4 ms·

> If I had ever gone to a doctor with any of those symptoms I would have gotten exactly your advice: It's just stress, it's psychosomatic. Don't worry so much.

> If I had ever gone to a doctor with any of those symptoms I would have gotten exactly your advice: It's just stress, it's psychosomatic. Don't worry so much. Or what if you had gone to a "lyme literate" doctor and been misdiagnosed with chronic lyme disease? Put on antibiotics for three years (like one of the patients in the story) with harmful side effects, and at enormous financial cost? Then you would have a whole bunch of problems in addition to your mercury poisoning. I realize that it must suck for the patient, but in cases where no diagnosis can be made I think the best thing a doctor can do is just to say "I don't know", treat the symptoms as much as possible, and prescribe lifestyle changes (diet, exercise, sleep) in the hopes that things clear up on their own, or that some test eventually reveals some useful information. Better to do nothing than to actively harm the patient with ineffective treatments.

moby_click 7y ago
> treat the symptoms as much as possible, and prescribe lifestyle changes (diet, exercise, sleep) That's pretty much what I have been doing, when I was 19. But I became sick, saw a couple of doctors without a diagnosis and that prescrption would have sounded like: "Have you tried not being sick anymore?" I had to wait for a NSAID to kick in to get down liquid food, had to sleep often, because I could only sleep for few hours at a time and everyday life was exercise enough. At that point blood tests for lyme were inconclusive, but the rheumatologist thought the symptoms warranted oral doxycycline, which cleared the symptoms within days. Maybe a lumbar puncture would have shown it, but I was asymptomatic before I was scheduled. Like nosianu experienced, there was a long period where I thought, I just had to get my act together and it takes a while to conclude that something is seriously wrong. At some point, you take a doctor's educated guess, even if the treatment is harmful.
lm28469 7y ago
> prescribe lifestyle changes (diet, exercise, sleep) in the hopes that things clear up on their own, People don't want that, they want pills dulling the symptoms of their bad habits.
nosianu 7y ago
> I think the best thing a doctor can do is just to say "I don't know" I think I said as much, pointing out that doctor's roles are a lot more "mechanical" than what most people assume and that obviously that means restricting what they do to the (more or less limited - depending on the area) set of diseases and treatments that can be (relatively easily) diagnose and treated. The problem is that many of them don't and that you are send to a psychological treatment "it's all in your head".

moby_click 7y ago

> treat the symptoms as much as possible, and prescribe lifestyle changes (diet, exercise, sleep) That's pretty much what I have been doing, when I was 19. But I became sick, saw a couple of doctors without a diagnosis and that prescrption would have sounded like: "Have you tried not being sick anymore?" I had to wait for a NSAID to kick in to get down liquid food, had to sleep often, because I could only sleep for few hours at a time and everyday life was exercise enough. At that point blood tests for lyme were inconclusive, but the rheumatologist thought the symptoms warranted oral doxycycline, which cleared the symptoms within days. Maybe a lumbar puncture would have shown it, but I was asymptomatic before I was scheduled. Like nosianu experienced, there was a long period where I thought, I just had to get my act together and it takes a while to conclude that something is seriously wrong. At some point, you take a doctor's educated guess, even if the treatment is harmful.

lm28469 7y ago

> prescribe lifestyle changes (diet, exercise, sleep) in the hopes that things clear up on their own, People don't want that, they want pills dulling the symptoms of their bad habits.

nosianu 7y ago

> I think the best thing a doctor can do is just to say "I don't know" I think I said as much, pointing out that doctor's roles are a lot more "mechanical" than what most people assume and that obviously that means restricting what they do to the (more or less limited - depending on the area) set of diseases and treatments that can be (relatively easily) diagnose and treated. The problem is that many of them don't and that you are send to a psychological treatment "it's all in your head".