Sunday, August 31, 2008

Book Review - Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life

As a practicing family doctor and author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System, I am a strong believer in empowering and educating patients so that they can make the right decisions to get the most out of life. As the only doctor in my family I don't think it is fair that only the people I know or care for are privy to the truth about staying healthy, so I looked forward to reading Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life, by Dr. Nancy Snyderman, chief medical correspondent for NBC News, which has a similar same perspective.

Overall, the book was a mixed blessing. It has interesting factoids, ideas we should all take to heart, but at times is misleading. As a consumer and a patient, I thought the truths and news you can use pieces were interesting. As a primary care doctor and patient advocate, however, I felt that many parts of the book were misleading. Perhaps one of the faults is it tries to be too ambitious and attempts to cover too many topics, which often are not in depth enough to be of much value.

Dr. Snyderman points out correctly multiple times that the path to good health is through prevention by adopting healthy habits, staying physically active, and maintaining a sensible weight. The structure of the book reflects this preventive focus and chooses to debunk many myths with these clever chapter titles - Annual Checkups Are Obsolete, Vaccinations Are Just For Kids, Doctor's Don't Play Favorites, Only Old People Get Heart Disease and Stroke, We're Losing the War on Cancer, Natural Means "Safe", and You Can Just Snap Out of Mental Illness. She tackles the truth about herbal and dietary supplements, the unproven value of full body scans, as well as the importance of vaccinations and preventive screening tests for cancer, heart disease, and diabetes.

Throughout the book there are plenty of truth tidbits including, "you cannot catch sexually transmitted diseases from toilet seats; you do not need to drink eight glasses of water every day", among many others and news you can use segments that will make some readers hopefully more aware of what is myth and what is fact. These small sidebars were very interesting. I think patients and consumers will find these factoids topics of conversation.

As a practicing doctor, however, there are many areas which are misleading and others that provide information too superficial to be of value. Dr. Snyderman is correct in one of her chapters that heart disease and stroke are the leading causes of death in this country. However, she uses two individuals, a twenty-six year old former beauty pageant winner, who suffered from a stroke, and a forty year old woman, who died suddenly from swimming, as reasons why we should be concerned. The problem is that these type of occurrences are extremely unlikely and rare for these age groups and gender. The typical cause of these problems, atherosclerosis, or hardening of the arteries didn't cause these cases. The former was most likely due to a heart wall septal defect or a blood clotting disorder, known as a hypercoagulable state. The latter was probably due to sudden cardiac death from a fatal arrhythmia, like ventricular fibrillation.

In the area of stroke, she talks about atrial fibrillation, a heart arrhythmia, as the leading cause of stroke. It is a cause, but this heart condition is typically found in patients over age 60 and far more common in people over 80 years old. She doesn't say that and one would naturally and wrongly assume based on the prior patient stories that it can happen at younger ages, which again is extremely unlikely.

Other areas that are covered superficially include when Dr. Snyderman discusses cancer and mental illness. She pushes for prevention as well as clarifies myths that still exist among the public. Unfortunately in the chapter on cancer, she also talks about various cancer treatments which isn't thorough enough and doesn't seem to fit in a book with this preventive theme. For the mental illness, one of the best written sections because of her personal experience, again the book is rather too ambitious and tries to cover anxiety, depression, and bipolar disorder and the various treatment options even as she admits that "it is impossible to go into as much detail as I would like to". Though she gives a website reference, perhaps it may have been better only to cover depression as she and her husband both had experienced it, and acknowledge the other conditions.

Overall, I wanted to like this book as I believe the intent of giving the public the facts about what they can do to stay healthy and well is vital. I think as a practicing doctor and insider, however, the book at times it is misleading, in some areas is too light in content and in others the information deviates from the book's intent of wellness and health promotion.

2 comments:

mh said...

Dr. Liu,

I haven't read the book you reviewed, but I suspect that the author may have been accurate in her assessment regarding atrial fibrillation.

As the founder of an atrial fibrillation patient resource, http://www.StopAfib.org, I must disagree with your comment that atrial fibrillation is extremely unlikely in patients under 60. Mine came on at age 51, and I hear daily from dozens of patients under age 60 who have afib, and many have had it for years and years.

Please visit us at any of the afib discussion forums and you will meet hundreds and hundreds of atrial fibrillation patients under the age of 60. A list of those discussion groups is here:
http://www.stopafib.org/newsitem.cfm/NEWSID/75

One of my huge concerns is the growing number of young athletes and exercisers dealing with afib. It is indeed becoming very common in young athletes in their 30s, 40s, and occasionally younger. Here's an article about some of the athletes with atrial fibrillation that competed in the Beijing Olympics:
http://www.stopafib.org/newsitem.cfm/NEWSID/89

Atrial fibrillation is a growing problem, especially in younger people, and that's why we have declared September as Atrial Fibrillation Month. Please come learn more about it at http://www.stopafib.org/newsitem.cfm/NEWSID/92

Thanks for letting me share this information.

Mellanie True Hills
http://www.StopAfib.org Atrial Fibrillation Patient Resource

Davis Liu, MD said...

Thanks for the comments. While atrial fibrillation can occur in patients under 60, the vast majority of strokes due to atrial fibrillation are typically not in this age group. Other factors which increase the risk of stroke due to atrial fibrillation include female gender, age, high blood pressure, and diabetes. An excellent interactive tool to determine risk of having a stroke due to diabetes can be found at http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=te8126&sectionId=te8127&contextId=hw160870

Thanks for your comments. Good luck on educating the public.

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