5 ms·

My mother got a tick bite and felt off and the doctor told her she had allergies and sinus infection due to high pollen. Luckily my younger brother is a physic

My mother got a tick bite and felt off and the doctor told her she had allergies and sinus infection due to high pollen. Luckily my younger brother is a physician and told her to go back and ask for a Lyme disease test. They said okay but said Lyme disease is really rare and wasn’t necessary. Long story short she was positive but was caught early enough that 30 days Doxy was all she needed. That same year I was bitten and had a super itchy spot near my private regions. It was crazy itch and made a bullseye rash. I went to a clinic and they said they had never seen the bullseye rash and it was textbook Lyme disease (or one other common tick disease). Same was treated with Doxy and was fine. It’s an strange disease because if caught early super cheap antibiotics work well… but if has spread through your body it can take years to recover and be quite serious!

The5thElephant 1y ago
Why have I heard so many stories of doctors not wanting to diagnose something as Lyme disease?
- soulofmischief 1y ago
  I literally used to get laughed out of the clinic, told I was a healthy young male and just needed to exercise more. After a decade of this, I was finally diagnosed with gout, something doctors had just been lying about testing for. No one could believe someone could have gout in their 20s (It's been developing since my late teens and I've generally had arthritis my entire life, since I was a child). It took a physician's assistant, who happened to see me one day when both of my doctors were on their third extended vacation of the quarter, to hear my plight, take my suggestion of gout seriously, and do the leg work, also revealing to me that "full test panels" don't include uric acid by default and that my doctors had been lying to me about their thoroughness. The assistant was also massively more knowledgeable about the disease, its history, the history of treatment, etc., and disease in general, than either of the two doctors running the clinic. Really opened my eyes.
  - The5thElephant 1y ago
    Funny enough I also got diagnosed with gout once in my 20s. I have always had somewhat bad toes/bunions (probably partially genetic, and partially wearing only tight soccer shoes as a kid) and I went to a wedding wearing some new leather shoes that I hadn't broken in yet. The next day I woke up with a fever and horrific pain in the sides of my toes. Went to doctor and they did some tests and were also seemingly surprised at the results indicating gout. They asked me to come back in a week to double check, and by then my symptoms were gone and the tests no longer indicated gout. Our bodies are such strange mechanisms.
    - soulofmischief 1y ago
      > They asked me to come back in a week to double check, and by then my symptoms were gone and the tests no longer indicated gout. Ha. Do you still have symptoms? If not, yea just a bad initial diagnosis. If you do still have symptoms sometimes though, it should be noted that gout is hard to test for when you're actively experiencing aggravated symptoms, as the uric acid crystals are lodged into your tissue and not freely available in the blood stream / urine. This exacerbated everything quite a lot, as when I was much younger I definitely got uric acid tests done when my symptoms were at their worst.
  - anitil 1y ago
    I have seen young men get diagnosed with gout, but they were Islanders (Samoans and Maori in my case), who I believe are at a higher risk so doctors are more aware of it
  - AdamN 1y ago
    This is why, although I know there will be problems with it, we should get AI and blood tests more accessible for individuals. Accessing the healthcare system for "I know I'm not 100% but ... I don't have anything specific wrong like a broken bone" is basically a crapshoot - and a totally stupid one.
  - jerlam 1y ago
    I wonder if the medical textbooks only mention gout as a historical curiosity and not as a modern day disease. I have an older relative with gout, have met someone in their 30s with gout, and yesterday heard a story about an acquaintance with gout, so it's not that rare anymore.
- dessimus 1y ago
  Lyme Disease : PCPs :: Lupus : Dr. House?
- BiteCode_dev 1y ago
  Doctors are trained to be arrogant, dismissive of unknown unknowns, and with a terrible understanding of statistics. Add to that: - They have a lot of patients and not enough sleep. - They need to pay back a huge student loan. - They hold terrible responsibilities and risk being sued. - They don't have much time for themselves, let alone update their knowledge. - Most patients are overreacting idiots, so it's a winning strategy to ignore what they tell you most of the time. - They are not trained nor selected for empathy or open-mindedness. And you get so many medical errors. Basically, you have to double-check everything they do, and endure their cynical rebuttal when you make suggestions, ask questions or try things they didn't request. I had to face many such errors myself, two almost lethal. When you can, shop for one that is both good and is open to discussion. But even then, there is a limit. At some point, your doctor WILL fail you, so you have to take responsibility, usually when you're weak and at a low point in your life. And if you are wrong, people will tell you you should have listened to your doctor, but if the doctor is wrong, well, shit happens. One of my practitioners is a friend of 15 years, I literally lived with him, he is considered top in his specialty. I'm surrounded by people working at the hospital. He saved my life once. Even that is not enough. I still have to double check stuff every time.
  - caycep 1y ago
    I would say, it depends. I also have a lot of colleagues who overtest out of paranoia and risk avoidance.
  - newyankee 1y ago
    Makes you question, how bad could an all encompassing AI be at diagnosing given enough multimodal data
    - adventured 1y ago
      One can debate its merit right now, the upside / downside equation. In 10-20 years? Game over. Doctors will largely be the physical space touch point. AI will in effect use meatbags to interact with the patients.
- wyager 1y ago
  The majority of doctors I've interacted with, with a low-single-digit number of notable exceptions, seemed to estimate their own intelligence at about 1 or 2 stddev higher than it actually was. Combine this with (I imagine) a large number of legitimately stupid and/or hypochondriac patients, and you have a recipe for really shitty diagnostics.
- fma 1y ago
  American doctors are also reluctant to do rabies shot. Yeah they are expensive, the risk is low and there are ways to rule it out, but I'd rather not die. Other countries can get them anywhere for cheap. Here...thousands of dollars in the ER. One reason could be its just not administered enough. The other is, for profit American medical system because no one wants to die.
  - hilbert42 1y ago
    "Other countries can get them anywhere for cheap." Those of us outside the US understand the US health care system is more profit orientated than many other countries but we cannot understand the huge price differentials, they're often huge in comparison with many others. Surely figures that high are nothing other than price-gouging. (Even if demand is low and the stuff has to be imported the additional costs can't be that costly. Surely not?) So why doesn't consumer and or monopoly law kick in to stop it (as it does in many other places)?
    - just6979 1y ago
      Because the US has absolute garbage enforcement of consumer safety and anti-monopoly laws, and those laws aren't exactly strong or clear to begin with. Health-care industry lobbyists spend huge sums to convince lawmakers that they're not price-gouging and _any_ kind of price control is somehow illegal and/or will destroy the economy. This allows them to keep prices high, colluding with health insurances to make deals that incentivize buy insurance (direct-to-patient prices for many medical things are much higher than the prices that the insurance companies pay). Prices high enoguh to make it worth spending so much on lobbying. It's completely backwards and very anti-consumer/anti-patient, but money has such an outsized influence on our politics, it's ridiculously difficult to get changes made that actually benefit the average citizen.
      - hilbert42 1y ago
        Yeah, I sort of thought that. But the US is such a competitive place one would have thought competition would have kept prices down. What seems to be happening is the nature of health care allows it to be a 'closed shop' so they do what they like. FYI, I'm in Australia where we have Medicare which is a universal health care scheme† supported by government taxes. It's not perfect and could always do with more money but people here love it. Tampering with it in a negative way would be electoral suicide for a government at election time. That said, a visit to a GP is only partly paid for by the scheme (about 2/3)—that is unless the Dr 'bulk-bills' all accounts to the scheme and many don't. Bulk-billing allows a patient to walk out of a surgery without paying anything. That long preamble lets me lead on to something you may not be aware of although many of your countrymen would be. Some years ago the government made changes to the Pharmaceutical Benefits Scheme—which is the drug store equivalent of Medicare where drugs are heavily subsidized—because many Americans who were visiting here used to stock up on prescription medicines and take them home because the price differential between here and the US is so great. Incidentally, COVID vaccinations are also free as they're covered by the scheme. Previously, anyone could take a scrip to any pharmacy and have it filled without ID, now one has to have one's Medicard card with one or have its number on file and the Dr's script has to match that ID. The pondering issue for us is why doesn't the US population rise up on mass for a better deal? _ † Some years ago I heard an American (I think it was Michael Moore) say that Roosevelt had intended to set up a similar universal health scheme but he died before he could implement it. Is there any truth in that?
- pjc50 1y ago
  Certain things are way under-diagnosed, especially anything relating to a chronic condition that does not have an easy biomarker. Doctors get cynical about their patients. A particularly nasty one is endometriosis.
- treis 1y ago
  Chronic Lyme Disease is a popular choice for hypochondriacs (or maybe they're actually right, who knows?) so it gets raised eyebrows when people think they have it.
jtbayly 1y ago
My wife got a tick bite in Indiana. Went to Wisconsin shortly after, and developed bullseye rash. Went to clinic and they told her she couldn’t get Lyme’s in Indiana. She insisted on a test. Positive. Doxy cleared it.
greenie_beans 1y ago
always have to argue with a doctor to get a lyme test. i'm like come on please i spend a lot of time in the woods idgaf what you think i'm paying for it
- n8henrie 1y ago
  Why don't you order one through labcorp in that case? Can't one just order and pay for bloodwork directly through a lab without a physician visit? I am a physician in the US and have done this before (prior to medical school), so I had always thought it was (still) possible.
  - jerlam 1y ago
    Labcorp doesn't appear to have a lyme test easily available to the public, but Quest does: https://www.questhealth.com/product/lyme-disease-test-with-confirmation-6646M.html https://www.questhealth.com/product/lyme-disease-test-with-c...
  - greenie_beans 1y ago
    have no idea, never heard of that. i'm an idiot when it comes to my health care. i've only ever been to the doctor when i have a problem. have been in and out of health insurance so to me going to the doctor is an extremely expensive thing to avoid. especially when doctors are dismissive about whatever issue i come with. i've never been for preventative care, don't even know what i would say when they ask what i'm there for.

The5thElephant 1y ago

Why have I heard so many stories of doctors not wanting to diagnose something as Lyme disease?

soulofmischief 1y ago
I literally used to get laughed out of the clinic, told I was a healthy young male and just needed to exercise more. After a decade of this, I was finally diagnosed with gout, something doctors had just been lying about testing for. No one could believe someone could have gout in their 20s (It's been developing since my late teens and I've generally had arthritis my entire life, since I was a child). It took a physician's assistant, who happened to see me one day when both of my doctors were on their third extended vacation of the quarter, to hear my plight, take my suggestion of gout seriously, and do the leg work, also revealing to me that "full test panels" don't include uric acid by default and that my doctors had been lying to me about their thoroughness. The assistant was also massively more knowledgeable about the disease, its history, the history of treatment, etc., and disease in general, than either of the two doctors running the clinic. Really opened my eyes.
- The5thElephant 1y ago
  Funny enough I also got diagnosed with gout once in my 20s. I have always had somewhat bad toes/bunions (probably partially genetic, and partially wearing only tight soccer shoes as a kid) and I went to a wedding wearing some new leather shoes that I hadn't broken in yet. The next day I woke up with a fever and horrific pain in the sides of my toes. Went to doctor and they did some tests and were also seemingly surprised at the results indicating gout. They asked me to come back in a week to double check, and by then my symptoms were gone and the tests no longer indicated gout. Our bodies are such strange mechanisms.
  - soulofmischief 1y ago
    > They asked me to come back in a week to double check, and by then my symptoms were gone and the tests no longer indicated gout. Ha. Do you still have symptoms? If not, yea just a bad initial diagnosis. If you do still have symptoms sometimes though, it should be noted that gout is hard to test for when you're actively experiencing aggravated symptoms, as the uric acid crystals are lodged into your tissue and not freely available in the blood stream / urine. This exacerbated everything quite a lot, as when I was much younger I definitely got uric acid tests done when my symptoms were at their worst.
- anitil 1y ago
  I have seen young men get diagnosed with gout, but they were Islanders (Samoans and Maori in my case), who I believe are at a higher risk so doctors are more aware of it
- AdamN 1y ago
  This is why, although I know there will be problems with it, we should get AI and blood tests more accessible for individuals. Accessing the healthcare system for "I know I'm not 100% but ... I don't have anything specific wrong like a broken bone" is basically a crapshoot - and a totally stupid one.
- jerlam 1y ago
  I wonder if the medical textbooks only mention gout as a historical curiosity and not as a modern day disease. I have an older relative with gout, have met someone in their 30s with gout, and yesterday heard a story about an acquaintance with gout, so it's not that rare anymore.
dessimus 1y ago
Lyme Disease : PCPs :: Lupus : Dr. House?
BiteCode_dev 1y ago
Doctors are trained to be arrogant, dismissive of unknown unknowns, and with a terrible understanding of statistics. Add to that: - They have a lot of patients and not enough sleep. - They need to pay back a huge student loan. - They hold terrible responsibilities and risk being sued. - They don't have much time for themselves, let alone update their knowledge. - Most patients are overreacting idiots, so it's a winning strategy to ignore what they tell you most of the time. - They are not trained nor selected for empathy or open-mindedness. And you get so many medical errors. Basically, you have to double-check everything they do, and endure their cynical rebuttal when you make suggestions, ask questions or try things they didn't request. I had to face many such errors myself, two almost lethal. When you can, shop for one that is both good and is open to discussion. But even then, there is a limit. At some point, your doctor WILL fail you, so you have to take responsibility, usually when you're weak and at a low point in your life. And if you are wrong, people will tell you you should have listened to your doctor, but if the doctor is wrong, well, shit happens. One of my practitioners is a friend of 15 years, I literally lived with him, he is considered top in his specialty. I'm surrounded by people working at the hospital. He saved my life once. Even that is not enough. I still have to double check stuff every time.
- caycep 1y ago
  I would say, it depends. I also have a lot of colleagues who overtest out of paranoia and risk avoidance.
- newyankee 1y ago
  Makes you question, how bad could an all encompassing AI be at diagnosing given enough multimodal data
  - adventured 1y ago
    One can debate its merit right now, the upside / downside equation. In 10-20 years? Game over. Doctors will largely be the physical space touch point. AI will in effect use meatbags to interact with the patients.
wyager 1y ago
The majority of doctors I've interacted with, with a low-single-digit number of notable exceptions, seemed to estimate their own intelligence at about 1 or 2 stddev higher than it actually was. Combine this with (I imagine) a large number of legitimately stupid and/or hypochondriac patients, and you have a recipe for really shitty diagnostics.
fma 1y ago
American doctors are also reluctant to do rabies shot. Yeah they are expensive, the risk is low and there are ways to rule it out, but I'd rather not die. Other countries can get them anywhere for cheap. Here...thousands of dollars in the ER. One reason could be its just not administered enough. The other is, for profit American medical system because no one wants to die.
- hilbert42 1y ago
  "Other countries can get them anywhere for cheap." Those of us outside the US understand the US health care system is more profit orientated than many other countries but we cannot understand the huge price differentials, they're often huge in comparison with many others. Surely figures that high are nothing other than price-gouging. (Even if demand is low and the stuff has to be imported the additional costs can't be that costly. Surely not?) So why doesn't consumer and or monopoly law kick in to stop it (as it does in many other places)?
  - just6979 1y ago
    Because the US has absolute garbage enforcement of consumer safety and anti-monopoly laws, and those laws aren't exactly strong or clear to begin with. Health-care industry lobbyists spend huge sums to convince lawmakers that they're not price-gouging and _any_ kind of price control is somehow illegal and/or will destroy the economy. This allows them to keep prices high, colluding with health insurances to make deals that incentivize buy insurance (direct-to-patient prices for many medical things are much higher than the prices that the insurance companies pay). Prices high enoguh to make it worth spending so much on lobbying. It's completely backwards and very anti-consumer/anti-patient, but money has such an outsized influence on our politics, it's ridiculously difficult to get changes made that actually benefit the average citizen.
    - hilbert42 1y ago
      Yeah, I sort of thought that. But the US is such a competitive place one would have thought competition would have kept prices down. What seems to be happening is the nature of health care allows it to be a 'closed shop' so they do what they like. FYI, I'm in Australia where we have Medicare which is a universal health care scheme† supported by government taxes. It's not perfect and could always do with more money but people here love it. Tampering with it in a negative way would be electoral suicide for a government at election time. That said, a visit to a GP is only partly paid for by the scheme (about 2/3)—that is unless the Dr 'bulk-bills' all accounts to the scheme and many don't. Bulk-billing allows a patient to walk out of a surgery without paying anything. That long preamble lets me lead on to something you may not be aware of although many of your countrymen would be. Some years ago the government made changes to the Pharmaceutical Benefits Scheme—which is the drug store equivalent of Medicare where drugs are heavily subsidized—because many Americans who were visiting here used to stock up on prescription medicines and take them home because the price differential between here and the US is so great. Incidentally, COVID vaccinations are also free as they're covered by the scheme. Previously, anyone could take a scrip to any pharmacy and have it filled without ID, now one has to have one's Medicard card with one or have its number on file and the Dr's script has to match that ID. The pondering issue for us is why doesn't the US population rise up on mass for a better deal? _ † Some years ago I heard an American (I think it was Michael Moore) say that Roosevelt had intended to set up a similar universal health scheme but he died before he could implement it. Is there any truth in that?
pjc50 1y ago
Certain things are way under-diagnosed, especially anything relating to a chronic condition that does not have an easy biomarker. Doctors get cynical about their patients. A particularly nasty one is endometriosis.
treis 1y ago
Chronic Lyme Disease is a popular choice for hypochondriacs (or maybe they're actually right, who knows?) so it gets raised eyebrows when people think they have it.

jtbayly 1y ago

My wife got a tick bite in Indiana. Went to Wisconsin shortly after, and developed bullseye rash. Went to clinic and they told her she couldn’t get Lyme’s in Indiana. She insisted on a test. Positive. Doxy cleared it.

greenie_beans 1y ago

always have to argue with a doctor to get a lyme test. i'm like come on please i spend a lot of time in the woods idgaf what you think i'm paying for it

n8henrie 1y ago
Why don't you order one through labcorp in that case? Can't one just order and pay for bloodwork directly through a lab without a physician visit? I am a physician in the US and have done this before (prior to medical school), so I had always thought it was (still) possible.
- jerlam 1y ago
  Labcorp doesn't appear to have a lyme test easily available to the public, but Quest does: https://www.questhealth.com/product/lyme-disease-test-with-confirmation-6646M.html https://www.questhealth.com/product/lyme-disease-test-with-c...
- greenie_beans 1y ago
  have no idea, never heard of that. i'm an idiot when it comes to my health care. i've only ever been to the doctor when i have a problem. have been in and out of health insurance so to me going to the doctor is an extremely expensive thing to avoid. especially when doctors are dismissive about whatever issue i come with. i've never been for preventative care, don't even know what i would say when they ask what i'm there for.