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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 69 to 93 of 129. Go back in thread:
Posted by JenStar on July 22, 2004, at 23:32:49
In reply to Re: I'm with TC and PC... » partlycloudy, posted by chemist on July 22, 2004, at 20:35:48
awesome, funny post! :) I love Catch 22 - one of my very favorite books. Good analogy! :)
Chuckling...
JenStar (Or...is it TexasChic....or it is AuntieMel? The possibilities, like the Yossarians, abound!)
Posted by JenStar on July 22, 2004, at 23:49:31
In reply to Re: I can imagine something worse, posted by fires on July 22, 2004, at 20:41:04
Fires,
why are you here? Are you here to stir up trouble for fun (for you), or do you genuinely want to connect with other people who are going thru rough spots in their lives?If you're here to connect, please stay. Welcome. Just try to be a little nicer. Then we'll all like you better.
If you're here to stir up trouble, take off!
I'm being blunt. I know it. Probably offensive, too.But your posts have not started anything positive here...except for the wonderfully human, outreaching letter from a few folks, esp. Dinah (wow...what a gal! I aspire to be so kind and forgiving...seriously.)
It's your choice. I'm interested to see what you decide.
JenStar
Posted by Larry Hoover on July 23, 2004, at 8:22:41
In reply to one small step for me, posted by fires on July 16, 2004, at 10:49:17
> I complained too much about my physical symptoms, apparently. Anyway, my Pdoc ignored the following FACTS: 1) Too much Effexor was responsible for some of the symptoms (they went away when my dose was lowered) 2) I had OBJECTIVE data (x-rays, biopsy, cardiac event recorder data, BP and Pulse data) to support nearly all of my physical complaints.
First off, I can be certain that the doctor did not ignore the factual medical evidence. In somatoform disorders, the symptoms are real. The suffering is real. There may also be concurrent medical disease. The one type of diagnosis does not exclude the other.
What sets somatoform apart (there are a number of different sub-types, but you don't further specify) is that following a series of diagnostic tests and assessments, no underlying disease state can be found.
> I'd urge everyone who reads this to never accept a DX of Somataform Disorder because it can not be proven with OBJECTIVE tests. It is a SUBJECTIVE disorder.
It is a syndrome which is defined by the failure to diagnose other disorders first (a process called the differential diagnosis). It's what's left, when you checked everything else. The objective tests failed. You're right that it isn't proven with objective tests. It's reluctantly assessed because of objective tests, though. Chronic fatigue syndrome is another example of diagnosis by exclusion. Personality disorders, too.
> The recommended treatment is still largely psychobabble. (Which is why I posted this here).
The recommended treatment is still *medical*. It is supportive symptomatic treatment, with reassurance (based on negative objective test results) that there isn't any evidence of a serious disease. From the Merck Manual: "Usually, the best treatment is a calm, firm, supportive relationship with a physician who offers symptomatic relief and protects the patient from unnecessary diagnostic or therapeutic procedures."
Posted by Larry Hoover on July 23, 2004, at 8:24:42
In reply to Re: Off topic digressions, multiple ids » fires, posted by Larry Hoover on July 22, 2004, at 16:15:38
It's okay. I have oven mitts.
> Some observations....
>
> > Notice how many times the subject line of my post got changed.
>
> Nobody changed the subject line of your post. It's still the same, and it's still at the top of this thread. People changed the subject line of their own posts. It's a simple matter to change it back, if it's important to you.
>
> > also, how far afield it got from my original subject line.
>
> Like you, right now?
>
> > Also, follow some of the posts by persons who say one thing to one poster than say another , to another. (180 degrees opposite).
>
> Don't read posters who trouble you, maybe?
>
> > I'm curious, don't some people have other things to do besides reply to posts all day long?
> >
> > Thanks
>
> 19 out of about 52 of all the posts in this thread are yours.
Posted by TexasChic on July 23, 2004, at 9:28:41
In reply to Re: I'm with TC and PC..., posted by fires on July 22, 2004, at 20:38:24
> I think everyone knows what "fricken" stands for. I would appreciate it if you would refrain from using it in any thread that I start.>
When you said "Sorry to have to inform you, but 99.99% of everything you wrote is in my opinion either : 1)pure fiction or 2) unprovable or 3) complete **,"" doesn't ** stand for something? Something that might offend others? Fricken is a common euphemism that is accepted by society as benign, just like 'darn' or 'heck'. It doesn't fall under the category of cursing. Its a substitute just like ** was for you.
Posted by chemist on July 23, 2004, at 9:32:05
In reply to Re: I'm with TC and PC..., posted by JenStar on July 22, 2004, at 23:32:49
> awesome, funny post! :) I love Catch 22 - one of my very favorite books. Good analogy! :)
>
> Chuckling...
>
> JenStar (Or...is it TexasChic....or it is AuntieMel? The possibilities, like the Yossarians, abound!)
hello there, chemist chemist here...or am i? all the best...
Posted by TexasChic on July 23, 2004, at 11:15:15
In reply to Re: one small step for me, posted by fires on July 16, 2004, at 19:21:54
You know, I truly enjoyed talking to you before you accused me of being dishonest and posting under another name. Everyone here has a common bond. It's an unspoken rule not to mess with someone like you insist we have. It would be breaking the very foundation that binds this online community together. No one makes fun, no one accuses someone of being deceitful. We are very protective and when someone comes in saying things that hurt, we do tend to circle the wagons. I think you might consider the fact that you have had problems on other boards as well as ours. Don't you think that indicates that maybe you should try a different tactic? I think the fact that so many people tried again and again to work things out with you, that it proves the people here are sincere. No one here wants to turn anyone away because of the seriousness of the issues we discuss. If you would give us a chance we would welcome you with open arms. I hope you will consider trying to work with us instead of against us.
Thank you,
TexasChic
Posted by fires on July 23, 2004, at 11:32:32
In reply to Re: somatoform disorder(s) » fires, posted by Larry Hoover on July 23, 2004, at 8:22:41
I don't think you attacked me in the near past with ad hominem messages, so I will repond.
>>What sets somatoform apart (there are a number of different sub-types, but you don't further specify) is that following a series of diagnostic tests and assessments, no underlying disease state can be found.<<
You so eloquently stated above the problem with Somatoform: It assumes that there are tests and assessments currently available for all disorders/diseases. That's an incorrect assumption!!
Stomach and duodenal ulcers were once considered to be of "psychosomatic" etiology, but along came "better" science, and a bacteria was demonstrated to be the cause of ulcers. So all the ulcer victims were suddenly no longer victims of their own psyches.
Perhaps you aren't too familiar with the medical field, so I will give you another example of how one can test/be assessed neg. for a med. problem yet still have one/it.
My sister (ECG tech) has told me many stories of people who have come into the ER with MI symptoms, only to test negative for MI. Then they die of a massive MI on the way home.
Thank you
Posted by fires on July 23, 2004, at 11:34:44
In reply to Re: Fires....too hot to handle?, posted by Larry Hoover on July 23, 2004, at 8:24:42
>>> Don't read posters who trouble you, maybe?<<
Good advice to those who feel the need to attack me personally.
Thanks
Posted by AuntieMel on July 23, 2004, at 11:37:07
In reply to Re: I'm with TC and PC..., posted by JenStar on July 22, 2004, at 23:32:49
and start over. Or if you feel you can't start over right now, please don't help make things worse.
Posted by AuntieMel on July 23, 2004, at 11:39:09
In reply to Please everyone, let's take a deep breath, posted by AuntieMel on July 23, 2004, at 11:37:07
I feel like someone in a 50s movie. "can't we all just play nice"
I take no sides here. I just want peace in the family.
Posted by TexasChic on July 23, 2004, at 12:17:34
In reply to Please everyone, let's take a deep breath, posted by AuntieMel on July 23, 2004, at 11:37:07
I didn't mean my post as an attack, I was trying to reach out. I was honestly trying to help, not make things worse. But if that's what I did I apologize.
Posted by fires on July 23, 2004, at 12:42:16
In reply to Re: I'm with TC and PC... » fires, posted by TexasChic on July 23, 2004, at 9:28:41
I think you may be misinterpreting what I meant by **? Is that possible?
Also, I don't think that "fricken" is an acceptable euphemism. I don't know of any schools in my area that would allow students to use it on campus.
Thanks
Posted by fires on July 23, 2004, at 12:46:35
In reply to Re: I'm with TC and PC... » JenStar, posted by chemist on July 23, 2004, at 9:32:05
> > awesome, funny post! :) I love Catch 22 - one of my very favorite books. Good analogy! :)
> >
> > Chuckling...
> >
> > JenStar (Or...is it TexasChic....or it is AuntieMel? The possibilities, like the Yossarians, abound!)
>
>
> hello there, chemist chemist here...or am i? all the best...I don't find these types of posts are beneficial , or amusing. Why don't some of you just admit to using multiple names here, *if you are indeed doing so*. Messages like above only further cause me to believe that it is being done here.
Thanks
Posted by Larry Hoover on July 23, 2004, at 12:52:18
In reply to Re: I'm with TC and PC..., posted by fires on July 22, 2004, at 20:38:24
> I think everyone knows what "fricken" stands for.
Then why did you post a definition, one far more explicit than the original form?
> I would appreciate it if you would refrain from using it in any thread that I start.
I would appreciate if if you would refrain from claiming ownership of any thread to which others post.
Thanks
Posted by TexasChic on July 23, 2004, at 12:58:29
In reply to Re: I'm with TC and PC..., posted by fires on July 23, 2004, at 12:42:16
Why you would use ** instead of the real word if it weren't something offensive? It doesn't matter. I don't want to argue with you, I just didn't think that was a fair request.
Anyway, I think I'm just going to shut up now. I'm obviously not communicating effectively today, everyone keeps misunderstanding me.
I hope your day goes well.
Posted by Larry Hoover on July 23, 2004, at 13:07:02
In reply to Re: somatoform disorder(s), posted by fires on July 23, 2004, at 11:32:32
> I don't think you attacked me in the near past with ad hominem messages, so I will repond.
>
> >>What sets somatoform apart (there are a number of different sub-types, but you don't further specify) is that following a series of diagnostic tests and assessments, no underlying disease state can be found.<<
>
> You so eloquently stated above the problem with Somatoform: It assumes that there are tests and assessments currently available for all disorders/diseases. That's an incorrect assumption!!No, there is no such assumption. Doctors not finding anything that corresponds to their current state of knowledge is not the same thing as assuming they know everything and how to find it.
> Stomach and duodenal ulcers were once considered to be of "psychosomatic" etiology, but along came "better" science, and a bacteria was demonstrated to be the cause of ulcers. So all the ulcer victims were suddenly no longer victims of their own psyches.
Stress is still a factor, and treatment is still symptomatic. Knowing "why to do" is better than knowing "what to do", but apart from adding antibiotic therapy, what to do hasn't changed.
> Perhaps you aren't too familiar with the medical field,Careful, lest you stray into ad hominem land.
> so I will give you another example of how one can test/be assessed neg. for a med. problem yet still have one/it.
>
> My sister (ECG tech) has told me many stories of people who have come into the ER with MI symptoms, only to test negative for MI. Then they die of a massive MI on the way home.ECG is not 100% sensitive to AMI (false negatives are possible), nor 100% specific for AMI (false positives are possible). Cardiac enzyme levels (myocardial troponin T) are generally very sensitive and specific to ischemia. In any case, anecdote is not really of predictive value. "The exception proves the rule."
>
>
> Thank you
>
>You're welcome.
Posted by AuntieMel on July 23, 2004, at 13:56:08
In reply to Re: Please everyone, let's take a deep breath, posted by TexasChic on July 23, 2004, at 12:17:34
Of course you didn't mean it as an attack. I read it as explaining how you feel.
That wasn't directed at any particular person, just a plea in general.
Posted by fires on July 23, 2004, at 14:47:26
In reply to Re: I'm with TC and PC..., posted by TexasChic on July 23, 2004, at 12:58:29
> Why you would use ** instead of the real word if it weren't something offensive? It doesn't matter. I don't want to argue with you, I just didn't think that was a fair request.
> Anyway, I think I'm just going to shut up now. I'm obviously not communicating effectively today, everyone keeps misunderstanding me.
> I hope your day goes well.I seriously doubt that "everyone" is misunderstanding you.
Thanks
Posted by partlycloudy on July 23, 2004, at 14:49:28
In reply to Re: I'm with TC and PC..., posted by fires on July 23, 2004, at 14:47:26
> > Why you would use ** instead of the real word if it weren't something offensive? It doesn't matter. I don't want to argue with you, I just didn't think that was a fair request.
> > Anyway, I think I'm just going to shut up now. I'm obviously not communicating effectively today, everyone keeps misunderstanding me.
> > I hope your day goes well.
>
> I seriously doubt that "everyone" is misunderstanding you.
>
> Thanks
>
>Sarcasm is not an appreciated art form here.
Posted by AuntieMel on July 23, 2004, at 14:52:13
In reply to Re: I'm with TC and PC..., posted by fires on July 23, 2004, at 14:47:26
Actually TexasChic is having a very bad day today. And she, too, is a very nice person. I'm sure she didn't intentionally try to offend you.
I'm one of those that believe intent is just as or more important as the action itself.
Posted by fires on July 23, 2004, at 15:06:27
In reply to Re: somatoform disorder(s) » fires, posted by Larry Hoover on July 23, 2004, at 13:07:02
> > I don't think you attacked me in the near past with ad hominem messages, so I will repond.
> >
> > >>What sets somatoform apart (there are a number of different sub-types, but you don't further specify) is that following a series of diagnostic tests and assessments, no underlying disease state can be found.<<
> >
> > You so eloquently stated above the problem with Somatoform: It assumes that there are tests and assessments currently available for all disorders/diseases. That's an incorrect assumption!!
>
> No, there is no such assumption. Doctors not finding anything that corresponds to their current state of knowledge is not the same thing as assuming they know everything and how to find it.
>
> > Stomach and duodenal ulcers were once considered to be of "psychosomatic" etiology, but along came "better" science, and a bacteria was demonstrated to be the cause of ulcers. So all the ulcer victims were suddenly no longer victims of their own psyches.
>
> Stress is still a factor, and treatment is still symptomatic. Knowing "why to do" is better than knowing "what to do", but apart from adding antibiotic therapy, what to do hasn't changed.
>
> > Perhaps you aren't too familiar with the medical field,
>
> Careful, lest you stray into ad hominem land.
>
> > so I will give you another example of how one can test/be assessed neg. for a med. problem yet still have one/it.
> >
> > My sister (ECG tech) has told me many stories of people who have come into the ER with MI symptoms, only to test negative for MI. Then they die of a massive MI on the way home.
>
> ECG is not 100% sensitive to AMI (false negatives are possible), nor 100% specific for AMI (false positives are possible). Cardiac enzyme levels (myocardial troponin T) are generally very sensitive and specific to ischemia. In any case, anecdote is not really of predictive value. "The exception proves the rule."
>
> >
> >
> > Thank you
> >
> >
>
> You're welcome.Well. Where to begin? I do believe that you have contradicted yourself.
>>> No, there is no such assumption. Doctors not finding anything that corresponds to their current state of knowledge is not the same thing as assuming they know everything and how to find it.<<
Then why don't they consider that a patient might have such a disorder instead of Dxing Somatoform Disorder?? I had/have such a disorder.
Thank goodness I didn't buy into the Somatoform Dx!!>>> Stress is still a factor, and treatment is still symptomatic. Knowing "why to do" is better than knowing "what to do", but apart from adding antibiotic therapy, what to do hasn't changed.<<
I will refrain from posting links, but my research indicates that your statement contains errors. 1) Stress *may* be a factor in *some* patients with ulcers. If you have scientific data to the contrary I would like to see it.
2)What to do has changed. Not only are antibiotics given, but Pepto Bismol(sometimes), and the newer PPIs are also used (nearly always) for ulcers.
>>> ECG is not 100% sensitive to AMI (false negatives are possible), nor 100% specific for AMI (false positives are possible). Cardiac enzyme levels (myocardial troponin T) are generally very sensitive and specific to ischemia. In any case, anecdote is not really of predictive value. "The exception proves the rule."<<
Thanks again for so eloquently making my point !! Re-read the above , then apply that same logic to the Dxing of Somatoform. Is there a blood test for Somatoform? or do Pdocs rely on anecdotal and subjective info. to Dx it? "The exception proves the rule"
Thanks
Posted by TexasChic on July 23, 2004, at 15:13:20
In reply to Re: I'm with TC and PC... » fires, posted by AuntieMel on July 23, 2004, at 14:52:13
I knew you didn't direct that at me. It just made me want to reinforce my intent.
Posted by Dinah on July 23, 2004, at 15:29:04
In reply to Re: I'm with TC and PC..., posted by fires on July 23, 2004, at 14:47:26
Posted by Dinah on July 23, 2004, at 15:33:20
In reply to Re: Thanks Mel!, posted by TexasChic on July 23, 2004, at 15:13:20
Please don't feel that this is a problem with you. :) You're communicating just fine.
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