|
Have you ever been driving down the highway and suddenly you see a police car? What is your response? I always slow down, even if I am driving the speed limit and I would bet that you do too.. Nothing causes traffic to bunch up like a State Trooper driving the speed limit on an interstate highway. Recently, there is a new "caution" about how fast we drive, which is really effective. You're driving down a city street and suddenly you see a blinking sign which is displaying your speed. I dare you to say that you don't instantly take your foot off the gas pedal and/or put your foot on the brake.
This last happened to me recently. I confess, I took my foot off the pedal. I think it is sneaky but it is equally effective. When this happened to me recently, I thought, "What if we could have signs along the way in our life that flash a warning about the unhealthy decisions we are making?" Do any of you remember the Burma shave signs along the highway? With one or two words per sign, in a series of five or six signs, the message was given. What if those kinds of signs reflected your health facts?
As health care providers increase their use of electronic devices to monitor and measure healthcare status, what if you had a device which preceded you in the cafeteria line? When you picked up a dish which might have an adverse effect upon your health, your "personal health monitor" would flash your most recent cholesterol level with an alert, "caution this dish will make your cholesterol go up." That same monitor would keep a record of the number of steps you have taken during the day and when you sit down in front of the television, that number would flash on your monitor with a red alert, "All illnesses are caused by, or aggravated by a sedentary life style."
Fortunately or not, no such monitors exist and try as I might, I can't imagine how to design one. Of course, Dick Tracy could create one and probably in our future such devices will be available. But how is this related to Medical Home? Again, for better or for worse, home is where we learned our values. We learned concepts of right and wrong, good and bad, and it is in the home where most of us learned the values which would guide us for all of our lives.
So, it is with the Medical Home that we should learn our health values and it is in the Medical Home where our "mental monitor" of our choices should be created. Each of us has the "right" to make bad health choices, many of which choices, we learned in our homes. But, before our health is damaged and while we are still in the position of "retaining our health," the first job of Medical Home is to teach healthy choices and to encourage us to make such choices. Like any value system, our "health choices" education is a collection of "dos" and "don'ts." And, all of these choices can be expressed positively or negatively.
- Do maintain an ideal body weight: don't get fat.
- Do exercise regularly and stay active; don't become a couch potato.
- Do avoid tobacco smoke; don't start smoking.
As we are so often dealing with health which has been lost that, we get stuck in a negative mode - stop that; don't do that; quit that - but as we continue to learn and to develop concepts of Medical Home, we want to establish a positive approach to health by creating a positive statement of health - do that; start this, keep doing it.
If you think about our "caution light" metaphor, you will realize that in order to have a caution which encourages us to avoid the negative, we must have a standard against which to measure, or "monitor" our conduct. It is that standard which Medical Home must be prepared to establish, to teach and even to preach to the members of the home. Well, what are those standards?
In the August 9, 2007, Your Life Your Health, we discussed, "How to survive your hospital stay! "Get up," "Eat up" and "Get out." The principle is that often patients are put at bed rest, which immediately results in negative health consequences; are placed on restricted diets or no diet, which immediately results in negative health consequences; and, are kept in the hospital too long, which immediately results in negative health consequences. In order to survive the hospital, patients should "get up" - get out of bed and stay active when possible - "eat up" - maintain their nutritional intake when possible - "get out" - do not extend their hospital stay for any reason other than absolute necessity.
While the circumstances of routine life are different than when a hospitalization is required, the principles are the same: "get up" - get off the couch and get active, which is important for you both physically, emotionally and mentally - "eat up" - in your Medical Home do what your mother advised you all of your life, eat your vegetables, limit between meal snacks, eat fruits and avoid inflammatory foods (fried foods, fatty foods, processed foods, sugar and excessive salt) - "get out" - get out of the rut in which you find yourself.
If we want to turn our Medical Home into a positive - "do this" - rather than a negative - "don't do that" - we can change the design of our health monitor. Instead of it flash at the end of the cafeteria line and tell us of the bad choices we have made; we can design it so that when we pick up the healthy dish, a cheer goes up, lights flash and a voice declares, "Good choice; keep it up." Preventive dieting would have the monitor produce an electric shock (not a big one, just a little one) when we pick up a dish of the wrong food. That's supposed to be funny but it may not be a bad idea. It would certainly get our attention. And, the intensity of the shock could be proportionate to the risk of the dish selected.
Medical Home - Mentoring Healthy Choices
Beginning with infants, youths, adolescents and young adults, Medical Home must be mentoring good health. Before the consequences of bad choices trigger genetic predispositions resulting in poor health, Medical Home must be teaching and preaching healthy living. Start with the two biggest components of healthy living: nutrition and exercise.
The Mediterranean Diet must be taught. Before taste buds develop appetites for refined sugar, processed flour, white breads, and fried foods; fresh fruits, vegetables, olive oil, fish and poultry must become the preferred foods. (For more information on the Mediterranean Diet see Your Life Your Health at www.jameslhollymd.com under the icon Nutrition, May 12 and May 19, 2005.)
In a seven part series in Your Life Your Health (see at www.jameslhollymd.com under the icon, Nutrition) entitled "Chronic Illness: The Effects of Exercise and Diet," the following summary is found in Part I, published July 20, 2006:
- Modern chronic diseases, including cardiovascular diseases, Type 2 diabetes, cardiometabolic risk syndrome, and cancer, are the leading killers in Westernized society and are increasing rampantly in developing nations.
- Obesity, diabetes, and hypertension are now even commonplace in children.
- Overwhelming evidence from a variety of sources, including epidemiological, prospective cohort, and intervention studies, links most chronic diseases seen in the world today to physical inactivity and inappropriate diet consumption.
- Modifying the lifestyle of children is paramount to reducing chronic disease risk.
- The evidence is overwhelming that physical activity and diet can reduce the risk of developing numerous chronic diseases, including CAD, hypertension, diabetes, metabolic syndrome, and several forms of cancer, and in many cases in fact reverse existing disease.
If our health monitor indicates how important an element of health maintenance is, then the frequency with which Your Life Your Health deals with a subject should reflect the element's importance. The following articles can be found at www.jameslhollymd.com under the icon entitled Exercise. These twenty articles are only a few of those published in this column over the past twelve years about exercise:
The key to exercise as an element of health is reflected in the following quote from a February 5, 2004 Your Life Your Health article. It is still valid today:
"Getting started." There are two maxims by which I have lived:
- "There are many things which I have started which I did not finish, but I have never finished anything which I did not start.
- "I would rather fail a thousand times trying than succeed once doing nothing.
"These are not unlike the more eloquent words of President Theodore Roosevelt, who said:
"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, and comes short again and again, because there is no effort without error and shortcoming; but who does actually try to do the deeds; who knows the great enthusiasms, the great devotions, who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory nor defeat.
Exercising for health is like that. It is possible to fail, but failing is far superior to never trying. The good news about failure is that you can always start over. The bad news about never starting is that you have never changed."
The foundation of Medical Home is health and the foundation of health is nutrition and activity. If we are to have a monitor which mentors us in health, it might be enough to have a small transistor (now that's old technology) which simply whispers in our ear - eat right, keep moving, get up, get out, think, read, be involved in the lives of others.
|
