lung cancer misdiagnosed as anxiety

[Hip]

One story to consider: when Dr Cheney developed some heart symptoms, it took him 10 years to work out what was in fact wrong with his heart.

Now think about this: here is very intelligent doctor, with full medical training, with full access to medical testing and equipment; and yet it still took him a whole decade to figure out what was wrong with his heart.

That should tell you something. It tells you that diagnosis is difficult.

 

[irwinsturtle]

But he didn't write his illness off as psychosomatic!

 

[Hip]

But he didn't write his illness off as psychosomatic!

Meaning?

You do know that Dr Paul Cheney is a well-known ME/CFS doctor, who witnessed the Incline Village ME/CFS outbreak, and is the last person who would say a disease is psychosomatic.

 

[Valentijn]

But he didn't write his illness off as psychosomatic!

Meaning?

Meaning, as has been said before, that the problem is not the failure to diagnose the actual disease. The problem is that an incorrect diagnosis is made which is not a reasonable one given the symptoms and tests that have (not) been performed.

Doctors are making assumptions about people's character and psychological state, and in the process creating a self-perpetuating circle of not investigating: "Some of these symptoms could indicate anxiety, thus the diagnosis is anxiety. The patient only has anxiety, thus investigating the symptoms is pointless." Repeat until the patient dies.

There is a huge gap in the logic, and in retrospect the holes have been plugged with the doctors' biases. "Some of these symptoms could indicate anxiety, and the patient is a middle-aged woman. Middle-aged women are prone to anxiety, thus the diagnosis is anxiety." And so forth.

 

[maryb]

Hip don't think anyone's saying diagosis is easy - just that will they please stop jumping on anxiety, depression etc. when they don't know what the cause is - its just too easy and gets the patient out of the door quickly which is what they want of course - in my opinion.
Its the culture now and most of the GPs do it - its just a constant battle for the patients. Thats why there is now concern about the number of patients in the UK on a/depressants, can they really all be clinically depressed?
They sit there clutching the cash and we walk in with this illness which would take test after test and many different drugs to try to try to get some improvement - a/virals, a/biotics etc - nah easier to say anxiety.
Sorry if I'm repeating myself on the thread, I know it gets boring reading the same thing over and over.

 

[Hip]

Meaning, as has been said before, that the problem is not the failure to diagnose the actual disease. The problem is that an incorrect diagnosis is made which is not a reasonable one given the symptoms and tests that have (not) been performed.

But many doctor's diagnoses are just educated guesses, of necessity, because diagnosis is hard.

Would you prefer it if doctors just said "I don't know" each time you visited them? That would be even less helpful. At least hear their educated guess; they might be right.

If a doctor says "your symptoms are just caused by stress, that is often their way of saying 'I don't know,'" so you may want to leave that doctor and find another.

Most smart people try to see different doctors, anyway, so that you get the benefit of different opinions, and get more than one possible diagnosis. It is very normal for people with chronic diseases to be given a variety of different diagnoses in their search for the actual truth; often it is the patient themselves that finally figures out which diagnosis is the most appropriate and accurate one.

Of course seeing multiple doctors is not really that easy under the NHS or other socialized medical systems, but if you are willing to pay, you can see as many private doctors as you can afford. If you are willing to pay, you can even hire a doctor to work for you for a whole week, exclusively on your case. I am sure they would come up with much more accurate diagnoses given a week to research and perform tests you.

If we wanted, we could even get our European socialized medical systems to provide us with multiple doctors, or our own exclusive doctor for a week. All we would have to do in Europe is increase our health taxation to much higher levels, and we could have this. But you would have to get the whole nation to agree to pay more.

 

[Hip]

I have to admit though, if you don't understand that when a doctor says "it's just stress," this is their way of saying "I don't know", then you may not realize that you have to find another doctor.

The first time a doctor told me "it's just stress," I took this statement at face value, and assumed it was true (it wasn't; I fact had developed IBS). But with a bit of experience of seeing doctors, you soon learn that these generic "it's just stress" diagnoses are just a way of saying "I don't know".

I guess for novice patients, there should be an info leaflet explaining that "it's just stress" = "I don't know".

 

[Valentijn]

If a doctor says "your symptoms are just caused by stress, that is often their way of saying 'I don't know,'" so you may want to leave that doctor and find another.

Sorry, but that's a load of bull. If they don't know, there is absolutely no reason to 1) lie, 2) create a false diagnosis, and 3) deny further testing. That a system would ever tolerate such behavior is inexcusable.

 

[Hip]

Sorry, but that's a load of bull. If they don't know, there is absolutely no reason to 1) lie, 2) create a false diagnosis, and 3) deny further testing. That a system would ever tolerate such behavior is inexcusable.

Yes there is a reason: it's called money.

 

[golden]

http://www.vernoncoleman.com/main.htm

This article by Dr Coleman has an interesting take on the NHS.

The employer/employee relationship has been destroyed he says. Very true. Bad doctrine should result in us the patient, sacking our employee, the Doctor! (As it happens I believe the cheeky Doctors are sacking patients!!!)

The idea that a charity would have been set up to give money to the poor so that they could then employ a Doctor is an excellent one.

I don't agree with everything in this article but I do see some very enlightening concepts.

 

[golden]

http://www.vernoncoleman.com/stupididea.html

This is the article I was referring to - SORRY! The above link refers to a main menu.

 

[Shell]

http://www.vernoncoleman.com/stupididea.html

This is the article I was referring to - SORRY! The above link refers to a main menu.

I will read that through.

I wasn't going to make a "political" comment here because I didn't want to send the thread off but as it has been mentioned here that Margaret Thatcher did health care a favour with Care in the Community and that before then psychi staff were abusing patients I think I will comment.

First of all - there were one or two cases of patient abuse and this continues today. It always has and sadly it always will. MIND put out a massive propaganda campaign against, not just hospitals for the mentally ill but medication for them too. This campaign caused so much damage to so many seriously ill patients. When Care in the Community came along MIND got a lot of money to open hostels and suddenly their campaigne ended, not least because they weren't so great at care themselves.

I was working in one of those big psychi hospitals in the 1980s. I saw with my own eyes the results. Wards were closed. Sick people got sent home to families who couldn't cope and ended up begging in the town centre. I and other members of staff had the heart rending experience of seeing ex-patients sitting under paper bags on street corners.
Meanwhile even the mainstream press noted that the prisons were filling up with mentally ill people.
A friend of mine did a large study and meta-analysis in which she saw the number of beds closed in hospt was almost bed for bed the number increase of psychi patients in prison.

Meanwhile I had a patient who had scizophrenia and brain injury (he had been mugged and beaten up) and was a long term patient. He was working with me on rehab. He had been in hospt over a year and had no family but for an elderly sick mother who had a small state pension.
Thatcher's "benefit reforms" meant that this man's benefits were suddenly lower than the rent on his flat. It put him into immediate areas and I ended up buying him toiletries out of my meagre pay (Thatcher didn't think nurses should have a living wage. Tony Blair was a nightmare but at least he gave a fairer pay to nurses).
Being in areas on a council owned flat meant this man couldn't have a much needed change of accomodation. His flat was up the top of a block and as he was a risk he needed a ground floor flat that was accessable to his mother (who would be his primary carer)
In the end his mother (God bless her) paid off his debt meaning she was having less to eat and no heating on.

Years later when I was "link" nurse meaning in charge of the whole hospital for a shift I could tell you horror story after horror story because we hadn't enough beds.
We ran on 150% capacity meaning we had patients in other patients beds when they were on leave and this led to patients being in police cells overnight because their bed was filled.
Families can't cope with seriously mentally ill people and the suicide rate is a disgrace.

Sorry if this is off-topic but I think it shines a little light behind the scenes and shows how so many people can be let down by a daft system.

 

[Hip]

I watched a very good documentary about how even relatively sane young people — young women with nothing much more than a bit of depression and frailty of personality, perhaps just going through a bad patch in their teenage years — were often recommended for incarceration in these psych wards. Once they were taken in to these psych wards, they often became permanently institutionalized.

I find that utterly frightening, and really sickening, and I am so pleased these places were closed down.

 

[Shell]

I watched a very good documentary about how even relatively sane young people — young women with nothing much more than a bit of depression and frailty of personality, perhaps just going through a bad patch in their teenage years — were often recommended for incarceration in these psych wards. Once they were taken in to these psych wards, they often became permanently institutionalized.

I find that utterly frightening, and really sickening, and I am so pleased these places were closed down.

Hip as I lost a dear friend 3 years ago to a horrific suicide thanks to the closing down of those wards I can't agree with you at all.
Insitutionaling patients who weren't ill did happen back in the 40s' and 50s but that was looooooooong before I was working in the hospt and it was an overlap from the days of the workhouses where poor people were insitutionalised.
But once hospitals were just that - hospitals for the seriously mentally ill, we were not in the buisness of insitutionalising patients without necessity. I bet you've never seen a person floridly and dangerously mentally ill or you wouldn't use sweeping generalisations.
As for "documentaries" they are never wholly accurate and always have a "message". I've yet to see any documentary on mental health that was balanced and fair. Not one.

If you can explain how living on the streets and/or being in prison is better I'd love to know.
Also please explain how my friend's suicide was so much better than her having a bed in hospital when she needed it.
Ye gods - you didn't see what happened. I DID.

 

[golden]

Hip and Shell,

I have seen both your experiences and I agree with you both.

This article is not absolute in my opinion but its a part of the puzzle too.

Underlying causes such as M.E. patients are trying to find , environmental toxins, thyroid problems, mercury poisoning etc etc. are not looked for before a psych diagnoses is given.

http://www.vernoncoleman.com/mentalill.html

 

[Shell]

Thanks @goldenn and Hip - and I know you (Hip) are not advocating denying care to seriously ill people - so I don't want to you read my experiences as an attack on you personally. But just as "hard cases make bad law" so it is in health care.
Instead of sacking all medics because so many make humungous mistakes like the one at the beginning of the thread there needs to be something at educational level - philosophy I suppose.
Closing so many beds that people can't get care is just as bad as having Workhouses for the poor. Both systems kill people.
But we must tread carefully that we don't let the media decide what we think.
It was this same media who said we had "yuppie flu".

 

[golden]

I have read also sugar and caffeine can cause the appearance of mental illness. People with Schizophrenia have cured themselves on a macrobiotic diet - i have only read this - but i believe it.

If these places were full of nourishment, enzymes, minerals, vitamins, in a peaceful, individual and empowering setting in order to encourage health then I think they would be great.

I don't even think Candidiasis is officially recognised yet, parasites are not tested for (can cause mental dysfunction) nor is gut function and a treatment protocol of healing the gut is omitted.

Instead patients are given a lifetime label - meaning a lifetime drug customer- with endless supply of caffeine and sugar.

 

[Hip]

If you can explain how living on the streets and/or being in prison is better I'd love to know.

I just think that if I was ever in a position of having significant mental health problems, I would hate to be locked in a psych ward, surrounded by lots of other people all with their own mental health peculiarities, as it seems to me that you would rapidly lose what little and tenuous grip you had on normal reality, as you would have too few people to relate to that were normal.

 

[Shell]

Hip - you don't seem to understand what severe mental illness does to a person. First of all the wards aren't locked. The only ward in the entire hosp that was locked was the ICU. And if you think it's safe to have patients who are very violent wandering around the streets then I don't know what to say!
Second; where on earth are these patients supposed to go? You talk about a "tenuous grasp of reality" - what grasp? I'm talking about people who can't answer basic questions because they are so distracted by hallucinations- some of which are terrifying for them.
One of my patients had locked and barracaded himself into his bedroom before admission. He wasn't well physically let alone mentally by the time he was sectioned and brought in. He explained to me that he'd done this because the voices told him if he left his room he would kill someone.
Coming into hospital opened doors for him instead of locking him and he learned to go for walks in the grounds with me and then further afield and so on until he returned home.
The patients who were well enough could attend clubs and classes outside the hospital as they began to prepare to go home. Patients in prison don't get that. They ARE locked up. Patients on the streets often end up back in hospital after being attacked. How this is better is beyond me.

And your point about being with other mentally ill patients. Actually this helped a lot of people. Just like we need to talk with fellow ME patients, so they needed the support of fellow patients and I saw some amazing progress made with patients, not because of us nurses or medication, but because of something another patient offered in support.
I saw one incident of a bad knock on and that was a patient who tried self harming because he'd seen another patient do so. We managed to nip it in the bud and he didn't do it again.

Golden - I don't doubt there are claims out there about all sorts of weird and wonderful cures. I've worked with hundreds of mentally ill people over the 16 years I was a nurse and I never saw ONE cured by diet nor made ill by caffeine or sugar. But then I don't know anyone who tried it either, so who knows.
Cannabis - yes. UTI's causing apparent mental illness- yes, quite often, and that may very well be linked with sugar.
Uncontrolled diabetes causing psychotic depression - yep.

But whatever we do, we can't care out of ignorance.
I am not saying everything smelled of roses. It certainly didn't. Some things that happened were awful - a child sent back to abusive parents sticks in my memory and will do forever.
A patient sent on leave even though we begged the doc not to, who then killed herself.
A patient killed by another patient on a ward because they had no staff - both nurses were dealing with another situation.
And so on.
Yes terrible things happened.
But the way to stop terrible things happening is to ensure the safety net is big enough, not make it even smaller.

 

[Hip]

Well from what you are saying, Shell, I guess I stand corrected. You clearly have a great deal of knowledge and experience in this area, and I defer to that.

Though it is this idea that people with only relatively mild conditions may get institutionalized that concerns me. I watched a film a while ago called "Girl, Interrupted", based on a true account of teenager with borderline personality disorder, who was institutionalized for a period. In this film at least, the girl seemed to find it a little shocking to witness the other patients.