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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 129. This is the beginning of the thread.
Posted by fires on July 16, 2004, at 10:49:17
one giant leap for the "mentally" ill.
Just have to tell this story. I was recently shocked and dumbfounded when I recently saw my med. records from a nearby University med. center. The Resident Pdoc had Dxed me with "somataform" disorder, without telling me so. What?
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.
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. The recommended treatment is still largely psychobabble. (Which is why I posted this here).
I recently saw a new Pdoc for the first time, because my Resident was no longer able to see me.
I've stated her before that therapy in the past did little for my Dep.. I didn't point out just how much it may have helped me with assertiveness.
When I saw my new Pdoc (recommended by my internist-- BTW, all of you in therapy do see an MD once in a while to make sure your therapist isn't missing a physical/brain/"mental" disorder -- right???), I told her first thing that my last Pdoc had Dxed me with Somataform, and I gave her ALL copies of my records.
I then told her that if she believed that I truly had somataform, then I did not wish to become a patient of hers. I also told her that if at any point in the future she believed that I had somataform, I would cease being a patient of hers. She said it was way to early for her to DX that condition. I said fine and we are now working on adjusting my meds.
I would urge everyone in therapy for SUBJECTIVE Dxes to be wary of such DXes that can not be OBJECTIVELY proven. That's all.
Finally, I don't desire to hear from anyone with a Dx of Somataform, if one is content with that Dx. My intent is not to try and change anyone's Dx - merely to alert others to the problems with Dxing a patient with only subjective data.
Health and joy to all, including my ex-Pdoc
Posted by vwoolf on July 16, 2004, at 14:13:09
In reply to one small step for me, posted by fires on July 16, 2004, at 10:49:17
I don't really know what somataform means to you, so perhaps that is why I can't understand why you are so angry. I know I was furious a few months back when I thought I had been misdiagnosed - it was the idea of being labelled that really got my goat, that seemed to take away some of my humanity. Please tell me more.
Posted by TexasChic on July 16, 2004, at 14:22:14
In reply to one small step for me, posted by fires on July 16, 2004, at 10:49:17
Wow! That is AWFUL! Its like calling you a hypocondriac or something, isn't it?
I had a similiar situation a few years back. I've always had painful female problems (don't worry, I won't be descriptive). At this point in time, I had been having severe, incapacitating pain. I couldn't make it through a day of work with out Tylenol 3 (codeine). After trying Lupron shots (puts you in a medically induced menopause – not fun), surgery, MRI's and every birth control known to mankind, my doc finally decided I was a 'drug seeker'. She couldn't figure out how to treat me, so she decided it must be me. When she made the accusation, I immediately burst into tears. She said crying went along with the 'profile', as did depression – which she was also treating me for. I left that office and never went back. I found a specialist who gave me the correct BC, and I've never had a problem since. I just couldn't believe after going to her for almost 10 years, and her prescribing me the painkillers in the first place, she then accuses me of being a drug seeker!
Yeah, I just don't know about these docs sometimes. To accuse a person that their pain isn't real sounds pretty egotistical to me. I mean, there's really know way for them to actually know that!
Posted by fires on July 16, 2004, at 15:20:05
In reply to Re: one small step for me, posted by vwoolf on July 16, 2004, at 14:13:09
In addition to Dep., I have been Dxed with Fibromyalgia and Chronic Fatigue Syndrome (also known as ME). Certain med. groups and insurance companies have been trying to get Drs to Dx such patients as Somatoform Disorder (sorry for earlier misspelling).
Here's a link to an article on Somatoform Disorder. Notice how subjective the symptoms and treatments are.
http://www.aafp.org/afp/20000301/1423.html
Finally, my friend once had a Pdoc who said that her asthma was psychosomatic. He quit saying that after he developed asthma. :)
Thanks
Posted by fires on July 16, 2004, at 15:25:47
In reply to Re: one small step for me » fires, posted by TexasChic on July 16, 2004, at 14:22:14
>>my doc finally decided I was a 'drug seeker'. She couldn't figure out how to treat me, so she decided it must be me.<<
That's exactly why I'm upset. So many Drs, instead of saying, "I don't know", label a patient as a "drug seeker", or a hypochondriac, etc..
My now retired MD used to say that, "Most doctors don't know what they don't know."
Thanks
Posted by TexasChic on July 16, 2004, at 15:56:53
In reply to Re: one small step for me, posted by fires on July 16, 2004, at 15:25:47
>That's exactly why I'm upset. So many Drs, instead of saying, "I don't know", label a patient as a "drug seeker", or a hypochondriac, etc..
Its good to know someone understands. I don't even think my T quite believed I wasn't addicted to the hydrocodone. But how do you 'prove' pain? Its a horrible situation to be in. I actually feel like it traumatized me. I felt like something broke inside me when she said that that to me.
> My now retired MD used to say that, "Most doctors don't know what they don't know."I love it!
Posted by fires on July 16, 2004, at 19:21:54
In reply to Re: one small step for me » fires, posted by TexasChic on July 16, 2004, at 15:56:53
I'm glad someone understands me too! I just read a very sad story about a child who went from Dr. to Dr. with horrible symptoms and they kept saying that nothing was wrong with him.
Turned out he had(s) Lyme disease. Some of his symptoms are "psychiatric."
Here's the entire quote from which my MD apparently got his:
"It is the tragedy of the world that no one knows what he doesn't know - and the less a man knows, the more sure he is that he knows everything." Joyce Carey
Best Wishes and keep the faith (faith in ourselves)
Posted by JenStar on July 16, 2004, at 20:54:01
In reply to Re: one small step for me » fires, posted by TexasChic on July 16, 2004, at 14:22:14
I totally agree! So many doctors don't know how to diagnose symptoms that may not be "textbook" and so they claim it is all in your head. This appears to happen more to women, regardless of whether they have a male or female doc.
I've had that happen: I went to my primary care complaining about pain in my lower abdomen (don't worry, i also won't get descriptive!) I knew it was something "real", but she kept telling me it was muscle strain or fatigue or "cramps." I insisted and she grudgingly set me up for an ultrasound; turns out it was a ruptured cyst. I wasn't HAPPY to have that but it was somewhat gratifying to say "I told you so" (not in so many words.) We know our bodies. If we have physical symptoms, it is not always "all in the head!" And if it is "in the head" that still may require drugs, treatment, etc.
I had a friend from work who was told by her prim. care that she was imagining things & was 'stressed' when SHE complained about physical symptoms. Turned out she had ovarian cancer (currently cancer free after treatment!) She too felt the frustration of not being believed, being condescended to, etc.
It sucks!
I feel your pain!JenStar
Posted by fires on July 16, 2004, at 23:53:07
In reply to Re: one small step for me, posted by JenStar on July 16, 2004, at 20:54:01
It's quite sad. If some Drs only knew the suffering they have caused by misdiagnosing.
Glad your friend is now cancer free. My brother past away about 1 month ago from esophageal cancer. He fought against a no win situation for 4 and a half years.
I noticed you are now JenStar rather than Texas Chic. I'm just curious why?
Best
Posted by shadows721 on July 18, 2004, at 20:02:53
In reply to one small step for me, posted by fires on July 16, 2004, at 10:49:17
"I've stated her before that therapy in the past did little for my Dep.. " How much feelings did you allow to be expressed in therapy?
Somatization is another psychic defense mechanism, another way of NOT FEELING FEELINGS. It is expressed by our anger against ourselves, or trying to control others, making others feel inadequate.
Posted by fires on July 18, 2004, at 21:12:58
In reply to Somatization -psychic defense against feelings, posted by shadows721 on July 18, 2004, at 20:02:53
I realize that is your opinion. I don't share it.
I believe Somatoform Disorder is often used by Docs who can't find what is really wrong with a patient. It's a wastebasket for disorders of unknown cause.
The history of medicine helps confirm my belief:
Autism was believed to be due to "cold mothering."
Schizophrenia and other biopsych. disorders were due to "demonic possession."
TB was due to "an overactive creative spirit."
Parkinson's Disease was the result of "conflict between an aggressive drive to action and an equally strong internal pressure to inhibition."
The NEJM not too many years ago included an editorial which stated: "It is time to acknowledge that our belief in disease as a direct reflection of mental state is largely folklore."
Need more examples?: Fibromyalgia, MS, Ulcers, Alzheimer's, stuttering, bed wetting, etc...
You seem intent on making everything due to "feelings". Correct?
Posted by Dinah on July 18, 2004, at 21:26:40
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 21:12:58
Do you by any chance think the school of psychiatry should be merged into or replaced by neurology?
If so, you might want to do an archive search. I think you'll meet a soulmate that way.
(Meds board, I think)
Posted by shadows721 on July 18, 2004, at 22:03:47
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 21:12:58
"You seem intent on making everything due to "feelings". Correct?"
Answer: Some depressed people overuse certain psychological defense mechanisms --denial, isolation, and repression, --to help keep "feelings" out of conscious awareness. Defenses help protect our conscious minds from awareness that underneath, we are in conflict with ourselves. When reality is too much to be accepted--a family member gets murdered--we can go into denial. Defense mechanisms are necessary for dealing with difficult situations or people. But, they can be used by people with depression as a way to AVOID feelings. A person can become so hypertrophied, that they lose their ability to feel altogether. This explains why the body will take on the feelings the person refuses to deal with. Hence, the person develops a Somatization Disorder to express what is not being expressed in with the conscious mind.
Furthermore, when we don't feel bad things. We will not feel good things either. We become numb to our feelings and to other feelings. The effects are enormous. So, how is it so beneficial to *not* feel?
Sorry, Fires, I didn't understand the relevance of your comparing my explanation of Somatization Disorder and those other conditions. Help explain, please?
Thank you.
Posted by fires on July 18, 2004, at 22:37:23
In reply to Re: Somatization -psychic defense against feelings » fires, posted by Dinah on July 18, 2004, at 21:26:40
I'd prefer that you just tell me the name of my "soulmate." :) or post a link to thread.
Posted by Dinah on July 18, 2004, at 22:40:31
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:37:23
But that would take away the mystery. :) If you can't find it in a week or so, I'll give you a hint - depending of course on the answer to the question:
So, do you think psychiatry should be merged into or replaced by neurology?
(because otherwise it would be moot)
You don't have to answer of course. I just wasn't sure whether to interpret your response to me as a yes.
Posted by fires on July 18, 2004, at 22:40:58
In reply to Re: Somatization -psychic defense against feelings, posted by shadows721 on July 18, 2004, at 22:03:47
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 **
That's all.
Posted by gardenergirl on July 18, 2004, at 22:42:23
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:40:58
> Sorry to have to inform you
Really?
gg
Posted by fires on July 18, 2004, at 22:54:58
In reply to Re: Somatization -psychic defense against feelings » fires, posted by Dinah on July 18, 2004, at 22:40:31
Hmm, something smells fishy, but I'll bite anyway. Yes, I think psychiatry should be merged with neurology, OR "mental illnesses" could be renamed "brain disorders."
Posted by shadows721 on July 18, 2004, at 22:55:05
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:40:58
"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 **"
Please explain. I don't understand your comment.
Thank you.
Posted by fires on July 18, 2004, at 22:55:59
In reply to Re: Somatization -psychic defense against feelings » fires, posted by gardenergirl on July 18, 2004, at 22:42:23
No, not really. It's a figure of speech.
Posted by fires on July 18, 2004, at 22:59:05
In reply to Re: Somatization -psychic defense against feelings, posted by shadows721 on July 18, 2004, at 22:55:05
Nope. As they say in video arcades , "game over."
Too many tilts. And, to hard to figure out who's on first. ;) I'm not a fool.
Posted by gardenergirl on July 18, 2004, at 23:00:17
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:55:59
Posted by Dinah on July 18, 2004, at 23:15:23
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:54:58
Nothing fishy, fires. You just remind me an awful lot of an old poster. And I think it would be more fun for you to find him yourself and see if you feel a certain kinship. So try typing in merging psychiatry and neurology into the search engine. It should come up with some hits. You could even use the Babble search I think. Meds board.
Or you can just forget the whole thing. But I think you'd really enjoy those posts.
Posted by shadows721 on July 18, 2004, at 23:19:43
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:59:05
"Nope. As they say in video arcades , "game over."
Too many tilts. And, to hard to figure out who's on first. ;) I'm not a fool."
What does this mean?
Posted by Dr. Bob on July 19, 2004, at 0:32:59
In reply to Re: Somatization -psychic defense against feelings, posted by fires on July 18, 2004, at 22:40:58
> 99.99% of everything you wrote is in my opinion either : 1)pure fiction or 2) unprovable or 3) complete **
Please don't post anything that could lead others to feel put down.
If you have any questions or comments about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
or redirect a follow-up to Psycho-Babble Administration.
Thanks,
Bob
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