Image: Blood pressure
Joe Raedle  /  Getty Images file
Forty-seven percent of doctors surveyed by Truth On Call said that patients' good intentions only last a matter of weeks after a dangerously high blood pressure reading.
By
msnbc.com
updated 3/1/2010 8:45:11 AM ET 2010-03-01T13:45:11

The medical tests are back. The cruel news is delivered: the numbers show trouble inside your body.

Instantly, you rocket from mildly anxious to scared straight. That’s how it feels, anyway. In the exam room, in that raw moment, you firmly renounce your bad health habits. You promise to adopt a low-fat, gym-heavy routine. You’ll live right, you tell the doctor — and yourself. You’ll stick to it. You swear.

Save it. Your doctor has heard it before.

“I think every physician has,” said Dr. Steven Chang, a family practitioner at the University of California Davis Medical Center and a staff physician at RightHealth.com. He recalled diagnosing some patients with diabetes and collaborating with them on a new diet plan. “They will leave my office and I’ll immediately see them in the [hospital] cafeteria — eating a hamburger and French fries ... That’s difficult.”

What’s the true shelf life of a health scare? That can depend on individual willpower, the height of the internal emergency and whether someone feels or sees physical symptoms — like chest pain or blood after coughing. Tangible signs of sickness may inject deeper fear and more lasting improvements compared to, say, merely reading ugly stats on a sheet of paper (such as a high cholesterol count).

A text message poll of 100 U.S. family physicians, conducted by Truth On Call for msnbc.com, found that 47 percent of doctors said patients typically stick to their vow to live better for just a matter of weeks after a health scare, 25 percent said the good behavior lasts several months and just 7 percent said patients stick to their resolve for a year or longer. Nineteen percent said the effect of a health scare lasts just a few days and 2 percent said it doesn't last for even a day.

Chang said he pins the typical duration of fright-induced lifestyle adjustments at three to six months. “Once you start an exercise regimen, if it peters out after a few months and if you don’t feel any different, the impetus to change may not be [as strong] as that initial shock.”

As Lori Hope found, drastic change is tough to maintain no matter how powerful your motivation.

“How long can we go vegan and macrobiotic? How long can we sustain that?” asked the former medical journalist. 

In 2002, after Hope was diagnosed with lung cancer, she stepped up her exercise routine. She already ate an organic diet but also added meditation and yoga to the list of things she tried to boost her health.

"I continued after my treatment, but that went away fairly quickly," she said, finding it her busy schedule made it impossible to do it all.

Hope, a blogger, public speaker and the author of “Help Me Live: 20 Things People With Cancer Want You to Know,” said she also became “wholly committed to avoiding anything that would exacerbate my condition.” Earlier, while researching a news documentary, she read about the theoretical links between cancer and electromagnetic fields (EMFs) — invisible areas of energy near power lines, wiring and appliances. Before undergoing surgery to remove the tumor in her chest, Hope noticed the close proximity between her desk and her office building’s bank of buzzing electrical meters. She borrowed a magnetometer, swiped it near the power boxes and saw high EMF readings.

“I walked to the opposite wall, got as far away as possible from the meters. It terrified me,”  said Hope, now eight years healthy. “I ended up leaving that office partly because of that ... And once I was diagnosed, it was like, there’s no way I’m getting a hair dryer near my head. I totally stopped using a hair dryer.”

Image: Lori Hope
Laura Turbow
Lori Hope, author of “Help Me Live: 20 Things People With Cancer Want You to Know,” was diagnosed with lung cancer in 2002. She stopped using a hair dryer for a few weeks to reduce her exposure to electromagnetic fields.
How long did her anti-EMF conversion last? “Just a few weeks,” said Hope, 56. “Yes, I use a hair dryer now.” What changed? “I’m embarrassed to say that maybe vanity won out. [Plus] you do go back into a kind of sense of denial."

Recording every heartbeat
Melanie Nayer, in contrast, can vividly describe her terror upon learning — at age 31 — that she had a heart rhythm disorder. While training for a marathon, Nayer noticed that her resting pulse was racing – sometimes staying above 180 beats per minute. After a month of exams, a doctor determined that she had supraventricular tachycardia, a disorder that causes the heart to beat faster than normal. Some tachycardias can raise the risk of stroke or cause cardiac arrest, while others may have no symptoms.

The diagnosis “scared the living crap out of me,” Nayer said. “I couldn’t understand why I had been dealt this card — I worked out regularly, ate well ... I cried for a few hours, felt sorry for myself for a few days, yelled, screamed and probably broke a few things around the house.”

Along with taking pills to level her cardiac pace, Nayer began to “religiously” measure her heart rate and “recorded every beat in a journal.”

“This only made me more anxious and the anxiety only intensified the situation, and that was no way to live,” she said.

After four weeks, she put the journal away and grabbed a fresh attitude. “I stopped worrying about the little things, and the things that were out of my control. I stopped caring that my carpet hadn’t been vacuumed in over a week, or that there were dirty dishes in the sink. I would get to them. And a dirty dish wasn’t putting anyone’s life in danger.”

Always passionate about seeing the world, she became a travel writer, working from Boston. “My health scare turned out to be the best thing for me ... Regardless of the severity of any diagnosis, you just never know when life will throw you a curveball. So I decided to start living the life I wanted to live,” Nayer said, “because, as morbid as it sounds, I wasn’t sure when it would end.”

Three years later, Nayer has been cleared for annual cardiologist visits (instead of twice per year) and is on a lower dose of medication. Just eight months after her diagnosis, she also began running again.

But for people who vow to start running and who stop, for those who abandon burgers and fries only to return to a fast-food lifestyle a few months after a bad health episode, the reasons for relapse can include a lack of self discipline and a tendency to “self sabotage,” said Debbie Mandel, who hosts a stress-management radio program, “Turn On Your Inner Light” on AM1240 WGBB in Long Island, N.Y.

Past mistakes also are hard to admit. And “to change, even for the better, makes a statement that one was wrong,” Mandel said. Moreover, life changes made amid a health catastrophe are often a drastic, desperate response to a crisis. “When the crisis is over, so is the motivation. For change to take hold, it is best to start small to reap giant gains. This way one can inventory and tweak along the way. All or nothing is hard to maintain.”

A little help from friends
Upholding healthier habits can require a little handholding, too. Chang noticed that many patients who successfully stuck with leaner diets and longer walks for at least a year were able to rely on friends and family members to accompany them down their new paths. For patients with diagnoses, such as diabetes, that require radical changes in diet and exercise, Chang makes it a point to call his patients one week after he gives them the news — or he asks them to return to his office three weeks later — to “check in” on their improvements and to vocally cheer them on.

Image: Ellen Snortland
Ellen Snortland
Ellen Snortland lost 50 pounds and became a self-defense teacher after being diagnosed with a heart valve problem.
Tapping a social support network is precisely how Ellen Snortland shed 50 pounds and kept the weight off, and how she transformed herself from a heart patient into a self-defense teacher in Altadena, Calif. In 2003, after a lifetime of yo-yo dieting — including taking the diet drug Fen-Phen — Snortland was diagnosed with a heart valve problem.

“I asked [my doctor], ‘So what are my alternatives?’ They said, ‘Surgery or, in some cases, if you lost a major amount of weight, it could make a difference.’ I said, ‘Holy moly!’ — although I may have used another word. I walked out of there like I’d been given a death sentence,” Snortland recalled.

She soon entered a 12-step program aimed at weight loss. She began speaking daily to a sponsor, submitting a daily food plan, and attending three meetings a week with her group. “It’s the only way I can see I’ve been successful,” she said, “because we are bombarded with food ads.”

At 56, Snortland described her heart’s current condition as “perfect” and said she feels “completely and utterly vigorous.”

The shelf life of her health scare? She can name it in four words: “Evergreen, perpetual, long-lasting, enduring.”

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