16 ms·

it's really hard being a doctor. i have recently been trying to work out what is the best treatment with two doctors. both are decent, smart people who unders

it's really hard being a doctor. i have recently been trying to work out what is the best treatment with two doctors. both are decent, smart people who understand the current literature and who care about me. yet they came to quite different conclusions, and the arguments for either side are clear. there's just too little known about many illnesses (in my case, it's not mental, but ms) and you are left balancing risks and unknowns. i am not sure what the answer is. i wonder if casting a much broader net, and collecting much more data, would help. maybe every patient should be tracked in some huge database that can then be trawled for correlations? but then the privacy (and insurance) implications are worrying - for me, it would not be such a hard choice, but others with more to lose would understandably object. in some ways medicine has advanced hugely (for ~50% of sufferers, ms is no longer a big problem, which is awesome). yet there are sudden borders, and when you cross them, you are in the unknown...

tomfakes 13y ago
Off the original topic, but I read something in the last week for MS treatment that seems to cure it completely. This is done by taking the patient's own bone marrow, and transplanting it back after killing off the existing bone marrow. Somehow, this has shown to be a cure, but the doctors that came up with it don't yet know why - the treatment is ahead of the knowledge in this case. Edit: Here's the story I read: http://www.ottawacitizen.com/health/Ottawa+doctors+behind+breakthrough+multiple+sclerosis+study/8189161/story.html http://www.ottawacitizen.com/health/Ottawa+doctors+behind+br...
- andrewcooke 13y ago
  yeah, there are lots of new things coming through. but also, these things often are much riskier (or the risks are simply unknown because they are so new and, with chronic illness, you may be taking the drug for years). i think just this month something was approved (in the usa) that, for some people, apparently "cures" ms with just a few injections over two years. one of the options i face now (far down the list, thankfully) is only safe for 2 years - after that you hope something else has come along... [didn't want to hijack the thread; posted initially because i think articles like this can lead to attacks on doctors, when often they are aware of the possibility that they are wrong, and are simply doing the best they can with limited data]
DanBC 13y ago
...add in the weirdnesses caused by off-label prescribing (frighteningly common with MH) and placebo / nocebo effects and it's easy to understand how difficult it is for clinicians and patients. Now think about children, where there's strong social influences, and where they might not have had symptoms for very long, and where few meds are licenced for use and it's quite scary.

tomfakes 13y ago

Off the original topic, but I read something in the last week for MS treatment that seems to cure it completely. This is done by taking the patient's own bone marrow, and transplanting it back after killing off the existing bone marrow. Somehow, this has shown to be a cure, but the doctors that came up with it don't yet know why - the treatment is ahead of the knowledge in this case. Edit: Here's the story I read: http://www.ottawacitizen.com/health/Ottawa+doctors+behind+breakthrough+multiple+sclerosis+study/8189161/story.html http://www.ottawacitizen.com/health/Ottawa+doctors+behind+br...

andrewcooke 13y ago
yeah, there are lots of new things coming through. but also, these things often are much riskier (or the risks are simply unknown because they are so new and, with chronic illness, you may be taking the drug for years). i think just this month something was approved (in the usa) that, for some people, apparently "cures" ms with just a few injections over two years. one of the options i face now (far down the list, thankfully) is only safe for 2 years - after that you hope something else has come along... [didn't want to hijack the thread; posted initially because i think articles like this can lead to attacks on doctors, when often they are aware of the possibility that they are wrong, and are simply doing the best they can with limited data]

DanBC 13y ago

...add in the weirdnesses caused by off-label prescribing (frighteningly common with MH) and placebo / nocebo effects and it's easy to understand how difficult it is for clinicians and patients. Now think about children, where there's strong social influences, and where they might not have had symptoms for very long, and where few meds are licenced for use and it's quite scary.