An Update on Patrick Volkerding 518
Noryungi writes "Patrick Volkerding, the maintainer of Slackware Linux has posted an update on his health problems on the ChangeLog of Slackware-Current. Unfortunately, it seems his health is getting worse and not better... Again, if you know some specialist in viral infections, contact Patrick ASAP. Hang in there, Pat!" Our original story.
Best of luck (Score:5, Insightful)
Re:Best of luck (Score:5, Insightful)
I'm a doctor at a teaching hospital so we see wierd stuff all the time. I'll give you my sideline quarterbacking of the situation.
First, you have a patient who is trying to diagnosis and treat his own condition. A good analogy would be a newbie blindly editing his/her registry. I know its the "hacker" way, but hacking your own body can be dangerous. It's difficult to reboot or reformat the body as a system.
Second, you can't have pulmonary "pops." If you pop a bleb, you develop a pneumothorax... and you are sick as poo. This can be seen on a chest X-ray and typically would need a chest tube to prevent respiratory failure.
He talks about going to Mayo... and multiple ERs. Doctor-shopping raises multiple red-flags.
His sedimentation rate (ESR) is normal. It is very, very difficult to have an infection or inflammatory process with a normal sed rate.
Obviously, I have not examined this guy. He might have a new disease that completely goes against science as we know it. But people come to us for rare medical problems all the time... we love it. When we find something rare, we jump around giving each other high-5s. We spend tons of research and government money trying to figure out these rare case. However...
I'm just not buying in this case.
Re:Best of luck (Score:3, Interesting)
ftp://ftp.slackware.com/pub/slackware/slackware-c u rrent/PAT-NEEDS-YOUR-HELP.txt [slackware.com]
Rodney has no ability
to directly admit me to a hospital without first sending me to an
infectious disease MD there who would have to agree with all of this.
I have an appointment on Friday.
What did the ID physician say?
All the cases of Actinomycosis I have treated have been pretty easy to diagnose.
Let's just assume for one moment... that this is not physiological possible. (Supratentorial, mental,
Re:Best of luck (Score:3, Insightful)
Re:Best of luck (Score:5, Insightful)
>diagnosis and treat his own condition.
This is usually the only way to get something fixed these days. Most doctors are very resistant to doing anything that could be called diagnosis. Their answer to everything is usually to ask you a few questions, interrupt you after hearing the first sympton they can connect with some common malady, and then decree what's wrong with you. As in Patrick's case, it's common for the doctors to ignore facts which don't fit (after all, how could stupid patients possibly know anything about all that hard "doctor stuff").
Most doctors seems to diagnose everything I get as "something that's going around" and prescribe antibiotics. I usually have to do their research for them and then come back for another visit, demanding the specific tests needed to diagnose the problem (which sometimes requires moving to a more cooperative doctor), and then insist on proper treatment based on the test results.
Fortunately, many medical texts are available online which contain the information needed to self-diagnose. But you still need a competent doctor to perform or authorize tests and prescribe treatments.
Over the years I've found it very rare to meet doctors who actually take an interest in diagnosing an illness by using specific tests to determine the cause instead of just prescribing antibiotics. They are out there, however, and worth looking for. Just don't expect to find one easily. Most doctors seem to be lazy, disinterested, or simply not capable of diagnosing patients. Sturgeon's rule (90% of everything is crap) applies to the field of medicine as much as any other field.
When I find a doctor that resists doing tests that could result in a diagnosis, in favor of randomly prescribing common drugs, and who argues against "doctor shopping" when a doctor is obviously wrong, it raises major red flags for me as a patient and is a good indication that a better doctor is needed ASAP. I hope Patrick can find some competent doctors in time. They're rare.
Re:Best of luck (Score:5, Interesting)
As the doctors were baffled by his condition, they were open to our suggestions and ideas. We were even able to review his chart (and ask questions) whenever we wanted (which is a lot different than most adult-hospitals I've been to).
What impressed me was the huge set of possibilities that the doctors had to consider in their decision tree. Minute facts about our son's case would shift the tree significantly, and the doctors were able to handle this large data set (and the changes) with ease. Their domain is many times more complex than software development, based on the size of the data, the quality of tools, and the integrity of the data logging (people tell many stories). Even better, these doctors were able to make me feel like an equal in a very difficult situation. That in itself is a hard problem.
Over the course of our son's time in the hospital, his condition was characterized in 3 ways. The first two didn't sit well with us, as we had experienced his episodes (heart attacks) first-hand. The doctors trusted us that the diagnosis didn't seem to fit the experience, and they persisted in asking us questions, and analysing the test results until something fit. It was amazing.
I've had other hospital experiences that were much worse, but the good ones are out there.
Re:Best of luck (Score:5, Interesting)
People get sick (usually with a viral illness), they go to the doctor and want a quick fix. The doctor is given two choices...
1. "It's a virus." No antibotic and educate the patient as much as possible.
2. "It's an 'infection'" and get the patient out with an antibotic.
So if doctors do the right thing and do #1, then the patients are unhappy. Doctors get tired of fighting for no reason and get bitter. This happens everyday in every "acute care" center in the US.
Now think of this in relation other common diseases that doctors can't fix. They can either prescribe different medications or they can try to educate the patient.
The only time education is appreciated and believed is when it comes from a physician that you know and trust. But who has a doctor (dentist, lawyer, mechanic, etc.) that they personally know anymore?
Yeah, it's sad for us too...
Re:Best of luck (Score:5, Insightful)
When I read this I was reminded of what my abnormal psych professor said at the start of class. "Don't start reading ahead. Don't just open the DSM-IV and start reading about wierd psychological problems. You're all perfectly normal and sane. When we study obsessive compulsive disorders, all of you are going to start thinking, 'I have these symptoms. I have OCD!'. You don't. When we start start reading about schizophrenia and people talking to themselves, and hearing voices, you're going to think, 'Wow! I talk to myself all the time. I'm schizo!'. You're not. None of you have the training or experience to diagnose anything. Don't act like you do."
Everytime you change doctors, you're starting the diagnosis over at step one. When you come in and say "I have disease X. Give me xyzzy, that new perscription drug I've seen on tv." The doctor thinks, "hypochondriac".
The reason he initially thinks it's "the thing going around", is because 90% of the time it is. Only when that treatment fails, will the doctor move off that. Instead of actually going back to the doctor in two weeks like he suggested, you go to another doctor who says, "Hypochondriac. Take the antibiotic and come back in two weeks if it's not working." Instead of moving to step 2, you've decided to shop around until you find someone who is willing to start at step 6. No wonder it's hard for you to find a doctor.
Re:Best of luck (Score:5, Interesting)
I once got sick enough where I thought I was paying for my sins before I died. I got on the Internet to see what my problem was, and had myself convinced that I had acute pancreatitis.
So I went to the doctor, with a semi-knowledge of acute pancreatitis, and described some of the symptoms I had read about. What was the result? Well, the doctor thought I might have acute pancreatitis. We did a rather expensive battery of tests to check for pancreatitis, kidney stones, gallstones, etc. etc. Nothing turned up.
By that evening I felt fine. It turned out to be some simple gastritis (probably due to some NSAIDs I was taking - without doctor supervision - for my tendonitis).
I sent myself to the ER because I tried diagnosing my own problem. I was fine, but I had to pay the price. It ain't cheap.
Re:Best of luck (Score:3, Insightful)
Funny, that seems to apply to a good proportion of the doctors I have seen. Things they (doctors) have not diagnosed when symptoms were obvious to someone in their field (or failed to send me to another doctor) have included: TMJ problems manifested as ear pain, went to ENT, nothing wrong), pinched nerve in neck (neurologist said nothing wrong), etc. These were eventually treated properly by GOOD doctors-who were i
Re:Best of luck (Score:4, Insightful)
I think that's a bad analogy: if he was treating himself, it might be like editing the registry. But recording symptoms and diagnosing himself is more like reading (and trying to understand) error messages. That's what even a newbie could and should do. -- Especially if his hacker friend is too busy to listen to his problems...
My best best wishes to Patrick. I hope he gets well soon.The Reality of the Medical System for non-MDs (Score:5, Interesting)
Also, how long will your doctor see you for? The typical visit time for my HMO is 2 minutes, and I've never personally been able to keep a doctor in the room for 5 minutes, even when it took longer than that span to explain my problem.
I've been in Patrick's position, having a chronic condition where I went through over a dozen doctors who were completely useless. All the doctors seemed to have the same set of flowcharts for diagnosing me and never listened to what I said. Each GP did the same tests, sent me to the same types of specialists, and gave up at about the same time. They were like bad help desk personnel reading from the same script.
Fortunately, I met someone with the same problem and went to her doctor (that she'd found through a multi-year search like the one I had been doing). Her doctor was outside my HMO and quite expensive as a result, but well worth the cost as he spent the time to talk with me and learn my medical history, diagnosed the problem correctly, and prescribed a successful set of treatments.
Perhaps you would know the right person to go to immediately, but most of the rest of us are trapped in the HMO system without your connections to find the right person or to convince most MDs to spend more than a couple minutes with us.
Re:Best of luck (Score:5, Interesting)
Re:Best of luck (Score:5, Informative)
I completely agree... thanks for clearing that up. I'll even support your clarification for you.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?c
The objective of this study was to evaluate the sensitivity of C-reactive protein (CRP) elevation compared to erythrocyte sedimentation rate (ESR), leucocyte count and thrombocyte count in the diagnosis of infective endocarditis (IE). It was designed as a prospective study of suspected episodes of IE in adults in tertiary care at a university-affiliated department of infectious diseases. In 89 episodes of IE, CRP was available from the start of treatment. Median age was 66 years, 45 were men and 44 women. Median CRP concentration was found to be 90 (range 0-357) mg/l with only 4% normal values. Episodes involving native valves had higher CRP than episodes occurring with prosthetic valves. Staphylococcal origin, short duration of symptoms, short duration of fever and highest recorded temperature all correlated to higher CRP levels. The CRP response was also prominent among patients > 70 years old. Among non-responders, a few cases with simultaneous cirrhosis were noted. ESR was less sensitive than CRP, with a normal level in 28% of the episodes. It was concluded that CRP determination is superior to erythrocyte sedimentation rate, leucocyte count and thrombocyte count in the diagnosis of infective endocarditis.
Re:Best of luck (Score:3, Informative)
I have gone through this several times with my mother, who has had colon cancer for about 4 years now. In her case, the initial diagnosis was not the problem, that was crystal clear. But when it came to treatment - yes, we did LOTS of doctor shopping and had multiple independent doctors (who were not active clinicians anymore) work
Re:Best of luck (Score:3, Informative)
Patrick, don't listen to this #$%@ doctor, keep reading and fighting for your health. If you are reading this patrick please remember to remind your doctor's you have a brain, and read up on patient rights. If you get really frustrated ask to speak to the Hospital Administrator the next time you are in the ER. Nothing says action like calling the Money, I mean boss. If it is the weekend ask for the nurse or doctor admin that is covering the hospital (not
Re:Best of luck (Score:5, Informative)
I assumed that this was posted (like everything else) on slashdot to generate discussion and comments. I did so. If you don't like my opinion, you can set me as your foe and choose to ignore my future posts.
If you were to reread my post, I wasn't giving advice. I was just giving my opinion of his situation.
You get what you pay for. (Score:3, Funny)
Obviously, I have not examined this guy. He might have a new disease that completely goes against science as we know it. But people come to us for rare medical problems all the time... we love it. When we find something rare, we jump around giving each other high-5s. We spend tons of research and government money trying to figure out these rare case. However...
I'm just not buying in this case.
*****
When his story was first posted on slashdot, several of the hospital network gurus came up to me and as
Re:You get what you pay for. (Score:5, Insightful)
In a world where 1% of the people provides food and another one prevents housing, why can't you get free healthcare in America. It would cost a few percent of the war in Iraq (which will flood the hospitals in the years to come, even if the fighting would stop now).
Anyway, the repuplican party is showing the whole world that a country led by companies and bureaucratics can be equally bad to those regimes you just mentioned. It just takes most of the public in the US some time to catch up with the rest of the world on this.
And as a last point, yes, I would go to my doctor, and if he can't fix it or points in the direction of a specialist, THEN I would go to that doctor. How the hell should I know what I've caught if I just feel sick. I would check the diagnoses of the doctor as well though.
Re:Best of luck (Score:5, Insightful)
If I were to see him and if I were to decide that he didn't have some horrible medical illness... would he believe me?
I would likely be included as one of those damn, nonbelieving doctors in his next posted update. Neither he nor I would gain anything from that.
Re:Best of luck (Score:5, Informative)
One of the reasons I stay in a teaching hospital is so I will not be pressured by the marketplace to see X number of patients per day.
Sometimes I see 4 in a morning... sometimes I see only one or two patients. I am in a unique position.
By the average person allowing HMOs, insurance, and the government to try to control medical costs... the system is now completely broken. Fossils like me hide out in teaching colleges where, for now, we have some insulation from the marketplace.
Re:Best of luck (Score:3, Interesting)
No clue how to reach Pat, so I'll assume he will be thoroughly reading the responses to the post. I understand his email would otherwise become unuseable.
I noticed last week that in British Columbia (Canadian west coast), a tropical fungal infection has been on the rise. It's often misdiagnosed, and it's been a bit of a problem in B.C. recently.
Take a look: CBC story from 23 Nov 2004 [www.cbc.ca], and CBC story from 25 Nov 2004 [www.cbc.ca].
Cryptococcus neoformans infection seems to cause serious lung and CNS problems. It's a
Humour (Score:5, Insightful)
Great to see he's kept his sense of humour.
Good luck Pat (Score:5, Insightful)
Re:Good luck Pat (Score:2, Insightful)
Well... (Score:3, Insightful)
What does your actual Doctor think of everything that is going on? You do have a family doctor, right?
Keep this up and the next /. post is going to be your Obituary. Not being a troll, but you need to stop with the games and ge tthis fixed.
Re:Well... (Score:2, Insightful)
I tend to agree with the GP, though. Continuity of care is essential to getting treated. Between his p
Bacterial, not viral (Score:5, Insightful)
Which can happen.
Med Labs routinely ignore mouth bateria in samples.
Antibiotics tailored to leave them alone.
Antibiotics don't work on virii, at all.
Needs old fashioned or special antibiotics.
Some heart disease caused by infection.
Still learning how much disease caused by infection.
Doctors don't do unusual very well.
Needs to get lucky with right doctor.
Nothing wrong with defending yourself.
Re:Bacterial, not viral (Score:2)
Re:Bacterial, not viral (Score:2)
All haikus are the same length - 5/7/5 - so one cannot be longer than another, else it's not a haiku.
Re:Bacterial, not viral (Score:3, Funny)
Re:Bacterial, not viral (Score:5, Interesting)
Then my GP retired, I picked up a new one who gave me a going over, and it took him 5 minutes to diagnose a chronic low level tonsil infection. You have no idea how good it's felt since I had those fuckers out. 12 goddamned wasted years because doctors couldn't be bothered with the simple things.
Re:Bacterial, not viral (Score:3, Interesting)
Re:Bacterial, not viral (Score:2)
Re:Bacterial, not viral (Score:5, Informative)
The only time we don't report out normal mouth bacteria is when we are working with a specimen from, uh, the mouth.
he scares me (Score:3, Interesting)
"Anyway, I'm still hoping to get the treatment that I'm sure I need, but if there's an insistance on clinical proof first and treatment second, the proof might be found at autopsy time."
Re:he scares me (Score:3, Funny)
Of course he was, but then so was B. P. Roberts when he had "I told you I was sick" inscribed on his crypt.
Cynical humor is the best way to stay sane when you're dead.
KFG
He found the Oregano oil ... (Score:4, Informative)
At least he found the Oregano oil
Hope Patrick is feeling better soon - cardiac stuff is scary++ and the things he describes are going to cause him long term troubles even if he does recover
Re:He found the Oregano oil ... (Score:2, Insightful)
Enjoyment has been tied to improved immune function and when it comes down to it with or without anti-biotics his immune system is what has to kick the bacteria.
From time to time you read anecdotes a
Oregano Oil is interesting (Score:3, Insightful)
Usually what you see sold in places like vitamin shops etc is a concentrated oil diluted with olive oil. Typically, you will get a 1 or 2 percent solution. And it is relatively high priced.
That said, you can order reaso
He needs to relax (Score:5, Interesting)
Unfortunately, these advantages can quickly turn into a liability. In the same way that a doctor may end up losing his shirt when he starts daytrading, experience and competence in one area does not necessarily translate to the next. Confidence however, generally does.
He's frequently using medical terms in very poor "context" for lack of a better expression. While technically appropriate, it ends up reading more like an essay written by someone who used a thesaurus too often without knowing exactly what the words mean.
He has been to many doctors, and all of them have found little to nothing wrong. This is drastically different from his own assessment of looming death. Statistically, from the number and variety of doctors he's visited, a false negative at this point is incredibly unlikely. As the saying goes, when everyone else is wrong, you're probably wrong yourself.
Yes, it is important to verify information and diagnoses given to you. But it isn't critical evaluation to assume a conclusion from day one, and stick to it regardless of multiple, consistent, informed opinion.
But then again, if he ends up dying from some bizarre rare disease, I'm going to feel pretty bad about this post.
Re:He needs to relax (Score:3, Interesting)
check out http://www.nnff.org/ [nnff.org]
its a site filled with stories from survivors of that flesh eating disease.. most of the stories talk about going to several doctors and not being diagnosed correctly until they're almost dead
Re:He needs to relax (Score:5, Interesting)
Yes you will, because you know --even if you don't admit it-- that the medical industry in the US is very, very out of touch with the actual needs of people, and more in touch the the "needs" of big pharma.
I've seen it first-hand, with the death of my brother-in-law, what doctors do in order to not make "controversial" actions, and not make a wrong prognosis (any prognosis, actually).
So, what's happening? No hospital will take Patrick in without a definitive diagnosis, and no doctor will make the diagnosis without proof, and the proof is inside Pat right now (biopsy), so it has to be obtained in a hospital, and no hospital will take Patrick in without a definitive diagnosis... (ad nauseam).
It really sux to be in his situation right now, I hope he finds a real MD which will listen to him, and make actual decisions.
Hang on Pat, you'll find him soon enough.
-gus
Re:He needs to relax (Score:3, Insightful)
Re:He needs to relax (Score:2, Insightful)
Re:He needs to relax (Score:5, Insightful)
I can't disagree with this strongly enough. This is very true for common illnesses, but very untrue for rare ones. I should know: I was recently diagnosed with Hodgkin's Lymphoma, a rare cancer of the lymph system that about 8,000 people will be diagnosed with this year in the US [1]. I had the symptoms of it (swollen glands, itchiness; ie very nonspecific symptoms) for nigh on 3 years, and had presented repeatedly to multiple doctors, all of whom missed the forest for the trees. I knew something was wrong with me (even, I think subconciously, that I had cancer), but I believed the doctors when they diagnosed allergies, or mononucleosis, or some other prosiac illness. It was not until the disease had spread extensively until it was drop dead obvious that something was really wrong.
I agree with the spirit of your post: he should let the doctors do the diagnosing. However, he should very strongly try to find the right doctors. Just like programmers, there's a huge disparity in talent between the good and the mediocre. Luckily, I found some good ones (I work at Mayo Clinic), and I'm doing much better now.
-c
[1] http://www.lymphomainfo.net/hodgkins/incidence.htm l [lymphomainfo.net]
Re:He needs to relax (Score:5, Insightful)
Dude. The other day, a porn site popped up on my computer. Just popped up ; I didn't click anything. I ran Norton Anti-virus. I ran AVG. I ran ad-aware and spybot. I checked Windows update, I rebooted, I swore. Everything told me my computer was fine. Clearly it is, and I am mistaken.
Re:He needs to relax (Score:3, Funny)
Re:He needs to relax (Score:3, Interesting)
My brother has a problem with his inmune system that went unnoticed by doctors for a long time. He has been in and out of clinics his whole life. At one point he developen an infection in one knee that wouldn't stop with anything, even as he was being treated on the best clinic in town (the same he went to all his life). The knee problem only got worse and worse, even after being for over a month in the clinic.
Thank God my parents are biologists, and took the task to thems
Re: (Score:2, Interesting)
Check him in (Score:3, Funny)
I personally think he should be checked into CVS.
Thats way, at least we have a backup..just in case
recent trend (Score:5, Interesting)
Re:recent trend (Score:2)
Find a good doctor and STICK WITH THEM! So many people bounce around from one doctor's practice to another and then (big surprise!) your new doctor doesn't know you, doesn't know your history and doesn't want to waste the time doing either (they know you'll be leaving them for another practice in a few months anyway).
Patrick doesn't seem to have
Re:recent trend (Score:3, Insightful)
I have noticed this too. Now before I say what I'm about to say let me just preface my comments by saying that I'm a conservative with a lot of doctors in my family, and in the past I have been staunchly against socialized medicine and gov't involvement in medicine. However recent events involving my mom's medical condition have led me to change m
Re:recent trend (Score:3, Insightful)
Re:recent trend (Score:3, Informative)
I've noticed that in the last few years (maybe it's just my perspective, I don't know) doctors seem less and less likely to actually listen to their patients. I have recurring tonsilitis that I get at least once a year and usually more. I have been going through this since I was 6, when the doctors refused to take my tonsils out even though my mother wanted them to.
So basically, you are trusting your mother's medical judgement over your doctor's medical judgement?
IANAD, but googling, there seems to
What scares me.. (Score:3, Informative)
Surely they should have him in until they get to the bottom of this! Our NHS may be in pretty rough shape but you if staggered into hospital with some of the symptoms he has been having, he'd be in a bed and getting looked at and wouldn't be allowed to leave until he was fixed up, or at least they had identified the problem and knew how dangerous it was and what they needed to do to fix it!
Scary, really scary. Good luck Patrick.
Scary is right... (Score:2, Insightful)
RTFM (Score:5, Insightful)
If he is as sick as he says, _any_ physician would insist on having him hospitalized and having multiple consultants see him (notably, infectious disease and oncology.) He symptoms suggest a progressive disease that requires agressive intervention - and that doesn't mean trials of expensive antibiotics.
He has either failed to see a primary care physician, or he has refused appropriate treatment and admission to a hospital. In either case, as an educated, intelligent man he has made his own decision. Slashdot should not be contributing to his decline by enabling his poor decisions. He needs to be told flat out by his friends that they are not going to work with him until he agrees to admission and workup at a major teaching hospital (which, by the way, will have access to every antibiotic in the world.)
Sadly... (Score:2)
Right?
Re:Sadly... (Score:2)
Anyway, best wishes to him, some 10 years ago I greatly benefited from
Re:RTFM (Score:2)
Re:RTFM (Score:4, Insightful)
I think it's great that we've taken the tricky work of medical care out of the hands of doctors and given accountants the authority to make all the life and death decisions.
The man is still working on updates??? (Score:5, Funny)
I get the flu and I can barely stand to surf the web or chat on IRC! Hopefully, he will live into old age and share this story with his grandkids...
"When I was your age, I was compiling code by hand, with a lung infection, uphill, in the snow! You linux programmers have it easy these days!"
Good luck man, I'm pulling for you.
He needs a teaching hospital (Score:2)
He needs to let them know that no one can find what is wrong with him and list the which physicians he has seen.
Finding a good doctor is hard. Find a good doctor that listens is even harder...
PubMed (Score:5, Interesting)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi [nih.gov]
My daughter has a heart condition and we found the doctors weren't interested in really discussing anything until we started using the "right" terminology. The terminology I picked up after reading a number of PubMed publications about my daugher's condition.
I highly suggest that anyone researching any condition (but especially something exotic like Patrick) hit PubMed. Make it your source you cite when talking to your docs. Make it your primary source of information. All the other websites you read are just summing up the papers published here.
Re:PubMed--tread with caution (Score:2)
A good study is double-blind controlled, with a sufficiently large yet con
Dude, stop changing doctors! (Score:5, Interesting)
Doctor's diagnose by a flow chart the same way programmers debug a program. Given a symptom x and y, localize where the problem could be and its causes and try a solution. But unlike programmers, they don't try various solutions, rebuild and retest... Solutions in medical practice take time or can't happen at all at which point the problem has to be mediated to get on with the quality of life(ie hacked).
The problem is that everytime you switch to a new doctor two things are happening. First, the new doctor is going to start from the top of the flowchart and work his way down to the first matching diagnosis and treat that. Even if you say that was checked and the problem is different, you're the pleeb, he's the doctor and unless he gets scientific proof otherwise, his opinion is the right one. Basically, unless you have every medical test result you have, on official paper, your opinion means squat. Secondly, you're retaining all this knowledge and experience so when you present your case to the new doctor you're coming off as: "I went to this doctor with chest pains, but he didn't see anything wrong and I have this other ache which I think is related, so I went to this other doctor who says the other ache is this unrelated problem, but meanwhile I've gained a third symptom of popping in my chest so I went to the emergency room but they didn't think anything of it, so I went to the internet and printed out these charts and I think I have a rare and exotic problem, what do you think?"
Well the new Doctor is now going to think "hypochondriac" and not take your opinion very seriously becaue you've disregarded other medical opinions.
Basically you've got to find ONE doctor that you trust, present your symptoms and then work with that doctor through the multitude of tests to come to a conclusion. A good doctor is a> smart, b> will listen to your case history and c> (and most importantly) will interact with you and answer your questions to alleviate your fears.
Two anecdotes here: Both Michael Eisner and David Letterman had family histories of father's dying early from heart attacks. Both men's doctors ran the usual EKG's and stress tests and found no heart troubles. Both men continued to push for better testing and finally their doctors relented and did an dye test on the heart and found major clogging in the arteries with NO other symptoms present.
On the flip side, a relative of mine had chest pains, stomach pains and pains on his upper left abdomen. After several heart tests, his doctor diagnosed acid-reflux and proscribed one of the common pills for it. After about a month, the pain was less but he still had it. So he went back to the same doctor who tested his heart again, no problem. But my uncle was sure that something else was up, so he went through a chest x-ray, clear. So then they ran some blood tests, clear. So then they ran a lower GI test by ramming a camera up his butt, clear. Gall bladder, clear. Finally, they dropped a camera down his stomach...and found something. Acid Reflux damage. My relative had stopped taking the medication because he thought it wasn't doing anything. So the doctor put him back on it and made him stay on it. Two months later, the pain had cleared.
What you're feeling is real to you. I sympathize with what you're going through and urge you to keep up the fight. But you've got to work WITH the system.
Re:Dude, stop changing doctors! (Score:3)
This is the key. As I said earlier, there's a huge disparity between talented and mediocre doctors, just as there is in programmers. And as others have pointed out, so many doctors these days just follow the flow chart without really caring or even listening. They hone in on the most likely cause without even considering other possibilities.
Good doctors listen, they evaluate all the symptoms, they don't dismiss anything. Hell, a key part of my cancer diagnosis was a sympto
I was getting freaked out too...READ THIS (Score:3, Insightful)
It turned out that My GALL Bladder is pretty much DOA , The coincidental timing with my prostatits was just bad luck.
I also have Reiter's Syndrome [mcw.edu] which can cause ALL Kinds of seemingly unrelated symptoms (INCLUDING HEART) AND IT generally goes hand in hand with prostatits in younger (under 40) men,
Mine was caused from a very serious bout as in nearly dead, case of Campylobacter.
Now I have just regined myself to taking lots of NSAIDS, for the arthritis part (but as many broken bones as I ve had its hard to tell if its from those or this) and dealin with a bout of the big P every other year or so. he heart issues are serious but treatable.
Nutrients and Antibiotics... (Score:2, Informative)
Pretend they are technical support... (Score:5, Insightful)
Think about computer technical support, as an example we are all familiar with. They are paid to solve your problem according to their standards as quickly as possible, then get the the next call.
Physicians are not different, due to hospital and insurance policy.
If you act belligerent, and insist that you know what's wrong and that they are to follow your orders, they will likely turn a deaf ear to your complaints, do the minimum necessary that won't get them in trouble, and hope that you bug some other physician next time.
Further, like a tech, if they hear that you are searching for the right doctor to diagnose you according to your desires, they will all the more easily dismiss your problem. Firstly because you may well be a hypochondriac, secondly because they know you won't stop until you're treated, and thus they don't need to be burdened with the thought that you might take their advice and then die.
The best way I've found to deal with people who essentially must operate according to a 'script' or 'SOP' is to approach them with my most major complaints/symptoms, avoid using any terminology that might show I know more than I'm letting on, and let them go through their normal procedures.
Doctors (and techs) are getting more used to the idea of self-help, so it can help sometimes to say something like, "I looked my symptoms up online and [reliable medical website] suggested something called 'technical term'. Is there a way to prove that I don't have that?"
The reason physicians and techs are so jaded is because in the vast majority of cases, the doctor hopping, belligerent, advice ignoring patient/client is wrong. Further, if they aren't willing to go through your normal procedure for knocking off the most obvious problems, there's no way in this world that they'll diagnose you for something that is rare.
The fact that your are doctor hopping and hospital hurts you more than it helps. At the minimum you need to get a copy of your medical record from every provider you've visited and then choose a doctor/health system and stick with them. Changing doctors is resetting your medical care. A new doctor has to start from scratch.
Lastly, make sure the 'trouble ticket' isn't closed until you are satisfied. If the doctor gives you a clean bill of health, then ask them why you still have these symptoms. If they won't give you a clear answer, then ask to be bumped up to the second tier of support. There are only three reasons why you might continue to have these symptoms, and ask them point blank which one it is: 1) You have an unresolved medical problem or 2) You are imagining your medical problem or 3) You are considering something 'normal' to be a medical or resolvable issue (ie, there is no treatment)
Tell them this is causing a quality of life issue, and if the problem is 1 then you need it to be resolved. If it's 2 then ask them to send you to a qualified psychologist (who can rule out or resolve hypochondria). If it's 3 then ask them who can help you resolve your pain and suffering so you can be productive again.
I'm sure I don't have the whole story from this side of the issue, nevermind the doctor's side of the issue, so I can't really weigh in on this particular case. My gut tells me that if this was a serious (ie, death at the door) case, then portions of his body would be failing in a detectable way. Especially if he's had this 'bacterial infection' for this long. Perhaps systems are failing and doctors haven't been given the chance (or time before switching) to find them. Funny thing about 'normal' levels of [measurement x] is that normal is a large band, and while you may fall in that band, it may not be normal for you. Until you have a comprehensive case h
eat better as well; can only be good (Score:3, Interesting)
-protein (i.e. whey)
+ others
The system sometimes fails (Score:5, Interesting)
Patrick's unfortunate plight is not all that surprising to me. I lived for 27 years with two undiagnosed major medical problems, despite scores of visits to doctors and ERs.
Years of unexplained nausea & abdominal pain, weak immunity, mysterious pains that roamed randomly over my body, recurring flu-like symptoms, joint and muscle pain, headaches etc. I was called everything.. hypochondriac, liar, quitter, faker etc. So many specialists, tests, and so on, that I can't even count them all.
Finally, on yet another desperate 3am ER visit, my then-wife demanded that they look until they find something to explain all of this. Some bright ER intern plops an ultrasound on my belly (no, none of the many other "medical professionals" had ever bothered to do this..). The discussion went like this:
Intern: Do you have any history of kidney disease?
Me: No..
Intern: You do now!
24 hours later, I was diagnosed with PROFOUNDLY ADVANCED Polycystic Kidney Disease. My kidneys were so enlarged that they were squashing all of my other organs out of place. This hadn't happend overnight; it was with me all of my life, slowly getting worse every year. Once they had the kidneys figured out, it wasn't long until they had the Fibromyalgic illness / chronic fatigue diagnosed as well. Needless to say, after 27 years of suffering, I was less than totally impressed with the medical profession.
In short, the system sometimes fails.. and when it does, it can be a real doozy. Hang in there Pat, every illness has a cause, and yours will surely be found. Blessed be.
Where's the evidence? (Score:3, Informative)
It's usually very hard to put a diagnosis without proper data. In this case, even though I'm currently preparing for USMLE-like examinations (you are presented with some data and you try to make a diagnosis), I find it very hard to trust Pat's "clues" because I don't know what is real and what is *his* idea of a diagnosis.
As a doctor I really like to hear my patients tell me actual facts and not their interpretations. E.g. "I have fever and sore throat" and NOT "I have the flu". Infectious diseases that may present with fever and sore throat are many (ranging from primary HIV infection to infectious mononucleosis to common cold) and it's highly unlikely that the patient has considered all of them. By focusing on a possible "diagnosis" the patient may ignore other signs that would be useful to the doctor.
I could list quite a few diagnoses that would fit Pat's description, but guessing is quite useless, especially in important health matters. Maybe some doctors did not follow proper standards of care but the fact that an assumed serious condition did not alarm so many of them is quite suspicious.
As a simple advice (I hope Pat is reading this!): IF you have fever (defined typically as over 38.3 deg. Celsius) plus a NEW audible cardiac wheeze (not mitral prolapse, which is quite different) you should be admitted to the hospital on the basis of an assumed diagnosis of bacterial endocarditis (unless *proven* otherwise). Bacterial endocarditis usually develops on PRE-existing pathological conditions (e.g. old rheumatic fever, IV drug use). Typically, cardiac ultrasound (why don't you go have one, if you are so worried?) will give very useful clues. Examination of the retina and blood cultures (at least three) are also necessary. If no signs of bacterial infection are found, several viral pathogens can cause pericardial inflammation but I can only remember Coxsackie and echoviridae off the top of my head. Viruses usually cause milder disease.
Finally, please do not trust the web, google, medline, nih. These are excellent data sources, but you are unable to properly interpret what you read without proper training. You can't just open "harrison's internal medicine" and hope to acquire the skills to make a diagnosis in a few hours/days/weeks. Find a good doctor and trust him. Sure, some people say that they correctly diagnosed their condition, even though the doctors where wrong. It happens, doctor's make mistakes. But on 99.99% of cases, your doctor knows better than you.
P.
Re:Where's the evidence? (Score:3, Interesting)
I'm really sorry to hear that and I understand your bitterness. However, this is not true everywhere. Why don't you have a look at what happens in countries like Sweden, Germany and Switzerland or Canada? Just b
Re:Plan Of Action (Score:2)
I don't see '???' or 'Profit!' anywhere in there.
Re:Plan Of Action (Score:4, Informative)
Re:Plan Of Action (Score:2)
For those of you who refuse to care enough to read the account, he HAS been to several doctors who have been unable to diagnose the problem and treat it successfully.
So, if there is someone out there that is a doctor or knows a doctor or someone who has been sick recently, had these symptoms and was diagnosed and
Its no better up here... (Score:2)
My pain is sporadic, its more annoying than painfull, i'd say maybe a 3/10. But after awhile you start to get tired of constantly feeling pain. My only choice,
UK hospitals are not free for americans (Score:2)
Re:The problem with Patrick... (Score:4, Informative)
Re:The problem with Patrick... (Score:5, Informative)
Exactly.
I'm also getting some people who are telling me that this whole issue was caused by antibiotics that weakened my immunity. However, from around 2/2003 to 11/2004, I did not take _any_ antibiotics. When I started to get really sick in October I hadn't had antibiotics in well over a year. I had only two short courses of antibiotics in 2002 and 2003 for what seemed to be bronchitis (though the docs never verified if it was bacterial or viral but just said, "here, eat some Cipro).
One more time:
I have not been "self-medicating".
I have never, ever, taken antibiotics until I felt better and then stopped them, allowing a resistant relapse to occur. I have, however, been given an insufficient initial course of antibiotics for prostatitis in 2001 (which is what then required a long course of Cipro).
For those who are making fun of my supposedly improper use of medical terms, or wrong context, or whatever: this is not my field of expertise and we both know it. I don't hassle people trying to get computer help from me when they use incorrect jargon. Maybe BMDFH should be a new acronym.
On the hypochondria theory: anyone who has ever spent any significant time with me in person would shoot that one down in an instant. The last two months have been highly unusual for me, and I've never been inclined to think that I'm sick, to worry about that, or to go see doctors.
I hate being a pincushion.
Oh, and I know that seeing a new doctor causes a reinvent the wheel syndrome, and that when you tell them how many other doctors you've seen recently they tend to suspect you're crazy rather than physically ill. I know this all too well. However, if the antibiotics I've taken are suppressing the usual clinical evidence then I'm in a bit of a catch-22. As sick as I've been, the idea of using my body as a petri dish doesn't appeal to me much, comprende? Plus, some of these bugs (especially anerobes) simply don't culture well, and they won't go for the slam-dunk with a needle biopsy. At some point you'd think there would be a time for proactive treatment. Like in, say, a patient with no history of heart trouble who has complained of a recent fever and infection who has developed a new mitral valve prolapse.
I guess that's about it for now. I know some of you think I'm an behaving like an idiot, or whatever. I only hope that those of you who feel that way never find yourselves in my shoes.
To everyone who has offered well-wishes, thank you!
Best regards to
Pat
Re:The problem with Patrick... (Score:4, Interesting)
In spite of this, I think at most this is a contributing factor. If I had an active aspergillus infection that would be a lot easier to find.
Oh, the fuel oil furnace in the house was also found to have a cracked heat exchanger that was allowing fuel oil vapor into the ventilation system. The ducts were choked with soot.
Re:The problem with Patrick... (Score:3, Interesting)
The problem with doctors... (Score:5, Insightful)
No, the problem is that he went to a doctor at the start, who told him nothing was wrong. He repeated that about 10 times. In the meantime, he tried to find out what was wrong with him because 1) he has more time than the GPs and crappy specialists he saw, 2) he cares more than them about his health, and 3) most doctors don't think creatively because they aren't trained to.
As someone who has had a hard-to-diagnose health problem, Patrick's course of action is the only one that works. You have to do your own research, and pester the hell out of doctors to get them to actually try to diagnose you. Otherwise, they either tell you nothing's wrong, or they refer you to someone else who repeats the whole process and refers you again.
Patrick didn't self medicate. He's just trying to get these damned doctors to take his condition seriously.
Re:The problem with doctors... (Score:2)
I'm going with a UTI, although with Frank, we can't rule out syphilis either.
FOR THE LAST TIME! HE DID NOT SELF-MEDICATED! (Score:4, Informative)
As you can read here [slashdot.org] in his last post on
Re:FOR THE LAST TIME! HE DID NOT SELF-MEDICATED! (Score:4, Funny)
s/last/latest
Otherwise, it's creepy.
Re:Jeez... (Score:4, Informative)
About 15 years back a friend had psittacosis [emedicine.com] that was so bad they had him on IV antibiotics for a year. It's pretty rare in humans and usually not so severe.
It took him forever to find a doc who recognized what he had.
I'm no doc, but common sense would suggest that if symptoms suggest an infectious agent, sampling and investigation of the site of infection would be in order.
As for docs, I had one who looked at an x-ray of my hand in which three bones were clearly broken with a good 3/8 inch between the broken ends and tell me that my hand was fine! Even the x-ray tech didn't see the breaks. It was a surreal experience. Ditto for my moms fractured pelvis (she fell through a rotten section of floor in a building we we're thinking of buying). X-ray tech and doctor did not see the fracture until I pointed it out on the film. They were going to send her home with some pain killers!
Last example was bicep torn completely off the bone in my forearm. Pretty obvious something was wrong. Bicep all bunched up near my shoulder. It was the THIRD doctor who looked at it that finally agreed something was wrong (although he still misdiagnosed). Finally found a good orthpedist who had seen the condition (pretty unusual) before.
Re:Jeez... (Score:4, Insightful)
I think the general consensus among medical professionals on the last go round, is he needs a SPECIALIST, not an internest, not an ER doctor. He needs to go to someone with a plan, an Infectious Disease fellow who deals waith these kinds of illnesses. He apparently is near some world class medical institutions, I am not sure why he is not utilizing them.
Re:Sad, but he's mostly brought this on himself. (Score:2, Informative)
http://slashdot.org/comments.pl?sid=129902&cid=108 33936 [slashdot.org]
Re:Sad, but he's mostly brought this on himself. (Score:3, Insightful)
Re:Don't bash me for being insensitive, but (Score:2)
The child? Less effort has been spent in sustaining the life so far. Seriously, why would one be 'picked' over another?
Re:Don't bash me for being insensitive, but (Score:2)
Re:Try this (Score:2, Insightful)
No wonder he didn't reply to you.
Chris
Re:Try this (Score:2)
is bad for business.
Re:Try this (Score:2)
Re:Hypochondria (Score:3, Interesting)
Re:Health (Score:2)