Modalities: Conventional Diagnostics
All about bloodwork, x-rays, and so forth.
Welcome to the first of a long series on medical modalities! “Modality” simply means the way something is done, and in these articles, we will be taking a look at many of the ways people approach healing, both conventional and alternative. We’ll investigate how each method works, evaluate it for pros and cons (keeping in mind the questions discussed earlier), and consider how it might be applied in a health coaching scenario.
Medical modalities come in two basic categories: diagnostic and treatment. Diagnostic modalities are all about figuring out what’s wrong in the body, and ideally, why. Identifying the problem is a crucial first step, so we’ll look at diagnostic modalities first, starting with conventional methods.
Many of these diagnostic modalities will be familiar—you’ve probably had one or more of them done at some point, maybe even on a regular basis. Let’s see what’s really happening in those routine tests!
Bloodwork
Your doctor orders some bloodwork, so you head down to the lab, where the nurse gives you a “big poke!” and fills a few vials. Off goes your blood to be analyzed, and on you go with your day, sporting a colorful elbow wrap (hopefully you didn’t faint). Sooner or later, the results show up, usually a bunch of numbers you have no idea how to interpret. The doctor will let you know if anything is interesting.
There are hundreds of extensively-researched blood tests available, from chemistry markers, to analysis of blood cells, to screening for pathogens, to genetic testing, and more. Almost any condition can be identified with the help of the right bloodwork, which is why it’s usually the first go-to when you visit the doctor. Results are typically fast and easy for professionals to interpret, and unless you’re like me and have impossibly tiny veins, the downsides are few.
For the life of the flesh is in the blood.
Leviticus 17:11
Cost can be an obstacle, however—bloodwork can run from tens of dollars to several thousand for a single specialized test. Most bloodwork requires an order from a licensed medical professional, and of course, you need someone to draw the blood, so it can be complicated to access the test you need. And with many tests, there is a risk of inaccurate results such as false positives or negatives.
Overall, bloodwork is a valuable modality, frequently used even in alternative diagnostics, and one I take into account as much as I can in my health coaching work. While I do not have the licensing to order bloodwork, I like to review any results my clients are willing to share from a licensed professional, and I can help them order some basic tests for themselves if they so desire.
Other Labs
Blood is not the only tissue that can be analyzed for diagnostic purposes. Other testing can be done on samples of urine, stool, and saliva, and since these don’t require a blood draw, they can sometimes be more accessible through at-home test kits. Cost is still a concern, however, since these tests can be even more expensive than comparable bloodwork and are less likely to be covered by insurance. Like bloodwork, I am happy to review other lab results for my clients, as well as help them find suitable at-home tests if they wish.
Far at the other end of the lab work spectrum is biopsy—analysis of deeper tissue like muscle, bone, skin, spinal fluid, and tumors. Biopsy involves an invasive procedure to collect the tissue, which must be done by a highly skilled professional in a licensed medical setting. Particularly in screening for some potential cancers, biopsies run the serious risk of spreading previously contained cancerous cells to other parts of the body. If a client of mine has had a biopsy, it should be included in their health history along with the results so I can take it into consideration.
Imaging
Modern technology has given us many ways to see inside the body, allowing us to visualize potential problems with bones, organs, blood vessels, and even the brain. These include x-ray, ultrasound, CT, MRI, and more. Many imaging options are minimally invasive, though some types involve varying levels of radiation and may require injected dyes or other contrast agents, which can cause mild to severe side effects. All imaging requires expensive specialized equipment, and a medical professional’s order is needed for access. For insurance purposes, some imaging options may not be available at all until other methods have been tried first, even if they are not the best option for the situation. This can increase costs and slow down care that may be needed promptly for the best outcome.
Imaging usually provides fast, clear results for peace of mind or a life-saving action plan, but it is also subject to misinterpretation, missed findings, or even incidental findings that may cause unnecessary worry. Of course, I cannot order imaging for my clients, but I am happy to review any relevant imaging results a client is willing to share. (In most cases, actual images are not available, but a medical professional’s report of findings.)
Other Methods
A variety of other specialized tests are available to help diagnose problems in specific areas of the body, for example, EKG for the heart, pulmonary function test for the lungs, and colonoscopy for the gastrointestinal tract. These are also usually ordered by a doctor and performed by professionals using specialized medical equipment. Some devices such as a Holter monitor or continuous glucose monitor can also be sent home with a patient for testing over a longer period of time.
Finally, a good medical professional in a conventional setting will also pay attention to the very basics, performing a thorough physical exam to note vital signs and any physical manifestations of disease. Physical examination of course is not limited to conventional diagnostics—though my ability is limited in the virtual setting where I meet with my clients, I am watching even over video chat for any subtle physical signs that might guide my questions to help discover issues that need to be addressed. (This is one reason I prefer video chat over an audio-only meeting.) And I am always interested if a client shares about abnormal vital signs. This simple information gathering can go a long way toward finding the cause of someone’s health issues, so next time, we’ll start our exploration of alternative diagnostic modalities with a look at some unique methods of physical examination!
Have you experienced any of these conventional diagnostic methods? What was successful for you, and what didn’t work out so well? What modalities are you interested in learning about with this series?