lung cancer misdiagnosed as anxiety

Hip

Senior Member
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18,116
There are a lot of negative comments and criticisms here.

It is very easy to make these negative comments, but I have not seen any constructive criticisms, nor any intelligent suggestion on how to make a better medical symptom.

I see nothing mentioned in this thread that can be used to improve the medical system. Moaning is of no help.

If you look at this article on How Common is Misdiagnosis, you see that misdiagnosis is massively commonplace in medicine.

What are the reasons for this? How can the situation be improved? How is it that this same situation is present all over the world? These are questions you should be contemplating.

I'd like to hear your intelligent and insightful reflections on these questions.

If you just want to moan without offering any suggestions, well, you are not making much effort.

I love that you're trying to defend an obviously failed system.

No, I am not defending the medical system; everyone wants a better system; I am just pointing out the inherent difficulties of making improvements. It is a very complex issue, and you cannot just shirk these complexities.

Hip the fact that you're blathering on with this nonsense "well if we give everyone an X ray thats a lot of x rays!" just made me lose all respect for your ability to think clearly. Sorry. If i didn't know better I would think you work in the medical world.

You saying this is exactly what I mean about shirking the complexities of this issue. You missed the point I was making about allocation of funding in order to maximize the effectiveness of the health service.
 

Enid

Senior Member
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3,309
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UK
Suggestion - better educated Docs, keeping up with all the latest medical understanding and advances - realising medicine does not stop at the point of qualification.
 

Hip

Senior Member
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18,116
Suggestion - better educated Docs, keeping up with all the latest medical understanding and advances - realising medicine does not stop at the point of qualification.

A good suggestion; though have you considered the angle that human intelligence is finite, and the quantity and complexity of the medical knowledge we have is exploding. As most of us here know, it's virtually a full time job for us here to stay abreast of the latest research in just one disease (ME/CFS).

When a primary care physician has to keep abreast of the exploding amount of new research in all the many thousands of different diseases he encounters in his practice, how is the finite human brain going to contain all that information?

Furthermore, how can a doctor find enough time in his schedule to devote to studying and digesting this new research (most primary care physicians spend a grueling 100 hours per week just looking after their patients; so it is not easy to find a quiet time to sit down and study).

This is not defending doctors, and the fact that they are not always aware of the latest research; it's examining the underlying issues connected to the idea of keeping up with all the latest medical understandings and advances.

I am not sure what the answer is here, but I am certainly aware of the difficulties.

Perhaps each doctor should be obliged take two months off each year, doing no clinical work, and spending all that time studying.
 
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97
Location
usa
So sad the story, but not surpising. i've been suffering for well over 12 years without ANY relief. i've seen too many doctors i lost count, still without proper diagnosis. i can say for sure it is not simply depression or anxiety, it is without doubt something physiological, systemic, and involves CNS, circulation, digestion/gut, and the immune system, likely involving neuroinflamation. to me depression and anxiety are symptoms. and while prolong state of either may lead to other problems, i would suggest there must be some underlying condition that starts the ball rolling (could be something as simple as diet/lifestyle, or more serious as allergy, stress, chemical exposure, or infection). i would suggest that misdiagnosis of these "invisible" illness is so common, and the pycho card gets played way too often (lets give em meds to mask the problem, maybe they might feel better). These misdiagnosis and mis-treatment, not being taken seriously, and poor and inaccurate record (notes) are extremely fustrating and disheartening... and when these misdiagnosis/notes get in the way of disability, then it simply is not right or humane. When ones life is distroyed without help, then you feel like discarded leftovers, a social outcast. you have to be proactive in this. how many lives will be lost before things change?
 

Hip

Senior Member
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18,116
The answer IMO, is the introduction of artificial intelligence (AI) doctors.

Yes, or perhaps a new breed of doctors genetically modified to be able to effortlessly absorb whole encyclopedias of updated medical information while eating their lunch...
 

Valentijn

Senior Member
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15,786
Yes, or perhaps a new breed of doctors genetically modified to be able to effortlessly absorb whole encyclopedias of updated medical information while eating their lunch...
I'd settle for doctors that don't arbitrarily categorize their patients into the "worthy sick" and "psychosomatic malingerers". Too often there seems to be a characterization involved, where they choose to see the patient as depressed, anxious, love-sick(?), lazy, and/or over-indulged. They are not acting as doctors when they make those judgements, and as a result of making those judgements are often refusing to act as doctors.
 

Ema

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Midwest USA
Yes, or perhaps a new breed of doctors genetically modified to be able to effortlessly absorb whole encyclopedias of updated medical information while eating their lunch...
Heck, I'd settle for reading a medical journal in their supposed area of expertise within the last decade!
 

Hip

Senior Member
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18,116
I'd settle for doctors that don't arbitrarily categorize their patients into the "worthy sick" and "psychosomatic malingerers". Too often there seems to be a characterization involved, where they choose to see the patient as depressed, anxious, love-sick(?), lazy, and/or over-indulged. They are not acting as doctors when they make those judgements, and as a result of making those judgements are often refusing to act as doctors.

Isn't this also mainly the same issue of misdiagnosis?

I remember years ago, when I had become pretty depressed due to a relationship split up, and went to see a one private doctor, and burdened the poor guy with a whole catalog of vague complaints about my depression and other mental symptoms and worries that appeared as a result of this depression.

This doctor was amazingly astute, and even though I mentioned nothing about this relationship, he was very quick to realize that I was in fact lovesick, rather than anything else.

He was tactful enough not to mention anything to me, an instead this very clever doctor started asking me about my most passionate interests, which at first I though was a strange line of questioning. But after I told him what my general interests were, he started to recommend a few very good books in the areas I loved, and in fact, getting back into reading about my deepest interests tuned out to be immensely helpful in overcoming my depression and lovesickness.

So in this case, his diagnosis of lovesickness was spot on, and his treatment was very effective. Looking back at how he responded to me, I was much impressed.

So to sum up: I expect that quite often doctors are confronted with complaints such as depression that do not arise from an organic cause, and are indeed due to lovesickness. So they do have to be able to recognize a patient that is lovesick.

Though I imagine not every doctor will have subtle enough perceptions to be able to distinguish lovesickness from other conditions.


The "psychosomatic malingerers" side of it is more to do with the misinformation put out by the meddling Wessely school. Doctors read these studies in good faith, assuming that these Wessely school psychiatrists are competent and honest, when in fact these psychiatrists are neither. I think the reason many doctors don't take ME/CFS seriously is because of all the bad work and bad influence of the Wessely school.
 

*GG*

senior member
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6,396
Location
Concord, NH
That's hilarious. You think this doesn't happen every day in the USA? How many members here are from the USA and get the exact same level of nonsense from their doctors? The exact same unwillingness to run tests. The exact same "anxiety" label without so much as a single exam? This isn't an "over the pond" thing. It happens in the USA every day. It happened to me from 6 different doctors over the last 10 months and I am right here in beloved america.

Simple statistic: 18,000 people die every year in USA hospitals due to medical errors or misdiagnosis. 18,000 people every year.

My comment was in reference of people making statements to defend the status quo. Sorry I was not clear on that, I know our system is not perfect either. I have been through a lot also, but I finally found a good Dr, which seems harder in the Socialist countries medicine. I know our medicine is highly socialized also, and the cost keep going up! Why is it laser eye surgery is cheaper now?

GG

PS Leave people their own money to invest in there health care, HSA are along those lines. Why not have prices posted so I can shop around? Simply unsustainable and likely to collapse! Competition keeps systems/people honest.
 

ukxmrv

Senior Member
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4,413
Location
London
Hip, I don't think that your own case adds to this argument. You didn't have an undiagnosed serious disease (that we know of) at the same time as being diagnosed with something (lovesickness) that has no tests available so your experience isn't really revevant. It was just "luck" and we deserve more than relying on luck when consulting a doctor.

I have never suffered from "love sickness" but under the UK NHS system I routinely have my physical symptoms blamed on these untestable types of complaints. This happens in an inappropriate manner and due to the constaints here (we cannot simply leave and see another doctor) it can take years or decades for the physical reasons for my physical symptoms to be found.

The answer would be for UK NHS doctors to stop diagnosing anxiety and depression as an explanation for physical symptoms until we have reliable tests for these conditions. We have the money to do better tests on people. We can just stop sending foreign aid and financing wars until it is done.

Patients like the woman who died of cancer simply deserve better.
 

maryb

iherb code TAK122
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3,602
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UK
All the GPs at my practice bar one work part-time - once they got their whacking pay rises a few years ago this was the option for many. 100hrs aweek o_O - not in the UK.
They don't have time for research into illnesses - too busy enjoying their time off - skiiing and the like, they love their winter hols:rolleyes:
A friend of mine asked about varicose vein removal the GP said oh things have changed since I left medical school (20yrs ago), they didn't do laser then I don't know anything about it:rolleyes: 10/10 for honesty but really!!!
 

golden

Senior Member
Messages
1,831
Honesty means a lot to me, especially when they are speaking of their own incompetence, that is good. LOL


But I popped back to Say you obviously can't hide if you have had a baby! And this is another area in which if you have any symptoms..... what's the diagnoses.....

yes, post natal depression.

(thyroid issues are going wildly diagnosed too and can be a particular issue after birth)

http://www.telegraph.co.uk/health/9106887/They-said-my-cancer-was-postnatal-depression.html
 

Shell

Senior Member
Messages
477
Location
England
A whole lot of these horrible mistakes would disappear if all doctors (and nurses) were taught that all human persons have inherent dignity which should be protected and are worthy of being treated with respect.
Once they have been challenged on the cultural crap that they grew up with that allows them to see teenagers as "just teenageers" and women as "hormonal cow" or "fat cow" or "middle aged fat hormonal cow" and when they no longer look at poor people as "chav" or "dregs" then perhaps we can move forward. But even some good kids I've known have soaked up those attitudes before heading off to Uni.
I taught British Sign Language to medical students and frankly I was horrified by their narcissistic nastiness. None of my other groups were like that. (in the same Uni).

Here in the UK some UKIP man was able to feel quite ok saying disabled kids shouldn't be allowed to live. It took a massive backlash before he stepped down and his apology was naff to say the least.

I could fill you a few pages of mistakes and horrible behaviour by doctors just from my nursing days, let alone from friends and family members who have died thanks to medical negligence. I'll never get over my friend's death or the shocking lack of care of the two doctors at her inquest even when the Coroner told them bluntly what she thought of them.

Changing attitudes would not cost money and I am convinced would save lives

In my training the dignity of the patient was drummed into us. All that went out the window with the stupid changes in training.
Doctors are dangerous and crap because they are enabled to be.

Rant over.:rolleyes:
 

PhoenixBurger

Senior Member
Messages
202
A whole lot of these horrible mistakes would disappear if all doctors (and nurses) were taught that all human persons have inherent dignity which should be protected and are worthy of being treated with respect.
Bingo.

I would just like to present to everyone here a letter I received from my doctor, the morning I told him that I woke up .... physically unable to *exhale*. After months of countless problems spanning multiple part of my body, and all normal bloodwork, I woke up and could not get all of the air out of my lungs.

Here was his assessment. Sound familiar?

"I am at a lost as to how to properly respond to this email without risking alienating you. From a symptom point of view, you are describing acute bronchospasm akin to that experienced by asthmatics and patients with Emphysema. In your case I believe it to be stress induced whether it is psychologically induced or biochemical or both remains to be ascertained. I believe we can agree that your current situation has you at least concerned and certainly frustrated. I don’t know about you, but when I feel frustrated and concerned I am not the same person; call it stress, anxiety or what have you.

Secondly, you mention that you have symptoms of various diseases yet not the disease. Many of these symptoms are non-specific and can apply to any number of diseases. For example, something like “fatigue” can be associated with literally pages of different diseases. ... My question to you is what happens if you are told that there is “nothing wrong”? It remains in the realm of possibility."

Of course. Everything is stress. Everything is anxiety. Naturally. Why would it be anything else? Why was I perfectly fine one day - then suddenly I self induced a myriad of health problems and have enjoyed continuing to self-induce health problems for nearly a year now. Thats a rational explanation mister doctor. You're right. I don't have anything better to do. And nothing in particular happened on the day that I decided to start self-inducing physical problems. I just .... started. I suppose you also think I enjoy it, right?





I have yet to get an X Ray to look at my lungs. Maybe that should be my next step. Since the doctors are convinced my utter inability to exhale that day was clearly stress induced, after just waking up from 9 hours of solid sleep.
 

Hip

Senior Member
Messages
18,116
A whole lot of these horrible mistakes would disappear if all doctors (and nurses) were taught that all human persons have inherent dignity which should be protected and are worthy of being treated with respect.

But how do you couple this touchy-feely approach that you would like to see, with the need for doctors to insulate and inoculate themselves from the horrors of their work and profession, for the sake of their own emotional sanity?

I'll give an example: when you do a 5 year medical degree, part of the course involves human dissection work, where you get a cadaver (a human body preserved in formaldehyde), all areas of which you have to slowly dissect over many months, including the face.

Who of us here would be emotionally capable of slowly dissecting a human face? Taking out the eyes, chopping up the nose, removing the jaw, pulling out the brain.

Unless you develop a hard constitution, and an emotional detachment from your work, you just aren't going to make it through medical school, and you certainly are not ever going to make it as a doctor.

This iron constitution is necessary not only because you have see human blood and guts all the time, but also, you have to constantly see and deal with death in front of you. And you have to frequently inform patients that they have fatal diseases and are going to die; you are in fact in a profession surrounded by death and disease.

I know I certainly would never have a strong enough constitution to face all this for 100 hours per week. In this respect, I am very impressed at doctors' abilities to cope.


This is not to say that doctors shouldn't have a respectful, compassionate disposition towards their patients; but I suspect this extending themselves emotionally towards patients always needs to be tempered by maintaining some emotional detachment, in order for doctors to preserve their sanity.

I suspect some doctors are very good at extending themselves emotionally, yet at the same time, not getting upset by (potentially) highly emotionally perturbing work. But perhaps other doctors find it hard to do this, and so remain emotionally distant.


I hope that people can see this, and see that these issues are not as straightforward as you would like them to be.
 

Hip

Senior Member
Messages
18,116
I woke up .... physically unable to *exhale*

This symptom you say happened just once, many months ago, and presumably only happened for a very short time, otherwise you would not be here to tell the tale.

Your momentary inability to breath out is, I suspect, due to the fact that the brain cuts off the voluntary nerves during sleep (otherwise we would all physically act out our dreams, like sleepwalkers do). The moment you wake up, the brain reconnects your voluntary nervous system, so that you can move your muscles and limbs once again.

Sometimes, however, there can be a slight delay in reconnection, and your voluntary nerves may still remain disconnected for some moments, even after you have woken. When this happens, it feels like paralysis, and indeed the phenomenon is known as sleep paralysis. There is a lot of folklore linked to sleep paralysis, like incubus and succubus creatures sitting on your chest; it is an interesting subject.

Sleep paralysis is nothing to worry about, however, even though it can be a scary experience.

Remember that the muscles which control your breathing are innervated by two separate nervous systems: the voluntary nervous system (which we use to willfully control our muscles), and the autonomic nervous system (which is an automatic muscle control system that will keep us breathing even when we don't consciously think about it).

If you had sleep paralysis, it would have prevented your voluntary nervous system from activating your lung muscles; but it would not have stopped the autonomic nervous system from operating your lung muscles, so there is never a danger of not getting your breath, as the autonomic nervous system always works, and it kicks in automatically as soon as we are short of oxygen.

Interestingly, the lungs of dolphins are only innervated by one nervous system, the voluntary nervous system; dolphins have no autonomic nervous system control of their lungs — no automatic breathing system — and this means that dolphins can never go fully to sleep, otherwise they would stop breathing and die. Just thought I'd add that bit of trivia.
 
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