9/12/08

So How Are Your Drugs Working 4 U?

A few things to consider when you are trying to unveil a health issue.

Most of us dive to the doc. Say 90% or more?

That's not necessarily a bad thing. But I would recommend a few things in doing so. Before I do, let's take a look at a few things.

A REAL LIFE STORY:
Recently someone (aka Mary) shared a sobering story with me. She recently came up against an alarming health issue with a dear family member (severe depression). The doc prescribed a high dosage of med, to which the side affects were not functional for daily life.

Not feeling comfortable with the doc's reasoning, Mary sought out other resources. By the way, not before the doctor insulted Mary. Mary, you see, had been doing her job and was asking LOTS of questions. The doctor suggested that because of her inquiries Mary was being too nervous and needed medication herself. Huh?

Then the doctor went on to say, "I feel sorry for you husband." Why? She said because he had to live with Mary. Are you shocked? Amazing. Mary's deafening silence and shocked look hushed the doctor. She was asking for a law suit, if you ask me. True lack of professionalism.

Mary sought a second opinion (good 4 her) from a doc in a different field. This doctor clearly felt the med dosage was way too high. They reduced the med. This would be a longer process than slam dunking a strong dosage for quick results, but providing better life functions.

Though it helped, there were still compromising effects.

Mary continued to look into other avenues of what was indeed going on. Upon further study, she discovered that the med her family member had taken for an overseas trip to prevent Malaria could be part of the problem. Its known side-effect can cause depression. She went back to the doc with this info to which the doc responded with, YES, she had seen these types of cases. What to do now? The damage had been done.

All that to say, why weren't these types of questions asked by the docs? Like had the patient been on any med in the last 6 mos? Under any undue stress? To which they would have found a well of answers to the whys of the debilitating depression. And if they had asked the right questions in the first place, she would have never been put on the malaria Rx, or I would like to think so. For you see, had they asked, they would have found she had experienced depression in the distant past. Meaning, she was even more suseptible.

Which leads me to the three questions Dr. Jerome Groopman, who is the author of How Doctors Think, challenges US to ask doctors when we are searching for a diagnosis.
  1. What else could my illness be?

  2. Could two things be going on to explain my symptoms?

  3. Is there anything my history, physical examination, laboratory findings, or other tests that seems to NOT fit with your working diagnosis?

Dr. Groopman says that mostly it's not the technical problems but the mind of the doc that causes the misdiagnosis.

I say, too, it's what the patient decides who and what they are going to turn their lives and health over to, without question.

It's not even fair to put doctors in the same house as God. Most of them are trying to do us a service. WE are at fault as well. WE acquiesce. WE put them on pedestals. Our parents did. NOW is the time for change.

Stats and Research:

  • Medical misdiagnosis is not rare; 15% of all patients are misdiagnosed.

  • Research says about 8% encounter serious results, even death. All because of error, neglectful or not. Do you want to be that one of the 7-15 out of the 100?

  • Research show that a doctor is likely to interrupt a patient 18 seconds within the beginning of the interview. Ever had that experience? uh-huh. Time to get a new doc.

  • Accidental death caused by patients improperly taking meds soared over 700% from 1983-2004.

  • The greatest increase in deaths was with people in their 40-50s; 890%. That's alarming. The cause? Lack of understanding on how to take the meds. What to take them with and not. Mixing drugs with alcohol, and street drugs are causative. As well as mixing Rx drugs. Doctors need to step up a level with communicating this to their patients.

  • Painkillers rank at the top as the Rx most often mixed, causing death.

  • Now that potent drugs are finding their way to store shelves, the heavier the responsibility rests on the consumer to know HOW to take OTC (over-the-counter) drugs. This in itself is causing serious problems in the wellness industry.

Groopman says he believes there are three variables that cause a doctor to misdiagnose.

  1. Anchoring. Meaning they have the tendency to grab on to the first symptom, physical finding, or lab abnormality and make their diagnosis off of that. Therefore, not looking at ALL of the variables in the person's life.

  2. Availability. Like in anything we tend to grab the last case we experienced and attach it to the current situation. Counselors have been plagued with this for years. Doctors as well.

  3. Attribution. A doc may stereotype a person, example the elderly, then they attribute symptoms to that "type". Women are locked into certain stereotypes as well. Many have died because doctors were not as aggressive in their treatment as they were with men. EX: a woman is often seen as having emotional issues when she states she is having pain in her chest, left arm, and or upper back; whereas a man is immediately treated as though he may be having a heart attack. Too, I have seen women who were clearly showing every symptom of having a stroke and yet the treatment comes in the form of questions like, "Are you having anxiety over something?" Heck yes, Y-O-U!!!!!!

NOTE: In this particular case, I was present. I had no problem advocating with, "NO, they are having a stroke." And indeed they were.

A Personal Example To #3:

My mother fell, hit her back, and after a couple of days of pain, that wasn't going away, I took her to the doc. She was x-rayed. Her doc couldn't find anything from her observation. She gave her pain med, and told me to look for Shingles .

Huh?, I asked. The look I got was like, well never mind. I was told to watch for Shingles cause that was probably why she was in such pain. And that it had nothing to do with the fall. She also suggested it was all in my mother's head. You've got to be kidding me. Sorry folks, it was NOT in her head but in her body. Though I contended the diagnosis, I was clearly corrected by the x-pert. After all, what do caretakers know?

Guess what? Shingles NEVER showed up. And it took about two-weeks for her internal bruising to heal. That simple. And the pain meds only made her sleepy...didn't take away the pain...just sick.

Groopman says that some docs have a negative attitude toward certain populations therefore causing misdiagnosis. He cites a case where an elderly lady was suffering memory loss. The doc said she was senile. Her family pursued, thank God, and found she had anemia. And with a supplement of vit B-12, the doctor's diagnosis of senility quickly left. Hummmm.

What To Do?

GET PROACTIVE. Be responsible for your own life and for those you take care of. Worry more about the possible life issue at hand than being afraid of confronting the doctor OR nurse.

Who knows your body more than you do? Certainly not a doctor or nurse who sees you once in a poka-dot moon. Yes, they are xperts. But so are YOU. Get a grip on that before you so readily jump ship and into their boat of drugs % diagnoses. Think. Question. Think some more. And question more. Seek other options. Seek other sound advice. I said sound.

I'm not telling you to ignore what a good doctor has to share. But a good doctor will invite you into the diagnosis in some form or fashion. He will ask you questions, and he won't interrupt.

By the way, the next time that happens, YOU interrupt him, and walk out.

Sources: Dr. Jerome Groopman, How Doctors Think, 2008; University of California; AARP 2008.

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