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You're used to answering a lot of questions at your doctor's visit. Where's the pain? How long have you had it? You know, the usual. But you may be taken aback when your doc broaches some odd questions, either on a form or verbally.
The reason? Questions like whether you wear a seat belt every time you get behind the wheel, or if you live with someone who smokes can provide important clues to your health.
“What I do isn’t atypical of other naturopaths. We all typically have longer first visits,” says Jaclyn Chasse, N.D., a naturopath at North East Integrative Medicine in Bedford, N.H. “Our goal isn’t just to get a diagnosis; it’s to understand how you got to where you are with your health.”
Most health conditions, especially chronic diseases, don’t develop because you are a random victim. Chemistry, environment and genetics all play a role in leading you where you are today. “We ask a lot of questions about lifestyle,” says Chasse.
While you may be thinking, “Gee, doc, what do these personal questions have to do with my high cholesterol visit?” be patient and see how the answers can help your health.
Odd question: How’s your stress level?
Why ask? “Somebody who is under high stress may not be adhering to medications, they may not be taking time to pay attention to their diet and lifestyle and not have time for exercise,” says Yasmine Subhi Ali, M.D., a cardiologist and president of Nashville Preventive Cardiology, as well as the assistant clinical professor of medicine at Vanderbilt University School of Medicine.
They may fall into bad habits. A lot of people turn to alcohol or eat too much junk food. Plus, the body responds to stress in different ways. One way is to release the hormone cortisol, which can cause people to gain weight and lose sleep.
“And if they are under a lot of stress I ask why, what’s stressful for them, and that opens up a window into their life for me, so I try to look at the whole patient,” says Ali.
How are you sleeping?
People who have chronic sleep deprivation are at a higher risk for heart attack and stroke. Ali asks how much sleep patients get, how well they sleep, do they sleep through the night, and do they have trouble falling asleep. Some people suffering from insomnia treat its accompanying daytime sleepiness with caffeine, which can lead to further heart problems depending on the source.
Are you in a happy relationship?
These things make a huge difference in overall health and especially in heart disease. People who live alone and are lonely because of that die earlier and have poorer quality of lives and tend to die of cardiovascular events, says Ali.
“People who have loved ones around them and feel they are appreciated are a lot more resilient," and are more likely to comply with treatment if they have a lot of support around them, says Chasse.
Do you own a gun?
A gun in the home is 43 times more likely to kill someone known to the family than it is to kill someone in self-defense, according to the American Academy of Pediatrics (AAP). Plus, a Harvard study found that states with the most guns at home have suicide rates double the rates of states with the fewest guns.
By letting your doctor know about your gun, in return, you may gain excellent resources on gun safety with kids and issues relevant to households with guns, like what’s the best way to manage a home with a firearm if someone in the household suffers from depression.
How do you feel about taking medication?
“I have some patients who don’t want to take medicines but they don’t want to tell me they don’t want to take medicines,” says Ali. Everybody is different. “I try to get to their philosophy about medication. Some people want to take whatever natural therapies they can find, but don’t want to take any medications; some people want to take one pill but won’t take more than that so they want to know which pill is most important, and some people want you to prescribe a ton of medications to them.”
Ali gets a sense of a patient’s medication philosophy so she can work with the individual to motivate him in the best way when it comes to taking medicine.
What do you do at work?
Job satisfaction can influence stress levels. For people in an office, do they sit at a desk all day? Sedentary lifestyle leads to heart disease. “I promote they get up from their desk every 20 minutes but certainly every hour,” says Ali. "Also, are they exposed to anything that could harm their health?"
Chasse is working with one couple that is trying to get pregnant, and the wife is a vet tech. She handles radioactive dyes used in imaging animals, mixes medications that aren’t safe for humans, and is exposed to harsh chemical cleaners after surgical procedures. “Getting all of that is really important because those things are toxins to the reproductive tract and can actually impair fertility,” says Chasse.
Do you live with a smoker?
Even if you don't smoke, living with a smoker — including those who only smoke outside — may come at a risk to your health. The long-term indoor effect of being exposed to someone who smokes is now called thirdhand smoke, which is residual chemical contamination that accumulates in indoor living spaces and on the hair, skin, clothing and personal effects of smokers, exposing housemates to known carcinogens.
In a study published in the Journal Tobacco Control, researchers found that tobacco byproducts were trapped in households, and found in the urine of all inhabitants of homes where one member smoked outside.
“When I hear an answer that might be a problem area, I start to dig deeper and sometimes I uncover really interesting problems or issues that way,” says Ali. She will never forget a woman who came to her for heart palpitations. When she asked about some bruises, she discovered the woman was a victim of domestic abuse — and that was the stress that was causing her palpitations.
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