If you've been diagnosed with a chronic illness, some of the first questions you probably want to know the answers to are how is it treated, and whether you will have it for the rest of your life. This article reviews some of the most common types of chronic illness, in the U.S.: heart disease, cancer, diabetes, and chronic kidney disease. We will take a look at common risk factors, how they affect chronic disease, and whether these diseases can be cured or reversed.
According to the CDC's National Center for Chronic Disease Prevention and Health Promotion, 60% of the U.S. adult population has a chronic illness. 40% have more than one type of chronic illness. Seven conditions lead to the majority of death and disability in the States, costing more than $3.3 trillion per year in medical care.
While many chronic illnesses are not curable, there are often ways to alleviate symptoms. In many cases, someone diagnosed with a chronic disease can improve their quality of life by making some changes themselves. It's certainly a source of comfort and empowerment when you have a chronic condition and discover that you are not entirely helpless to your disease.
Types of chronic illness
Today we are going to focus on four chronic diseases. This article is not an exhaustive description or list of symptoms or treatment. For now, I'd like to concentrate on steps you can take to prevent, feel better from, and perhaps reverse, these chronic conditions. I will separate risk factors by whether they are controllable (you can do something about them) or something that can't be controlled, such as age or gender.
After discussing risk factors, we'll go over what you can do specifically to improve chronic illness and the science behind it.
Heart disease
Current statistics show that one in four deaths in the United States is from heart disease. Just think about what an immense impact on our population is. What many people may not realize is that heart disease that is not congenital (something one is born with, such as a defect in a valve) is very preventable. So potentially 25% fewer people could die every year if they made changes to their health.
There are, of course, some things that you cannot prevent. Here's what you can't control:
- A family history of heart disease
- Age, which increases risk in general, and also increases the risk for women after menopause
- Gender; men are at greater risk, although post-menopausal women are at higher risk than pre-menopausal women
Now let's talk about factors you can control to prevent or reverse heart disease:
- Weight (obesity increases risk; so does lack of physical activity)
- Diet (to change cholesterol and other risk factors)
- Mental health (stress and anxiety worsen heart problems)
- Diabetes (uncontrolled diabetes complicates heart disease)
- Smoking
Cancer
Cancer kills just as many people as heart disease every year (around 600,000 in the United States). Estimates in early 2018 were of 1.7 million new diagnoses of cancer.
Different cancers come with various risks, and there are many things that we still don't understand about what causes cancer. But here are some of the main ones.
Risks for cancer that cannot be controlled:
- Family history and carrying genes that increase susceptibility to cancer
- Age
- Accidental or unpreventable exposure to environmental toxins and chemicals
- Suppressed immune system due to organ transplant or other diseases
- Personal history of infection
- Preventable or reducible cancer risks:
- Intentional exposure to toxic substances, such as alcohol, cigarettes, or other chemicals and hormones in food and medicine
- Obesity, poor nutrition, lack of exercise
- Chronic inflammation from other conditions (reducible by better managing other condition)
- Over-exposure to radiation
- Sunlight
Diabetes
Diabetes and its complications are the seventh-leading cause of death in the U.S., taking over 80,000 lives in 2016. As a reference, Type 1 diabetes causes the pancreas to stop producing insulin. It is usually diagnosed in childhood and must be managed for the rest of someone's life. There is currently no FDA-approved cure for Type 1 diabetes, although now there are clinical trials investigating the use of islet cell transplants. A pancreas transplant (usually done in combination with a kidney transplant) would also cure Type 1 diabetes, although not everyone is eligible for this transplant. Also, organ transplant creates other risk factors and requires life-long care of other potentially chronic conditions.
Type 2 diabetes involves insulin resistance, where your body makes insulin but cannot use it properly. Diagnosis often happens in adulthood, although we are seeing more and more young people getting this diagnosis.
Gestational diabetes only occurs due to pregnancy, and usually goes away after. If it stays, it becomes Type 2 diabetes, so we will cover its risks under the umbrella of Type 2.
For the sake of clarity, some risk factors only apply to either Type 1 or Type 2 diabetes. If that is the case, they will be designated in parentheses.
Risks for diabetes that you can't control:
- Genetics (family history)
- History of pancreatic diseases, such as infection
- Ethnic background
- History of gestational diabetes (for Type 2)
- Polycystic ovarian syndrome (PCOS - for Type 2)
- Age
Risks for diabetes you can control:
- Diet
- Weight
- Exercise
- Smoking (Type 2)
- Chronic kidney disease (CKD)
In chronic kidney disease, the kidney's ability to filter toxins from the body is impaired, which causes other complications. CKD is the ninth leading cause of death in the U.S. and affects about 10% of the population (31 million people).
Risk factors for CKD that you cannot control:
- Diabetes
- History of kidney infection or other urinary system diseases, such as cancer, polycystic kidney disease, enlarged prostate causing urinary tract obstruction, kidney stones
- Heart disease
- Ethnicity
- Family history
- Age
- Abnormal kidney structure (due to injury or congenital disorder)
- CKD risk factors that you can control or reduce:
- Better management of other diseases, such as diabetes, heart disease, and high blood pressure
- Smoking
- Obesity
How to prevent or reverse chronic conditions by reducing or avoiding risk factors
You may see a common theme among the four diseases discussed above. Several risk factors that are preventable are present for all the diseases, even though the conditions are very different. These factors are diet/nutrition, exercise, weight management/obesity, and smoking. We will focus on these first and then address other risk factors.
This commonality is probably no surprise to anyone, as these are general recommendations for good health. But when you have a chronic, life-threatening condition such as the ones mentioned in this article, it becomes that much more important to manage these risk factors. People not suffering from chronic illness are in the minority in the United States, and should arguably count themselves lucky and do everything they can to maintain that status.
Diet and nutrition for chronic illness
As mentioned in my other nutrition articles, most Americans are not getting the nutrients they need. Take a look at my post about vitamin deficiency and suggestions for increasing your nutrient intake.
And before you go out and buy supplements for your chronic illness, make sure you read my article about dietary supplements.
There is a common misconception that proper nutrition is expensive; that people have to buy special foods or vitamins to get adequate nutrition. I've also heard people say they eat fast food because it's all that they can afford. They try fad a diet like keto, paleo, etc. because they want to lose weight, but they have a hard time staying on it for the long term.
The truth is that some of the cheapest food is also the healthiest. Some examples are beans, rice, potatoes, veggies like carrots, leafy greens, and broccoli.
If you're intimidated by cooking, there are easy ways to get around that. Many frozen veggies come in bags that allow you to steam them in the microwave, and potatoes are easy enough to make in the microwave as well. I love my Instant Pot because I can cook beans, rice, potatoes, and other vegetables in it. All I have to do is add some water and press a few buttons. If you can read and follow instructions, you can cook in an Instant Pot.
Pressure cookers are wildly popular and getting cheaper all the time. But if they scare you, you can use a slow cooker to make beans and veggies, or a rice cooker. Either one by itself can usually be found for less than $30 and will save you a bunch of money on pre-cooked foods.
The benefit of cooking yourself is you get to control how much salt, fat, and sugar goes into each meal. Food that comes in packages also has many preservatives and other chemicals that our bodies may react to poorly. Processed foods are more likely to trigger inflammation, which is a chronic illness sufferer's enemy, regardless of which conditions you have.
If you eat a lot of processed foods or have other dietary issues as mentioned in my article about nutrient deficiency, then I encourage you to start making small, manageable changes. Get into the habit slowly of adding a serving of fresh or cooked veggies to a meal. A serving is as little as half a cup. Experiment with different spices rather than oil, butter or salt to flavor your vegetables. As a side note, spices are cheaper than oil or butter, so if you can do without them, your wallet will thank you.
Drink more water as well. Drink plain water, and have a glass before you drink something else, like coffee, juice, or soda. Each of these drinks has dehydrating properties, so if you drink them after water, at least you will be less dehydrated. Water is vital in both hot and cold weather, because in the heat you are sweating more, and in the winter you have more exposure to indoor heating. Hydration is essential for muscles to work correctly; without it, you are more prone to injury and can experience increased pain.
Notice that I recommended you add healthy foods and water rather than take away other things. You are looking to make permanent lifestyle changes, not a temporary dietary change. The best way to do this is to create habits that stick without feeling deprived. So for the time being, don't try to remove unhealthy foods. Just add in healthy foods.
Exercise for chronic illness
One's ability to perform exercise is dependent on the type of chronic illness. Always check with a doctor about what kind of exercise it's safe for you to perform.
However, there are a few things that most people can do. The first is walking. It requires no equipment, it's free, and you can start in tiny increments and work your way up. After my back injury, I started walking for one minute at a time. It was all I could do at first, but I slowly built up my tolerance until I could walk for an hour. It was painful at the beginning as well, and I won't lie and say walking doesn't ever cause me pain. But it's my main form of exercise these days.
Riding a bicycle is another option. When I got back into bike riding, I started with an electric bicycle called a Pedego. An e-bike helped me get stronger; my muscles, my heart, and lungs all improved while riding. I started off needing braces on all my joints when I rode my bike but eventually required less. I did have to sell the bike a while back because I didn't live in a place where I could use it, and it was just sitting there. But as soon as I can, I plan on getting into bicycling again. However, if you don’t feel safe on a moving bike, use a basic stationary bicycle or even a pedal exerciser.
The last form of exercise that most people can do is isometrics, also called static strength training. Isometrics usually don't use any equipment and don't require any particular strength. You only hold a contraction without moving the joint. You can gain strength and muscle tone this way without lifting weights, which can be a positive first step for someone who is too weak for regular exercise.
Weight management and obesity
The number one thing you can do to lose weight is to change your diet. It's more important than exercise when getting to a healthy weight is at stake. This is good news for chronic illness sufferers who need to lose weight but have mobility issues.
In case you're wondering why the correct diet helps more than exercise, there are few simple reasons:
- It takes less time to cut calories than increase exercise. A McDonald's Big Mac is 563 calories. Meanwhile, it would take a 150-pound person 83 to 104 minutes walking at 3.5 to 4.5 miles per hour to burn 500 calories.
- Exercising without proper nutrition increases the risk of injury. If you get hurt, then you'll probably stop exercising.
- Often, when people are nutrient deficient, their bodies hold on to excess weight. Improving your diet may allow you to lose weight without changing anything else.
- If you enjoy exercise and can do it, that's fine. Just know that you're making things more difficult for yourself if you don't also change your diet.
Smoking with chronic illness
I don't have to tell you how bad smoking is for health. Any of those detrimental effects are magnified for someone with a chronic disease. But let's only discuss the financial harm of smoking for a moment.
In the United States, a pack of cigarettes costs about $7. Someone smoking one pack per day is paying about $50 per week, $210 per month, and $2555 to buy cigarettes.
According to wallethub.com, smokers also have decreased productivity due to smoking-related health problems, which means more sick days and lost wages at work. Smokers' medical and life insurance premiums are higher, and they have to go to the doctor more often.
There are other, more hidden costs to smoking. You may not know this, but non-smokers generally receive a 5-15% discount on their homeowner's insurance. There is also the financial opportunity cost -- the revenue a person would receive if they invested that money in the stock market over the same period instead of using it to buy cigarettes, pay extra for health care, etc.
Over a lifetime of smoking (with an average lifespan of 69 years for a smoker), a resident of the state of Georgia will have nearly $1.4 million in extra expenses due to smoking. For many people, that's enough money to retire on.
So if you're ready to quit, get the help you need. There are many options out there:
- start using a patch
- meditate
- join a support group
- find a hobby
- manage your stress
- talk to your doctor
These days, many insurance companies and employers offer smoking-cessation programs at no charge. The tools can be found when you are ready to use them.
Other risk factors for chronic illness
Now that we've discussed the most common risk factors, we'll dive into the other risks on the list.
Stress management and mental health for chronic illness
People with one or more chronic conditions are more likely to have depression, anxiety, financial troubles, and be socially isolated. All this can add up to increased stress.
That's why it's so important to find healthy ways to manage stress better. Getting enough rest, nutrition, and exercise definitely help. Having a strong support system is also essential. This support network can include friends, family, health care providers, community services, and counselors. Home-bound individuals can still benefit from social interaction through the phone or the internet. These days, there are online support groups/forums and phone-in support groups. I even saw a commercial for counseling through the internet using webcams.
It's stressful just dealing with a chronic illness, let alone everyday life. It makes it harder to work, to take care of yourself, and to relate to everyone else who seems healthier than you. It gets harder and harder each time you visit the doctor and leave with more questions than answers. Discouragement increases each time yet another treatment doesn't make things better (and sometimes makes it worse).
Despite all this, the best thing the chronically ill can do for themselves is to continue to be their own advocate. Sometimes this can help relieve stress because it gives back a sense of control that is lost when you struggle with ongoing medical issues.
So find a way to get what you need to manage your stress and uplift your mood.
Chronic inflammation
As mentioned above, chronic inflammation comes from diet and other conditions. Here are some symptoms of chronic inflammation:
- constant fatigue
- pain
- digestive problems
- weight gain
- frequent infections
- fever
- rashes
Unfortunately, these symptoms overlap with those of other chronic diseases, so it's sometimes hard to say whether or not you have chronic inflammation. There are a few ways your doctor can investigate, though:
- review your medical history for recent acute inflammation that may have become chronic, such as an injury or infection
- test for an autoimmune disorder
- ask about past exposure to inflammatory environmental factors, such as chemicals
Losing weight if you are obese or overweight, changing your diet, reducing stress, and kicking smoking and alcohol to the curb also help with chronic inflammation, regardless of the cause.
Sunlight and other radiation sources
Managing exposure to sunlight is simple. When you go out, use sunscreen, hats, and other protective clothing. I recommend JASON mineral sunscreen because it doesn't have irritating fillers that cause rashes on my skin. Sunlight is a source of radiation, which is why it increases the risk of cancer. Skin cancer is at the top of the list, but all cancers have some risk related to radiation exposure. Tanning beds also do NOT keep you safe from radiation.
There are other types of radiation exposure. We are all exposed to radiation every day, just by living on this planet. However, some people receive more exposure than others.
Behind cigarette smoking, radiation exposure from radon is the number two cause of lung cancer. Exposure to both amplifies your risk.
Depending on where you live, radon from the soil can leak into your home or work. Basement rooms tend to have the most radon, as they are below ground level. Working underground or in mines also can increase radon exposure, as well as people who come into contact with phosphate fertilizers.
There are other types of radiation, such as from X-ray machines, microwaves, and cell phones. Their risk for cancer is still being investigated and is somewhat inconclusive at this time.
Radiation sickness can be fairly severe in symptoms, and if you wait too long, it is not treatable. Early signs are nausea, vomiting, and headaches. If you think you may have excessive radiation exposure, seek medical care immediately.
Managing other chronic conditions
When dealing with multiple chronic diseases, the incentive to managing them properly is that life only gets more complicated and miserable when you let symptoms go.
I'm afraid I'm guilty of that myself. For the past several months, I had to take care of my mother and husband, both of whom also suffer from chronic conditions. I put their needs ahead of mine because they needed help with necessary daily activities like cooking meals and chores. I was in a slightly better position than them health-wise at the time, but I started neglecting my own needs because I didn't have enough energy to do everything. Now my symptoms are worse, and I'm struggling to get back on track.
This backsliding is a common situation for many people who are parents or caregivers. It's important to find balance whenever possible, and learn your limits and when to say no. Keep in mind that if you get too sick, you won't be able to help yourself or others.
The last thing you need is to go into kidney failure because you aren't managing your diabetes, or get cancer to go along with your heart disease. I'm not saying it's easy to make changes, but by doing nothing, the alternative scenarios are much worse.
