Is medicine becoming too much for doctors to comprehend?...

I happen upon case after case when the doctors seem to be unable to correctly recognize and diagnose
so many conditions,
that I started to think either they are either grossly undereducated or flat out unwilling to dig deep enough = truly help the patient, or both.
Worst case scenario- some of them are so horrendously stupid they can't forest for the trees and must have passed their test by sheer luck or bought them.

I just watched an episode of Monsters Inside Me. - Sleeper cells

where a man was infected with a parasite that gave him a very definite symptoms, but none of the doctors was even remotely interested in getting to the roots of whats' causing this.
Even when his scrotum has swelled to extreme size, the urologist whom he went to see after a general look-over told him initially "I can't do anything for you".

It wasn't until the man insisted "there's gotta be something wrong with me somewhere" that the doctor finally has started taking more detailed, deeper history.
And as soon as he found out the man used to serve in Vietnam and contracted malaria that he immediately had an idea what it can be.

Then why in the heck's name he- the doctor!- did not has this initiative to look for clues elsewhere BY HIMSELF!- - and right from the start?!
why was he all too ready to walk away from this patient, who was suffering for 4 years - FOUR years!!
by now with unspeakable pain and misery and, as it later turned out - suffered irreparable damage from lack of care? if it wasn't for the patient's final determination yet another doctor would simply walk away from him.

I know of a case when doctor rejected cancer Dx on the spot because the lab test were inconclusive for it,
whereas the physical symptoms screamed cancer, which two weeks later was confirmed in a hospital after the patient collapsed from weakness at home. what kind of "doctor" is that?!

Is medicine becoming too big, to complicated a subject for today's mere human brain to comprehend?
Should it be divided in some sort of subdivisions and as such studied and practiced?

Risa

I think I've spent enough time as a patient to chime in on this. There are doctors that are good at what they do--they spot the obvious, then there are doctors that cannot pull together complexities.

I don't think medicine is too much. I think it comes down to brainpower and commitment. They really need to keep up with things. Unless they do a residency + specialization and really, really keep up on things they may miss things.

Risa, it's already divided into some really complex sub-specialities. Only problem is they are centered at elite medical schools and the docs are into research and are in teaching positions. They don't see a whole lot of patients. They may be a tip of the spear, but they don't integrate everything. Takes a bit of brain power, but not that much.

If you have a complex case, you as a patient really need to dig in and ask the questions. Become educated. Get copies of everything. Do research. Fire the bad docs and be willing to be a Jack Russell terrier and bite their asses.

It took 21 years for my blasted pacemaker. It's made a huge difference. I saw the top docs in the U.S. if not the world, and they didn't pull it all together. The heart rhythm problem was so obvious, it was missed. They were looking for very complex things, and the problem couldn't be diagnosed with all the mega high end testing that was done.

Now, from all the testing I have a problem with how much radiation exposure I've had. It may now be showing up in my bone marrow. The next hurdle.

I think it takes a talented doc (or team of docs), a dedicated patient, and really good diagnostics. $$$$$$ is important too.

I will admit, it's takes it's toll. I will not give the medical community a pass when it comes to tough cases. Granted there are truly unsolvable cases, but......

If you think through problems and approach them from many angles and think through what's going on you can arrive at different conclusions. Doing so may lead you to the ahhhh, ha!

It's not much different than complex manufacturing. It's problem solving.

Just my .02.

Tomorrow I see my doc, and a whole slew of problems to go over. Some new. We'll walk the process of figuring out the next steps.

Yes Risa, I agree.
There are doctors who don't even know the difference between HEADACHE and MIGRAINE.
I had to argue with our former Company doctor because of this. I became almost rude at a certain point of the conversation when he accused me to take too many medications. He sustained that a headache is nothing serious and that you just have to wait till it goes away.....

I think that a good doctor must have a particular intuition intelligence that makes him/her evaluate symptoms and must have a huge listening capability. Too many physicians, instead, just applyprotocols which probably are fine for 90% of the cases, but that 10% of patients whose symptoms are vague or can be cheating, it takes more.

Just my personal experience anyway....

I can concur Ivy. Totally from the UK (well my) Point of view.
I have missed you, are you okay?
Please get in touch Ivy.

P

I think it is laziness or complacancy or being overworked or just being disinterested. My doctor is so passionate about breast cancer and goes to all these symposiums around the world and if I had breast cancer, I would be in good hands. Alas, I have stupid migraines and he keeps trying to pass of stupid propanalol because that is all he knows. I've educated my doctor over the years on the new stuff but he keeps going back. I don't think he has ever picked up a book or article on migraines on my behalf.

In and out, as fast as you can. I'd love to change doctors, but there are so few around and I fear the others are just as bad as this one. Prescribe a Tylenol with Codeine and see me in a week. It is pitiful.

I feel hopeless and beleive that only an anerism or stroke will get attention in this pathetic system. A good doctor is hard to find.

Yeah, me too - mostly laziness and complacency but also the vastness of cases and unpredictability of symptoms...
Could be impossible to overcome for some.

Marc if you could see the entire episode you would understand why.

Here's the physician who was has seen the symptoms with his own two eyes, listened to the patients partial history, and as soon as he heard the patient was a former Vietnam vet he Dx him just like that.

So how come he didn't make any effort any sooner!
This tells me the knowledge was right there! he knew the symptoms, he just didn't bothered!
It's despicable.

Another case, the cancer - the doctor based his Dx solely on what the lab test were telling him.
We know how unreliable those can be.
what's more, apart from blood he ordered only the USG of the liver (the patient had extremely high Iron level and was an alcoholic) which happened to be inconclusive.

Basing his dx on the lab test results he ruled out cancer, which turned out was of the kidney and the bones.
After the proper diagnostic done at the main hospital and going once more over all the lab test he himself did,
then he found some things that should have alerted him something is seriously amiss, and profusely apologized.
What kind of dr is that? clueless, is what.

And don't even start me on Mystery Diagnosis or Mystery ER.. eh...

Risa

Today I saw my PCP for my chronic headaches and to go over my low Vit D levels.

He looked over my records from my neuro (I am with an HMO, both work for the same organization) and the neuro had correctly stated that my headaches may be due to neck and shoulder pain. Which is exactly what I told him. He only gave me pills for my headaches. I had also told him that I thought that my tight muscles might be due to statin use and/or vit deficiencies. He dismissed both contentions.

Any way, my PCP gave me a script for heavy doses of Vit D to see if that my muscle tightness (myopathy) may be due to this deficiency. He did not think so, but he went along with me. I also told him that I going off the statins to see if that, also, may be causing the myopathy. I am sure that he was humoring me. Thats ok, at least I will have looked at this possibility.

I wonder, if these neuros or PCPs, look at muscular misalignments of the body as possible causes of headaches. I was told by a sport med. doctor that doctors receive very little training in this area. For me, the only thing that has helped lessen the headaches are neuromuscular therapy, physical therapy, somatic exercises, and acupuncture. All these therapies deal with muscles, making me think that the cause of my headaches are a muscle misalignment of my body.

Could it be that doctors do not look at the muscular system? And while, our heads may be hurting, the cause of the pain may be due muscle tightness elsewhere in the body? The muscles do compensate for bad posture, pain med after effects, and injuries, thus causing misalignments.

Anyway, could this lack of dx for vitamin deficiencies or muscle problems, be a problem for some of us headache people?

Well, I better get of my soap box, thanks for hearing out my theory. I am having a good day with a very mild headache (I went to the acupuncturist yesterday).

Martin

Martin

Martin,

Did they diagnose you with a myopathy? EMG, biopsy, labwork?

Myopathy is a disease of the muscle fibers (statins can cause it) vs. Myalgia, which is muscle pain.

Statins nailed me very hard and did result with myopathy.

And you're absolutely right about neuromuscular involvment in the back, shoulders and neck causing head pain.

Porsche Fan said:

Did they diagnose you with a myopathy? EMG, biopsy, labwork? Myopathy is a disease of the muscle fibers (statins can cause it) vs. Myalgia, which is muscle pain.

No, I am just taking a shot by taking Vit D therapy and being off the statins. If I still have the problem, I will request testing. As for lab work, creatinine kinese testing for muscle problems for about 1% or so of the statin population, tests show normal ranges, while still suffering from myopathy/myalgia.

Thanks for the definition of myopathy and myalgia. I took the definition of myopathy to include muscle cramps and stiffness. As for myalgia, I had forgotten the definition.

No problem Martin.

Statins definitely can cause a lot of problems. Didn't know if you had to go through the myopathy testing process or if you were going to have to. Muscle biopsies really hurt, and causes some serious pain for about 2-3 years.

The Myalgias hurt as bad as migraines--if you can picture having a migraine in a quad muscle, then you have a good idea.

I've been on Vit. D supplements for about 3 years now. I don't really notice any difference.

Crestor is the most powerful statin and can cause the most extense myalgia, and a myopathy while Zocor and Pravachol are a bit nicer on the muscles.

Coenzyme Q10's results are very anecdotal for statin muscle pain.

-mgb

mjb said: I've been on Vit. D supplements for about 3 years now. I don't really notice any difference.

Crestor is the most powerful statin and can cause the most extense myalgia, and a myopathy while Zocor and Pravachol are a bit nicer on the muscles.

Coenzyme Q10's results are very anecdotal for statin muscle pain.

I have been on Zocor since Nov 2003 and Coenzyme Q10 for three years, I don't think it has helped. I checked my appt calendar since early 2004, and I noticed a lot of trips to chiros, acupuncturist, and massage therapists for very tight shoulder, upper back, and neck muscles. Simple tai chi moves would make my muscles very sore. I gave up going to the Gym and taking walks. I took a lot of Advil. It wreaked my stomach. Before that, I was on Lovastatin and niacin, if there was a problem, it was very slight.

Headaches started on Dec 5, 2006.

Only, an experienced neuromuscular therapist and an accomplished acupuncturist (I've tried four) have lessen the muscle tightness. Once, the HA was almost gone for about a week. What a week! These therapies make it, so Tylenol and Midrin work to a certain extent.

The three preventives I tried 1) tofranil was no help with the HA, but also had urinary side effects. 2) lamotrigine helped but I could not take the lower back pain, gastritis, and sound sensitivity (mild) which I still have, and Baclofen, it works but makes me groggy the next day. Some days, I use the Baclofen.

As to the Vit D and going off the Zocor, we will see. The Vit D dosage is 50,000 I.U. weekly, I will check levels at the end of three months. I had been taking 2000 I.U. D3 for about two months, still my levels were low.

Martin, still looking for the magic bullet!