"Mr. Smith, let's review the results of your blood tests. Your CBC, BMP, and LFTs were basically negative. You have prediabetes and a slightly elevated LDL, and since your BMI is 28, you should watch your diet and exercise more to prevent metabolic syndrome. Oh, and it's OK to keep taking an occasional NSAID with food for your idiopathic knee pain."
Huh? Although I hope I've never said anything resembling the above to a real patient, doctors routinely use so many medical terms and abbreviations that it can sometimes sound as if we're speaking gibberish. What's worse, many patients may feel pressure to simply pretend they understand what the doctor is saying. Unfortunately, that approach often leads to misunderstandings and poor health choices. A report published last week in the Annals of Internal Medicine found that patients with low health literacy (the ability to read and interpret medical information) were more likely to be hospitalized, use medications inappropriately, and receive fewer recommended vaccines and screening tests. While the report only covered written materials, it stands to reason that patients also make worse health-related decisions when they don't understand medical jargon spoken in the doctor's office.
So let's demystify the terms I just used with my imaginary patient—terms family and friends told me they wished doctors would explain.
CBC: Complete Blood Count. This test contains four separate measurements. The two most important are the white blood cell (WBC) count, which is usually higher in the presence of a bacterial infection and lower in some viral infections, including HIV (the virus that causes AIDS); and the hemoglobin level, which, if low, suggests blood loss, cancer, or kidney problems.
BMP: Basic Metabolic Panel. This test includes levels of sodium, potassium, calcium, glucose (sugar), and measurements of kidney function. It is most often used to check for dehydration in illnesses that cause vomiting and diarrhea, and to monitor patients with heart failure or kidney disease.
LFTs: Liver Function Tests. Higher-than-normal levels may indicate ongoing liver damage from an infection or medicine. Doctors usually check LFTs when starting or tweaking the dose of medicines that lower cholesterol.
Negative: Doctors use this word to mean "normal." Conversely, we call abnormal test results "positive," which actually means bad news. (For example, "the chest X-ray was positive for pneumonia.")
Prediabetes: In most people, a fasting (not eating for at least 8 hours) blood sugar level should be less than 100. A person whose fasting blood sugar level is persistently above 126 has diabetes; between 100 and 126 means a person has "prediabetes," which hikes his or her future diabetes risk. Unlike diabetes, prediabetes is usually treated with diet and exercise rather than medicine.
LDL: low-density lipoprotein, better known as "bad cholesterol." The less you have in your blood, the lower your risk for heart attack or stroke. A normal level is 130 or less; people with heart disease or diabetes should have levels well below 100.
BMI: body mass index, the most widely used measure of weight relative to height. A normal BMI for an adult is between 20 and 25. Adults with BMIs between 25 and 30 are overweight, while those with BMIs over 30 are obese. Doctors may recommend that "morbidly obese" adults (a BMI over 35 or 40) consider weight-loss surgery, as lifestyle changes alone are unlikely to bring them down to a normal weight.
Metabolic syndrome: defined by the National Heart, Lung, and Blood Institute as a cluster of related risk factors that increase a person's risk for diabetes, heart disease, and stroke. These include high blood pressure, a large waistline, prediabetes, and abnormal cholesterol measurements.
NSAID: non-steroidal anti-inflammatory drug. These medicines (think over-the-counter ibuprofen, such as Advil or Motrin) treat occasional aches and pains as well as chronic arthritis. Unfortunately, long-term NSAID use can cause stomach ulcers and heart and kidney problems.
Idiopathic: Defined in the dictionary as "arising from an obscure or unknown cause," this is the term we doctors use when we can't explain what's causing a patient's symptom or condition, despite thorough examination and the usual tests.
For help decoding medical terms you may encounter, see the online glossaries at Dummies.com and Familydoctor.org. Although these resources can be useful, if you don't understand what your doctor is telling you, please ask him or her to translate in plain English. Doctors often don't realize when they're using medical jargon or just not getting their point across. Most importantly, remember that the only "dumb" question at a doctor's visit is the one you have, but don't ask.