7 ms·

That story of how the doctors just dismissed her pain as delusion is terrifying. Doctors are supposed to be people of science, but one of the very fundamentals

• tarsinge 7y ago
  Psychosomatic diseases are a real thing though. You can have real physical symptoms. Last year my muscles started to « shake », with lots of skipped heartbeats (extrasystoles). After all the checks the doctors said the classic « it’s stress ». Well then I took a real break and embarked on multi month road trip on another continent. The symptoms disappeared nearly overnight. I think I experienced a burnout but it manifested through physical symptoms. Edit: needless to say the medical response was very frustrating and hard to believe. In the end they were right that it was not a physical cause, but apart from that it really felt like they had no idea. Also it could be a multi-level cause like gut flora causing anxiety causing be physical symptoms but it’s beyond what a doctor can diagnose I think.
  • 0xcde4c3db 7y ago
    They're real, but doctors often do a half-assed (if not downright negligent) job of ruling out other possibilities before settling on somatoform disorders (or any other psychiatric diagnosis, for that matter). Especially when it comes to women presenting with chronic or recurring pain or fatigue as their primary symptoms.
  • armada651 7y ago
    Regardless of whether you think the advice from the GP is sound or not, the best way to get a doctor to listen to you is to listen to (and follow) their advice first. Cursing at them out of frustration only makes your situation worse.
    • TheSpiceIsLife 7y ago
      That has the possibility of working out disastrously if the doctors first recommendation is surgery, when physical therapy (rest + strengthening) ought to have been the first prescription.
      • armada651 7y ago
        There are exceptions of course, don't go for a treatment you aren't comfortable with. But the recommendation here was therapy.
    • Igelau 7y ago
      The GP didn't give 'advice' so much as they said "your medical records? ha, right... you're crazy." And then proceeded to shut down all avenues to further care and pain management. Honestly it sounds like the GP is so cynical about the hot garbage they perceive UK healthcare to be that they basically said "please go away so that our utter inability to help you doesn't weigh on my conscience any further... oh thank god you invoked the loophole that lets me kick you out now and pretend it's all really your fault"
      • armada651 7y ago
        > The GP didn't give 'advice' so much as they said "your medical records? ha, right... you're crazy." And then proceeded to shut down all avenues to further care and pain management. That's a patient's perspective, but how about a doctor's perspective? You've got a patient refusing treatment for what could very well be a psychosomatic condition and instead demanding opiods that are very likely to result in addiction. There is a large stigma around mental health, but there's no such thing as a person who's completely sane. Just because a doctor is saying you might have a psychosomatic condition is not the same as him saying you're deranged.
        • licebmi__at__ 7y ago
          I support your point, but there's also one more thing to consider. Some MDs share the social stigma around mental health, and won't waste the opportunity to make the patient feel like it's their fault because they don't want to get better, and that they should make space for patients who have real conditions.
  • scottlamb 7y ago
    > Psychosomatic diseases are a real thing though. You can have real physical symptoms. +1. Several people at work have reported that "The Mindbody Prescription: Healing the Body, Healing the Pain" helped their wrist pain go away. YMMV. But just as doctors shouldn't dismiss the idea symptoms are due to a "real" (read: physical) condition, folks suffering shouldn't dismiss the idea they can be cured (or greatly improved) through non-physical means, even if there is some physical origin. I haven't tried this book myself. I've had wrist/forearm/hand problems (weakness, tingling/numbness, pain, loss of flexibility, diagnosed as carpal tunnel and tendonitis), but they largely went away before I'd heard of the book. I think a bunch of things helped me, including wrist exercises suggested by a physical therapist, TENS (administered by the physical therapist), time, Qi Gong, meditation/relaxation techniques (I'd always had a lot of muscle tension, including tension headaches), and (later on) resuming rock climbing and weight lifting. So some combination of physical and mental changes.
  • curioussavage 7y ago
    Unfortunately for most people taking a break like that is impossible. I’m sure stress is a major factor in many of my health problems but the biggest break I can take is an hour or two to myself once a week.
• korijn 7y ago
  My experience is that in particular cases where multiple disciplines need to work together in order to reach a diagnosis fail. It is up to the patient to relay information between specialists. In my experience, they don't even look at the records and images their colleagues produce.
• jchw 7y ago
  I’ve had weird symptoms for over a year. If it’s not something plainly obvious, most doctors want you the fuck out of their office. No joke.
• neltnerb 7y ago
  Yes, this has happened to several family members in the US, though thankfully mine was diagnosed properly because I could point to family history. Initially they wanted to write it off to migraines (I can't blame them since it's more common and can have similar symptoms at first) and now nine years later it's painful to use my hands and I've mostly given up martial arts. It would almost certainly be worse if I hadn't had the family history to point to and actually convince them to do the tests that would confirm the diagnosis. For chronic illnesses defined by random irreparable damage the sooner you start treatment the better your outcomes are likely to be. I am surprised that four doctors in a row did this, that's shocking. Usually a second or third opinion is enough that at least one of the doctors is paying attention.
  • korijn 7y ago
    What diagnosis did you end up receiving exactly?
    • neltnerb 7y ago
      I wouldn't worry if it's little stuff, migraines really are weird. Don't anxiety yourself or anything, I just have a propensity for immunological stuff. In my case it was early symptoms of multiple sclerosis.
  • arkades 7y ago
    One of the doctors took them seriously, did a biopsy, and gave them a diagnosis. They did not like their diagnosis because “idiopathic” means “we don’t know what causes this,” which the patient translated as “go the fuck away.” As if all human disease is deeply understood and an admission of ignorance is equivalent to laziness. They then continued going to additional doctors.
    • armada651 7y ago
      > As if all human disease is deeply understood and an admission of ignorance is equivalent to laziness. People think that there is a pill or operation for whatever ails you, which is simply not true even with modern medicine.
• marcinzm 7y ago
  I've had better experience with older doctors who no longer care about maximizing their billings. Extra points if they consider most other doctors to be idiots and like to prove them wrong. Unfortunately to find good ones like that takes time, determination and being ignored many many times. >That story of how the doctors just dismissed her pain as delusion is terrifying. The frightening thing to me is that from my reading there is little recourse for her since the UK has a centralized health system controlled by GP referrals.
• arkades 7y ago
  You really don’t know how many hypochondriacs we get. And general anxiety disorder with a focus on healthcare. And totally reasonable people who start attaching every last twinge and twitch to their (real) core symptom, and want an answer that encompasses all of them. And these people seek care. A lot. Literally orders of magnitude more than ordinary people do. You have your one story of (x). I can tell you about a score-plus of nuts I see in a regular week. Many of them are frequent fliers: I will get to see the same ones pretty soon with wildly different symptoms that in no way relate to their current symptoms. They certainly don’t relate to the crap they brought me a month ago. I’ll take your wager for “more than half.” Dunning-Kruger is not your friend.
  • hestipod 7y ago
    I do. I worked in healthcare and the overwhelming majority of patients are legit. Same with any category where people are cynical and project that cynicism onto the majority. When I became a patient I became a victim of this categorization. I've been labeled immediately as drug seeking or mental or whatever and things have gone ignored or dismissed until I pushed long enough and hard enough for testing etc. I've told the story over and over irl about working in inner city hospitals and seeing people consistently dismissed and joked about for hours until testing prove them legit and then watching people scramble mostly to CYA not out of any empathy. Was a major contributor to my burnout in the field. Calling worried patients with scary symptoms "nuts" and their issues "crap" really sums up the sort of thing I am talking about and is what makes patients afraid their provider isn't going to do their best to help them. Empathy is required for good healthcare. I recently got another confirmed and terribly depressing diagnosis of an incurable issue, but the provider I was working with was so kind, caring, and informative it reduced the mental impact as much as is possible. A dismissive provider, who was ultimately wrong, a few weeks before had me in an even worse head space than normal until I got to someone good. When I reached out to the wrong one to notify them they didn't seem care at all and dug in harder despite the proof/labs etc. "A few bad apples" isn't because of the few bad apples. It's because the farmer decides all the apples are rotten, and throws them all out with the few rotten ones, while telling others constantly about those rotten ones as if they are the norm.
• tedunangst 7y ago
  Would it be better if the doctors told patients the condition is idiopathic?
  • marcinzm 7y ago
    In this case yes because then the patient could seek further experts who might be able to identify a cause. By labeling it psychosomatic you are forcing a path of treatment even if it's not the right path.
• justaguy500 7y ago
  I think it's mostly due to the 80-20 rule: Most(80%) issues doctors encounter are textbook cases with easily visible symptoms that match a known cause. The remaining 20% consist of rare problems that might be really hard to spot and diagnose. I'd guess doctors get a lot of unneeded spam visits from the mentally unwell, so it's really easy to get clumped into that same category as them if your problems aren't within that 80%
• shakna 7y ago
  Getting a diagnosis when you don't have something easily understood can be an utterly soul destroying process. I have fibromyalgia. Not as a label stuck to something that can't be understood, but firmly fitting to a disease that isn't yet fully understood. (Yay for me - I have every known symptom at one time or another.) It took ten years, an enormous amount of pain, two neurologists, three GPs, a psychiatrist and a pain specialist before they were able to nail it down - and now they're able to help. Unfortunately, there was a tendency to treat it as psychosomatic. Also unfortunately, treating it as psychosomatic promotes behaviours like "pushing through the pain" that are absolutely guaranteed to cause a flare up or major relapse in fibroymalgia. This kind of story created fear for you. And it should, I'm sorry to say. For the most part, you will suffer alone and without understanding, and it's up to the sufferer to push their story along until they get an answer. I'd wish that process on nobody.
  • cat199 7y ago
    > and now they're able to help. what was the nail-down / how are they able to help now?
    • shakna 7y ago
      Diagnosis is a diagnosis of exclusion. Eventually with my set of symptoms it became clear that only two illnesses fit well enough. Fibromyalgia or multiple sclerosis. A clear MRI eliminated MS as an option. --- Treatment is a multi-pronged attack. I have a drug cocktail aimed at desensitisation of the nervous system. It works well enough to take the edge off, but not during a flare up or relapse. It's the least important and least effective part of treatment. I have a psychologist, aimed at pain management. The mental techniques around dealing with pain and stress on a daily basis. This becomes more important during a flare. It is also probably the most important part of treatment. I have a physiotherapist. I need to maintain a certain level of physical activity or the illness can rapidly get worse, whilst at the same time, too much activity can also cause the same process. --- I should also point out that if I became completely resistant to treatment, a possibility for the future if things get worse, then my pain specialist is also involved in a series of trials using ketamine that usually results in desensitisation of the nervous system over the course of a couple weeks. Point being, there is always hope for increasing quality of life, even if there is currently no hope of cure.
• robocat 7y ago
  I suspect anti-american bigotry by the British doctor. It is a cliché that Americans are hypochondriac* (especially women) so I can imagine some stuck-up British guy being so completely unprofessional and damaging. * Why is it not HYPERchondriac? I wish medicine would replace hypo with another prefix: how many deaths and how much damage occurs by miscommunications due to mixups of opposites? Edit: hypochondrion means "below the cartilage" where the Greeks though the "seat of emotion" organ was - arrrgh.
• hogFeast 7y ago
  I think this is something that happens more in the UK. The NHS has a "policy" on these issues. If you have anything that is falls into the category of "poorly understood neuro", you are mad...according to NHS policy. What is even more disturbing though is that the research is fairly clear that these problems aren't psychological...but doctors within the NHS, usually non-researchers, are utterly convinced that it is which has massively hindered the amount of research on this within the UK. And the massive irony of this is that most doctors in the UK, usually not in primary care, will happily accuse patients of being mad...but there is almost no investment in psychological services in the UK. The doctors are seeing an epidemic of mad people...but don't think they need treating...logical. Btw, I look after a relative who has something like this and it is fucking terrifying (and upsetting watching someone get sicker every day with no professional help or even interest in help). These problems are usually genetic, if I get sick then I have no-one to look after me, and I know if I get sick there will be no professional help. Let's hope I am lucky.