A World of “INSTANT”
PETE DELA PENA, MD, FPCP, FPSEDM
This year, we see great challenges intersecting with great opportunities. At the moment, far too many Filipinos lack access to quality healthcare and even more are uninformed about the common diseases that stalk our country especially thyroid disorders. Too often, hearsay and fake news on social media triumph over common sense and evidence-based information from medical publications, making it more difficult to spread new insights and fix what is broken in our health care system. This is the challenge. We have tools available today. Our magazine, Hormone Hotspots, can be our instrument to put back into proper perspective the very nature of teaching and learning. There is a fierce hunger for reliable evidence about what to avoid, what works, and what heals in the realm of medicine, this is our opportunity. So I challenge all of you to stay eager, to learn and to make a difference. It is now, more than ever, that the threats of thyroid disorder and other hormone-related diseases are imminent. Through our magazine, let us provide our people with powerful information and open communication lines.
Instant coffee, instant noodle, instant messaging, instant camera, instant mix. In today’s world where time flies very fast, many “instant” creative solutions abound to make life easier. However, doesn’t anybody enjoy the long brew of a well-crafted coffee with a breathtaking aroma rather than an instant coffee mix? Talking face to face with your friend, laughing and having drinks sure trump instant messaging and facetime. Instant gratification is often substituted for a divine experience. This is no different to endocrine care. Take for example, FAD diets for weight loss. Indeed, South beach, Atkins, Paleolithic diet, Cohen’s , etc. elicit a profound drop in weight in the first 3-6 months but eventually most will have a “NIKE” effect and weight rebounds with more deleterious effect. During the precipitous weight loss, patients may experience gouty attacks, gallbladder pains, loss of energy, inadequate vitamins and minerals, and lightheadedness due to loss of sugar and blood pressure. A one to two pound/week weight loss or a 5-7% drop in weight over 1 year is a more sustainable and reasonable goal. By tackling your weight loss this way, you can find an eating plan that is enjoyable and suits your complex lifestyle. A tailored plan that is flexible enough to include your favorite foods, drinks and activity will give you best results with desirable long term outcomes. In the realm of diabetes management, diabetic patients undergo fluctuations in blood sugar and they experience drastic changes in lifestyle which makes them feel frustrated.
The daily grind of taking their blood sugar levels, taking their multitude of medications and in some, insulin injections just zaps their enthusiasm. Nevertheless, it is the job of their physician to keep pointing them in the right direction and coaching them to stay on course for the next couple of years to be able to secure the full benefit of a well-controlled diabetic treatment plan. Emphasizing to patients that keeping blood sugars close to normal decrease complications of amputation, stroke, kidney failure and heart attack over the long term. Another example is hormone replacement for hypogonadism which may even take even longer period of time before body changes may occur. Follow up for patients with thyroid disorders takes 4-8 weeks because adjustments and treatment effect occurs over this time. You will often hear your endocrinologists say that they “start low and go slow” when discussing their therapeutic approach. “Instant” solutions do have important roles in medical management but at times may also give you a band aid effect hence long term treatment plans are preferred goals. It is therefore paramount to discuss the long term strategy and the enormous benefit that a patient may reap after strictly sticking to the plan. Tips to keep you stick to your goal is by starting a journal of your progress, reward through reinforcement and by sharing your plan with a friend or family. I view the long term endocrine treatment plan like taking an insurance plan. Your daily investment to health may make a big difference when the important time arrives to collect it. Doctors and patients need to always look toward that northern light and not be swayed by storms or rough seas. Patients just need to ask help. Doctors are willing to commit themselves for the long haul. PS You may email Dr. Villa at firstname.lastname@example.org