Chronic disease. Whose responsibility is the treatment?
Like most of our country's residents, you probably believe that because you paid your health contributions, it is solely the doctors' job (duty) to heal you. You think it's enough to take a pill or two and have nothing to do but sit in an armchair and wait to recover. You don't give up unhealthy eating, you don't change your sedentary lifestyle, and you certainly won't give up your harmful habits. Yet you wonder why you don't feel better from the pills!?
It's time to learn that the majority of chronic diseases are caused by your lifestyle! You can't blame others for their development, and you must take part in their treatment. In treating chronic diseases the doctor's role is to provide a treatment plan. Its execution, however, depends almost entirely on you!
A chronic (also called persistent or long-term) disease means an illness that lasts for years, even decades. The disease has a slow course and its symptoms are less intense. Sometimes, after long months or even years of quiet periods, the characteristic symptoms flare up again. The condition changes, sometimes worsening, sometimes improving.
It usually does not pose an immediate threat to life, but its symptoms make your life difficult and reduce your quality of life.
Why does a chronic disease develop?
A chronic disease can be the consequence of an acute illness. For example, you overuse your hand and develop tennis elbow. If you don't rest it and don't treat it, the inflammation may persist. In acute illness, eliminating and treating the triggering cause as soon as possible ensures that the condition does not become chronic.
Other times the disease develops slowly over years. For instance, the consequences of regular smoking often appear only decades after the first cigarette. By then enough of your lungs have been destroyed to cause symptoms. If you already have complaints, your lungs have usually suffered irreversible damage.
Overweight is similarly insidious. It gradually overloads the joints and leads to pain, inflammation, cartilage wear, and eventually loss of mobility.
The connection between disease and diet is also well known. The more carbohydrates you eat, the more likely you are to develop joint inflammations and tumors. Excessive meat consumption (the average Hungarian eats several times more than what is normal) can lead to intestinal cancer.
Atherosclerosis caused by a faulty diet does not develop overnight either. It slowly creates arterial narrowing in the limbs, kidneys, heart, or brain over many years. The end results are heart attack, stroke, kidney failure, or dementia.
Look for the cause of chronic disease in your lifestyle!
About 80% of chronic diseases are attributable to lifestyle, lack of exercise, poor diet, and harmful habits. Even diseases like cancer occur more often in those who, in addition to genetic susceptibility, increase the risk through their lifestyle. Of course, there are always exceptions.
The cascade of consequences
Lifestyle mistakes lead slowly, over years, to progressively worsening consequences.
If, for example, you exercise little, your muscles gradually lose strength. Weak muscles cannot support your spine, your vertebrae compress against each other, flatten the discs, which then press on the nerves exiting the spine. Back pain makes you move even less. Despite the abundance of painkillers, your complaints only get worse.
If you consume slightly more calories than you burn, your body stores the excess as fat. Obesity usually develops slowly, with your weight increasing by just 1–2 kg per year. The burden on your joints increases, your heart must supply blood to a larger body, your breathing must take in more oxygen, etc. Because of the resulting complaints you move even less, and weight gain accelerates over time.
Certain substances that accumulate in your blood are deposited on the walls of blood vessels and slowly narrow them. Later, symptoms may appear in the arteries of the limbs (peripheral artery disease), in the heart (heart attack), in the brain (stroke), or as simple decline and dementia.
The vicious circle
If joint pain begins because of your excess weight, the most effective treatment would be exercise and losing the extra kilos. However, training with overweight—especially if started suddenly—increases the strain on joints, circulation, and breathing. Increasing joint pain prevents you from moving, and your weight continues to rise. You may become depressed and try to 'relieve' it by eating.
This is the vicious circle in which unfavorable effects reinforce each other and create an increasingly worse situation. Breaking out of this circle by your own strength is difficult or may be impossible.
Treatment of chronic diseases
In most chronic diseases the drugs used do not aim to eliminate the cause of the disease but to 'remove' the symptoms.
For most chronic diseases, you can expect greater improvement from changing your lifestyle than from medications.
For example, with weight loss your blood pressure decreases, there is less strain on your heart and joints, and your diabetes eases.
Regular exercise strengthens your muscles, reduces neck, back, and spinal pain, and mitigates circulatory problems. This is also a 'circle', but here the favorable effects reinforce each other.
It is not the doctor's task to treat the chronic patient!
“Medicus curat – natura sanat” (meaning: the physician treats — nature heals) is the old saying I was taught as one of the first lessons at medical school. From Hippocrates, the father of medicine, I learned another: “If you do not change your lifestyle, you cannot be helped!”
In chronic disease the doctor's advice, guidance, and supervision are important. You may also receive (symptomatic) medication from them. But maintaining and especially improving your condition depends mainly on whether you follow and carry out their recommendations.
I already mentioned that the cause of most chronic diseases is to be found in lifestyle. The logical conclusion is that the doctor cannot change it—only YOU can!
Most medications do not aim to 'eliminate' the cause of the disease; they try to suppress your symptoms. Blood pressure-lowering drugs reduce the pressure, a painkiller can remove pain for a few hours, and steroids "mask" the symptoms of inflammation.
However, turning off the pain with medication for a time does not solve the underlying cause, such as excess weight or inflammation. If you do not eliminate the cause, the pain will return again and again.
You cannot take drugs indefinitely either; after a while you must reckon with side effects for each one. Just read the patient information leaflet in the box. The list of possible side effects is almost always much longer than the expected beneficial effects.
This does not mean you should not take medicine! It means that you cannot expect substantial improvement of your chronic disease from medications alone.
You must take action! You need to reduce the calories you consume, change the composition of your diet, give up harmful habits, and incorporate exercise into your daily routine.
What would be the optimal measures in your case? Rely on the advice of your doctor and physiotherapist.
However, neither the doctor nor the physiotherapist, nor anyone else can do it for you! Your life and your illness are in your own hands!
