should stay away from people who cough or sneeze and if possible avoid larger groups of people.
  

Immunization against flu can have side-effects; These are however rare. If any such side-effects occur, you should contact your doctor. The vaccine does not offer absolute protection against influenza, but contracting it is very unlikely. If you think that you suffered from it despite having had a vaccination, it probably was just flu. If you still get ill from flu, then you should use a new toothbrush once you recovered in order to avoid infecting yourself again.
  

The view that whoever has suffered from a flu is immune against the next one is a myth; the effect of the vaccination is only temporary. Additionally, the virus causing the flu changes continuously, and so does the serum which is customized to the new virus.
  

Ticks can transfer early summer Meningo Encephalitis (FSME) and lyme borreliosis. With the change in climate, ticks are more wide-spread and become active early. If you are in frequent contact with plants, get yourselves immunized against FSME. Antibiotics help tackle lyme borreliosis.
  

Prior to travelling to the tropics, enquire about which vaccinations or prophylaxis are advisable, at best at an institute for tropical medicine. Ask your health insurance company to meet the costs.
  

Have yourselves immunized against the measles, mumps, German measles and chickenpox (combo immunization), tetanus, Poliomyelitis and Diphtheria (combo immunization, too) as well as against Hepatitis A and Hepatitis B and also take additional vaccinations in the recommended intervals. If you neglect to have yourselves immunized against Poliomyelitis, at some point during your travels you might encounter new epidemics with grave consequences. To that extent, you are responsible not only for yourselves, but also for your kin.
  

Enter the dates for immunizations which are not essential every year, including the protective immunization for pneumococcal in your immunization pass and check at the beginning of every year as to which immunization is essential.
  

If you have been bed-ridden for a long time, you will be likely to be affected by respiratory infections, which cannot be prevented by immunization against pneumococcal alone. In such a case, under instructions from your family doctor, please take the medication called BronchoVaxom®. It contains bacteria from the most frequently occurring pathogen causing cold, which will impact your immune system positively in a natural way. This is also recommended in case of all the periodic infections of the upper and lower airways, particularly as a result of chronic respiratory ailments such as Bronchitis or Sinusitis (an inflammation of the paranasal sinuses).
  

A reaction following a vaccination, such as a temporary fever, is common, especially among children. If you are unsure you should still ask the doctor.
  

The self-healing powers of the body is greater than you imagine. Be braver than before. The body should be able to repair the herniated discs by itself, even if it has formed despite resting your back (refer to 4). Are you ill? In several cases, your will power can help you to recuperate quickly and become healthy again. The ancient Romans knew that already: "Part of the recovery is the desire to recover!" (Seneca). "Hope and confidence are excellent means to recover quickly", says Marianne Koch (loc.cit.). A good example for this is the former wrestling world champion, Alexander Leipold. In 2003 he suffered from three successive apoplectic strokes, and was paraplegic on one side after the third. But six months later, he again stood on the mat. "Fight, never give up, and believe in yourself! One can achieve a great many things when one does this!", He writes about himself here: www.alexander-leipold.de.
  

According to a folk wisdom, laughing is the best medicine. To be more exact, it should say that laughing is the best painkiller, strengthens the immune system, protects the heart and reduces the blood sugar. This has been scientifically proven.
 

Did you consult an orthopaedist about your back problems and did he examine your spine with an imaging procedure? If so, please enquire as to whether he recommends a bone density measurement. If you had to or have to take Cortison for a long time, have such a test done, in order to thwart progressing Osteoporosis, which could otherwise break your spine to say the least. If you have to worry that a vertebra might be broken, you should see an orthopaedist, who can straighten and strengthen the vertebra again with the help of a keyhole surgery alone. In all such cases, request your health insurance to bear the cost.
  

Also, think of all those for whose welfare you feel responsible.
  

If you want to return home from the hospital as soon as possible after an operation (or leave the hospital as soon as possible after an operation and return home), ask your surgeon in advance, if it is possible to have an ambulatory operation. To keep your hospital stay as short as possible, you should always make sure that examinations and treatments come after each other as fast as possible. According to my experience, you can contribute a lot to this yourself if you press for it; even though you may have to go back to the hospital occasionally for follow-up treatments or examinations, ECGs, ultrasounds, X-rays or similar procedures. In a hospital others decide when and what you get to eat; if you do not have a private insurance you have to share the room with other people and the hospital bed is higher than you own one. If someone can look after you at home, then you enjoy greater comfort, you can maintain your way of living and you will find it easier to go back to your daily life. The other way around you can organise the life of your housemates easier if they already are in need of care.
 

Ask your family doctor if he can take care of you. If he is willing to do so, then insist on leaving the hospital early, even if you have to confirm in writing that this is at your own responsibility and risk. You can give yourself injections against thrombosis.
 

Should you require urgent medical attention outside the consulting hours, contact the emergency medical service. Ensure that its telephone number is always handy.
 

Specialists in Germany can be found at www.aerzte-im-netz.de. Search for a similar site wherever you are. Do you require medical treatment? Are you wondering about the best place to get treated? In Germany the essential information can be found at www.qualitaetsbericht.de. On this site, every hospital mentions which ailments it treats, and also publishes its quality report according to legal prescriptions. Please check whether a similar service is available in your country.
  

If someone recommends you an alternative treatment like acupuncture, search on the internet for the effectiveness of such a treatment and read the book by Singh and Ernst: "Trick or Treatment: The Undeniable Facts about Alternative Medicine (W W Norton & Co, 19.10.2009) including preface and the following chapters
1. How do you determine the truth?
2. The truth about acupuncture
3. The truth about homeopathy
4. The truth about chiropractic therapy
5. The truth about herbal medicine
6. Does the truth matter?
and an appendix: alternative therapies- a short guide.
  

There is no general procedure for dealing with dentists.
  

Do not follow the advice to have your amalgam fillings replaced by others, because the quicksilver contained in these fillings does not harm your body. Furthermore, the drilling to insert the replacement fillings unnecessarily destroys the tooth further.
  

If your dentist proposes gold crowns, ask him why he cannot use cheaper ones made from metal alloy and gather information on the internet about his arguments for gold crowns before you make your decision. Both types have to be faced with ceramic.
  

If your dentist recommends one or even more implants, you should jointly consider carefully if another solution would be much less straining for you and in addition much cheaper. Ask him to explain what reasons speak in favour of implants and then consult a second dentist to try to find another solution.
  

Furthermore, you should use toothpaste with fluoride; fluorides improve the resistance of teeth against attacks by the acidic products of metabolism of the germs in the dental plaque and the acids contained in food. Wisdom teeth don’t have to be removed prophilactically but only if the cause you problems.

Forewards

Back to contents