March 18, 2017 Liza Colimon, MD Honoring Health Vow # 2 I Vow to Stay Connected to My Body to Hear and Feel Everything it has to Say I’m always deeply thinking about ways to connect, inspire, and motivate my patients. This requires recognizing what influences their actions. Over the years I’ve realized I have several categories or types of patients. One of the most hopeful is The Procrastinator. I am hopeful because I know if I show more love, more concern, teach more, there may be room for change… That is, if they are open to the benefits medicine has to offer. One has to value conventional medicine for its gifts and breakthroughs as well as its challenges and imperfections. No doubt seeing Doctors, considering their advice and expertise, and marrying their vision with your own can be challenging. And often when I meet a Procrastinator, it’s my job to figure out what is the cause. My goal is to establish trust, connect and to motivate. I can’t lie. These visits are the most exhausting and time consuming. Helping others identify and overcome their fears has been a life long acquired skill and a continued work in progress. I cannot forget caring for, let’s call her, Hanna. A young woman in her late 30’s challenged and tormented by her family history of breast and ovarian cancer. She decided to pursue genetic testing and found she was in fact positive for BRCA 1. This is a genetic mutation found to drastically increase one’s risk for developing breast and/or ovarian cancer. I spent countless hours counseling her on the recommendation to remove her ovaries once she completed her plans to have children. Approaching her fourth decade of life and with a supportive husband she’d come to my office, and we would spend an hour, always at the end of my office session, going over statics, medical studies, recommendations, and laparoscopic surgery. It was clear one ovary needed to be removed, as it appeared abnormal. However, she wasn’t ready to let go of the other ovary entirely for the obvious reasons. Losing that ovary would mean no more children to be had in the natural manner. Losing the ovary to her meant losing a part of her womanhood. Losing her ovary meant surgical menopause. She had countless understandable fears. But the focus was never on the piece of mind she would gain. I would try to remind her why she had the genetic testing in the first place. I’d remind her we have hormones to help replace those produced by her ovaries. I would encourage her the recovery of laparoscopic surgery is swift and complications rare. I would empower her, recalling that it was her decision to get the testing in the first place to ensure she’d be present for the life of her current child. I reminded her the fear of the unknown is now known, with a positive BRCA 1 mutation, and decisions must be made. After rescheduling her procedure at least 3-4 times and ultimately agreeing to remove the one ovary, she decided to keep the other to give her a little more time to decide on whether or not she wanted one more child. However, everything in her life was telling her otherwise; another child did not make sense. She had given me a number of reasons why, but yet the fear of not having the option solidified her decision. I respected her wishes, as I must. I saw her two weeks after her surgery and the first question she asked when she learned she did not have cancer was “So, when are we taking out the other ovary?” After months of trying to convince her, the surgery was over. And I believe with the surgery, some of her fears were released. I told her she needed her ovary out as soon as possible, as I always had. She waited. She presented less than 11 months later in pain, with a large mass and ovarian cancer. Usually there are a many of reasons why individuals procrastinate seeing their doctor, doing necessary tests, and making their health a priority. But often times the root cause is fear. Fear is a paralyzing force. People commonly fear: Hospitals or office settings Medical tests or procedures they have heard about or ones they have experienced The diagnosis one has worked up in their mind or fear of an illness or chronic condition Your Mom, sister or best friend’s chronic disease or cancer will one day be your own The appearance of lack of control (when in fact you are in control) If you fear your Doctor, that’s simple, find one who makes you feel comfortable. Probably the best life changing advice I received was during a four-day silent retreat… a yogi and spiritual seeker told us a brilliant account of his life filled with wealth, poverty, love, loss, faithful decision-making, divorce and death of a spouse. The take home message was make decisions out of love and not fear. Once I attended that retreat, my entire world opened up considering those eloquent 8 words…. Make decisions out of love and not fear. I began to find those same words in so many teachings. Let your inner voice guide you to what you know is right. But make sure that voice is speaking from a good place. A place of love and not fear. Put yourself first. Love yourself and make the necessary steps to live the healthy life you envision. Love yourself enough to envision a healthy life in the first place. And remember, you are in control.