The first question to ask your doctor is: "How sick am I?"
• Ask your doctor about the actual health risks for someone with your weight, age, sex, race and overall health.
• Ask how the treatment might translate into longer life or better quality of life for someone with your characteristics.
• Inquire about the details of the treatment: How does it work? What will it do for you specifically? What evidence is there that it will work better for you than other treatments available? What other areas of the body might it affect?
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• If a drug is recommended, ask: How long you will have to take it? What protections does it offer, and what proof exists that it is worth your trying?
• Ask about the good and bad effects the drug has had on other people who have taken it.
• Ask your doctor and pharmacist how the drug will interact with other drugs you’re taking.
Dr. Marcia Angell, former editor in chief of The New England Journal of Medicine, offered this advice in her recent book, “The Truth About the Drug Companies”:
• Older drugs tend to have better safety records, so ask whether taking an older drug at a higher dose would be comparable to taking a new one for the same condition.
• Ask your doctors about their relationships with drug companies, whether they are paid to enroll patients in drug trials, or consult for drug companies whose products they prescribe. Such relationships should be viewed with caution.
• Ignore drug advertising, which increases the cost of drugs.
In searching for health information, use sites accredited by HON — Health On the Net Foundation. The nongovernmental Swiss foundation was founded to link people with “authoritative, trustworthy Web-based medical information.” It links only to those sites that adhere to its code of conduct: http://www.hon.ch.
Drug safety: The FDA provides information about drug recalls and problems with safety: www.fda.gov/medwatch/index.html
Guidelines: The U.S. Preventive Services Task Force writes guidelines for treating various diseases. Its members are independent scientists, with no financial ties to drug companies. To search for guidelines: www.ahrq.gov/clinic/
The first question to ask your doctor is: “How sick am I?” Because there is a range of risk associated with hypertension, ask for specifics on what risks are associated with your blood-pressure reading for people of your age, sex, race and overall health.
The first question to ask is: How much body fat is too much? Medical experts disagree about the point at which body fat presents a dangerous health risk and the best ways to reduce risk.
The use of portable X-ray machines to measure bone-mineral density in the wrist, finger and heel has proliferated in the past decade. But the method still considered the “gold-standard” is called central DEXA, an enhanced form of X-ray that measures bone density in the lower spine and hip — the areas where doctors are most concerned with preventing fractures. Because bone density varies at different spots in the body, devices that measure bone density at the heel, wrist or finger are not considered as accurate in predicting fractures.
Central DEXA can’t predict you’ll fracture a bone, but it can help assess your risk of having a fracture in the future based on your age, gender, race and overall health.
Bone health: For an overview on bone health, go to an advertising-free Web site run by Dr. Susan Ott, a bone specialist at the University of Washington: http://courses.washington.edu/bonephys/
• When presented with a treatment plan, ask specific questions about the evidence behind it. Get a picture of the actual risks for your age, sex, race and overall health.
• Inquire about the details of the treatment: What will it do for you specifically? What evidence is there that it will work better for you than other treatments available? Why is it better than no treatment at all?
Female sexual dysfunction
While experts agree that some women suffer from very real sexual problems, they disagree over whether those problems constitute a disease. Treatment guidelines have been published, along with new proposed definitions of various disorders, but they’re controversial and still evolving.
While some doctors advocate psychotherapy and counseling as the main treatment, others have prescribed drugs that were approved for other uses. The use of those medications in women is largely untested, so the risks and benefits are hard to weigh.