Here is an issue that has been bothering me. Time and time again I hear from people that have been feeling just fine, they go for a routine checkup and then – tra la! Something terrible is found in the test. This brings on another round of tests, a great deal of worry and anxiety, and most often, invasive treatment to deal with the “problem.”

Cases I am familiar with include a) 80% blockage in one coronary artery, in one healthy-acting 60-yr old male; b) a microscopic cluster of cells in a mammogram that were deemed “malignant”; c) heart valve abnormalities in a female with no heart attack risk; d) and the many who are found to have “too high cholesterol” and are put on medication.

In case a), this healthy person, who regularly exercised and played sports up until the checkup, was immediately given heart bypass surgery, and ended up feeling very sick indeed.

In case b) the woman got a lumpectomy and a diagnosis of “breast cancer”; after a series of radiation treatments, she was found to be cancer free. She also still sees herself as very sick indeed.

In case c), the female with heart valve abnormalities decided to do nothing about it, and continued her life as if she were healthy.

In case d) of course, most cases I know go obediently on the cholesterol medication, which may damage the liver, the brain, and the muscles, even though there is little actual proof that cholesterol has anything to do with heart attacks or plaque in the arteries.

Then there are the numerous cases of women who have a bone density test and are given a diagnosis of “osteoporosis”, even if they don’t break anything when they fall; and they are also put on medication. Some of these types of medication, the bispohophonates, are now associated with weaker and more brittle bones, and a serious degenerative condition called “osteonecrosis of the jaw”, in which the jawbone becomes badly broken down and the teeth may fall out.

The opposite problem is when people feel really sick and the checkup and tests show “nothing.” Diagnosis “You’re fine” -- Yet people are seriously under par and have trouble keeping up with their normal lives.

My point here is that there are two ways, nowadays, in which we get the label of “sick”: 1) We feel sick, unwell, under the weather, not right; and 2) we get a test and the results are not in accord with what has been determined to be “normal.” It reminds me of how “normal” levels of blood values are set, at least how they were set some years back according to a hematologist who worked at Bellevue Hospital and was a student of mine. She said that the lab was setting up “new normals” and everyone at the lab had their blood tested. Then the values were averaged out, and whatever the average of all the workers at the lab was, those were the values considered “normal,” and all patients whose blood went to the lab were compared to those “normal” values.

I suppose as we are all human beings we can be compared to one another, but still, something about the procedure bothered me. I cannot assume that it is still done the same way, but my lack of trust in the numbers that we are supposed to conform to has not disappeared. Studies have shown that there is great disagreement, for example, about the bone density values; and even that different machines give different numbers. Years ago, a total cholesterol level of 250 was considered normal; now the powers that be (that is, the drug companies and their friends, the FDA and the CDC) have changed their minds, and 180 is the new “normal”.

So when are we sick? Are we sick when we feel sick? Or are we sick when various measurable values in our blood or tissues don’t fall into the norm and we’re told we’re sick, even if we feel fine? How many people go into a medical checkup feeling just fine, and come out feeling sick and damaged? Which way of being sick counts? What about tests that give false positives – that say you’re sick when you really are not, and put you into invasive treatments that are not necessary – and those that give false negatives – saying you’re well when you’re not, and keep you from treatment that you would need?

I know one person who won’t listen to any doctor or healer who tells him he is sick when he doesn’t feel sick. And perhaps that is something to consider. Who knows best? The expert or the body? I would think the body knows best, and intuition also counts. However, it should be said here that there are many people who do not have a good relationship with their bodies, and who cannot tell how they feel. They should indeed listen to the experts.

At this time, I have made some decisions for myself, and I do not under any circumstances recommend these for others unless they really feel comfortable with such an approach. First of all, I consider myself sick when I feel sick, and I’m sure I can tell. My body and I have a good relationship, and it has always told me when things are off, at which time I’ve sought out a good practitioner, either of conventional medicine or alternative modalities. Second, I do not go for tests unless I feel I would benefit from the information, or know what to do with it – thus, I have never had a mammogram nor a bone density test. For the former, one paper I read some years back (I don’t have the information right now) said the time difference between finding a lump on the mammogram or finding it by hand is about 4 months. As the body routinely makes and destroys cancer cells, sometimes it should be given the time, I believe. For the latter, the best bone density test is a fall. If you fall and nothing breaks, you’ve passed the test. And I wouldn’t take the drugs anyway, so what is the point.

Remember, I do not recommend this approach as a general measure. We each have to follow our own system, and the placebo effect works no matter what approach we take.

How do we make sure we keep ourselves healthy? Tests only tell us when we failed to do so – they are not preventive. They only tell us “you’re not sick YET. Come back next year and we’ll see if you got sick then.” It’s not a system I like, because one is almost obliged to get sick, to please the doctor and also to show “see, it was worth checking, I’m sick now, I’ll be getting my money’s worth.”

So, how do we know we’re OK? Here are some pointers.

Conditions of Health

1. There is no fatigue, and no aches or pains
2. The appetite is good, not too much nor too little
3. There is good, deep and refreshing sleep
4. Memory is reasonably functional as needed
5. Emotions are calm and steady, and any flare-ups are quickly over
6. There is enough energy for all daily activities
7. One manages to have generally good relationships with friends and family.

If any of these are not up to your expectations, that may be the time to find some help from a health professional you trust.

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