The recipe for each child - and person - is different

 

 

While we may share the same basic anatomical features, there are a huge amount of variations, as a glance around any group of people will confirm. But what about the variations which are less obvious? 

 

Our individual personalities, outlook on life, skills, IQ and traits. How our own particular body functions. The effects life, together with our own particular history and experiences, has on us. As one Client put it, there are so many possible permutations that the maths becomes almost surreal and, probably, impossible! 

 

And, we know what you’re thinking, where on earth are we going with this? 

 

Well, despite the incredible amount of diversity of life on every front, the trend these days is to try to pigeon hole people – and experiences – into increasingly narrow “acceptable” ranges. What is acceptable – and so deemed “normal” (!) – and what is not. 

 

Standardisation and conformity have become the name of the game, with individuals – and their own particular idiosyncrasies – being increasingly side lined. 

 

Sadly, nowhere is this more apparent than the modern approach to medicine, which is driven by a complex set of standard criteria against which each person is measured. Blood pressure, cholesterol, weight – or BMI, Body Mass Index – eye sight, hearing, etc, etc, etc. The list goes on and on… 

 

However, this drive for conformity ignores the most basic fact. That we’re all different. Not only that, but the reasons why we’re different are equally varied too (!). And, just to make matters even more complicated, the reasons can also vary with time. More about this in a minute. 

 

While it’s true to say that many people will come within the range of “normal” – acceptable – figures for a particular criteria, many won’t. Or don’t at the time that particular test is done. After all, don’t forget that any test is only a snapshot of what was happening at the time it was done. It doesn’t automatically mean that this is always the case for that particular person. 

 

Then, even if they do meet that particular criteria, they’re unlikely to meet every single one. This has led to us likening these criteria to the search for a “mythical person”. As in we’ve never met one and are unlikely ever to do so! 

 

So, what does this mean in practice? 

 

Well, sadly, the increasing drive for standardisation all too often leads to a knee jerk reaction. Any deviation from the perceived “norm” – whether above or below – is used to make a rapid diagnosis. In other words, to put a label on the perceived problem, deficiency or excess. This is then followed just as quickly by the implementation of the standard protocol for whatever it is, usually in the form of medication and / or other interventions. Which is where the problems really begin… 

 

So, are we saying there’s no value in having standard guidelines, protocols and treatments? No, of course not. However, they should only ever be treated as guidelines, a starting point, rather than being written in stone. Only triggering a rapid and standard response in an emergency situation. 

 

Just as we’re all different, so are the reasons why we may deviate from the “norm.” And this is where the waters can start to get very murky and confusing. However, there is a very simple antidote, although it’s often seen as rather old fashioned. It’s about getting to know your Client, ideally over a period of time. Which means spending time with them and, most importantly, talking to them and actually listening to their replies! 

 

Yes, we know there are always time pressures during an appointment, but a few pertinent questions usually quickly clarify matters. Whether the test result is simply showing what’s “normal” for that particular Client – even if it’s outside the “norm” – or not. And, if so, whether action is really necessary or it’s simply a case of seeing what happens over a period of time. In other words, “watching and waiting”. If this sounds like a good old fashioned common sense, it is, although this seems to be in rather short supply these days… 

 

To illustrate what we’re talking about, let’s take a simple example and an issue which comes up regularly with Clients. High – or elevated – blood pressure. 

 

As a rule of thumb, normal blood pressure is said to be 120 / 80. While it’s well known that blood pressure changes with age, tending to increase as we get older – although not always so (!) – it also varies quite naturally during the day. However, there are many other factors – some well known, others less so – which can affect it. 

 

To start with, it’s well known – and you may have experienced it yourself – that simply suggesting having your blood pressure is checked is enough to send it rocketing. It’s even been given a term of its own, “White Coat Syndrome”. This is why it should always be taken at least twice, with time left in between the two readings for the person to relax, so giving a more accurate reading. 

 

Results can also vary depending on any other medical issues the person may have at that point in time. A short term illness – an Acute – such as a Cold of Flu. Or a longer term one – Chronic – such as Heart Disease, Diabetes, Obesity or hormonal issues. 

 

And this is without anything else going on in their lives, let alone their busy heads… Just to complicate matters further, people can respond very differently to potential triggers. Not only temperament and personality wise, but from many other things too. One person’s blood pressure may instantly rise in response to a particular event, while another’s may not. Perhaps seeming to have no reaction at all. Or not showing any response for days, weeks, months or even years afterwards. Then there’s the “straw that broke the camel’s back” scenario, where someone seems to cope quite well with a whole series of events until something seemingly minor tips them over the edge. 

 

With this huge range of potential triggers and underlying causes, it’s obvious that relying solely on the results of one test results to make a diagnosis is fraught with danger. It’s also illustrates why it’s so important to talk to people to put the results into context and provide a broader perspective. Their medical history and any ongoing – or new – health issues. Asking what’s going on in their lives at the moment, what may have changed and whether there have been any changes or stressful events in the last few months. Joining the dots together, even if it’s over a longer period of time than would usually be expected. 

 

Perhaps, repeating the tests a few weeks later, to help build up a better picture of that particular person and what’s “normal” for them. Suggest things they can do at home to help themselves, so making them feel more in control of their own health. 

 

Yes, we appreciate this involves a little more work – on both sides (!) – and may take a little longer to reach a more definite conclusion. However, it’s more likely to lead to a more accurate result and better health care for the person concerned in the longer term. Which, at the end of the day, is what it’s all about. Just as important, it helps reduce the likelihood of a misdiagnosis and all the problems this causes further down the line. 

 

Guidelines are just that, guidelines. Any test is only ever about providing information, helping to clarify the picture. Neither are the end in themselves and both are only ever part of the puzzle. The human element, ie, talking to people (!) is what really matters and is essential to provide an accurate assessment of what’s really going on for that particular person. While many may not want to admit it, helping people is as much an art as a science! 

 

And, before we finish for today, if you thought the words of wisdom at the top of the post were familiar, you’d be right! They come from the irrepressible Mma Ramotswe, heroine of the Ladies Number One Detective Agency books written by Alexander McCall Smith. Full of gentle humour and words of wisdom, they are well worth a read for their observations of the vagaries of human life. 

 

As always, the choice is yours.