The Critical Importance of Being Your Own Advocate

Own your health

As I experiment with different subject matter to decide on the topics that I like to write about and share here, one of them that keeps bubbling to the surface is self-care.

As my wife and I go through our early 50’s with our two college-age kids, it’s becoming crystal clear to me how critically important it is to take care of your physical and mental health no matter what age you are. Poor decisions made today about your health will most certainly come back to haunt you years down the road.

What I want to touch on here ties directly into the heart of self-care, and that’s the fact that you must be your own advocate in all of your health matters. Nobody else is going to do it for you, and in our complex healthcare system it’s more important now than ever before that you’re aware of your full set of options in any given situation.

By using the word “advocate”, I mean that it’s important to:

  • Communicate: Develop the skills and communication methods to define what your problems are and explain them clearly to medical professionals. People can’t offer the right help without the clearest explanation possible of what your problem is. Perhaps start by writing down your questions and the history of your problem (including any relevant dates) so you don’t forget things when you need to speak with someone about it. Having things written down is a stepping stone to an effective and thorough discussion. Also focus on listening and interpreting what’s being said. Don’t accept something that you don’t understand and move on from it because that will ripple through the rest of the conversation.
  • Research: Use trustworthy and reputable internet research tools to further understand and self-educate about your problem. Learn what it is, why it might be happening, what might be done about it, and whether or not it’s something you can improve on your own or something for which you need professional help. Corroborate what you learn across different websites and experts, and dig incrementally deeper to separate fact from fiction. Do this before or after you speak with your doctor, but definitely put the effort into it. I often start with general heath websites like WebMD, Healthline, Mayo Clinic, or Harvard Health and then work my way into specific sites dedicated to a problem I might have, for example the American Heart Association for cardiac topics. Etc…
  • Know the system: Understand who the best people are to help you with your problem and how to find them. Or maybe you can help yourself without them and avoid the need for the healthcare system altogether. If you need a doctor, start by asking your Primary Care Physician for referrals. You can also use a site like Castle Connolly Top Doctors to explore further. Just make sure that if you use a physician search or ranking site that you understand how they make their selections and do their rankings. You can also ask friends you trust about their experiences and recommendations.
  • Question: Ask as many questions as you need to understand your situation, write down the answers, and note who was involved in the conversation and when. Don’t just accept a prescribed path as the only one for you. I’ve been given conflicting advice by physicians on a number of occasions, and you shouldn’t just walk away from those situations without trying to understand why they made their recommendations and how they differ from one another.
  • Persist: Relentlessly drive toward a solution to your problem. There are often several ways to pursue a health solution, and many don’t involve immediately turning to medications. One might not work, but another will. Understand your options, because we all want to stay off medications for as long as possible in life. Stand up for yourself when you feel that finding your solution is going off course. You are in control of your health.

Why is this important?

In just the past five years or so, I’ve seen many examples myself and also through the stories of friends and family of how poorly various health situations were handled by the medical community and sometimes the patients themselves. I’m sure you’ve experienced the same thing. We would like to believe that we go to doctors who are knowledgeable, cutting edge, and whose opinions we can trust. Fortunately, in many cases this is true. Sadly, in some cases it’s not.

To be clear, this is not an indictment of the entire medical establishment. I have no problem with the majority of medical professionals I deal with. This is just a simple message that no doctor knows everything, some let their biases determine a treatment path that might not be optimal for you, and sometimes they’re just wrong.

Here are two quick examples…

Scenario 1:

My friend’s elderly father with Parkinson’s disease recently suffered a fall and hit his head. He went to the hospital, was treated for a few days until he seemed stable, and eventually returned home. As often happens with the elderly after an accident, things just didn’t seem quite right with him after that. One thing led to another and eventually he had to return to the hospital with various issues, one of which was breathing difficulty. He was diagnosed with pneumonia. He was treated but his condition continued to worsen to the point where my friend was told there was nothing else that could be done for his father and that he should be moved to hospice care.

He was moved to a rehabilitation facility where hospice care was offered and my friend was told that his Dad had just a short time left. I recommended to him to say what he wanted to say to his Dad now because this might be his last chance, which he did and was very glad he was able to have a semi-lucid discussion with his Dad before he possibly passed away.

In hospice care, a new doctor stopped in to evaluate the situation and decided quickly that more help was possible, and put the father on an IV for a few days. He eventually improved to the point where he was able to sit up, interact with people, and eat pureed food. Eventually he improved enough that he went home! He needs extensive mobility assistance at home, but he is there and he is alive.

So he went from fall + injury, to hospital, to hospice, to near death, to re-diagnosis + treatment….and then to home?! Wow! Talk about a roller coaster ride. Makes you wonder what was going on in that hospital and with the initial set of doctors that sent him down a path toward death when the option of saving him was so quickly picked up by another doctor in a different facility. Terrible situation…

Scenario 2:

Another example is my own experience with trying to solve several problems I’m having with my feet.

Do you know what size shoe you should be wearing? I bet your answer is “Of course I do”. My answer was the same. I was wrong, and I’ve since learned that many adults are possibly wearing the wrong size and/or width shoes and might be causing irreparable harm to their feet.

I have the good fortune to be in a high quality medical group for the past 20+ years that has grown over time in our region to include many doctors and specialties under their umbrella in almost every area you would normally need. I don’t think I’ve gone outside of our medical group once in the past 20 years because the doctors have always worked well with me, given solid advice with explanations as to what was going on, etc. Great situation! Unfortunately, I’ve learned that this doesn’t always protect me from poor or incomplete advice because it lurks even in places we consider trusted.

The first podiatrist I went to about my problems within my medical group wanted to do an MRI imaging test of my foot using an injected contrasting agent though an IV to make the MRI image clearer. I’ve read some bad things about contrasting agents and I didn’t want to use it during the test unless absolutely necessary, so I asked to do the MRI without it because I learned before the test that contrasting wasn’t really needed to diagnose my suspected problem. He refused. I left and never went back. He was stubborn about listening to my concerns and wanted to do things his way despite evidence showing it wasn’t necessary for my particular situation.

The second podiatrist gave me a thorough exam, started targeting the same possible causes as the first podiatrist, and recommended some actions to try to solve the problem (including an MRI without using contrast, imagine that?!). None of his solutions seemed to work with my somewhat chronic problems, and indeed one of the solutions about using orthotic inserts in my shoes may have caused a further problem because he didn’t give me proper instructions for how to acclimate my foot to the orthotic over the period of a week instead of just suddenly using them in my shoes all day, every day.

Seeing how this was going, I decided to further research the problems these podiatrists were diagnosing me with, and I do indeed have all of them. But here’s the crazy part….All of my problems are primarily caused by incorrect footwear. In my case I was erroneously wearing the wrong size sneakers over a long period of time.

When you were a young kid and you went to purchase new shoes, they would always measure your feet in the store with that metal device with the sliders on it called a Brannock device. That’s how you were assured of proper fit as your foot grew like crazy in your younger years.

As an adult, when is the last time you measured your feet with a Brannock device? Exactly. I don’t either. My foot stopped growing around the age of 20 and I’ve been generally buying the same size shoes for the past 30 years. I buy shoes that feel “good enough”, and move on without giving it a second thought. Until I developed foot problems…

When I discovered how much feet actually change over the years once past the age of about 30, and that all of my problems are typically caused by incorrectly fitting shoes, I realized that neither of the podiatrists I went to even bothered to measure my feet! What??? They jumped right into diagnosing me and offering solutions without first measuring my feet and then asking the most basic question that a podiatrist should ask, which is: What size and type of shoe are you wearing? It never even dawned on me at the time how stupid this was, and I willingly went down their path without pausing to assess the situation.

Using the philosophy mentioned above about being my own advocate, I’ve learned more about feet and shoes in the past three weeks than I ever thought I needed to know. In fact, everyone should know these things. I used a Brannock device to measure my feet properly, was surprised to find that I had both my size and width wrong, and I’ve since purchased the right size shoes. My wife needs to do the same. Interestingly, I’ve also learned that many common athletic sneakers are shaped incorrectly and contribute to the problems many people have, so I’ve switched to what’s called a natural shape shoe (I have some photos below to demonstrate how absurd that situation is).

Since getting the new type of sneakers in the right size, the discomfort from my chronic conditions is somewhat easing. I’m hoping that it continues to do so to the point where it’s not such a big distraction to my everyday life.

Improve your outcomes

So what is the point of the two stories above? The answer is simple: Be an advocate for yourself.

In the case of my friend’s father, they were basically in a situation where they were guided to follow the advice of a single doctor without being offered a second opinion, and only saved him by the happenstance of another doctor giving him one final check at a different facility.

The difficult takeaway from that is that in those dire circumstances, perhaps we should all consider a second opinion before final decisions are made. When I think back about some of the decisions our family made in my father’s elder years, the takeaway would probably be the same because he had some clunker doctors for sure (one of which was eventually terminated from the retirement community where my Dad lived).

In my situation, the point is that what I was hearing and seeing didn’t make sense to me. When I educated myself about all of the involved topics, I found that I was likely diagnosed correctly and the solutions offered were mostly right, but they had absolutely no chance of helping me because of the basic fact that I was wearing the wrong size shoes. Zero chance.

So the overall message of this article is about owning your health and the possibility of achieving better outcomes. Don’t blindly turn yourself over to the medical system and assume they’ll make all the right decisions, because they might not or might be following a “one size fits all” approach that’s not right for you.

Learn, ask questions, get answers. In my experience over the years, I’ve found that doctors have appreciated and commented positively about the effort that I put into understanding my conditions and options. It enables them to better help me and have a more complete discussion when they know that I understand the problem, the possible options, and that I can work with them to make appropriate decisions.

I hope the information in this article (and the photos below) are helpful. Be your own advocate and own your health!

Bonus: Want to help your feet? Here are some photos as food for thought…

I mentioned above that a common problem that shoes have is simply using the wrong shape. Driven by the desired appearance of the shoe, marketing needs, or whatever…many companies design their shoes to have a curve in them in the toe box area that jams your small 3rd, 4th, and 5th (pinkie) toes up against each other inside the shoe. They also force your big toe inward when it should be straight. These things lead to your toes flexing unnaturally and your bones rubbing against the nerves in your feet to create painful conditions like Morton’s Neuroma, metatarsalgia, numbness or tingling, and many other problems.

The types of sneakers that I’ve been wearing my whole life have this exact type of design, and when researching my problems I made the decision to buy natural shape sneakers instead. The relief from eliminating that inward toe box curve in my old shoe’s design was nearly immediate. My toes felt like they had room to spread and move with a less crowded feeling in the toe box area of the shoe, and my feet were more comfortable all day long.

Here are two photos that show the differences…

This first photo below shoes the two shoes. The typical athletic shoe is on the left and the natural shaped shoe is on the right. You can notice the leftward curve in the toe box area of the shoe on the left. Not good… The natural shape shoe is basically straight ahead from back to front.

The second photo below shows the insoles of these two shoes which I took out of the sneakers for this photo, and it demonstrates the difference more dramatically. My old athletic insole is on the left, in the middle is the insole from the new natural shape shoe, and finally on the right is a custom orthotic molded from my foot. Is your foot shaped like the insole on the far left or the one in the middle? My guess is the one in the middle. You can see that the natural shape insole and the custom orthotic are the same straight ahead shape.

See where this is going? Typical athletic shoes probably aren’t doing your feet many favors, and many other types of shoes have the same design problem.

If you have foot problems and you want to explore shoes that might help you, check out HealthyFeetStore.com. There’s a good search tool on their site that lets you specify your problem and then it matches you to shoes that might help you. To be clear, I have no affiliation to their site and I didn’t even buy anything from them, I’m just putting the link here because their ‘problem-to-shoe’ matching search tool was helpful to point me in the right direction. I actually ended up buying my new shoes directly from the New Balance website.

Happy shopping and healing!

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