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Good Fear, Bad Fear

It’s fascinating how the things we often worry about can be so out of proportion to the actual danger they represent. Take Ebola. The hysteria here in North America about an outbreak that was concentrated in West Africa was a tad excessive. So I decided I’d share two of the things that I feel my patients worry too much about—and then present two things that actually deserve their concern.

Let’s begin with toxins. Info­mercials have done a fabulous job at training us to believe that our blood and bowels are full of vicious critters, determined to make our lives miserable. The truth is that our bodies are incredibly efficient at processing and eliminating unnecessary chemicals and environmental exposures. Things like cleanses and herbal detoxifiers are unlikely to improve on this system and may in fact cause harm.


I’m not denying the existence of toxic chemicals: Lead, mercury and radon are well defined and measurable. But spending time and money trying to rid your body of nebulous, hidden “toxins” is pointless and won’t reverse the damage done during your last party weekend.


Vaccine-related toxin terror has been in the news for a while now and brings me to my next point. Vaccines are safe, reliable and exceptionally effective. While I completely agree with questioning the quality and safety of anything someone injects into their body, I can quite comfortably say that worry over vaccine safety is not warranted. It has clearly been established that vaccines do not cause autism, to take one. We can safely put that one to rest.


While some vaccines do contain preservatives such as formaldehyde, the concentrations are so incredibly low that even after 70 years and millions of doses, there is no indication that they cause disease.  Even as adults we can benefit from routine vaccination, and I encourage you to make sure yours are up to date.


My suggestion is that we turn our attention away from the above problems to focus on some important emerging issues. The first is antibiotic resistance. I understand how frustrating it is to be sick. As a doctor, there’s nothing that I’d like to do more than to cure bronchitis or a persistent sinus infection. But the fact is that many infections we encounter are viral in nature and just don’t respond to antibiotics.


The improper use of antibiotics leads to resistance, meaning people are getting sick with bacteria that are no longer killed by our current drugs. The frightening thing is that there aren’t any great drugs on the horizon to fall back on. This is a major worldwide issue, but we can all do our part by questioning whether every antibiotic prescription is really necessary. I promise you: Doctors are not evil gatekeepers taking pleasure in denying you a cure for your most irritating cough!


On the flip side, if you do get a prescription for an antibiotic, it’s incredibly important to take it properly. This brings me to my final concern: medication adherence. Studies suggest that people take only 50 percent of their medication correctly. This can be because of side effects, complicated medication schedules or people who simply do not understand why their medication is important. All of that can lead to a massive amount of preventable illness. Be honest with your doctor about taking medication. There are ways we can help make it easier for you to stick to your regimen. It also provides an opportunity to review your medication and make sure that what you’re taking is still the best choice.


So there we have it—a few small things that in my opinion deserve a shift in priority. It’s interesting to hear about the diseases people fear most: rabies, dementia, cancer. Often my job involves reassuring patients that these scary things aren’t actually the problem. I think it’s important that we objectively investigate those things that we fear and question the validity of the information we receive, whether it’s from a friend, the Internet or even your doctor!


Dr. Malcolm Hedgcock is a Toronto-trained family doctor living and working in Vancouver. He has a special interest in gay men’s health issues, including the primary care of those living with HIV and AIDS.