摘录

Excerpt Foreword: Welcome to the Harvard Medical School Family Health Guide I am proud to introduce you to the Harvard Medical School Family Health Guide. For more than 200 years, the Harvard Medical School has provided state-of-the-art health care to millions of people from New England and all over the world. First and foremost, the 7,000 doctors on the faculty take care of patients. Harvard Medical School faculty staff some of the world's most distinguished hospitals and health care systems. We teach our patients how to stay healthy. And every day we are there to care for them when medical problems develop, whether they have a bad cold or need emergency surgery. We also teach the next generation of doctors and conduct the largest medical research program in the world. At Harvard Medical School: Anesthesia was discovered. Can you imagine having to undergo major surgery without anesthesia? The virus that causes polio was discovered, leading to the development of the polio vaccine. If you are over 50, you will remember what it was like to live with the fear that you might be the next victim of polio and paralyzed for the rest of your life. The cure for pernicious anemia was discovered. The transplantation of organs was first performed. The use of the artificial kidney was pioneered. The field of brain surgery was started. Harvard Medical School today is home to the largest and longest ongoing study of women's health -- the famous Nurses' Health Study -- and three of the largest and longest studies of men's health. We are very proud of what we have done to help people lead longer and healthier lives. We also make house calls, all over the world. For more than 20 years, Harvard Medical School has been publishing health information for the public in our newsletters. Now we are publishing books. The members of the faculty who edited this book care for patients every day. We know that people are faced with many confusing choices and with more health information than ever before. We also know that the face-to-face time you have with your doctor can be limited. This book gives you the latest information -- what you need to know to keep yourself healthy and to cope with illness. It also provides you with the information you need to navigate the sometimes confusing and frustrating world of managed care. To deal with the world of medicine, you need information that is clear, accurate, easily understandable, and accessible. This book provides that information, sometimes presented in special features, many of which cannot be found in other books. These features include: Symptom charts What do you do when you develop a particular symptom, such as sudden pain in your abdomen? Is there a home remedy, valid alternative medicine treatment, or over-the-counter medicine you can get at the drugstore? When do you need to contact the doctor? Along with several other colleagues, about 30 years ago I first developed the idea of outlining medical logic in the form of symptom charts. When you or a member of your family has a new symptom, the logically organized charts in this book will help you determine how you may be able to care for yourself, and when you need to contact the doctor. Advice for when you visit your doctor Today, more than ever, you need to know what questions to ask your doctor. And you need to know what your doctor should be doing for you. You should be getting the best medical care. For many common illnesses, we provide information about what should happen when you visit your doctor -- what issues you should discuss and what kind of a physical examination and laboratory tests your doctor should perform regularly. Think about and write down questions to discuss with your doctor before your visit. Knowing what to expect when you see your doctor can also help you judge how thorough your care has been. For an example of the kinds of questions to ask, see p.899. Advice on understanding medicines Your doctor may be too busy to fully explain all about your medicine, its benefits, and its possible side effects. In the chapter Medicines, we describe the major types of medicines that doctors prescribe today, and what they are used for. Advice on drug-drug interactions The Medicines chapter also has an extensive chart of possible adverse reactions between different drugs. If you are taking more than one medication, you need to know if there might be a dangerous interaction between them. Home remedies You don't always need a doctor. In this book, we offer home remedies that can give you relief from common cold symptoms. For an example of home remedies for the common cold, see p.461. Alternative medicine treatments A variety of alternative medicine treatments are being seriously studied at Harvard Medical School and elsewhere, and a number have been found to be beneficial. We present them in this book. Conventional medicine has been too slow to study alternative medicine treatments, some of which have won the confidence of healers and patients for thousands of years; it is wrong to reject them out of hand. Alternative medicine treatments, like new conventional treatments, need to be studied scientifically to determine their benefits and risks. For an example of an alternative treatment for chronic low back pain, see p.620. Understanding diagnostic tests Modern medicine uses many diagnostic tests. In the section called Diagnostic Tests, we describe what these tests are and what they are used for. In the Guide to Imaging, we show you the most sophisticated tests available. Take a look at the remarkable imaging procedures on p.135 that produce pictures of the inside of your body without causing you pain. We also describe many other tests performed in your doctor's office or that can be performed by you at home. Benefit and risk-assessment graphs There is so much health information available and, often, more than one treatment for a problem. How do you choose among them? We provide information about the benefits and risks of various diagnostic tests and treatments, and the benefits of adapting certain lifestyle changes designed to preserve your health. This numerical information is provided in easy-to-grasp graphs. An example, showing the benefits and risks of blood-thinning treatment, can be found on p.348. Advice from Harvard doctors Some of the best doctors on the Harvard Medical School faculty have provided personal words of advice based on their experience -- the advice they give their own patients. For example, take a look at Dr Brazelton's advice on the developmental touchpoints in your young child, Dr Lipson's advice on back surgery, Dr Samuels' advice on preventing strokes, Dr Benson's advice on the relaxation response, and Dr Ferber's advice on helping your young child learn healthy sleep habits. First-person stories We present the personal statements of people who have suffered from an illness, and sometimes how they have coped with it. For example, author John Updike describes what it is like to live with psoriasis, the actress Patty Duke describes her experience with bipolar disorder, and an anonymous person -- perhaps someone like you -- talks about living with gout. Advice on understanding how your body works Other books describe how your body is built. We show you how your body works -- in colorful art that clearly depicts how you see, hear, move, digest food, circulate blood, and so forth. To better understand what can go wrong with your body, it is important to understand how your body works when it is healthy. Advice on finding health care resources In the Appendix, we provide the names, addresses, phone numbers, and (when available) Internet addresses of the agencies and organizations that can help you with many different problems, particularly community support services. Glossary A glossary defining various medical terms is found on p.1220. On-line updates As a purchaser of this book, you will have access to a special Harvard Medical School site on the World Wide Web that will provide you with updated information. The Web site address appears at the bottom of the Index pages. The Web site contains: New information since the book was published that the editors think is important Additional color pictures beyond what could be included in the book Interactive features that are not possible in a printed version of any book Listing of the Harvard Medical School Newsletters, including sample content from recent issues and the ability to order the newsletters on-line This material will remain on the Web site until the publication of the book's second edition. At that time, a new Web site providing updated information to the second edition will be created. Advice on dealing with the health care system Dealing with the health care system can be a pain in the neck. The many different kinds of health insurance policies and managed care programs can be very confusing. Also, doctors are under increased pressure to see more patients -- which means they have less time to spend with you. Throughout this book, we provide information that will enable you to be your own advocate in obtaining the best health care. In Navigating the Health Care System, we specifically discuss managed care, health insurance, ways to get information about the quality of care in various health care systems, and the quality of care by doctors. Having this book on a shelf in your home can help you stay healthy, cope with illness, and deal with the health care system, particularly the world of managed care. My colleagues and I have spent literally thousands of hours putting this book together. I have personally written or edited every word and the captions for every drawing or picture. For some of us, you might even call this book an obsession. Just ask my wife. We wanted to give you the clearest, most current, and most complete information possible -- information you can use today, when you or a loved one is faced with a frightening symptom, a new diagnosis, or a recommendation to have a test or a treatment that may have risks as well as benefits. With this book, the other books that will follow, and our newsletters, we think we have done that; we hope that you agree. Acknowledgments Harvard Medical School More than 165 members of the Harvard Medical School faculty participated in the writing and editing of this book. I am enormously grateful to the associate editors who pulled together many of the book's chapters, as well as to the many contributing editors who gave generously of their time, experience, and wisdom. My special thanks go to deans Daniel Tosteson, MD, and Joseph Martin, MD, PhD; executive deans David Bray and Paul Levy, and colleagues dean Daniel Moriarty, Elizabeth Allison, PhD, Robert Donin, and Cynthia Glott, without whom the Harvard Health Publications program would not have become a reality. I must also thank my wife, Lydia Villa-Komaroff, and my colleagues at Harvard Medical School who, through observing my occasional absences from the normal activities of life, came to appreciate how editing a book of this size and complexity can become all-consuming. Thank you for your patience. Simon & Schuster It was a great pleasure to work directly with Simon & Schuster and the Stonesong Press as the book was taking shape. I am especially grateful to Roslyn Siegel and William Rosen at Simon & Schuster for their ongoing support and superb editorial advice; to Paul Fargis, Ellen Scordato, Martin Lubin, and their colleagues at The Stonesong Press and Martin Lubin Graphic Design for their great skill in producing a beautiful-looking book; and to Robin Husayko for her remarkably careful and thoughtful copy-editing. Finally, my eternal gratitude to editorial director Heidi Hough of Heidi Hough & Associates Inc, who worked tirelessly and skillfully to organize this enormous project, and to make sure that everything in it was clear and comprehensible. We couldn't have created this book without the help and involvement of everyone, especially Heidi Hough. Anthony L. Komaroff, MD Editor in Chief Professor of Medicine, Harvard Medical School Editor in Chief, Harvard Health Publications Boston, Massachusetts September 1999 Copyright (c) 1999 Anthony L. Komaroff. All rights reserved.