Learning how to responsibly evaluate and act on information about new health studies.

I spend a good portion of my day reading, whether it be reading the newspaper, the magazines I receive, on-line sources for my blog posts, or just reading mystery novels for fun.  The thing I love about reading is that words matter.  They are powerful things, and can convey a wealth of information.  We must evaluate carefully the information we read that pertains to health, and we must not jump to hasty conclusions.
  
What do I mean by this?  Whenever you read anything, it is important that you avoid the tendency to just scan it to glean the meaning that you want, rather than to comprehend what the author is trying to tell you.  This is a mistake I made recently about the news of a health study.  I saw in the article the solution that I wanted my medical providers to endorse, rather than the actual information that was presented.

As I have mentioned many times before in this blog, starting about 5 years ago my doctors recommended that I start to take low dose aspirin.  Given my heart failure, they thought that this drug would be beneficial for me.  And as you know, I usually quiz my doctor about health advice, not to dispute their expertise, but so I will know why I am doing something and any potential side effects, etc.  I trust them and I strictly follow their advice. 
 
But I have to say that low dose aspirin has had some downsides.  First, there is just the fact that it is another pill that I have to remember to take.  Happily because I am such an organized person, it isn’t really difficult to remember to take this pill each morning.  But then there are all the forms I have to fill out at medical service providers regarding my extensive medication usage.  A minor inconvenience, but it is one more thing that I have to remember to put on the form. 
 
Then there is the side effect that comes with taking low dose aspirin.  Specifically, it can act like a blood thinner.  What this means is that the smallest of cuts can gush blood like the geyser known as Old Faithful in Yellowstone Park. 
 
Most of the cuts I have are small, but there was the time I banged my head against the edge of an open cabinet door.  As I think the parents of small children can tell you, small, shallow head cuts are the worst because in addition to the gushing blood, it is hard to find the source of the blood through all that hair.  Fortunately a friend in my building was able to find the source and clean the blood out of my hair before I totally freaked out.  It was enough to make me want to shave my head to make it easier to resolve any future head cuts.  Then I concluded that I just needed to slow down and be more careful and deliberate in my movements so I don’t have any unexpected wounds.
 
I also have gone out of my way to prepare for unexpected cuts.  I have a ton of bandaids and first aid materials.  I have a can opener that leaves a smooth edge on the lid and side of the can so that I don’t inadvertently cut myself on a sharp edge.  Plus, I have some liquid bandage on hand for the cuts that are hard to get a bandaid on.  But despite all these measures, I still am besieged by pesky little cuts.  After five years, I’ve had just about enough!
 
So imagine my excitement a few months ago when I saw an article that seemed to say that a health study cast doubt on the health benefits of taking a daily low dose aspirin.  My face lit up and my brain ran amok – was there a possibility that I might have one less pill to take each day?  If so, would I be able to finally stop any excess bleeding when I just looked at something sharp?  Could I make room in my bathroom closet for something other than first aid supplies?

I am correct in stating that there was a study about the health benefits of low dose aspirin.  According to the National Institutes of Health (NIH) website, the NIH funded study examined outcomes in both the United States and Australia.   According to an article on the Washington Post website, this study looked at 19,000 people over an almost five year period.  So I was intrigued – if they looked at 19,000 people and concluded there was no benefit, shouldn’t that be enough for me (and more important my doctors) to conclude that there was no need for me to take a daily low dose aspirin?  I was excited and made a mental note to once again quiz my doctors.
 
When I went to see my heart failure doctor in January, I told him that I wanted to discuss whether I needed to take low dose aspirin in light of the recent study that showed the lack of a benefit.  He assured me that given my particular heart issues, I am in the population of people who benefit from a daily low dose aspirin.  So I was a bit bummed out - but I'm not sure whether it was because I had to continue taking the low dose aspirin, or if it was because I had apparently misunderstood the articles.  When I got home, I decided to go back and reread the articles, which admittedly I had not looked at for months.
 
I am beginning to wonder if the the small cut on my head had injured my brain so that I was unable to see the plain language of the article.  Because if I had read it just semi-carefully, I would have seen that it was telling me that the study said that for healthy people there was no benefit in staving off cardiovascular disease, dementia or disability!  Therein lies the rub – I fell out of the category of healthy people about six years ago.  In fact, there was evidence that it could help a cardiovascular patient like me.  The Washington Post article said: 

• There is good evidence that taking aspirin can help people with known cardiovascular problems. But it had been unclear whether healthy people older than 70 would derive the same benefit. 

 
More to the point, the American Heart Association website has a webpage providing an answer for “What is Cardiovascular Disease”.  The AHA says that the term can refer to a variety of conditions.  Of course, one of the conditions referred to on the webpage is heart failure.  Another condition referred is an arrhythmia such as Bradycardia.   Additionally, heart valve problems are another condition that the AHA refers to, and this includes the condition of regurgitation, or when the heart valves don’t close properly and thus allow blood to leak through. 
 
As I have all of these conditions, I clearly fall into the category of a patient with cardiovascular problems.    Maybe I should have just evaluated the information more carefully.  But then again, I am a patient and not a doctor.  So even if I hadn't rushed to a hasty judgment, the best course of action for me always is to keep up to date on health news, and then pepper my doctors with appropriate questions.  Yes, admittedly my questions were fueled by the minor annoyance of a plethora of irritating small cuts.  But my heart was in the right place (pun intended) in just striving to assure that I understood my condition as well as the latest in treatment developments. 
 
Some of you may have noted that the study did not address what healthy people over 70 do should if they are currently taking a low dose aspirin?  Also, according to the Washington Post article the findings apparently do not apply to black or Hispanic people younger than 65 or others younger than 70.  So what should people in these categories do?      
 
This is how I look at it.  We need to go to the doctor for a variety of reasons.  One of the most important is that your doctor spent a lot of time in school learning about a particular field of medicine.  Then the doctor left school and began to treat patients, and over time has probably treated a lot of patients.  In other words, the doctor has a lot of book and practical knowledge that the patient does not – and that the patient should value.  In fact, if you look at the low dose aspirin box, it likely includes a warning that says:  "Aspirin is not appropriate for everyone, so  be sure to talk to your doctor before you begin an aspirin regimen." 
 
The smart patient owes it to the doctor to be as informed about the condition as possible, and to discuss matters of concern with the doctor.  This is especially the case when you see news about studies in your newspaper or in magazines or on-line.  The doctor will have heard of the study or know about and is better able to interpret the findings and apply them to your particular health facts. 

So do yourself a favor.  When a new health study or finding comes to your attention, avoid the temptation to act on it using your own judgment.  Instead, do exactly what I did.  Before acting on your own bring the relevant study, etc. to the attention of the people who are paid to know and to help you.  Good doctors will be happy to share the benefit of their knowledge with you because I suspect they want to have you around as a patient for a very long time.