Ask MetaFilter questions tagged with doctors

Did this doctor cross the line?

heytch — Sat, 31 Oct 2009 00:03:49 -0800

Was this doctor a creep for suggesting a gynecological examination, or am I overreacting? A few months back when I was trying to conceive, I took a home pregnancy test that was vaguely positive about 2 weeks after ovulation. I started bleeding the following day. I rushed to the medical centre and got an immediate appointment with a random male GP (not an Ob/Gyn) whom I had never dealt with before. I semi-frantically asked him if there was any way to "save" the pregnancy. We did another ultra sensitive urine test which came back negative. Then he said quite intently and convincingly that he would like to do a gynecological examination on me, right there and then in his office. I declined, because he made me uncomfortable with his general creepiness. He pushed it, and tried to convince me that it was the best way to "make sure". I bolted out of there and never looked back.

Having read up on the topic, I realise that I had what's called a very early miscarriage, which is unavoidable and most often due to a genetic/developmental error in the fertilised egg. Surely he would have known this.

My question is: In this situation, would there have been anything at all to gain from him "having a look"? He would be able to see the bottom of the cervix, and what good would that have done? Am I missing something here? Is this normal practice, or did he attempt to take advantage of a young woman in distress?

I'm generally not suspicious of doctors or other professionals, and I'm not much of a complainer. This one just gave me an icky gut feeling, and I'd love some MeFi insight.

Help me get my Prozac without breaking the bank!

larkspur — Tue, 27 Oct 2009 19:47:29 -0800

I don't currently have health insurance. I need back on the antidepressant I was on in college. What are my best options? Generic Prozac is $4/mo or $10/3mo at Walmart. But what's the cheapest way for me to get the prescription? I live in a small town in NE Ohio, if it's relevant.

I know places I could get it online for like $30/mo, but do I have some hope of being able to find someone who, for like $100-$200, could give me a prescription with say a year's worth of refills? Is that a reasonable thing? I have no idea how this works out in the real world now, the health center in college wanted me to come back in every three months but there was also no charge to see the nurse practitioner so that posed no problem. Now, I don't know how much seeing a regular doctor costs, or how long they'll be willing to prescribe me for each visit.

So I don't walk into this with unreasonable expectations, what should I be doing to make this as painless as possible, and how much can I reasonably expect this to cost me?

More about doctors and privacy

Anonymous — Wed, 21 Oct 2009 05:57:02 -0800

What exactly can a doctor's office tell anyone who happens to pick up your phone? I've recently come across couple of issues with doctor's offices and privacy. The first one was my mental health clinic, who dialed my home phone number. My boyfriend picked up and told them I wasn't home (I wasn't), and my mental health clinic said "well X therapist would like to make an appointment to see her." My bf doesn't live with me and they didn't even ask who he was when they left that message. I called them and said WTF, but they said that by providing them my home number, I authorized them to leave non-specific (i.e. no details about my care) messages there. I had no idea they were allowed to speak to anyone who answered the phone! Are they? (Note, I've since told them they are only allowed to call my cell phone number and they agreed.)

The other issue: My mom went to a specialist and specifically gave them only her cell phone number because she did not want them to give her test results to my dad. Specialist's office requested my mom to get her records from the general practitioner, which she provided. They pulled her home number off the GP's records and called the house. She went in to Specialist's office and explained that she was preparing to separate from my father and she did NOT want them calling him, they said, "well that will be a problem." Two days later they called when she wasn't home and told my dad the test results, when she explicitly told them not to. To me this is even worse than the first case because they did not leave a general message - they gave him test results! After she did not give them permission to and even specifically told them not to! Isn't that illegal?

When you go to a doctor's office, you usually have to fill out a form with the names of the people they may release information to. Why are the doctors' offices, then, not checking these forms and asking who they are speaking to when calling a phone number?

Maybe the askme crowd can tell me I'm overreacting?

Solon and Thanks — Wed, 30 Sep 2009 15:23:02 -0800

I messed up my eye - please help me figure out doctor stuff. This morning one of my contact lenses fell out without my knowing, and I spent some time trying to remove/fix the non-existent lens, as a result really nastily pulling at and irritating my eye. It now feels sort of bruised and sore on one side. My vision is normal and the sensitive area looks pink and irritated.

The internet is unhelpful but is pretty clear that minor eye problems can become bad if they get infected. I'm not sure if something is torn, but I don't want to mess around with my eyes. I'd like to see someone about it tomorrow if it doesn't feel better then.

My problem is inexperience in dealing with doctors, and the fact that I'm at school - my regular doctor and optometrist are far away. I do have insurance.

Is this something I should go find an emergency room for? To be honest I haven't been to one before and that seems over-the-top. Would urgent care places be prepared for eye-related things? Frankly, the small clinic in the local CVS is the most convenient place. My university (Ohio State) is huge and has a medical center, but I have no experience navigating it beyond getting prescriptions. Wondering where to go for things like this has always been an issue with me.

Any insight would be helpful - especially if someone has had a similar experience and does/doesn't think it's that serious.

How can I circumvent a crazy doctor?

RajahKing — Thu, 17 Sep 2009 15:15:50 -0800

Can I go around my crazy eye doctor and get the glasses and contacts I need? I have a horrible eye doctor who is doing everything possible to not give me my eye presciption. Total bullies, brazenly overpriced, and it was reconfirmed for me today in my most recent visit. Unfortunately, as I have terrible eyesight combined with an empty wallet, I am in a tough position. I need some hive mind advice, if you can follow this.

After some cajoling, yelling, whining (all on their part) I was able to pull from their cold fingers my a) current eyeglasses prescription and b) my last year's contact prescription.

So I am very nearsighted in both eyes, plus I have severe astigmatism. What I use to function is
a) a standard set of strong eyeglasses, then
b) soft contact lenses
c) with eyeglasses over them to correct the astigmatism.

Here is my question: using my current eyeglass prescription, along with the base curve from last year's contact prescription, can I order new contacts by combining the new prescription with last year's base curve? Or does a base curve change much?

*PS I know the alternative is to go back and get my damn prescription, and I will do so if necessary. I really just want to know if I can do the above and have the satisfaction of never dealing with these creeps again.

Emergency medicine in 1920

asockpuppet — Mon, 07 Sep 2009 18:34:02 -0800

I am a 40 year old man that died of a skull fracture in August, 1920. I was brought to the city hospital of our large metropolitan area by my brother. I died later that night. Cause of my skull trauma is unknown. What was my medical treatment like? What was the education and medical training of my doctors? How sterile was the hospital? What drugs would I have been treated with? What happened to my body and family when I died?

Asking because a former resident of the house I now own many years later died this way.

Do smart men prefer bimbos?

Goodgrief — Mon, 17 Aug 2009 10:03:32 -0800

I am a successful professional woman, I want to date successful professional men, but they seem to want subservient types. Should I be looking for a subservient man? The middle-aged, say divorced doctors & lawyers, they say they want to date intelligent, age-appropriate women, but I think that just may be for show to their peers, that they can actually get a woman like that, when in reality, they prefer just a pretty girl with a nice body who will not challenge them intellectually. Is this true? And if so, to balance the scales, should I just start looking for that in men?

I've got the mid summer blues

thankyouforyourconsideration — Mon, 03 Aug 2009 12:49:13 -0800

Can anyone recommend a Psychiatrist and a Pyschologist (or mental health specialist) in Portland, Oregon? It's for a new bout of depression that seemed to have disappeared for the last six years or so. I would love specific names, as a couple of the resources I've used in the past are full through September and I'd prefer to begin treatment now. As far as psychologist or mental health professionals I'm a girl in mid twenties, and would prefer someone liberal but don't have a gender preference. Thanks!!

I saw a similar psychiatrist post, but there were no specific names given, I'd prefer personal recommendations.

How can I prevent a future health insurance co from discovering a previous dematology treatment and use it for denial of insurance?

Anonymous — Mon, 20 Jul 2009 07:45:05 -0800

I'm an American without health insurance, who needs (minor) dermatological care... how worried should I be that this will prevent me from getting private health care insurance in a year or so (denial due to prior condition)? And what can I do to prevent this from happening? After waiting for a year, I really need to have a few warts and dermatofibroma taken care of, maybe get a prescription or two. Nothing serious or particularly costly. I'm going to pay cash out of pocket, to a dermatologist or general practitioner whom I haven't seen before. I'm worried that this could be used against me in the next year or two when I will purchase private health insurance ... what should I do to prevent this? Is there a way the insurance company will discover this, etc... ?

Is this something I should worry about?

How to request/get a referral to another doctor?

tristeza — Sun, 19 Jul 2009 18:26:28 -0800

How does getting a medical referral/requesting a medical referral REALLY work and how do you ask for one effectively? My mom recently got a preliminary cancer diagnosis (from a CT scan for an unrelated injury) at a medical center in Maine where she's staying for the summer. She was told that a likely first step is to remove the kidney with the mass, sooner rather than later. She's only been seen by her GP at this point.

My family wants her to be seen in Boston at a comprehensive cancer center like Dana Farber right away, before the ball really gets going in Maine. Oh, and she's a senior with MediCare.

She has a urology appt tomorrow morning as her first follow-up since the "we found a mass" news, and I want her to get a referral to Dana Farber, but I realize I'm not 100% sure how this works.

Can she simply say to the urologist, "please refer me to DF" without having a name of a specific doc? If she does, will the doc just go ahead and call DF and find someone to see my mom?

Or does the doc just say "OK" and call DF to tell them we're going to call them to make all arrangements??

Thanks for any help, we're all completely clueless about this process and I want her to have a good "script" when she goes in tomorrow.

help me find a doctor for my asthma in oklahoma

nadawi — Mon, 29 Jun 2009 12:42:15 -0800

i have asthma, i live in oklahoma, and my inhaler just ran out. i have no insurance and my boyfriend makes too much for aid programs - now what? i moved to oklahoma not to long ago and now it's time for me to get another inhaler. i love in owasso (just north of tulsa) and the only walk in clinic in town is $120 for the visit. i am use to walk in clinics being more like $50. adding to the money woes is the fact that the inhalers have been changed to the non-CFC versions which are far more expensive (use to be $12 per inhaler, the last one i got was $50). i don't work and i have no insurance, but my live in boyfriend claims me on his taxes so my household income is too much for any of the assistance programs i can find.

i wouldn't mind paying $120-200 if i could find a doctor that would give me an inhaler with 6 or so refills, but every clinic i've gone to will just give me the one inhaler and if i really, really beg they'll give me a single refill. i can't seem to get a doctor to understand that this is a chronic condition and i don't have $100 to plunk down every 2 months just so i can keep breathing.

so - any tulsa clinics you can recommend? any programs that can help reduce the price of medications or the doctor's visit? any advice on getting the doctor to give me more than one refill?

Any recommendations for a helpful mental health practitioner person in the area of Portland, Oregon?

brisquette — Thu, 21 May 2009 13:25:55 -0800

Any recommendations for a helpful mental health practitioner person in the area of Portland, Oregon? After a few stressful months of medication issues, my boyfriend and I have lost a lot of faith in our psychiatrist, and are looking for additional forms of help and advice, whether a therapist, counselor, or even just a different psychiatrist. We'd both been on ADD medication for a while (I'm on Adderall, he was taking Vyvanse) when my boyfriend (Charles) began to feel that maybe he was depressed. So in January, on the next trip to the psychiatrist, the doctor gave him a prescription for Zoloft. That seemed to be going pretty well, but I didn't ask too many questions about it because I didn't want him to feel weird about being on anti-depressants.

A month later, his prescription ran out right as we were leaving on a 2 week vacation to the other side of the country, and my kind and funny boyfriend started acting like a manic irritable whackjob who saw mystical signs everywhere.

Once we got back to Portland, I managed to get him into the doctor's office again after a week or so, and by the end of the session the doctor was worried enough to put Charles on Zoloft for a little longer, but had him taper down over about a week. The doctor also sent home a sample bottle of Zyprexa, with vague instructions ("take this if stuff gets too much, or if you get too irritable.). This curbed the manic behaviour, and things settled down for a while, but he was still acting weird and saying weird things, and our friends started to notice and get concerned.

This gets us to the beginning of April, when I get a call from Charles' work, since I'm his emergency contact. They think it's best if I come pick him up. They had a meeting to discuss his erratic behaviour, and it became obvious he wasn't in a mental state to talk about it. So another round of calls and doctors appointments and now meetings with human resource folks follows. The doctor now decides that mood stabilizers are in order. Hellooo, Tegretol.

Life has calmed down a bit. My boyfriend's on meds, he's back at work, and we can talk and hang out and be a couple again. Although his work and his union has been really great about all of this, it's been a downer for our relationship and our friendship. Walking down the street can be overwhelming for him. After months of coping with all the ups and downs, I'm starting to get exasperated, even though I know better.

We both are carrying a grudge against our doctor, for various reasons. Neither of us feel that he gives enough practical information about the medication he dispenses. The recent incidents surrounding the antidepressants made me remember how little info I got when the same doctor first put me on Adderall. I used the internet like crazy, but it feels like I had to dig up my own solutions, even though this guy is supposed to be really good at ADD stuff.

My impression is that the doctor didn't give my partner enough warning about how anti-depressants are sort of a big deal, and the last thing you want to do is go off of them suddenly.

Our doctor also seems too willing to indulge philosophical meanderings, which is fine when you're feeling normal, but even when Charles was getting over the paranoid, manic episodes, the doctor didn't tone down the philosophy, and it left Charles feeling weird.

The last time we saw the doctor together, the doctor said that the episodes and behavior were signs of something that probably would have come out anyway, in a couple years. After spending the last couple months scouring the Psych/Disorders section at the bookstore, I do see his point, but it's also really hard not to have him even even acknowledge that maybe none of this would have happened if my partner had just stayed on the medication. I have close friends who've given me way better practical advice than our doctor has, and that's disappointing.

So I'd like to go see a new doctor, psychiatrist or otherwise . Charles is a little burnt out on meds and doctors right now, but accepts that after the last couple of months, it's important to have someone sane to check in with every now and then. He's still on the Tegretol, but is disgruntled about the apparent complications that medication has brought into his life.

I don't know enough about the big wide world of mental health people to know exactly the term for what I'm looking for. Someone who can be practical about real life, someone who will help us find our personal goals and then follow through with them. Someone who's good at talking to a couple of ADD twentysomethings.

What/where are the old episodes of "Doctors' Diaries"?

jytsai — Sun, 05 Apr 2009 08:00:07 -0800

So in the next two weeks Nova, a science program on PBS, is airing the conclusion of a series that followed doctors from when they were medical students (1988) to today. I know that there was 2 previous episodes (1988 & 1998). Being a stressed out med student in the middle of midterms, it would be awesome if a bunch of classmates and I were to be able to watch all of the episodes (from 1988 to present) in a Nova marathon after exams. So... Does anyone in the hive mind know how I can get my hands on the first two parts of the series, or at least the titles of the old episodes?

In search of medical blogs/articles

nursegracer — Tue, 24 Mar 2009 12:14:55 -0800

Tell me all about your favorite intelligent professional or casual medical blogs/articles somewhat in the vein of Atul Gawande. I am an intensive care nurse with a hankering for "war stories" told by doctors and nurses (and I'm open to other professions like RTs and PTs) dealing with exceptional, emotional, notable etc cases. I love reading all of Atul Gawande's New Yorker articles and books. I just finished reading the entire back-catalog of Vital Signs in Discover Magazine. I love watching House, MD on TV, but I live for the deconstruction done by Polite Dissent's resident doctor.

I prefer longer pieces with details that go beyond a layman's understanding of medicine. Vital Signs and Gawande's writing tends to 'dumb it down' more than I find necessary but I'll accept that if it's a good article. I prefer Emergency and Intensive Care type situations but I'll settle for anything else so long as it is interesting. Any topic within medicine is game (ethics, patient relations, medical staff interactions....). My goal is to learn more about all aspects of medicine from multiple perspectives.

Thanks!

Doctor recommendations in North Seattle

creepygirl — Tue, 17 Mar 2009 10:44:48 -0800

Looking for doctor recommendations in North Seattle I recently moved to the Seattle Northgate area and am looking for recommendations within 5-10 miles of Northgate for:

1. A female primary care doctor (I'm just more comfortable with a woman doing my pelvic exams.)

2. An orthopedic surgeon/sports medicine doctor (I hurt my shoulder recently.)

3. An eye doctor to do an eye exam and write a new glasses prescription. I'm a bit confused as to whether I want an ophthamologist or an optometrist. My previous eye doctor/glasses prescriber was an opthamologist, but every ophthamologist on my insurance list says that they DON'T do eye exams/glasses.

For all three, I'm looking for someone who listens well, and is easy to get along with.

Also, Dr. Matin, who was a recommendation in a previous thread, is no longer taking new patients.

Source for Medical Malpractice Insurance Quotes for Doctors/Hospitals?

Quarter Pincher — Mon, 16 Mar 2009 18:28:59 -0800

Do you know of any reasonably credible sources that list the premiums and deductibles that hospitals/doctors (of any kind, but largely medical surgeons for intensive-care/emergency/surgical hospitals) pay for medical malpractice insurance? I'm researching figures for a malpractice reform idea. The idea is based on a rumor that medical malpractice insurance is an absurdly burdensome expense for hospitals/doctors who must pay it in order to legitimately practice. If there were a way to eliminate that particular burden, the massive periodic (monthly/etc) savings would gradually equal lesser medical expenses for Billy and Susie down the line.

My idea was to eliminate the need for malpractice insurance by enacting legislation requiring the hospital in question to add the malpracticed-against as simply a new employee, paid out of the standard payroll expenses, at a comfort-offering rate (variable according to terms of the suit and local standards of living) instead of having to lop over this giant sum (and pay insurance for the dark cloud of a giant sum to loom over them, waiting to be dished out). Does this idea hold much water?

Serotonin Syndrome after quitting antidepressants?

Clay201 — Tue, 10 Mar 2009 12:30:01 -0800

Could I possibly have Serotonin Syndrome even though I've been off anti-depressants for two or three years? And whether I have it or not, what's the best way to get a doctor to hold my hand while I try the recomended treatment for it; an antihistamine called Cyproheptadine (brand name Periactin) that blocks Serotonin receptors? I've had health problems most of my life, but developed my current set in 1995. At first, I thought it was the flu. Fevers, night sweats, fatigue, constipation and diarrhea. But as those symptoms decreased, new ones arose. I was incredibly tense, agitated, and restless. I felt like I wanted to peel off my own skin. I literally could not relax. It felt like someone had my neck in a vice. When I tried to relax - laying down in bed, comfortable and peaceful - I'd feel a horrible surge of restlessness and agitation. It's hard to describe, but it felt like an electric eel wrapping itself around my spine, delivering a constant voltage. Then, the involuntary movements would kick in. I'd start flailing around, my head jerking to the side, my legs twitching. I wouldn't return to "normal" until I once again tensed up completely. In addition to all this, i was incredibly anxious. I could barely even talk to people. I couldn't do anything. Everything made me freak out.

During and prior to this period, I was on and off anti-depressants pretty frequently. If I took more than a tiny amount, they made me wired, talkative and fidgety. If I took too little or didn't take any at all, I was depressed. So I was always trying, and usually failing, to find a happy medium. I'd take them until I felt better, then stop. A few weeks would go by, I'd get depressed again, and the cycle would repeat.

For the mystery problems, though, there didn't seem to be any treatment. Finally, desperate, i tried a medication that had been prescribed to a family memember; a muscle relaxer called Flexeril. It permanently knocked my restlessness and tension down a notch or two, but my involuntary movements got more frequent (also permanently). Scared and having no idea what was happening, I didn't take any more Flexeril. I did, however, continue taking anti-depressants as before.

I's been fourteen years and, in that time, I've tried countless treatments. Nothing's done much good. I did finally stop taking anti-depressants in 2006 or thereabouts. I went through withdrawal for several months, but when all was said and done, very little was different.

Then, recently, I read a description of Serotonin Syndrome. This disorder is caused by taking anti-depressants or other serotonin boosting medications. It causes fevers, sweating, involuntary movements, restlessness, and dry mouth; all of which I have or have had. (I can't seem to find the links for the following info, but I did read it somewhere on the web). The involuntary movements tend to be in the head and neck, which is where mine are, for the most part. There's a characteristic foot twitch; you bend the foot upwards at the ankle, then push it back down again and the foot twitches repeatedly. My foot does that. The problems are made worse by a number of different neurotransmitter enhancing drugs, including dopamine boosters like Sinemet. Sinemet and others on that list do make my problem worse. The only thing that made it better was, as I said, Flexeril. And it turns out that Flexeril blocks serotonin receptors.

So S.S. sounds like a pretty good fit, right? Only one problem. I just got off the phone with a psychiatrist who was adamant to the point of raising her voice; you just can't have Serotonin Syndrome if you've been off serotonin-boosting drugs for years. I can't find any direct statements to that support this assertion, but it does seem implicit in all the available material.

So, question number one is... Is it possible for me to have Serotonin Syndrome even though I quit the meds a while back? I have been using magnesium and malic acid to keep my mood up. When I was taking a lot of them, I was behaving in a manner that might be considered manic (starting lots of big, complex projects; making overly optimistic plans, etc.). Could the magnesium and malic acid be increasing my Serotonin? It seems terrribly unlikely, but thought I'd throw it out there.

Now, the most popular treatment for Serotonin Syndrome (besides taking away the offending meds) is a drug called Cyproheptadine (brand name Periactin) which blocks certain serotonin receptors. It turns out, you can get this drug legally through pharmacies outside the US. I've already placed my order and it's supposed to be here in about five days.

Ideally, I don't want to just perform experiments on myself. I want a doctor to supervise and be there to take care of me should things go wrong. In addition, I want one who has actual experience treating S.S. But I've been calling people left and right and I just can't find a doc who's both experienced and willing. I did manage to score an appointment with a psychopharmacologist who has actually treated S.S., but he may very well look at me and say "No, you don't have it and I'm not giving you Cyproheptadine. Now that'll be two hundred bucks." (He doesn't accept my insurance and I'm planning to pay out of pocket).

I realize no doctor is going to commit to a diagnosis over the phone. But if I walk into the appointment blind, I've got to to risk a lot of time and money on the (apparently small) chance that he or she will go along. I could end up spending six months and thousands of bucks trying to get the okay for a medication I already have sitting on my shelf. I'm stubborn, but I'm not that stubborn.

If the doc in question were pushing a different diagnosis, that would be one thing. I could look at it and decide whether it was more or less likely than S.S. But none of them are going to offer anything I haven't heard before. So it's a choice between trying the cyproheptadine and possibly getting better or trying nothing (or nothing new) and definitely not getting better. I certainly choose the latter. Besides, even if it doesn't help the problem, it could tell me something important.

So question number two is: How do I get a doc to get my back while I try this medication? I'm open to suggestions.

(Don't try to talk me out of the solo treatment. Yes, I'm sure it seems kind of harebrained to some people. But I have an undiagnosable disorder that makes me miserable twenty four hours a day, prevents me from writing, keeps me from dating, and is slowly trashing my body. I require more and stronger meds for the headaches and am worried about my stomach, my liver, and addiction. I can't take much more of this; I've got to do something. My doctors just look at me and shrug, so it's up to me to come up with the ideas and this is the best one I've had so far. I am more than justified in taking this relatively small risk.)

Please help me filter out the good from my list of NYC doctors covered by my insurance.

scazza — Mon, 09 Mar 2009 12:04:27 -0800

Please help me filter out the good from my list of NYC doctors covered by my insurance. This is my last resort after days over months of searching trying to connect the dots and find doctors. Maybe you guys can help. I have searched on yelp, zocdoc, and all kinds of lists of good doctors (nymag) on google for ways to filter the list of doctors my insurance covers and have come up empty. I can't believe after days and hours online I've come up empty.

1. I am looking for a really awesome family practice doctor who can do it all OR a coop-type office that has multiple doctors (gyn, internal medicine, ortho or DO, etc.) I could see on my visit that takes my obscure crappy insurance First Health/Coventry Health Care.

2. Or techniques to filter out the good from the bad in an insurance's list of doctors.

I live in Brooklyn 11220, am often in 11215 and don't mind going to Midtown or below. I'd prefer a female or very nice male. I would really appreciate anyone who has wisdom about this or is willing to help. I'm at my wits end. Thank you.

Can my therapist speak to my Dr. without my permission?

secretsecret — Tue, 10 Feb 2009 12:55:15 -0800

Can my therapist speak with my medical doctors without my permission? My therapist and I just ended our relationship because I had (what I believe to be) 3 seizures. I saw a neurologist but have chosen not to seek more medical treatment at this time. My therapist said she wanted to be able to speak with my regular doctor about this, and I told her I did not want her to.

She informed me that, as my therapist, she has the right to speak with my doctors, with or without my permission. Can this really be legal?! I've never talked about hurting or killing myself--why would she have the right to speak to my medical doctor and inform them that I've had seizures (my regular doctor does not know about the neurologist I saw)? Why would my doctor release medical information without my consent? (my therapist also wants to see the results of a bloodtest I took)

My therapist said that all therapists have this right. I never signed anything giving her that right, and I don't remember signing anything saying my medical doctor would be able to release my medical information to a therapist.

Is my therapist full of it?

House vs Scrubs - The "real" diagnosis

FireStyle — Fri, 12 Dec 2008 21:21:18 -0800

Can doctors really diagnose illnesses like they do on TV? I'm a huge fan of the shows House and Scrubs. I've noticed that in Scrubs, when the doctors are faced with a tough case (including Dr. Cox) that they sometimes have to resort to medical books and journals to find a diagnosis. In House, it seems all the doctors have encyclopedic knowledge of every diseases there is, including defects that are caused from inhaling cat urine, to a particular chemincal in a perfume that causes kidney failure to acute dichemodysentrophicmystemia due to eating lettuce grown in Iowa on the 2nd to last week of the growing season.

My question, can doctors, even genius doctors, really be *that* good at diagnosising illnesses, or is that unlimited knowledge of medicine a Holloywood convenience?

Questions for Doctors

Anonymous — Fri, 12 Dec 2008 13:53:15 -0800

How to get some candid answers from the medical staff? My wife and I have some questions for the doctors and nurses we encountered while going through a recent high risk pregnancy. We would like to know why certain actions were or were not taken. We suspect more could have been done and communication between the doctors, the specialists, and nurses could have been better, and that the outcome could have been different. My wife started to question her OB/GYN at a follow-up appointment, but the doctor seemed to get defensive and said "we did nothing medically wrong". What would be the best way to get some of our questions answered?

Here are some examples:

Why was the Doppler ultrasound not used to determine if there where knots in the umbilical cords?

Why were we not told that one of the babies had mild to moderate heartbeat decelerations at a previous appointment?

Why did it take four hours to get an ultrasound when heartbeats were not detected with fetal monitoring?

Did the specialists actually know we went inpatient?

Did the antepartum nurses have familiarity with our case and condition?

How best to convince one's doctor to do a procedure now rather than wait a month?

wowbobwow — Fri, 31 Oct 2008 18:52:30 -0800

Thursday I went to the ER with sudden sharp pains, which turned out to be a large ovarian cyst. The Dr said I might need emergency surgery to remove it. After getting some tests back he wants to "wait and see" about a month before approving their removal. I'm still in a lot of pain and want to try convince him to please just take them out... but not sure how I can talk him into it. In short, what can I do to help him understand that:
1. when the percocet wears off, it still hurts as much as it did when I went to the ER (ie, very very much)
2. I am not very excited about being on percocet for longer than a few days, given it's addictive nature
3. Regular ibuprofen doesn't work for the pain, even at higher dosages

I'm also hoping this will happen so I can kill two birds with one stone. If I'm going to be under some sedation for the laparoscopic procedure, I want to have them remove my IUD at the same time- having it inserted was just awful and I don't want to be awake when they take it out if I can help it. The threads are not down in the os at all, they'd have to work a lot to extract it. The IUD is probably what triggered the cysts in the first place, and I want it taken out post haste b/c I already have some larger follicles in my other ovary.

Please note I'm not asking for medical advice. I just want some insight into how I should present my concerns to him in a way that will be more effective than "because I say so." He's not my regular Ob/Gyn, he was who I got assigned to via the ER.

Why Is Obesity Help Often Excluded By Health Insurers?

WCityMike — Mon, 20 Oct 2008 19:26:28 -0800

Why do medical insurers treat obesity different than other vices? Not a GYOB (I've got one); I literally don't understand the facts of the situation. What do I mean? A moment's thought yields thousands of examples every day where medical insurers cover medical treatment that helps people recover from the aftereffects of their own choices. Childbirth. Smoking. Heart attacks. Lacerations incurred while drunk. (And accidents caused by drunk driving.) Alcohol and/or drug rehabilitation programs. And so on. We make mistakes with our body every single day, and they incur a medical cost to our body's well-being. Most of those medical costs are alleviated by insurance.

But medical services available to help people recover from the aftereffects of obesity seem to be almost specifically excluded. Nutritionists? Nearly always excluded in every plan I've seen. Physiatrists or sports medicine for medically safe exercise? Ditto. Removal of large amounts of loose skin post weight-loss? Some people have navigated their way through appeal processes into coverage, but it's not covered without great effort and trial.

What puzzles me is that preventative and "repair" treatments has got to be more cost-conscious than paying for heart bypasses, etc., so it makes from the ultimate viewpoint that means the most to these companies, the Almighty Buck.

So what's up? Where am I making the mistake in thinking this through? The pattern seems to have boundaries that are clearly enough defined -- it seems highly, highly improbable to me that this wasn't a purposeful policy decision.

I know you are not my doctor, but right now, no one is!

Anonymous — Fri, 12 Sep 2008 17:44:01 -0800

Over the last few years, a number of health problems have flared up that I suspect might have something to do with each other: weight gain, fatigue, acid-reflux/loose stools (possibly related to gluten intolerance) and irregular periods. What kind(s) of doctor should I see? I'm in Minneapolis. I'm 30 years old, female. Oh, and my insurance ends at the end of the year, so there's a deadline.

Weight gain: In 2002, I weighed 200 lbs, now I'm up to 248. This is a lot of weight to gain in 6 years, especially given that I was already quite overweight. There have been some lifestyle changes (went from working outside to a desk job) and my eating habits haven't been the best, but they haven't been the worst, either (whole grains, avg of 4-5 fruits and veggies a day, some junk food, some fast food). I also seem to have a harder time now losing weight: I did Weight Watchers two years ago and lost 15 pounds in six weeks by staying within points and following a Mediterranean-style diet. But this last spring I went back, tried to do the same thing, and lost nothing.

Acid-reflux/loose stools: this has been a problem for a while, but recently has gotten painful enough for me to cut out gluten. I had noticed that my heartburn was much, much worse about an hour after eating anything with wheat in it several years ago, but was sort of in denial and didn't want to give up gluten. Anyway, I started a gluten-free diet this week and poof! No heartburn, and my stools are all nice and firm.

Fatigue: I've been feeling easily fatigued and a bit mentally fuzzy for the last few months. The fatigue is actually helped a LOT by the lack of gluten - I've had a ton of energy this week. But the mental fuzziness is still there. I've always been scatterbrained, but it's reaching ADD levels now.

Irregular periods: this is the part that is freaking me out most and thinking I need medical attention stat. My periods used to be extremely regular - you could set your calendar to them. But this winter they started getting all screwy. After I moved and entered a very stressful phase at work, I skipped one month and then had a super-heavy flow the month after that. Then I quit my job and moved across the country for a new one. I skipped two months and then had a period that lasted, intermittently, for 3 weeks. I know I should have gone to the gyno, but I was hoping this was all due to stress. Well, again I had a long stretch (6 weeks) between periods, and am now in the middle of another long period (2 weeks so far). And these periods are quite heavy, with mucousy chunks in them.

So of course I've been googling my symptoms like mad, and scaring the hell out of myself. According to what I've seen, it could be celiac's (which would address all my issues), a thyroid condition (which would cover the weight, fatigue and menstrual stuff but not necessarily the gastro issues) or - eep! - diabetes (which covers the weight, fatigue and menstrual stuff but not the gastro/gluten issues). And then there's PCOS, which seems to be sort of a catchall.

So now I really want to get this stuff resolved. But it seems like I need to see a gastroenterologist, a endocrinologist, AND a gyno. I got an appointment with a gastro RN for the week after next, but the others have months-long waits. And that's where the time issue comes in: the job I moved here for is just till the end of the year (it was a contract position but they gave me benefits). I can get COBRA after that, and probably will, but I will be moving again, this time to be closer to family and look for a new job. So I'm hesitant to start a rotation of seeing different kinds of doctors, only to have my quest interrupted at the end of the year and have to start all over again.

So, after that long and rambly set-up, my question is: is there one kind of doctor that I can see who will be able to help me address all of these issues? Perhaps some sort of holistic MD? I don't want to go the homepathic route to the exclusion of traditional western medicine, but it would be great to find a doctor that would work with me across sub-specialties and would be knowledgable about stuff like diet and lifestyle in addition to perscriptions. I realize this is the role primary care physicians are supposed to play, but I don't have one with my current plan, and can't get an appointment with a GP till...January (I called several).

And yes, before people jump all over me for this, I do realize it's possible that all these things could be discrete, unrelated symptoms. But given that they have all gotten worse at approximately the same time, I'd like to see someone who will be able to see those patterns if they are there. From talking to friends and other research, I know that these symptoms are often related.

So does anyone have thoughts on the kind of doctor I should be looking for in general, and maybe some recommendations in Minneapolis? Here's my throwaway email:whatkindofdoctorshouldisee@gmail.com.

Are sites like Healthgrades worth the money? Are there better ways to research doctors?

Ostara — Thu, 11 Sep 2008 11:35:53 -0800

I am trying to find an excellent neurologist for my Mom in Omaha, NE. I have been doing research with little success. Are sites like HealthGrades worth the money? Are there any other ways that I can research a doctor's background and perhaps read reviews on them? My Mom suffers hearing loss and headaches and they are both getting worse. She is 60. Her old neurologist is pushing 80, and seems to be just going through the motions or his job at this point.

She needs to find a new neurologist who is very pro-active and systematic in finding out what's wrong. I am trying to do research for her but it seems like every site with actual information on doctors wants me to fork over at least $30 to read a report on a single doctor. I don't mind paying the money if it is actually worth it, so I was looking for some feedback or other ideas on how to research doctors. Thanks.