Dealing with your own ill health

What to do when you're ill

Nobody really wants to be ill, and traditional images of the male as the strong, silent provider and protector can make illness particularly difficult for men to deal with.

Perhaps that's why male reactions to ill health are often extreme: from whinging over a slight sniffle on the one hand, to ignoring potentially serious symptoms on the other. But the two reactions are really two sides of the same coin.

It's a fact that one day you will, quite literally, be less of a man than you are today. Your strength, intellectual capacity and testosterone levels will all decrease, and illness is a reminder of that. However, the one certain way to bring that day forward is to ignore health problems or carry on regardless.

The human body is a superbly crafted machine — in terms of engineering, the finest Ferrari is a punctured Space Hopper by comparison — so you should respect it. That doesn't mean you should never do things which your body might not like, only that you should understand what you're doing and how to put it right.

You know the body doesn't work so well after five pints of lager, so you give it time and plenty of water afterwards to let it recover. You know it doesn't play football so well with a pulled muscle, so you provide prompt treatment, strapping, ice and rest. (And that means no football.) Similarly if your immune system is fighting off a cold, it needs your support — more rest, plenty of vitamins and, again, water. You don't have to take to your bed and send for the undertaker but you might give the pub or the gym a miss.

If you have this balanced attitude towards your body, you will find it less difficult to deal with something serious when it does come along. Because whether it is a cold, a cricked neck or cancer, the approach is essentially the same — acceptance.

Accept the illness into your life and acknowledge it as a new experience. That way you stand a better chance of both seeing it off and getting some benefit from it as a person. Equally, although your illness is a part of you and your life, it is not all of it — don't let it take over. The information in this section should help you with this.

When to see a health professional

With just the barest of maintenance, the body will give years of excellent service. But occasionally, someone who knows what they're doing will need to have a look under the bonnet. It's a question of balance — you don't get a mechanic to change your wiper blades but you would, if you had any sense, get one to fix your dodgy brakes. You know full well the familiar symptoms of a cold or flu. If you have them, look after yourself, or ring NHS Direct (0845 4647) for advice, but don't bother your GP with them for at least a week. On the other hand if you have an unusual symptom that worries you — an unfamiliar bleeding or discharge, an unexplained pain or growth — see your GP promptly.

If in doubt, check it out. By all means find out more about your symptoms beforehand, but that's no substitute for seeing a doctor, just a useful preparation for it.

How to get the best out of a health professional

You have a right to see a doctor and they have a duty to treat you, but there's more to it than that. Doctors (and other health professionals) can be delicate flowers, and you need to work on your relationship with them to get the best out of it.

• Show them respect even when they don't seem particularly interested in you. Their impersonal approach is a way of coping in a life-and-death profession. What's more, a doctor's medical training can encourage this attitude by focusing on symptoms and diseases rather than on people.
• Be aware of the pressures they are under — both their high workload and your high expectations — and recognise how difficult their job is. The ideal doctor is as up-to-date as the Paris catwalk, has the knowledge of a dozen Mastermind champions, the people and communication skills of a roomful of diplomats, and the detective skills of Inspector Morse. Not surprisingly, such people are rare. Having said that, don't put your doctor on a pedestal — try to talk to him or her as you would to a friend.
• Be realistic — the media can give the impression that all known ills can be cured, but the truth is that medicine will always be a bit of a hit-and-miss affair. We don't know exactly how the body works, and everybody is different anyway. Don't expect instant solutions — be a patient patient.
• Be honest. It's embarrassing to talk about problems with a complete stranger — you may feel ignorant, scared and not in control: emotions that men are generally encouraged to suppress — but don't worry about it. Be honest about how you feel and about your pain; don't trivialise it or worry about wasting the doctor's time.
• Ask about your biggest worry first — it's a mistake to mention the football-sized lump in your groin as you're backing out of the door.
• Make sure you can understand — if you don't know what the doctor is on about, ask for an explanation.
• Be professional — your doctor makes notes so why shouldn't you? Beforehand, prepare answers to the questions that are regularly asked — "How are you?", for instance — and try to be precise as possible: "Where and when does it hurt?" List the questions you want to ask of your doctor and make sure you have time to ask them.
• Be assertive — after this appointment you won't get another chance for a while, so make the most of it. Ask for clarification: "What do you mean by a couple more tests". Ask for more detail: "How much more exercise should I take. And what sort?"
• Make notes between appointments — what you discussed, what you agreed you would do, what the doctor agreed to do. You can record fluctuations in symptoms or responses to treatment too. Then, when the doctor asks next time, you'll be able to answer.

The good patient is a CAD — they Come prepared, Ask questions and Discuss problems. These techniques can be applied equally well to your appointments with other health professionals. It's easy to forget an exercise a physiotherapist has shown you, for example.

How to find out more about your health problem

When first diagnosed some people want to know everything about their problem, others want to know nothing at all. Neither approach is right or wrong, it depends on the person and on the problem. However, sooner or later you'll probably want to know more. When you do, use your research to quiz your doctors more thoroughly. And always discuss what you've learnt with them before acting on it: you don't want to do something that will reduce the effectiveness of the treatment they're providing.

• Talk to people at your clinic — the doctor may be too busy for an in-depth chat but what about your nurses, pharmacist or physiotherapist? Other patients can be helpful too. They may not be experts in the disease (though some will probably think they are) but they know about living with it and can provide a surprising amount of comfort and support.
• Read — books are the best way to build up a picture of your disease as you can read them at your own pace, whenever and wherever you want, and return to them as often as you like. Make sure you get a book aimed at patients rather than at doctors, and check that the author can actually write well — not all doctors can. For this reason you might be better off choosing books by health journalists. Check the publication date and the dates of the research quoted: general books won't date too much, but if a book offers more detail on a particular subject you'll want it to be as up-to-date as possible. Read newspapers and magazines too, but be critical. News, by definition, tends to be about extremes, so health stories are often about crises, rare or unusual medical experiences, or research breakthroughs. Sometimes quite everyday stuff can be overplayed by the media, and even in the case of a genuine breakthrough it will take several years for the research to have any impact on patient care.
• Talk to specialist organisations — there are hundreds of charities and voluntary organisations dealing with particular health problems, and there may well be one for you. They provide specialist information and the chance to talk to experts and other people who have experienced the disease. They may run self-help groups or offer counselling and advice. Organisations are listed in the Voluntary Agencies Directory (NCVO publications). Click here for links to over 600 voluntary agency websites.
• Talk to complementary therapists — see "How to explore complementary therapies".
• Use the Internet, but use it with care — the trouble with a posting to the Internet is that you don't know if it's by a qualified expert or the bloke down the road. Joe Smith may be his country's most respected writer on the subject or he may be someone who was diagnosed yesterday. Dr Joanna Brown may have a Nobel prize for research into your disease, or her doctorate may be in pig breeding. Try to visit sites that you can trust, such as those recommended by health professionals, other quality sites such as this one(!) or those hosted by respected organisations. This is a better approach than just typing the name of your disease into a search engine. Join lists and discussion groups only when you're beginning to understand your illness and what it means. The day after a diagnosis you don't want your e-mail box filled up with obituaries for people who have just died of the disease or tales of some poor soul's gruesome surgery.
  

How to explore complementary therapies

The term complementary therapy covers a broad range of treatments. Some, such as chiropractic, acupuncture and osteopathy, are now generally accepted by the medical establishment; others, such as homeopathy and aromatherapy, they are very sceptical about. Could complementary therapy help you? Here are some things to think about:

• Complementary therapies work in a different ways. Some offer potions or pills, some involve the manipulation or massage of the body, others call for new skills to be learned or different lifestyles to be adopted. Some claim to work by faith alone. But they all put you and your views at the centre of the process, and this alone can be a big boost.
• Sometimes a therapy might claim to cure a disease, but more often they ease symptoms or simply make you feel better in yourself. The one thing all approaches have in common is that someone, somewhere, thinks they work.
• When research shows that people benefit from complementary therapies, some doctors dismiss it as all in the patient's mind, or the placebo effect. They might be right, but why should you care? Most people just want to feel better. Leave the scientists to worry about the how and the why. The placebo effect only emphasises the importance of your mental attitude in health and healing.
• The best way to find a therapist is through recommendation, preferably from your doctor or other health professional whom you respect. But you can also ask fellow patients or friends, check out local health and leisure centres, or look at notice-boards in doctors, pharmacists or health-food shops.
• Check out your therapist — however highly recommended they come, you need to be sure that they are right for you. There's not much regulation of the health claims people can make, so be sceptical. Fortunately, many complementary therapies have regulatory bodies who should be able to provide a list of registered practitioners in your area. But check what inclusion on the list means: does it indicate particular qualifications or experience, or only that a membership fee has been paid?
• Beware of any therapist approaching you and offering an instant cure — as rule of thumb, the more a therapist promises the less they're likely to deliver.
• Quiz your therapist before committing to them: What exactly do they do? How long have they been doing it? How did they start? What training have they had? Where? For how long? What professional bodies do they belong to? How long will each session take? How long will the whole programme take? What sort of benefits might you expect to see, and when? How much will it cost? A key question is: are they are insured? Few insurers will insure unqualified practitioners. No decent therapist will mind the questioning. Theirs is a person-centred approach, so it will be important to them that you feel comfortable.
• Check you can afford it — starting a programme that is too expensive will create more problems than it solves. Discuss costs with your GP. The range of therapies to which a doctor can refer patient is increasing all the time. Some voluntary organisations may be able to help. There may be sessions at a local authority leisure centre or other council facility.
• Don't do it if you don't like it. If you don't like the treatment, the therapist or the way they explain themselves — some of the theories are very hard to believe — then quit. No decent therapist will object, so don't be bullied into staying. On the other hand, don't give up if results aren't immediate. Discuss your concerns with the therapist.
• Get into it. To benefit from complementary therapy you need to be both open-minded and self-centred. You need to let yourself go without giving up responsibility for your health to someone else.
• Practising any form of complementary therapy will get you thinking about yourself, your lifestyle and your disease, and this is always beneficial. So unless the therapy itself is harmful — and some are in some cases, which is why you should discuss them with your doctor first — the pros will often outweigh the cons.
  

How to get the practical and emotional support you need

• You can only get the support you want if you ask for it. Don't expect people, even health professionals, to guess how you are feeling.
• Be realistic about who can do what. Family and friends can provide practical support but it may be harder to speak to them frankly about how you feel as you may not want to worry them or hurt their feelings. Talking to other patients or self-help groups can help here. Ask your health professionals or voluntary organisations working in your disease area. See "How to find out more about your health problem". Patient UK also have a database of health and illness websites.
• Explore help provided by your health authority (through district nurses), local authority (through social services) and central government (through the benefits system). If you are unable to work you may well be entitled to some sort of payment. For information on benefits, click the category applicable to you on the Department of Social Security web site.
  

How to make the best possible recovery

You won't go far wrong, if you follow all the above advice. But also:

• Don't try to do too much too soon. Once you're on the mend, it's easy to assume everything is back to normal. It isn't. Recovery is gradual not instant. Don't go back to work too early after flu, don't play sport too soon after a break, don't expect to have your strength back as soon as your cancer is in remission. Through impatience you could be creating false dawns for yourself and it's very depressing when you relapse.
• Let it go. If you've accepted your condition, your disease will have become a part of your life. Once you recover it will become a much smaller part, and that transition can be difficult. One minute the doctors are worried about you and the nurses are caring for you; the next they hardly notice when you arrive for a check-up. This can be especially tough if you have been in hospital for a while. But life's a journey. You need to move on to the next challenge. This is why many patients seek counselling at the end of an illness.
  

How to live with a chronic health problem

Not all health problems are going to go away. Some chronic (or long-term) conditions such as asthma and allergies are on the increase. If you get one, don't fight against it. "Why me?" is a natural initial reaction, but if you keep feeling like this you're not going to be happy. So why hold on to an emotion that's making you unhappy?

Read "What to do when you're ill" and incorporate the advice into your life. Accept your condition and adapt the way you operate to accommodate it. Thousands of people are doing it every day of their lives. In the summer of 2000, rower Steve Redgrave represented Great Britain at his fifth Olympic games — the same number of times a day he injects himself with insulin for his diabetes.

How to live with disability

Some people consider disability to be the worst thing that can happen to a man. Nobody would pretend it's easy. All the advice on acceptance in "What to do when you're ill" and "How to live with a chronic health problem" applies, but it's much tougher to take. It could be the biggest challenge of your life, but, as with all big challenges, the feeling when you come out the other side is priceless. Some disabled people will tell you that their disability is one of the best things that has happened to them, that they have developed as people and understand themselves and others better. Even those who don't feel so strongly will say it has made them stronger.

If you become disabled, talk to other disabled people. Don't be like the alcoholic in denial, and pretend you are not like them because their disability is slightly "worse" than yours. Contact patients organisations, self-help groups and local organisations of disabled people (your local authority social services department should be able to point you in the right direction).

Disability is a perfectly normal thing. Ultimately, we are all only temporarily able-bodied. At sometime in the future, whether through age, illness or accident, we will all become more or less disabled.

• Meet Mark for more on life as a disabled man
  

How to live with a terminal disease

The toughest call of all. Shock, anger, sadness and guilt are all common and perfectly normal reactions to being told you are going to die. Fear of the unknown is natural, and nothing is as unknown as death. The advice often given is that whatever you feel you must talk about those feelings — it may make them less unbearable. Talk to people who are used to dealing with death, such as hospital support teams or hospice workers. If you want to know what your death might be like, ask your health professionals.

Think about what you really want to do with your time. Some people like to tie up what they see as loose ends — say things that have not been said or see people they haven't seen for a long time. Others prefer to immerse themselves in the present. Some people become reflective, others busier than ever. There's no right way. And you certainly don't have to be brave. But being open will probably help those around you.

There's a useful introduction to this difficult subject on the BBC website at www.bbc.co.uk/health/death_transcript.shtml, and there's an American website for people with terminal illness at www.death-dying.com/terminalillness.

Jim Pollard

More real people talking about living with dying on Dipex

Have your say about ill health

How good are you at coping with ill-health? Do you find it hard to go to the doctor? Do you hate asking for help? Or have you learnt how to come to terms with illness and to take better care of yourself? Tell us your tips, problems and thoughts about coping with ill-health and we'll post them here. Please note, we cannot answer any queries posted here.