a hardware store, is driving and plans to travel overseas with his friends.

“It’s all because we used the internet,” says Julie.“Without it, the chances are we may never have knownabout the benefits of DBS, nor would we have found Dr Stell. There’s no doubt it changed my son’s life.”

DIAGNOSTIC DILEMMAS

The Wilmots are part of a burgeoning new trend. Anincreasing number of us are playing doctor, using the

internet to look up symptoms and diagnose medical conditions, order self-diagnostic kits and medical equip-

ment, and even treat ourselves with medications or herbalremedies we purchase online.

Some of us are deliberately avoiding doctors because of the cost and time involved, or because we’re afraid of what we might find out. Others are too embarrassed to talkabout our health problems, preferring not to discuss suchsensitive topics as our weight, diet, alcohol consumptionand other bad habits. Some of us, due to bad experiences inthe past, simply don’t trust our GP, or feel we can put moretime and effort into researching our conditions than any

57HEALTHSMART Autumn 200756 57HEALTHSMART Autumn 200756

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IT WAS 2PM ON A SUNNY AFTERNOON in February 2005when Julie Wilmot logged onto yet another medicalwebsite. Somewhere out there in cyberspace, shereasoned, there must be the answer she was lookingfor. The 41-year-old nurse was desperate to find acure for her son, Luke, who had been diagnosed

with a rare neurological disorder called dystonia when hewas six.The disorder causes involuntary muscle spasms andstiffening of the body and, in Luke’s case, had become sochronic that he was now confined to a wheelchair.

Julie had consulted specialist after specialist in her hometown of Perth, and all had said the same thing: Luke, now17, would never walk again. But Julie and her husband Ian,a teacher, refused to accept the prognosis. Together they

began scouring the internet in the hope that – somewhere,somehow – they would stumble upon a cure.

Finally, Julie caught a lucky break. She clicked onto theDystonia Medical Research Foundation website and cameacross an Australian neurologist, Dr Rick Stell, who spe-cialises in Deep Brain Stimulation (DBS). It is a surgicaltreatment in which electrodes are placed deep into thebrain, where they deliver electrical impulses to control muscle movement. It had been successfully used to treatdystonia sufferers overseas, but was not widely known inAustralia. Julie knew this was the answer to her prayers.

In May 2005, Luke underwent the six-hour operation at Sir Charles Gairdner Hospital in Perth. Just one month later, he was walking. Today he is working part-time in

DIYDOCTOR

These days, we’re diagnosing and even

treating what ails us ourselves. It’s a hands-on

approach which

A has many advantages, b

B is fraught with danger, c

C can be OK if you know what you’re doing.

Read on to find out which answers apply –

and when BY JOHN KRON

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one professional is able to set aside.Whatever the reason, thefacts remain: playing doctor has many advantages, but it canalso be fraught with danger.

Every year, five million Australians search for health information online. A 2004 survey conducted by ACNielsenfound that 66% of internet users are satisfied with the quality of health information available on the web. What’smore, a HealthSmart poll carried out in April 2006 revealedthat only 5% of internet users think following medicaladvice from the web can be dangerous. That indicates enormous public confidence in web content. Unfortunately,

we may not always be in a good position to judge.Just look up the word “depression” or “osteoarthritis”

and the chances of finding a website that contains safe,reliable, unbiased information are remarkably slim, accordingto research carried out by two Australian universities.A 2002 study conducted by the Australian NationalUniversity (ANU) assessed the quality of 15 Australian medical websites that dealt with depression and found that only half the sites bothered to warn people about the side effects, dangers and contra-indications of anti-depressants. Overall, they rated the quality of the healthinformation on all of the sites as “relatively low”.

When Monash University conducted a similar study inlate 2003 on medical websites that dealtwith osteoarthritis, theydidn’t fare much better:only 29.9% of the sitestested bothered to citeresearch papers to supportthe information that waslisted on their website.Similar online studies con-ducted overseas have alsofound a long list of faultymedical facts about all sortsof health conditions,prompting experts such asProfessor Peter Yellowlees,former director of QueenslandUniversity’s Centre for OnlineHealth, to warn that the internet

is awash with “inaccurate, incomplete and deliberatelybiased health information”.

The biggest problem, he says, is that most people don’t know how to tell a serious website from a shonky one. “Most people rely on a search engine like Google or Yahoo, where the choices offered first tend to be the most popular rather than the most reliable,” Yellowlees says. “And some of these websites can look exceptionallyprofessional – so it’s hard to differentiate between what isauthoritative and what’s not.” (For tips on finding a reliablemedical website, see box overleaf.)

However, he is quick to point out that when you stick to credible medical sites, the internet can be a valuablehealth resource: “I encourage all of my patients to go to specific websites that I know are helpful, so they can receive accurate information and make links with otherswho have the same condition.”

HOME-TESTING HYPEThink you might have diabetes? Curious about your cholesterol levels? Worried you might be going throughmenopause? Not that long ago, you could find out only by visiting a doctor, but these days you can test yourself at home thanks to a wide range of medical test kits that can be bought online, at chemists and even in supermarkets, for as little as $15. So, in addition to testing for pregnancy, you can now screen for bowel cancer and glaucoma (through the US website keepyoursight.com) and even check to see if you have highblood pressure.

Home diagnostic testing is already booming in Europe,the UK and the USA, and now Australians are embracing the trend, too, spending more than $200 million on kits last year alone.The reason? People are just too busy to go to

the doctor, says Tom Crimmins, managingdirector of Health-One, which marketshome-test kits.

“The irony is that, as we have becomemore knowledgeable about health and

more empowered to take careof our health, we havebecome busier than everbefore and don’t have thetime to do it,” says Crimmins.“People are saying, ‘Just giveme a simple test that I can dowhen and where I like.’ ”

That was certainly howJenny Howard of Warradale in South Australia felt whenshe received a home-test kitfor bowel cancer last year.

“I had my gall bladderremoved years ago and I’dheard this was associated withan increased risk of bowelcancer, so it had been at theback of my mind that I shouldget checked,” says the 56-year-old banker. “But I workfull-time and have six grand-children. I’m busier now thanI’ve ever been. Who’s got thetime or inclination to have a colonoscopy?”

The home-test was quick,easy-to-use, and simply in-volved using a cotton swab towipe over a faecal specimenonce it had been deposited in the toilet bowl. She thenposted the sample to a localpathology lab and waited forthe test results. When they came through, it was bad news:the test revealed some irregularities and Jenny was referredto a specialist.

“They found a cancerous growth,” she says. “But I waslucky because it was caught in the early stages.” Jenny has no doubt that the convenience of the home-test savedher life. “Now I’ve told all my family and friends to do the test, too.”

Experts are keen to caution that not all home-tests arereliable. Some kits that are freely available on the internet –including one that claims to be able to detect HIV – do nothave TGA (Therapeutic Goods Administration) approval.(To avoid buying a non-approved test, first check to see if itis listed on the Australian Register of Therapeutic Goodsdatabase at www.tgasime.health.gov.au.)

Another problem is that, without consulting a doctor,it’s easy to get overly distressed or confused if the test turnsup positive. A positive result doesn’t always indicate a serious health problem, but can simply mean you need to

Available inAustralia:bowel cancer cholesteroldiabetespregnancymenopauseovulation

Availableoverseas: anaemiabladder cancerchlamydiagonorrhoeahepatitis Bhepatitis CHIVkidney diseasemalaria male infertilityosteoporosisprostate cancerstomach ulcerstress levelssyphilisthyroid problemsurinary tract

infection

+ Local doctorswarn againstpurchasing testsfrom overseas,where qualitycontrol andinstructions may not matchAustralianstandards.

Google on the term “health” and the search engine will return about940 million results. Narrow yourquery to “symptoms” and you’redown to slightly over 96 million web pages at your fingertips

WHY WE USE THE WEB

In April 2006, HealthSmart polled 1006

Australians and found that:

58% surf the net for general health information

42% research professionally diagnosed conditions

32% keep abreast of medical news

29% research fitness and nutrition issues

21% shop for medicines or supplements

15% diagnose or treat themselves

7% join support groups or chat rooms

TESTINGTIMES DIY medical testsare now bigbusiness. Here’s a sample of whatyou can test for at home.

investigate the matter further. Nor isthere any way of knowing if you’veeven carried out the test correctly,says Dr Carolyn Block, a GP inDouble Bay in Sydney. In particular,she says, she’s noticed a problemwith home medical equipment, suchas blood pressure monitors.

“A 60-year-old woman came tosee me recently convinced she had a brain tumour,” says Block.

The woman was feeling light-headed and had been suffering dizzyspells, and said she was generallyfeeling unwell. As it turned out, shehad recently bought a blood pressuremonitoring device to use at home.

She had tested herself the weekbefore and had been shocked to

record an abnormally high blood pressure reading.“Almost certainly she was anxious, or had been rushing

around, which raised her blood pressure temporarily,”explains Block. “What she should have done was take another measurement when she was relaxed, but instead she doubled her dosage of blood-pressure-lowering medication and, as a result, her blood pressure fell belownormal levels. That was what caused her fainting and dizzy spells.”

There’s no denying that home medical tests can and do save lives, but only when they are correctly used. That’swhy experts recommend purchasing such tests from achemist, where you can receive personal instruction beforeusing them, rather than over the internet.

TREATMENT TRAPSThere’s no doubt the most risky part of DIY

doctoring is when patients attempt to treatthemselves, either with prescription

drugs or herbal remedies bought online. Many believe that just because supplements or herbs are “natural” theymust be safe, but according to Dr Tracey Bessell, actingdirector of the Patient Safety and Quality Unit at ACT Health,that’s simply not the case: if a product is effective enough tomake you feel better, it can also produce side effects.

“One of the dangers with self-medicating is that herbs

can interact with conventional medications and, while healthprofessionals are trained to know what these interactionsare, the public often has no idea,” she says.

Three years ago Gayle*, a 51-year-old manager fromGoulburn, NSW, chose not to consult a doctor when she feltunusually tired. Gayle was embarrassed by recent weightgain and wanted to avoid it being raised in a GP consultation.Instead, she looked up her symptoms on the internet andcame to the conclusion she had anaemia.

For the next 18 months, Gayle took iron-enriched vitaminsupplements, increased the amount of red meat in her dietand confidently waited for her ailments to go away. Theydidn’t. In fact, they got worse. She started developing poorsleep patterns, fungal nail infections and poor concentration,and had become depressed.

Finally, Gayle booked an appointment with her GP,Dr Carole Castles, and discovered she had developed typetwo diabetes and also had an inherited disorder calledhaemochromatosis (where the body stores excess iron).Ironically, it is the exact opposite of anaemia.

By misdiagnosing the problem and delaying seeing a professional, Gayle had allowed her diabetes to worsen. Andthe iron tablets and extra red meat probably exacerbated thehaemochromatosis, says Dr Castles. Now, Gayle has to visitthe blood bank to be bled, to get her excessive iron storesunder control.

“The thing to remember (if you are going to take mattersinto your own hands) is to set a realistic time limit, so thatif you don’t improve – or you get worse – then you see a doctor,” says Dr Castles. “In Gayle’s case, I understand why she did it: she’s a bright woman who’s used to workingthings out for herself.” :

*Not her real name.

HEALTHSMART Autumn 200760

Do you intend to take online healthresearch along to your next doctor’sappointment? Then allow extra time. A survey of oncologists found that itextended appointments by ten minutes

FOR SAFE SITES, CLICK HERE

NEXT TIME you’re searching the web for health

information, keep this checklist handy.

1/ Check that the website owner has clearly disclosed

his or her name, and that the site has contact

details. Is he or she a medical professional? If not,

has their perspective been clearly stated? For

example, “I’m a breast cancer survivor,” or “I’ve

had acupuncture every week for the past ten years."

2/ If the site is owned by an organisation, is it a

credible health authority? The web address can

provide clues here. For example, a government

agency has .gov in the address; an educational

institution has .edu; a professional organisation

such as a scientific or research society has .org.

3/ Does the site contain the HONcode seal that shows

approval by the Health on the Net Foundation?

4/ Is the information presented factual or opinion?

If factual, does it provide source material such as

medical journals or links to university websites? If

opinion, does it state the medical qualifications of

the person giving that opinion? Does the site list

advisory board members or consultants?

5/ When talking about treatments, does it provide

information on how they work, the pros and cons,

and any alternatives?

6/ Does the site offer clear instructions about how

the information should be used? Are there

cautions? Does it explain that the information

should never be used as a substitute for visiting

a health professional?

7/ When was the information updated? Health

information changes constantly, so it’s important

to be frequently updated.

8/ And finally, is there any potential for bias? Can

you easily identify any sponsors or commercial

affiliations?

Based on guidelines from the Health on the Net

Foundation, the US Medical Library Association, and

the Australian Department of Health and Ageing.

SELFCHECK