Providers always ask, “How do you describe your general state of health?” An evaluation of your medical status requires you to look at your past, present, and future. Before you do this, you need to understand the different illness categories.

Generally, the American medical system in the past has been centered on the treatment of acute illnesses or conditions. An acute condition is just what it sounds like—an illness that comes on quickly, progresses rapidly, and lasts a short time. Acute conditions might include a severe sore throat, a myocardial infarction, or a newly torn Achilles tendon. When we suffer from an acute condition, we’re typically treated quickly, thoroughly, and often very well for that particular problem.

Today, more focus is being placed on chronic conditions. In past years, though, chronic conditions weren’t necessarily well managed. They’re more difficult because they often require special providers to coordinate multiple therapies over an extended period of time. The U.S. National Center for Health Statistics defines a chronic condition as lasting longer than three months. Unfortunately, some people with chronic conditions think or behave as if they have a series of acute illnesses when, in fact, they suffer from a chronic illness. It’s the past misdiagnosis or mismanagement of chronic conditions (often from patients not doing what they’re supposed to!) that has led patients to this conclusion. Often the patient, together with a health care system communication breakdown, inadvertently creates this problem. We’ll give you an example. Jane Doe has been hospitalized on more than one occasion for confusion or dehydration due to elevated blood sugar levels. The caregivers at the clinics and hospitals she visits, however, acutely treat only the infection that caused the symptoms. The result: Ms. Doe never discovers the real problem. Jane Doe, it turns out, suffers from a chronic condition called diabetes mellitus, not just a recurring bladder infection. She needs to see a physician in an office or clinic to help her understand and manage her diabetes. This would also prevent many ER visits. The point is, a lot of folks think they have acute conditions when, in fact, they suffer from a chronic condition. You must help your providers by being informative, compliant, and consistent with your health care.

Diabetes, as we saw with Jane Doe, is a great example. If her diabetes had been managed, she wouldn’t have been hospitalized. Blood sugar can be controlled, and the resulting acute conditions of dehydration and confusion, for example, can be eliminated or reduced. The incidence of decreased kidney function, heart disease, and hardening of the arteries all increase when you have diabetes. What do a sore on the foot, a mini-stroke, and impotence have in common? There’s a good chance they’re related to diabetes. People with diabetes can avoid other symptoms by understanding and controlling their disease. In other words, you need to learn if you have a chronic condition and, if you do, what you can do to manage it. Although there are lots of people to help you, only you can take responsibility for organizing your disease management.

What can you do? Talk to your doctor. Sir William Osler, a famous medical professor, taught students to find the unifying condition that explains all the symptoms. Why? It’s usually all connected—much like your leg bone being connected to your hip bone. This is why you must tell your doctor everything. Prioritize. Explain your most pressing problem first, and then follow up with your other concerns. Not sharing every symptom and pertinent details of previous medical care could result in a failure to connect the dots and find the underlying unifying condition. You may be embarrassed that you’ve experienced forgetfulness, impotence, or incontinence. Don’t be. Tell your doctors. Additional problems result when we only treat episodic conditions instead of discovering and treating the underlying chronic condition, especially because the condition can usually be managed and effectively treated once revealed. A diagnosis of Lupus gave Dave, age 33, a new attitude. Once he learned what was making him sick, he accepted his fate and began looking “at things more positively...it was like I could control my destiny.”

You may think of health insurance companies as being the enemy, but they really do want you to stay well. (They, of course, save money when you aren’t sick.) That’s why some offer wellness programs to keep you in tip-top shape. Others have hotlines and help links with nurses who will assist you in understanding and managing your condition. Insurers can be a great resource, but they won’t contact you. It’s up to you to reach out to them. Call your insurance carrier to find out more, or log onto its Web site. Humana Insurance, for example, offers MyHumana Condition Centers, which are a terrific resource to help you or a loved one learn more about preventing, treating, or managing a variety of conditions, such as asthma and diabetes. Your carrier probably offers similar resources.

Although we rely on doctors to help us stay healthy, the greatest responsibility is our own. So listen to your doctor and follow his or her advice. If you’ve been given a prescription for cholesterol-lowering medication, you need to take it! If you suffer from asthma, stay inside on smog alert days. If high blood pressure is your problem, work on limiting your salt intake. Most of all, use common sense and talk to your doctor.

The final type of condition is one that is considered terminal. Although many doctors are loathe to give an exact prognosis for the end of life, a terminal condition is one that is likely to result in death in less than six months. Today, many practitioners refer to a terminal condition as being the end stage of a progressive disease. The diagnosis of a terminal condition can be important in determining your wishes at the end of life as well as any decision you may make regarding the treatment of your condition.

That’s why it’s important to learn about your different disease types and the categories they fall into. Charting your unique medical situation is the best way to do this. Map out your health conditions from least to most complicated. (You can use the following chart.) Remember, it’s possible to have acute conditions that complicate chronic and terminal conditions. Chronic conditions may coexist with terminal conditions.

YOUR HEALTH CONDITIONS

If you have no real medical conditions, it’s easy. You’re in the least complex category in the bottom left of the chart. As your luck fails or you just get older and suffer from more health conditions, your health conditions chart may include a mix of acute and possible chronic or terminal conditions. It’s a useful way to analyze what your medical conditions are, how they interact, how aggressive you wish to be with various treatments, and how your other conditions may be affected by your treatments.

The importance of differentiating between disease types has also been recognized for a long time. However, it wasn’t until recently that we discovered how to make these differentiations. Think about the second leading cause of death in America: cancer. Should we really say “cause?” Or should it be “causes?” In other words, it’s basically useless to ask, “When will they find a cure for cancer?” because cancer isn’t one disease—it’s thousands, if not more. Other diseases are the same—there are hundreds of infection types, for example.

That’s why we can’t just think about disease in general categories. Heart disease, the number one cause of death in the United States, isn’t necessarily just one problem with your heart—it has to do with your arteries, your blood flow, and other things like your cholesterol. Our point: Until we can break down each disease, we can’t fully understand it. And if we can’t fully understand it, we often can’t fully know what to do to treat it.

We’ll give you a brief example. In the treatment of cancer, cell typing became important when it was discovered that a cancer starting in a woman’s breast generally behaved differently from a cancer that started in a woman’s lung or bone. Even when the breast cancer would go to a lung or bone, it still behaved and looked (under a microscope) like a breast cancer. This is why cancer physicians (oncologists) don’t refer to someone with advanced cancer in multiple places as having, for example, breast, lung, and bone cancer, but rather breast cancer that is metastatic (cancer that has spread to other parts of the body) to lung and bone. It may be in different places, but it’s still the same kind of cancer.

The stage of a disease is another differentiating factor in treatment. Generally, there are four stages to most cancers, which indicate, depending on cancer cell type, how advanced a cancer is. Stage I is the most limited; stage IV is the most advanced (metastatic). So even after we’ve found the sub-sub-subtype of a cancer, there are still up to four more divisions of staging to determine. A doctor must know both the specific sub-sub-subtype of cancer and the appropriate stage to decide the best way to fight the disease.

Understanding your disease type helps you to understand who you should call and where you should go. It’s this fundamental understanding that can make the control and management of your disease less overwhelming. There’s also a degree of comfort in this understanding, especially knowing that, if need be, resources are available to help you, no matter what your condition. Although there may be factors out of your control that dictate your disease, your actions can ensure that the wants, wishes, and wills of your treatment are fulfilled.