271–280 of 438 posts
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high quality here means "genuine", ie discusions made by real humans and not corporate advertising.
Unfortunately Reddit discussions can be made to look genuine when they are really corporate advertising.
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> Gatekeepers that block access to potential treatment pathways until you can convince them it’s worth a try. You assume they actually know what needs to be done. In my experience, you can see they don't have a clue and aren't willing to do research to learn. They just hand out their usual prescriptions, etc and sometimes hope an exam will give them an obvious answer. On top of that, most doctors only have a very nar…
> On top of that, most doctors only have a very narrow understanding of the human body and don't know when to refer you to some other doctor they will be better equipped to help you. Are we talking about doctors, not nurse practitioners? It's hard to understand how a doctor with 4 years of medical school and 3-7 years of residency would have a "very narrow understanding" of the human body. Also, my experience has bee…
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>I can’t count on doctors _at all_ to move the process forward. This has been my experience as well dealing with fatigue. I was 25 when I finally got diagnosed with sleep apnea, after over a decade of symptoms. How something so common could go unnoticed by the adults and professional doctors in my life astonishes me still today. Eventually, thanks to ego, I questioned the narrative that I was just normal and lazy. Wi…
I think the situation has improved there in the last couple years. I had a friend who I suspected of having sleep apnea. She called her doctor and asked for a sleep study. They gave her a device to wear while sleeping and the diagnosis of sleep apnea came the next day. Getting insurance to approve the CPAP, though... that is still an open problem. Weeks later, no treatment for diagnosed disease.
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I think the situation has improved there in the last couple years. I had a friend who I suspected of having sleep apnea. She called her doctor and asked for a sleep study. They gave her a device to wear while sleeping and the diagnosis of sleep apnea came the next day. Getting insurance to approve the CPAP, though... that is still an open problem. Weeks later, no treatment for diagnosed disease.
I'm not sure what your friends financial situation is but maybe try to collect some money for her and buy one? I googled that the average cost is just under $1k for a CPAP machine. If it could change her life then maybe should could even pay it back one day.
It is far from an ideal solution, but in the 3 months it takes insurance to get their shit together - your friend could have the energy to work a side job to pay off whatever it costs and just be generally happier overall
This is also why a weekend on pubmed and similar gives you a better result than a doctor ... who spent 2 minutes reviewing your chart and comes into the room for a few more minutes to talk to you.
“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…
I took this seriously and made some changes. I went back for a follow up I had scheduled for 6 months later. I met with a different doctor this time and she looked at my charts, asked why I was here, I explained I fasted over night and wanted to take a liver function test and I needed her to order one. She argued that "It's fine, you're not even that over the maximum!" and "Do you feel pain? If not you're fine."
From my research there are both completely false statements when it comes to increase in this enzyme at my age range. Everyone said that if they see an increase in 6 months that's a sign of a larger issue and it's worth getting the test since your insurance would cover it (which mine did) just to be safe. After telling her I wasn't leaving until she ordered the test she opened her laptop to enter it into the EMR. I saw her open Google, copy "Hepatic" from "Hepatic Function Test" on my previous labs and then read the popup Google showed me out loud: "Liver.. ok good" and then order the test in the EMR again.
Some doctors haven't got a clue. It's unpopular to say because it's a convenient fiction to think you will get good care from any qualified doctor but when one doesn't know what "Hepatic" means then I don't know what to think.
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> Gatekeepers that block access to potential treatment pathways until you can convince them it’s worth a try. You assume they actually know what needs to be done. In my experience, you can see they don't have a clue and aren't willing to do research to learn. They just hand out their usual prescriptions, etc and sometimes hope an exam will give them an obvious answer. On top of that, most doctors only have a very nar…
I‘m really not trying to sound snarky, but - is this the supposedly high quality treatment that U.S. citizens get that is so much more expensive as opposed to the „socialized“ insurance we get in Europe that is cheaper for everybody and supposedly therefore not as good/cutting edge?
I see these comments all the time on Reddit and HN but never see the reverse from US posters. They just come across as insecure and snooty.
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Can confirm. They paint people who google symptoms as kooks or as annoying, but you have to if you ever want to get an actual diagnosis and treatment, because doctors and hospitals are, quite often, worse than Google at figuring out WTF is wrong. Do your best not to end up in a hospital without an advocate (friend, relative) watching out for you. They'll fail to treat you at best, then discharge you with a shrug and…
I was misdiagnosed with Bipolar Disorder for 30 years. Turns out it was Neuropsychiatric Lupus. Despite all my pleading to them to look further they never did. I had to teach myself biology and genetics while I was on disability. They missed all the common signs of Lupus; my skin, bad kidneys, etc. I am afraid all this technology is taking away all of our wisdom. Too easy to know things, very hard to understand them.
It would be nice if we could have an omniscient oracle to gate-keep us away from ineffective treatments - but we don't live in that universe. Instead we have (in the US) the FDA, which is staffed by smart, well-intentioned, and very fallible human beings, each with their own (well-intentioned) agenda. At the very least these folks are simply weeding out treatments with major negative outcomes, like killing the patient. So some placebos get through and called 'treatments' like LBR - unless there is some better treatment that you're forgoing, there's really not much harm except for the $400.
The folks that do a lot of research will make better choices than those that don't - but they will also help all those others make better choices over time as they communicate their ideas and results to the masses.
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> Gatekeepers that block access to potential treatment pathways until you can convince them it’s worth a try. You assume they actually know what needs to be done. In my experience, you can see they don't have a clue and aren't willing to do research to learn. They just hand out their usual prescriptions, etc and sometimes hope an exam will give them an obvious answer. On top of that, most doctors only have a very nar…
I‘m really not trying to sound snarky, but - is this the supposedly high quality treatment that U.S. citizens get that is so much more expensive as opposed to the „socialized“ insurance we get in Europe that is cheaper for everybody and supposedly therefore not as good/cutting edge?
I'm transgender, and everything the top-level poster said about incompetent doctors, gatekeeping, and having to read literature and teach yourself about your own medical condition absolutely 100% applies to me and nearly every other trans person I've talked to (I remember printing out the Endocrine Society guidelines and taking a highlighter to them in order to convince a doctor that what I'm asking for is standard practice). I also have friends who have other chronic medical conditions, and their experience with doctors is pretty much the same as my experience and the experiences of other trans people.
And everything I've heard from people in Europe is that over there, it's even worse. At least in the US it's possible to doctor-shop and find someone who knows what they're doing—or who at the very least is willing to listen—but in European countries with single-payer healthcare you are entirely at the mercy of whatever doctor gets assigned to your case (yes, this isn't as bad in multi-payer countries such as France as it is in single-payer countries like the Nordics). And in some cases, the barriers aren't even the competencies of your individual doctors but institutional requirements doctors are legally required to follow even if an individual doctor is competent. Mind you, there are some exceptions: in parts of Spain and in much of Southeast Asia, for example, a good amount of medications that are Rx-only in most other countries are available over-the-counter, so at least you can self-med if you've put in the exhausting effort to research your own condition and figure out what you need (and even then, good luck getting blood tests to confirm your dosage is appropriate).
This isn't an endorsement of the US healthcare system, just an acknowledgement that the shit sandwich offered in the US has slightly less fecal content than the shit sandwiches offered in many other countries.