Long Reads

Why do I care so much about tracking my health?

Health tracking can be gruesome, obsessive and - at times - pointless. So why am I still doing it, asks Hannah Keegan.

Taking a sample of your own blood is exhausting.

Let me explain: first, there’s an awful lot of preparation. There’s the alcohol wipe you have to use, the minutes (3-5) you have to spend with your hand under a warm tap to create blood flow, the massage you’ll need to give your palm if the skin fails to become adequately pink (indicating blood). You can expect your adrenals to come alive right before you press the needle down into your finger, causing your hand to shake. 

And then there’s the blood itself. If you hit a good spot (left of centre on your index finger, I discovered, works well), it will flow faster than you can scoop it up into the vial. Your bathroom - I would recommend doing this over a sink - will look as though a crime has been committed. I had blood on my forehead at one point. I caught a glimpse of my reflection in the mirror and momentarily wondered if I’d gone mad. 

Here’s something else to consider: I am perfectly healthy. There is no medical reason for me to be taking a sample of my own blood, posting it and waiting giddily for the results. But that, it turns out, is the whole point.

At-home health kits, spearheaded by companies like Thriva (who I used), EverlyWell and Forth, are part of a movement known as proactive health. The idea is that you should be tuned into to what’s going on inside your body at any given moment and can prevent a health crisis in doing so. They largely operate in the same way: you order the tests you would like (B12 and thyroids, for example) and then send off a blood test. At Thriva, a doctor will then review your results and make suggestions. 

If that doesn’t really sound far-fetched, it’s because it isn’t: this kind of behaviour when it comes to our health is more normal than ever. Think of the people you know who track their steps, their heart rates, their sleep. When a friend frets about her window of “disturbed sleep” between 4am and 5am on her Fitbit and the measures she’s taking to close it, I nod voraciously. I mean, doesn’t she deserve optimal sleep? Don’t we all? As I’m writing this article, Apple has announced its plans to make the Apple Watch “an intelligent guardian for your health” and the NHS has voiced its interest in entering the home blood-testing market. 

Part of the attraction to all this is the feeling that you’re bettering yourself. Guarded with facts, numbers, information, a new you is pending. You’re flying! Going somewhere. Making changes. A blood test, I think, can tell me exactly where I am lacking - and I can act on it. The new me is waiting on the other side of all this fussing, glossy and glowing. Just get her started on health and vitamins and meditation - she’s so well, she can tell what’s wrong with you just by being around your energy. You should do a cortisol test, my best self says, I sense it’s high.

According to Professor Peter Tryer of Imperial College, an expert in health anxiety, personalities like my own (a worrier, tendency to be obsessive etcetera) are predisposed to find these kinds of things appealing. “It’s to do with control,” he explains, “people who are health anxious tend to be looking for certainty in their lives and tests, numbers and records can give make them the impression they’re in charge of what’s going to happen to them.” But we also know that this kind of behaviour is bad for our general health in the long-run; studies have shown anxious people have higher mortality rates. You’re actually digging yourself an early grave.

I still wince thinking of the time I FaceTimed my mum from France, (while she was unable to actually do anything in England) and told her I was having a stroke. She was quite sure I wasn’t, but I was in a total panic. “Look,” I said, pointing to my face dramatically, “my mouth is lopsided.” In these moments, I know I sound ridiculous, but the instinct telling me Something Bad Is Happening feels realer. That night, I went to sleep with the French emergency service number lighting up my phone. I woke up fine.

I’m also troubled by the small part of me that wants the test to show a problem. Take, for instance, the time I asked for some blood work to be done because I felt tired. My doctor looked at me with a weak smile and said, “ok, Hannah, we can do some tests, but I’m going to be honest I think this is going to come back fine”. When I got a call that I was very low in vitamin D and there was prescription waiting for me, I thought, ha-ha. A small victory. But who had really won? I was the one with a deficiency making me tired and at risk of brittle bones, not my doctor (a lovely woman who is, I’m sure, overflowing with vitamin D), so why was I happy? 

Professor Tryer tells me it’s about self-comfort, like warm chicken soup when you have the sniffles. “A nice, negative result means you were right, doesn’t it?” he asks. It does. “But the trouble with reassurance is that it’s like a drug, it gives you a kick to begin with, but you have to keep on getting it to feel alright,” which is where problems can arise. He recalls a man in one of his studies who had suffered a heart attack. He was fitted with a stent and told he was medically fine, but still, the man felt anxious. He began checking his blood pressure every hour. Avoiding anything that would raise his heart rate. Soon, it seemed perfectly sensible to quit his job. His job had stairs, you see. All those the stairs!  In his quest to be well, he was no longer leaving his house.

Mind you, that’s an extreme example. I believe it’s possible to engage with health-tracking in a non-obsessive – even rewarding - way for most. For Hamish Grierson, co-founder of Thriva, the idea that healthcare is a series of events that unfold after you get sick is old-fashioned and dull. “I’m frustrated with the idea of ‘the worried-well’,” he says, “because it suggests says that if you’re not sick, then you’re therefore well and don’t have a justified interest in understanding what’s going on with your health. I think that’s wrong.”

Grierson cites that we don’t just go from well to unwell in an instance, there are signs along the way. Signs, he says, that can be picked up in blood work. Thriva recommend following up any worries with a GP (their own doctors will tell you to do this). “We now have easy access to information that’s previously been locked up inside our bodies, so people want to understand the control they can have,” he adds, “it’s an exciting thought. We want people to be excited about what they can learn.”

When my results finally come in – after five anxious days – I do feel excited. I have been thinking (dreaming!) about the possible deficiencies I could have, maybe, I think, I’ll still be low in D but up in iron - I’ve been trying with iron. Will they recommend tablets, treatments? How fun! (FYI, they do). I turn on my laptop, follow the email link and find out I am healthy, I am astoundingly well, in fact, and I am - paradoxically - disappointed. When health becomes a game, it seems you can only really win - get a return on your investment in time, money, brain space - when you lose. 

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