Aggressive medical care can lead to more pain with no gain

[HysteryDiagnosis]

http://health.groups.yahoo.com/group/iatrogenic/message/4139

The chronically ill are not the only ones vulnerable to overly aggressive care. Consider the case of a middle-aged IBM executive from the New York City area who experienced chest pain. He went to a cardiologist, who ordered a full workup, including a CT scan of his chest. The scan found no heart problem, but at the edge of the film the radiologist noticed "something funny" in the neck area. A neck surgeon performed a biopsy and found nothing wrong. The cardiologist then performed an angiogram to look for abnormalities in the blood vessels. Complications from that procedure landed the executive in the hospital for a brief period. By the time it was over, his bills were more than $150,000 and he still had no diagnosis. Eventually the pain disappeared on its own.

Months later, when the executive's chest pain returned, he told his medical history to Paul Grundy, M.D., an internist and director of health-care technology and strategic initiatives at IBM's headquarters in Armonk, N.Y. Grundy asked him what he was doing at the time. "Oh, we started gardening again," the man told him. It turned out that overzealous use of his string trimmer had strained a chest muscle, a condition that required no treatment other than an over-the-counter pain reliever. None of the high-priced specialists (some call them the "partialists") had considered muscle strain, a common condition often mistaken for heart pain.

[flamingdem]

1. This is a huge issue. Specialists are clueless about causes that are

out of their area. They will admit this. One has to go through at least one of these bad experiences to learn you must do some of your own diagnosis or be doomed to the specialist circus

[HysteryDiagnosis]

2. This may or may not interest you, it may or may not be considered safe or practical, but I

have found at least some good information here:

http://www.doctoryourself.com/

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"If we doctors threw all our medicines into the sea, it would be that much better for our patients and that much worse for the fishes." Oliver Wendell Holmes, M.D.

I have seen the foolishness of conventional disease care wisdom. I have seen hospitals feed white bread to patients with bowel cancer and hospitals feed "Jello" to leukemia patients. I have seen schools feed bright red "Slush Puppies" to 7 year olds for lunch and I have seen children vomit up a desk-top full of red crud afterwards. And, I have seen those same children later line up at the school nurse for hyperactivity drugs.

I have seen hospital patients allowed to go two weeks without a bowel movement. I have seen patients told that they have six months to live when they might live sixty months. I have seen people recover from serious illness, only to have their physician berate them for having used natural healing methods to do so. I have seen infants spit up formula while their mothers were advised not to breast feed. I've seen better ingredients in dog food than in the average school or hospital lunch.

And I have seen enough.

[flamingdem]

5. The site looks interesting

I think we're taught to believe in authority. It's only after a bad experience in the medical system that we realize how incompetent many are -- hopefully before it's too late.

My rule is to go to a University hospital with the best reputation, hard if you're far away from one, and even then one must watch out. The communication and bedside manner can be missing in a hectic environment.

Plenty of doctors with their own practice will slice and dice to keep their doors open.. they justify it somehow

[Donnachaidh]

7. We once visited a family member and watched in horror as a pneumonia patient was given milk products

Not just milk, but ice cream etc.

This woman was on a breathing machine, fluid in BOTH lungs - and the meals she was being given were causing more problems for her.

I kind of went apeshit on the staff about it. It was outrageous that no one was being vigilant in this woman's care.

[Ship of Fools]

3. Having gone through my own chronic illness experience,

I only have to say, IMO, that once everything settles down (IF everything settles down), we could use a
serious discussion about euthanasia (like THAT would ever happen).

Just one woman's opinion.

[enlightenment]

4. While I agree in general with the sentiment of the article,

I have to allow that a 'partialist' who noticed 'something funny' on a thoracic x-ray kept my father alive. That 'something funny' turned out to be a very difficult to pin-down tumor (it required an ultrasound of the interior of his stomach - performed by another 'partialist' - to find it).

The tumor was not standard-issue - it was something called GERD that is a bit more rare and rather difficult to treat (at the time). They found it early and managed to remove it (more 'partialists' involved, of course) and though he still, technically, has the disease, he has been with us eight years longer than he would have been had that radiologist not noticed 'something funny'. Purely apocryphal, purely personal, of course - but I'm glad someone noticed.

Errors in diagnosis have a nasty tendency to multiply, that is very true, and whenever an initial idea is clung onto too determinedly it can lead to more problems than solutions. Medicine is - for all the hard science involved - an art. Perhaps we should rethink how physicians are trained to think?

[flamingdem]

6. Valid point. Sometimes they find things of note

so we can't throw the baby out with the bath

[salvorhardin]

8. a GERD?

GERD is usually an acronym for gastro-esophageal reflux disease.

Also, I've not yet heard 'partialist' used as anything as other than a derogatory title for a subspecialist with tunnel vision, but maybe it's coming into common usage.

[enlightenment]

9. Sorry! I meant GIST.

That's what I get for trying to type before coffee. *blush*

Gastro-intestinal stromal tumor. (May have misspelled something in there, but that's the basic idea).

As for 'partialist' - that was in the OP. I was using it - in quotation - to highlight the oddness of the phrase.

[salvorhardin]

10. Ah! Everything is clearer now!

Thanks. :D

[trotsky]

12. It's not very popular, at least in this forum,

to give credit to those in the medical profession that do their jobs and do them well.

[Gregorian]

11. Paul Grundy is my cousin!!!

This is so cool. He's a great guy. I'll spare the stories. But there are a few.