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#660936 - 03/03/08 01:14 AM
are all docs like this??
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scruf
GRAND Pooh-Bah
Registered: 03/21/05
Posts: 2565
Loc: pacific nw
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my ex-doc told me fibro does not even exist. he says it is a made-up "condition" used by women to get opiates. he was gleeful when they came out recently with lyrica, says it derails all the opiate-seekers using the fibro complaint. I wouldn't doubt he feels the same way about migraine sufferers. he even devised a 30-question sheet to ask migraine patients to determine if they really have migraines or are drug-seeking.
he has no problem rx'ing benzo's though. ask for a narcotic or just go in nervous, shaking and wring your hands - he couldn't rx benzo's fast enough, just wanted you out of there!
despite having all the classic symptoms, (dark urine, abnormal test, intense itching from bile backing up in the blood, yellow eyes) it took hom 3 months to finally order an mri that showed a cancerous growth on the pancreas was blocking her bile duct. at 87, she had to have the whipple procedure, the most invasive surgery there is other than a liver transplant.
also, every time I'd ask a question or he needed to rx a med, he had to mess around on the computer to find an answer.
and all this takes 10 minutes. if you need longer, the only thing you can do is block the door, stand in front of it till you are thru with your questions and concerns. then bills the ins co for $165!
are doc's all like this? I fired him obviously, but mom still goes to him. I feel like I really have to research all symptoms now and tell the doc what's wrong. shouldn't be that way.
luckily my sub doc is a regular doc - she's my pcp now. charges $98 for a once-a-month visit and spends the full hour chatting. you can get out all your questions out and get intelligent, unhurried answers. no computer in sight. almost like a welcome therapy session.
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#660940 - 03/03/08 02:31 AM
Re: are all docs like this??
[Re: scruf]
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Grasshoppa
GRAND Pooh-Bah
Registered: 06/23/05
Posts: 4187
Loc: most Days, just laughing!
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I would not want to go to that Doctor either. But at the same time, I know of a woman that read all about fibro to get pain Meds. She gets 180 perks a month and there is nothing wrong with her.
As far as the question sheet for migraine sufferers, My Doc has one that comes from the drug companies. It helps to explain what type of Headaches you may have. Clusters/Migraine/Tension.
Therefore you can have the right treatment/tests/Meds. That can be a good thing, but not alone. One could study Migraines also. My Doc has seen me with a Migraine and you can not fake what that does to you.
Even know a Doc may put in a certain price for the visit with the Inc co, does NOT mean they will get it. The Inc co only pays out so much. At least for a visit when you just see the Doc. (not talking tests)...
All in all sounds like this Doc is to worried about getting lied to than helping out someone, so I would have moved on too.
hoppa
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#662213 - 03/05/08 07:26 AM
Re: are all docs like this??
[Re: ROSE22]
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vetsyd
Member
Registered: 10/05/05
Posts: 120
Loc: TN
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What a real piece of work that doctor mentioned above is. He(I'm assuming he is male) just doesn't know everything like he wants us meek patients to think he does. That just makes me sick how insensitive and uncompassionate another human being(let alone a physician) can be to others. Don't get me wrong, I have gone to some real "winners" in the medical fields that were WOMEN, who didn't sound much different, so no sexism on that at all. Just depends on who you wind up with, I guess. 
As another Fibro sufferer as well, who was OFFICIALLY diagnosed less than 5 years ago, but suffered WAY longer than that, I totally empathize.
Also, Fibro may have psychological ramifications, but only due to the chemical imbalances that usually go along with it as well. Those same chemicals can also cause people to be predisposed to SLE, RA, MS, just to mention a few. Yes, good ole' Serotonin, Melatonin, and the like can have a direct effect on this stuff, to be sure, as well as 5-HTP and many others.
I think they think since there isn't a specific blood test or x-ray or other diagnostic tool that cinches it, then it doesn't exist. Oh, but if there were an equal amount of men that suffered from it(no offense to you swell guys-not your fault the medical profession is somewhat of a crock sometimes:), then...well...I don't want to speak out of turn, because my best friend who suffers from a VERY detectable and blood test confirmed chronic disease also has Fibro and yes....he is a GUY! As to not hurt our fellow DB FELLOWS on here...that's not my intent AT ALL!
It is sort of like when women have hormonal imbalances. I know personally, my docs have never just said, oh well here honey....lets inject you up with some Estrogen, Progesterone, etc. and that will fix you right up. But, my guy friend who has an imbalance...his doc gives him Testosterone injections any time he is feeling lethargic or weak, along with B-12 and some other things. Granted, I know that some of their issues are different and if they get an imbalance, it can cause other problems that we ladies may not have to deal with too. Just one of those things I have never understood I guess, but trying.
Then, he goes through much of the same trials and tribs that we ladies do with his docs for some of the same reasons...just different aspects, so I DON'T really think it is all about sexism here...not completely anyway. Doctors have a lot of prejudices toward their patients that have nothing to do with that. Then, NOT all doctors are like that either, so to the kind, compassionate and understanding ones out there....good for you, thank God we have you and KUDOS!
So, just wanted to vent and tell you others to hang in there. I know how hard just living with this is, let alone dealing with jerks who have no idea what they are treating.....or NOT treating as these cases seem to be.
Pain-free as possible days to you all, as well as WUV! That sounded corny, didn't it? lol
V
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#662364 - 03/05/08 11:53 AM
Re: are all docs like this??
[Re: scruf]
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mmyp
GRAND Pooh-Bah
Registered: 02/20/06
Posts: 1690
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Right now diagnosis is based on patient symptoms.If a patient has x number of symptoms than they presume it is fibro. There is no blood test or xray etc that can be performed to define it. Like strep, either it is there or it isn't in a blood sample. You can definitely say someone does have strep by the presence of it in the blood sample. Not so with fibro.
What Is Fibromyalgia?
Deborah A. Barrett
Fibromyalgia is not a new syndrome; evidence for its existence dates back centuries. Until recently, however, the cluster of symptoms that comprise fibromyalgia, or fibrositis one of its former names, were largely considered psychogenic. It is the case that doctors who lack a physiological explanation for symptoms are prone to attribute complaints to mental problems or malingering. This has been the case for fibromyalgia because it lacks a clear test to verify its existence, its sufferers "look fine," and are predominantly female, a group less likely believed. This skepticism began to change in the late 1970s and early 1980s when more research became available about sleep abnormalities and reproducible tender spots in fibromyalgia. An important group of rheumatologists (the specialty of physicians that treat arthritis) realized that this group of patients did not fit the profile of hypochondriacs. Rheumatologists started to pay more serious attention to the suffering described by these patients, who continue to make up 20% of a rheumatologist's practice.
I believe fibro is a real condition. Unfortunately there are many, many docs out there who don't believe in it. mmyp
Edited by mmyp (03/05/08 11:58 AM)
_________________________
Your village called... they want their idiot back !
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#662377 - 03/05/08 12:05 PM
Re: are all docs like this??
[Re: Ruggie]
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mmyp
GRAND Pooh-Bah
Registered: 02/20/06
Posts: 1690
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Was it the blood pressure test?
While such fibromyalgia tests as a tender point count physical exam have been useful in the diagnosis of fibromyalgia syndrome, a new fibromyalgia test is being used to identify whether an individual experiencing fibromyalgia symptoms such as fatigue and cognitive impairment truly has fibromyalgia. The test is based in part on the most common of the symptoms of fibromyalgia: pain. A recent study that tested blood pressure (BP) discovered that participants with fibromyalgia were 69% more likely to experience pain during a routine BP test than those who did not have fibromyalgia.
Using A Blood Pressure Test to Diagnose FMS
The study found that while fibromyalgia patients experienced discomfort while undergoing a blood pressure test (or a sphygmomanometry), only 20% of the study participants that did not have the condition did so. Therefore, experts believe that a blood pressure test can be a useful tool in fibromyalgia diagnosis.
Allodynia is the term given to the condition in which an individual experiences pain and discomfort in reaction to a stimulus that typically does not result in such responses.
The study participants with fms experienced pains at levels less than 210 Hg. Pressure was sustained for a maximum time of 30 seconds or less.
Participants were tested on their dominant arm, although participants reported that pain was experienced on both arms.
In addition, findings have shown that a BP test is more reliable than a tender point count that is part of a typical physical exam in the diagnosis of fibromyalgia. In such a test, a variety of areas sensitive to pain (known as fibromyalgia tender points or fibromyalgia pressure points) are examined for their response to pain.
Blood pressure tests are typically used to evaluate cardiovascular health. A blood pressure test includes wrapping a cuff around the arm. The cuff is then inflated, causing a large artery in the arm to compress and blood in the arm to stop flowing.
When the cuff is released, blood flows once more, producing sound. Your doctor listens to this sound in order to check that your blood pressure is healthy.
Blood Pressure Tests: A New Fibromyalgia Diagnosis and How It Affects Treating Fibromyalgia
These findings suggest a new ray of hope for fibromyalgia sufferers. Because of the believed accuracy of a blood pressure test in fibromyalgia diagnosis, those whose lives are being affected by common fibromyalgia symptoms, such as chest discomfort, anxiety and vision problems, can be directed to fibromyalgia treatment sooner by their health care providers.
Typical treatment options for fibromyalgia can include physiotherapy, chiropractic care and cognitive behavior therapy.
_________________________
Your village called... they want their idiot back !
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#662716 - 03/05/08 09:40 PM
Re: are all docs like this??
[Re: scruf]
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mmyp
GRAND Pooh-Bah
Registered: 02/20/06
Posts: 1690
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There is in the body something that is called substance P. It is a neuropeptide and neurotransmitter. This substance P has something to do with the pain pathways. Lyrica works on this substance P. I think this is why some docs think it might be helpful. The module I posted explains some of this. It should be noted that the three docs giving this lecture have some financial ties back to the company that produces lyrica.
From Wiki: In neuroscience, Substance P is a neuropeptide: a short-chain polypeptide that functions as a neurotransmitter and as a neuromodulator. It belongs to the tachykinin neuropeptide family.Functions
In the central nervous system, substance P has been associated in the regulation of mood disorders, anxiety, stress, reinforcement, neurogenesis, respiratory rhythm, neurotoxicity, nausea / emesis and pain.
The vomiting center in the brainstem contains high concentrations of substance P and its receptor, in addition to other neurotransmitters such as choline, histamine, dopamine, serotonin, and opioids. Their activation stimulates the vomiting reflex. Different emetic pathways exist, and substance P/NK1R appears to be within the final common pathway to regulate vomiting. [1]
Substance P antagonist (SPA) aprepitant is available in the market in the treatment of chemotherapy-induced nausea / emesis.
[edit] Pain
Substance P is involved in the transmission of pain impulses from peripheral receptors to the central nervous system. It has been theorized that it plays a part in fibromyalgia. Capsaicin has been shown to reduce the levels of Substance P probably by reducing the number of C-fibre nerves or causing these nerves to be more tolerant. Thus Capsaicin is clinically used as an analgesic and anti-inflammatory agent to relieve pain associated with arthritis and many types of neuralgia.
_________________________
Your village called... they want their idiot back !
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