If you had to live without something, what would you choose?

And if you didn’t have a choice, how would you handle that forced forgoing with grace?

An op-ed in the NY Times is making a big noise in the health blogosphere, and is – in my opinion, at least – an essential story about how to be an e-patient, even in the most challenging circumstances.

Anna Stoessinger, a freelance advertising writer in New York, is a life-long foodie. In her opening line, she refers to herself as a “ravenous” eater, one that friends and family have compared to a wolf at the dinner table. She grew up grabbing gastronomic getaways with her mom – close to home, and as far as southern France – where they would savor a cascade of gustatory delights ranging from roadside cheeseburgers in Connecticut to filet of sole in the south of France.

Her recent marriage, to a man whose appetite for epicurean exploration matched hers, was only 10 months old when the case of heartburn she thought she’d brought back from Italy turned out to be a tumor: stomach cancer. Adding to the impact of that discovery was her doctor’s revelation that she’d lose her entire stomach – a gastrectomy – to ensure the cancer troll was defeated.

What could you live without if you had to? What would you sacrifice in order to stay alive, what defines your quality of life?

This is a question that millions of people face every day, as they weigh treatment options for a variety of diseases and conditions. From cancer to ALS, from congestive heart failure to sarcoidosis, patients are often forced to make choices that take something they love off the table. Forever.

Ask yourself what you could give up, and what could make you decide to forgo treatment for a life-threatening disease. That’s just the sort of “worst case scenario” planning that helps you make informed decisions about your medical care.

Diagnostic information is only half of the information making up a decision tree. The other 50% is your history, your knowledge of yourself, your sense of what makes your life livable, your vision for what makes your life yours.

Life is more than existence. But what you think is the central feature of your quality of life might be able to take some slings and arrows from that outrageous fortune b*tch and still live to fight another day. Enjoying the tastes, the touches, the experiences that remain.

Think about it: what could you live without?

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What could you live without?

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