10/15/2011

On being ... a gut reaction

By Ingrid Sapona

I don’t know about you, but I’m getting pretty tired of reading news stories about medical guidelines because it’s just getting too damned confusing. It seems that every day there’s another headline about some medical recommendation that seems to contradict other medical advice that they told us about last year.

The thing is, no matter how confusing the news is, I’m drawn to such stories. How can you not be? Of course, I can quickly rule out about half the stories because they’re about a group that I’m not part of (for example, stories about people taking specific medications) or about a condition that isn’t an issue for me (like prostate cancer). But there are lots of topics that clearly are potentially directly relevant (like mammogram screening guidelines) so I can’t simply tune out.

This week was a banner week for confusing and seemingly contradictory medical advice. First there was the news that men who don’t have prostate cancer symptoms should not get PSA (prostate-specific antigen) blood tests. Until now, the test was pretty standard for men over 50. Apparently the experts are now of the opinion that not only is the test not particularly good at detecting prostate cancer, the test has caused harm.

Next there was news about dangers to “older women” who take vitamin supplements. Though I’m not quite in the age group they were talking about, I paid attention to this story because I take vitamins. Some reports made it sound like the danger comes from mega-doses, but others make it sound like there’s danger from even “normal” doses. Does this mean I should give up my multi-vitamin? I have no idea.

Ironically, a medical headline with an intentional contradiction actually made perfect sense to me. The headline read: “If you know CPR, do it. If you don’t, do it anyway”. The article was reporting on a warning made this week by Canadian emergency physicians who believe too many Canadians are dying from cardiac arrest because bystanders refuse to help.

According to the story in Friday’s Toronto Star, doctors are campaigning to teach more people how to perform CPR. I know, seems like old medical news, right? Well, the new twist is that doctors are now saying that even if you have no CPR training, if you see someone in cardiac arrest you should do chest compressions on them. As Dr. Christian Vaillancourt, an Ottawa doctor quoted in the article, put it: “You cannot harm a cardiac arrest victim. … You cannot do CPR wrong. Doing something helps.”

The article also quoted Peter Macintyre, a spokesperson for Toronto Emergency Medical Services, who put it even more plainly: “It’s a scary thing. But one thing to remember is the person is dead. They have no pulse, they’re not breathing. They’re dead. Nothing you’re going to do to them is going to make them any worse. Do CPR and they’ve got a chance.”

Many years ago I took CPR. We all practiced on the dummy torso and we were taught how many compressions you do in a row between delivering breaths. Some years later I even took a refresher course. By then they had revised the training and we were told to do compressions to the beat of the Bee Gees’ Saturday Night Fever. The message I took away from both courses is that CPR is a serious thing and doing it right is important. Unfortunately, I quickly forgot the exact number of compressions and so I figured I’d never actually do it on anyone.

Then, one day in 1998 I happened to be at my parents’ house when my father collapsed in the kitchen. About six months before that he had had a heart attack and while in the hospital his heart had stopped and they had to use a defibrillator to get it started again. So, when he fell in the kitchen, I rushed to him and started compressions. I remembered thinking that I really didn’t know what I was doing, but that I had to do something. Meanwhile my mother phoned 911.

Thankfully, Dad came around before the ambulance arrived. As they took him to the hospital, I hoped I hadn’t made him worse by doing what I did, given that I knew I didn’t do it exactly as I had been taught. To help ease my guilt, I reasoned that chances are the jolt he got hitting the floor is probably what got his heart going again, not my attempt at CPR. In the weeks that followed that incident he had by-pass surgery and eventually they implanted a defibrillator.

So, reading that article this week about doing CPR even if you’re not sure how to do it put to rest any lingering doubt I had. More importantly, it reaffirmed my belief that when it comes to any kind of medical news, the best you can do is try to make sense of it in the context of your own life and the particular situation. And then, after weighing the alternatives, go with your gut and hope for the best.

© 2011 Ingrid Sapona

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