Pearls and perils of cyberchondria

Pearls and perils of cyberchondria

 

Nitin K Sethi, MD

Assistant Professor of Neurology

New York-Presbyterian Hospital

Weill Cornell Medical Center

New York, NY 10065

 

 

Cyberchondria is a relatively new term used at times to describe the behavior of some individuals who use the Internet to gather information about health or a disease which they feel they may have based on their signs and symptoms. The Internet search results leads to an unfounded concern, preoccupation and worry about their health status.

The term is derived from the more commonly used term hypochondria. Hypochondriasis is excessive preoccupation or concern about having a serious often incurable illness.

Nowadays more and more people are turning to the Internet for health and disease related information. In my practice I frequently come across patients who have already “Googled” their diagnosis even before they come to see me. Some even “Google” their MRI results.

Cyberchondria can have its pearls as well as its perils. Let us start with the pearls first. No one doubts the power of the Internet. It has and continues to revolutionize the way medicine is practiced. There is an abundance of information on the Internet about common and even esoteric neurological conditions. All one has to do is type the relevant key words into a popular search engine like Google and low and behold, Dr. Google starts churning out answers-pages and pages of it. The Internet houses many blogs and sites exclusively devoted to a particular condition. Some of these sites are run by reputable organizations like American Academy of Neurology (www.aan.com) and Centers for Disease Control and Prevention (www.cdc.gov). Thus sitting in the comfort of one’s home, useful and credible information can be readily accessed. Is there any new treatment for multiple sclerosis or ALS? If yes, where is it been offered? Where are the best doctors in NYC? Which is the nearest hospital for acute stroke care? Are there any caregiver organizations for neurodegenerative conditions like Alzheimer’s disease? Pretty much whatever you type in, Dr. Google shall have an answer.

But in this pearl itself, are the perils of the Internet. There are ample sites where in the information content is not standardized. These include blogs run by patients themselves, some by care-givers and yet others by pharmaceutical companies or companies which manufacture medical equipment. The abundance of information leads to many falling prey to cyberchondria. Let us take an example. Your doctor gets a MRI scan done because you have headaches. The MRI report reads “non-specific white matter hyperintensities are seen. These have been noted in ischemic, inflammatory and demyelinating conditions like multiple sclerosis. Clinical correlation is advised.” Now you get this report in front of you and of course what do you do? You go to the Internet and page Dr. Google for help. In you type “white matter lesions, headache and multiple sclerosis” Dr. Google hums for a nanosecond and churns out pages and pages which talk about multiple sclerosis, white matter lesions on MRI and at times headache.

THERE THE GROUND HAS BEEN SET FOR CYBERCHONDRIA!!! You are now convinced you have multiple sclerosis and spend another couple of hours in cyberspace getting worried, confused and finally panicky.

It is indeed easy to get cyberchondria. The Internet is a powerful tool. By all means use it to get health and disease related information. It is way easier than going to a library and searching for it there. BUT THE CATCH IS TO USE IT WISELY!!! If rightly used it is a slave working tirelessly on our behalf. Random searches with random key words about signs and symptoms of a disease you feel you have, risk leading to cyberchondria giving you many sleepless nights and needless worry.

Paging Dr. Google

Paging Dr. Google

 

 

Nitin K Sethi, MD

Assistant Professor of Neurology

New York-Presbyterian Hospital

Weill Cornell Medical Center

New York, NY

 

I get quite a few patients who prior to coming to see me for a neurological consultation have already googled their disease or at least the disease they think they have. Many of the readers of my blog too, it seems spend a significant amount of their time searching the internet for information about their medical condition. Paging Dr. Google to come to the rescue can have its pros and cons. Lets start with the pros.

 

 

Dr. Google obviously is well informed, a vast sea of knowledge, thousands and thousands of pages of health related information is available at the click of a mouse. He is quick, rarely moody (unless you have a slow connection) and moreover cheap. One can spend hours with him, for even esoteric neurological conditions he has an answer, he sees patients 24/7 and even does house calls (though a café is at times his favorite de novo office). The internet already has and continues to revolutionize medicine and how health information is disseminated. When I did my internal medicine residency in India in the late 1990’s, the internet was still not available. I remember spending long hours in the National Medical Library in New Delhi pulling up articles I needed to research my thesis. The work was tedious, back breaking (big volumes of dust covered journals to be pulled off the shelves) and painstakingly slow. Even though I was a medical resident, I found it difficult to find relevant articles and information. A lay person had it even tougher. There were a few books available which touched on general medical conditions like how to take care of your diabetes and blood pressure. For anything else, you needed to pay a visit to your neighborhood doctor or to a specialist in a tertiary hospital.

 

Then along came Dr. Google. Smart and tech savvy. A few search words and up pops the answer, pages and pages of it too. For doctors, the internet has being a blessing. We can now share and assess each other’s work so much easily. When confronted with a difficult case, sitting in my office in New York City, with a click of the mouse I can find out if any of my colleagues have seen something similar. How did they treat this vexing neurological problem foxing me, what were their results and is there anything new on the treatment horizon? No more going to the medical library and trying to search through the journals. All the journals are available on the internet and Dr. Google makes my life easier by listing out which article appeared in which journal. In fact recently someone raised a relevant point, are the days of the medical library numbered? For the patient too, Dr. Google is a blessing. There are many good patient oriented websites which come up when Dr. Google is called upon for an opinion. Patients can learn more about their disease and this information gives them confidence and a hence of actively doing something to help themselves. Apart from health and disease related websites, Dr. Google also churns up blogs and various foundations providing much needed information to patients and caregivers alike. But does Dr. Google have any chinks in his armor?

 

Yes, he does. He can be wrong just like any of us mortal doctors. If you feed him the wrong history, he shall make a wrong diagnosis. Patient’s frequently search Dr. Google with key words. If the key words themselves are wrong, the diagnosis shall be flawed from the start. Here in lies Dr. Google’s weakness or rather our weakness. Dr. Google may diagnose you with amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative condition with no cure currently because your history to him included key words like muscle twitches and weakness. It is only after a visit to your mortal neurologist that a correct diagnosis of benign fasciculations is made.

 

So the moral of the story is that Dr. Google is indeed a physician extraordinary but he is no substitute to an actual visit to your physician. You may read about the disease you feel you have but always, always do consult your physician because unlike Dr. Google he has the advantage of sitting down in front of you, taking a thorough history and conducting a clinical examination.  Dr. Google’s services are most helpful when he is paged with the right information in hand.