1. 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 known
about 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. An
increasing 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 herbal
remedies 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 talk
about our health problems, preferring not to discuss such
sensitive topics as our weight, diet, alcohol consumption
and other bad habits. Some of us, due to bad experiences in
the past, simply don’t trust our GP, or feel we can put more
time and effort into researching our conditions than any
57HEALTHSMART Autumn 200756 57HEALTHSMART Autumn 200756
PHOTO:PHOTOLIBRARY
IT WAS 2PM ON A SUNNY AFTERNOON in February 2005
when Julie Wilmot logged onto yet another medical
website. Somewhere out there in cyberspace, she
reasoned, there must be the answer she was looking
for. The 41-year-old nurse was desperate to find a
cure for her son, Luke, who had been diagnosed
with a rare neurological disorder called dystonia when he
was six.The disorder causes involuntary muscle spasms and
stiffening of the body and, in Luke’s case, had become so
chronic that he was now confined to a wheelchair.
Julie had consulted specialist after specialist in her home
town of Perth, and all had said the same thing: Luke, now
17, 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 the
Dystonia Medical Research Foundation website and came
across an Australian neurologist, Dr Rick Stell, who spe-
cialises in Deep Brain Stimulation (DBS). It is a surgical
treatment in which electrodes are placed deep into the
brain, where they deliver electrical impulses to control
muscle movement. It had been successfully used to treat
dystonia sufferers overseas, but was not widely known in
Australia. 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

2. PHOTO:GETTYIMAGES
HEALTHSMART Autumn 200758
PHOTO:PHOTOLIBRARY
one professional is able to set aside.Whatever the reason, the
facts remain: playing doctor has many advantages, but it can
also be fraught with danger.
Every year, five million Australians search for health
information online. A 2004 survey conducted by ACNielsen
found that 66% of internet users are satisfied with the
quality of health information available on the web. What’s
more, a HealthSmart poll carried out in April 2006 revealed
that only 5% of internet users think following medical
advice 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, according
to research carried out by two Australian universities.
A 2002 study conducted by the Australian National
University (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 health
information on all of the sites as “relatively low”.
When Monash University conducted a similar study in
late 2003 on medical websites that dealt
with osteoarthritis, they
didn’t fare much better:
only 29.9% of the sites
tested bothered to cite
research papers to support
the information that was
listed on their website.
Similar online studies con-
ducted overseas have also
found a long list of faulty
medical facts about all sorts
of health conditions,
prompting experts such as
Professor Peter Yellowlees,
former director of Queensland
University’s Centre for Online
Health, to warn that the internet
is awash with “inaccurate, incomplete and deliberately
biased 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 exceptionally
professional – so it’s hard to differentiate between what is
authoritative and what’s not.” (For tips on finding a reliable
medical website, see box overleaf.)
However, he is quick to point out that when you stick
to credible medical sites, the internet can be a valuable
health 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 others
who have the same condition.”
HOME-TESTING HYPE
Think you might have diabetes? Curious about your
cholesterol levels? Worried you might be going through
menopause? 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 high
blood 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, saysTom Crimmins, managing
director of Health-One, which markets
home-test kits.
“The irony is that, as we have become
more knowledgeable about health and
more empowered to take care
of our health, we have
become busier than ever
before and don’t have the
time to do it,” says Crimmins.
“People are saying, ‘Just give
me a simple test that I can do
when and where I like.’ ”
That was certainly how
Jenny Howard of Warradale
in South Australia felt when
she received a home-test kit
for bowel cancer last year.
“I had my gall bladder
removed years ago and I’d
heard this was associated with
an increased risk of bowel
cancer, so it had been at the
back of my mind that I should
get checked,” says the 56-
year-old banker. “But I work
full-time and have six grand-
children. I’m busier now than
I’ve ever been. Who’s got the
time or inclination to have
a colonoscopy?”
The home-test was quick,
easy-to-use, and simply in-
volved using a cotton swab to
wipe over a faecal specimen
once it had been deposited
in the toilet bowl. She then
posted the sample to a local
pathology lab and waited for
the test results.When they came through, it was bad news:
the test revealed some irregularities and Jenny was referred
to a specialist.
“They found a cancerous growth,” she says. “But I was
lucky because it was caught in the early stages.” Jenny
has no doubt that the convenience of the home-test saved
her 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 are
reliable. Some kits that are freely available on the internet –
including one that claims to be able to detect HIV – do not
have TGA (Therapeutic Goods Administration) approval.
(To avoid buying a non-approved test, first check to see if it
is listed on the Australian Register of Therapeutic Goods
database 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 turns
up positive. A positive result doesn’t always indicate a
serious health problem, but can simply mean you need to
Available in
Australia:
bowel cancer
cholesterol
diabetes
pregnancy
menopause
ovulation
Available
overseas:
anaemia
bladder cancer
chlamydia
gonorrhoea
hepatitis B
hepatitis C
HIV
kidney disease
malaria
male infertility
osteoporosis
prostate cancer
stomach ulcer
stress levels
syphilis
thyroid problems
urinary tract
infection
+ Local doctors
warn against
purchasing tests
from overseas,
where quality
control and
instructions
may not match
Australian
standards.
Google on the term “health” and
the search engine will return about
940 million results. Narrow your
query to “symptoms” and you’re
down 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
TESTING
TIMES
DIY medical tests
are now big
business. Here’s
a sample of what
you can test for
at home.
investigate the matter further. Nor is
there any way of knowing if you’ve
even carried out the test correctly,
says Dr Carolyn Block, a GP in
Double Bay in Sydney. In particular,
she says, she’s noticed a problem
with home medical equipment, such
as blood pressure monitors.
“A 60-year-old woman came to
see me recently convinced she had
a brain tumour,” says Block.
The woman was feeling light-
headed and had been suffering dizzy
spells, and said she was generally
feeling unwell. As it turned out, she
had recently bought a blood pressure
monitoring device to use at home.
She had tested herself the week
before and had been shocked to

3. 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 below
normal 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’s
why experts recommend purchasing such tests from a
chemist, where you can receive personal instruction before
using them, rather than over the internet.
TREATMENT TRAPS
There’s no doubt the most risky part of DIY
doctoring is when patients attempt to treat
themselves, either with prescription
drugs or herbal remedies bought online. Many believe
that just because supplements or herbs are “natural” they
must be safe, but according to Dr Tracey Bessell, acting
director of the Patient Safety and Quality Unit at ACT Health,
that’s simply not the case: if a product is effective enough to
make 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 health
professionals are trained to know what these interactions
are, the public often has no idea,” she says.
Three years ago Gayle*, a 51-year-old manager from
Goulburn, NSW, chose not to consult a doctor when she felt
unusually tired. Gayle was embarrassed by recent weight
gain and wanted to avoid it being raised in a GP consultation.
Instead, she looked up her symptoms on the internet and
came to the conclusion she had anaemia.
For the next 18 months, Gayle took iron-enriched vitamin
supplements, increased the amount of red meat in her diet
and confidently waited for her ailments to go away. They
didn’t. In fact, they got worse. She started developing poor
sleep 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 type
two diabetes and also had an inherited disorder called
haemochromatosis (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.And
the iron tablets and extra red meat probably exacerbated the
haemochromatosis, says Dr Castles. Now, Gayle has to visit
the blood bank to be bled, to get her excessive iron stores
under control.
“The thing to remember (if you are going to take matters
into your own hands) is to set a realistic time limit, so that
if 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 working
things out for herself.”
*Not her real name.
HEALTHSMART Autumn 200760
Do you intend to take online health
research along to your next doctor’s
appointment? Then allow extra time.
A survey of oncologists found that it
extended 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