I had just received the third pink slip in two weeks from the lab that said my payment was passed due. Over three times I had called & my insurance company had assured me that the lab work was covered & that they would mail out a check that afternoon. This time, when I finally got a representative on the telephone, I was polite but firm. I said that I wanted the problem taken care of immediately, & I wrote down her name & the supervisor’s name. It was time to get even more assertive.

Has assertiveness gotten a bad rap, however, among the chronically ill? Is it assumed that we won’t have the energy or stamina to fight all of the battles that we will face? When we do talk to someone in customer service, we are rarely taken absolutely seriously.

After all, isn’t it just the drugs that make us impatient & nit-picky about all of this insurance stuff? Has anyone ever brushed off your assertiveness simply by assuming, “She doesn’t have anything else to think about all day, so no wonder she’s upset!”? Or “She’s just taking her frustrations out on me because she has a chronic illness.”

When you imagine an assertive person, what comes to mind? Webster’s Dictionary says that assertiveness is “positive; affirming confidently; affirmative.” Too often we confuse assertiveness with aggression which is defined as “making assaults & unjustly attacking.” Most of us have had moments when we have slid into an aggressive mode, but assertiveness is based on one’s ability to confidently step forward.

Rather than becoming aggressive, I believe that the chronically ill often become burnt out on fighting & we simply avoid any conflict. Who has the energy to fight for our rights? Next time a situation arises where you may need to be a bit assertive, here are some things in which to remember.

I have the right to say no without feeling guilty.

For those of us with chronic illness, this is a big one! We must say, “no, thanks,” or “I’ll pass,” much more often than we would prefer. Even when we master the ability to say no, the guilt continues to sit with us for days. Let it go! You know your abilities & limitations & what is best for your own health & your family’s well being.

I have the right to state my opinion, even if I change my mind.

Have you ever been on a jury & you had to state your decision up-front, but than as the deliberations continued, you changed your mind about the verdict? You have the right to say what you think, but it’s best to think before you speak. Is what you say going to hurt someone’s feelings? Are your comments going to help the situation?

I have the right to take risks & try new things.

Just because you have a chronic condition doesn’t mean you have to eat at the same restaurant the rest of your life. Try new things! You may find a new hobby or a new activity that you are able to easily do, in which you would have never thought about.

“When I started taking photos it was on one of those cardboard cameras,” says Darcie. “But then I found that I really loved it & I wasn’t half bad. So I bought a real camera. It’s been fun. I’ve had an excuse to go to events that I couldn’t participate in before, like boat races, because I am ‘the photographer.’”

I have the right to be heard.

Whether you are having a conversation with a medical professional or your mother, you do have the right to be heard. Too many of us fall into the habit of talking all of the time, however, & forgetting that we also have the responsibility to listen. Know your boundaries & what you are willing to listen to & not.

When a man approached me after a health fair & said, “I can cure you in 30 days,” I replied, “You have sixty seconds to tell me why I should talk with you further about your product.” I listened… & no, he didn’t convince me. He felt okay about it though, & I got out of an uncomfortable thirty-minute sales pitch.

So be assertive – practice in front of the mirror if you must. As you step out & share your opinion, it may feel awkward at first, but then you will gain more confidence & it will become simpler the next time the opportunity arises. Even studies have shown that assertive people are more likely to have personal & professional relationships that are based on honesty & mutual respect.

If you lead a support group or are considering it, don’t miss Lisa Copen’s new book, http://StartAnIllnessSupportGroup.com for your ministry needs. Over 300 pages with step-by-step instructions on how to write a vision statement, promotion & attendance & much more!

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Since herbal products are not regulated for their purity & potency, like conventional drugs, there can be severe adverse effectss & drug interactions. They can even be different from one batch to another. David Kroll, Ph.D., a pharmacologist & consultant to the Duke Center for Integrative Medicine (DCIM) says, “The single greatest resource for people who want credible herbal information is a health care practitioner who is uniquely trained in both conventional & alternative medicine. Those people are rare, but the DCIM has been established to train physicians accordingly & to offer a place for patients to turn today for this type of information & medical care.”

Your own research should never replace a physician’s advice, but here are some helpful web sites to learn more before downing your vitamins.

* Consumer Lab – find out tons of information on your vitamins & more. This lab tells you where to buy products, what to watch for & what to stop taking if it’s recalled.
* Diet-&-Health – Have gout, insomnia, or acne? This site tells you what you may be defincint in & what to consider taking.
* http://www.experimentalmedicine.org
* Guide to Nutritional & Herbal Remedies
* An FDA Guide to Dietary Supplements
* Quack Watch – though some people may find this controversial, the owner brings up a lot of points worth considering during your research.
* Mayo Health – Look up herb, vitamin & other supplement information

As with any health information you receive, check with your doctor before taking anything. No information provided by Rest Ministries is meant to be health advice.

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• Herbal Remedies Can Cause Cardiac Problems (nlm.nih.gov)
• Medical decision making is influenced by patients, lawsuits, & money (kevinmd.com)

E- patients take internet searches a step further. Not only do they occasionally conduct internet searches about health; but they become involved in online groups & organizations dedicated to a particular aspect of their health.

The upside? We can find people out there who know what we are going through. We can become involved in discussions with other patients like ourselves who have experienced the same side effects, the same pain, & most importantly, some of the same emotional aspects of dealing with an illness.

The downside? The internet makes everything accessible instantaneously. This may be feeding our fast paced society where our questions are never answered fast enough, especially in relation to our health. The internet is creating a shift in the health world, & this fast pace may be hard for hospitals & doctors to catch up with.

As far as generic information & moral support, the internet is a great tool. However, there is still a need to rely on traditional healthcare & to have a team of professionals around you. Not all patients are the same, & not all of our health related questions can be answered on Google.

Naomi Kingery, twenty year old brittle diabetic & author of The Sugar Free Series available at www.livetolovediabetes.com.

Does your friend have an HMO that requires her primary physician to be a “gate keeper?” In this model, doctors must cut costs by limiting referrals. It may be necessary to contact the HMO administration to dem& a second opinion. Read the fine print in the insurance packet before calling. Alternatively, she may request a new primary physician. These two processes will take time.

Unfortunately, your friend may need to spend money out of her own pocket to see the physician of her choice. Try to stick with a doctor covered by her plan because that doctor may end up being her advocate with the insurer. Explain the situation up front.

Many illnesses are difficult to diagnose. One example is a disease called “interstitial cystitis.” Doctors give antibiotics because they mistakenly think the symptoms of pain & frequent urination are due to infection. Another example is acid reflux. Doctors give antibiotics for a sore throat or cough that is not caused by strep bacteria, but by acid bubbling up from the stomach. If you “google” symptoms, you may find some clues.

I am embarrassed by doctors who give patients the brush off & HMOs that gouge. Your friend is blessed to have your concern.

Amy Fogelstrom Chai, MD, MS, is an Internal Medicine specialist with additional training in the area of medical research methods. Her experiences as a patient helped to redirect her priorities to home life & Christian ministry.

A Newsweek Poll found that 72 percent of Americans say they would welcome a conversation with their physician about faith; the same number say they believe that praying to God can cure someone—even if science says the person doesn’t st& a chance. Tell your doctor you’d like to see more physicians trained to underst& spirituality & medicine.

(Newsweek, Nov. 10, 2003).

It has a whole new meaning now that doctors & medical charts are part of my daily life. I hope it brings you a smile.