Medical Psychosis
I have to admit--I am afraid to go to the doctor. I have always hated hospitals--they seemed so depressing and scary--which is why I have a PhD and not an MD; I figured fainting at the sight of blood would probably be a bad quality in a doctor. While I am over the fainting at blood part, (you get used to all the blood drawing when you have heart problems) just the thought of going to a medical facility starts my heart palpitating. Yesterday, it was time for another three month check-up of my ICD. My check up was with a heart rhythm specialist who does an interrogation of my cardiac device by hooking me up to a computer and running a magnet over my chest to control the defibrillator. Somehow, just the thought of someone else being able to control my heart is enough to send me over the edge.
In preparation for my appointment, I packed an interesting book, bottled water and some food to calm my nerves after it was over. However, I found that nothing could distract me once the doctor started talking. I can usually interpret with fair accuracy what my own clients are trying to tell me but my translation of what a doctor is saying about my medical condition is so far off the mark, I sometimes wonder if a diagnosis of "medical psychosis" should be added to my chart. My translation goes something like this:
Doctor: Hi, I'm Dr. so and so, nice to meet you.
My Translation: I'm here to give you your last rites.
Doctor: Your potassium is a little low.
My Translation: You're lucky your heart is beating at all.
Doctor: Your heart is beating a little fast, are you nervous?
My Translation: Your heart is pounding out of your skin, you'll be lucky to make it out of this office without a major heart attack.
Doctor: Did you have a nice Christmas Holiday?
My Translation: You're damn lucky you made it to Christmas.
Doctor: We're going to try some new meds.
My Translation: Lord knows, the old meds weren't working--it's amazing you made it into the office without a gurney.
Doctor: Well, we're all done, see you in six months!
My Translation: Sucker! You'll be lucky if you make it three.
Well, you get the idea. For my next appointment, I think I'll bring a tape recorder so I can actually hear what the doctor said!
Update: Shrinkette has more on why it might be risky for doctors to reassure patients.
In preparation for my appointment, I packed an interesting book, bottled water and some food to calm my nerves after it was over. However, I found that nothing could distract me once the doctor started talking. I can usually interpret with fair accuracy what my own clients are trying to tell me but my translation of what a doctor is saying about my medical condition is so far off the mark, I sometimes wonder if a diagnosis of "medical psychosis" should be added to my chart. My translation goes something like this:
Doctor: Hi, I'm Dr. so and so, nice to meet you.
My Translation: I'm here to give you your last rites.
Doctor: Your potassium is a little low.
My Translation: You're lucky your heart is beating at all.
Doctor: Your heart is beating a little fast, are you nervous?
My Translation: Your heart is pounding out of your skin, you'll be lucky to make it out of this office without a major heart attack.
Doctor: Did you have a nice Christmas Holiday?
My Translation: You're damn lucky you made it to Christmas.
Doctor: We're going to try some new meds.
My Translation: Lord knows, the old meds weren't working--it's amazing you made it into the office without a gurney.
Doctor: Well, we're all done, see you in six months!
My Translation: Sucker! You'll be lucky if you make it three.
Well, you get the idea. For my next appointment, I think I'll bring a tape recorder so I can actually hear what the doctor said!
Update: Shrinkette has more on why it might be risky for doctors to reassure patients.
posted by Helen at 7:15 AM
35 Comments:
ronin1516,
I did have someone come with me in the beginning to make sure I got all the medical information right since it's hard to take it all in sometimes when you are not feeling well. Now that my medical problems have calmed down, I just have to learn to deal with the visits as best I can--frightened or not. I do try the breathing and in fact, when I was going through the more unpleasant medical tests, I took up yoga which helped tremendously!
You transformed your fear into a most amusing and insightful blogpost. :)
So glad you are feeling better.
Stay well and, just in case you might contemplate a wander up into the Smokies, "don't feed the bears."
Wouldn't it have to be an unjustified and irrational fear to be a psychosis?
scooby,
Psychosis is a distortion of reality--I am joking, of course when I use it here--my point is just that no matter what the doctors say, I look for signs that they are just giving me the party line and not telling me how bad my situation is. The truth is, none of us really know how bad our situation is. We can be sick and live to 80 or be really healthy and die early--but you are correct in that some of the fear is justified and rational. Anyone who already has a chronic illness is at higher risk of complications than those who are low risk.
Helen,
You need medical hypnosis.
Helen,
You are getting very sleepy...
You are getting very sleepy...
...you will feel safe and warm in hospitals.
...you will think of kittens and ducklings at the doctor's office.
Ditto on the hypnosis suggestion --- I'm willing to bet you'd be a good subject.
I wish that you'd pass this around to the MD types, though. I did the classroom work for an MD as part of my grad school, and I'm constantly being called upon by my riends to translate from the MD-ese because of this kind of reaction. They could do a *lot* by just adding in some "you needn't worry about this" stuff.
Two sets of ears are better than one!
Seriously, a very wise woman (now gone) took it as her personal ministry to accompany people to doctor's visits for this very reason.
Interestingly, I know a number of people in similar situations who took up yoga to help control the stress of dealing with the medical process.
I have a relative whose doctor has a tough time assessing her exact blood-pressure situation, because the reading spikes so badly when she has a check-up. No chance of her getting her to take up yoga, though, unfortunately.
I have 4 people in my family (1 parent, 2 sons, me) with chronic, debilitating illnesses that require significant medical treatment. There are several things you can do to alleviate anxiety in this situation. Some of them have already been alluded to here, such as yoga (meditation) and hypnosis. Desensitizing techniques, spiritual support, and even taking up knitting or crocheting (or other busywork) can also be effective.
I recommend that you work at mastering the medical issues involved, especially the terminology, so that you can concentrate on hearing what the medical professionals tell you. Otherwise it's like listening to an explanation in a foreign language - you miss the nuance and it's easy to be overwhelmed. I have done several things to make myself comfortable in medical situations: I purchased medical textbooks online that help me understand the basic concepts and terms, and advanced texts that deal with specialty topics. I read them until I had a basic comfort level even though I'm sure I don't fully grasp all the concepts. It enabled me to ask much better questions when I met with doctors rather than feeling like a student in a class where I never quite knew what they were talking about. I was also able to make better decisions about who would treat my family and what treatments might work.
I have also attended medical conferences on specialty subjects that greatly enhanced my understanding of the issues involved. My signature is my initials, and I'm not a doctor. However, there are medical conferences that permit laymen to attend if they have a sincere interest in the subject matter. In other cases, our doctors provided authorization for me to attend relevant seminars. I've found that the better the doctors, the more they appreciate input from responsible family members.
I'm sure you know by now that medicine is part art and part science - and I think it is predominantly statistics. In diagnosing people, doctors generally rely on statistics to tell them what symptoms suggest certain specific diseases. And when a doctor tells you that you probably don't have to worry about something, it's because statistically people with your problem have a low incidence of that happening. If you can better understand the literature, you can better decide on the statistics of something happening and then you will feel less anxiety. It's the difference between playing the lottery with every decision and feeling like you have some control over the situation. Obviously, being in control is the goal.
In my family, our medical issues are such that whenever a doctor tells us something won't happen, I can almost guarantee you that it will. I guess we are the exception that proves the rule and, as a result, we now have some very good doctors studying our medical issues. This would never have happened if we had left it up to our initial treating physicians.
Doctors may be trained experts, but you are the expert on YOU. Take advantage of that. Learn all you can about cardiology and any other subjects that relate to your condition. Take a list of questions with you everytime you go to the doctor - not necessarily questions about you or your condition, but some aspect of cardiology you want to understand better. Learn something new everytime you go to the doctor and, in an amazingly short time, you will have learned a lot. It will also help your anxiety because you will have a goal to accomplish with each visit, and this will enable you to stay focused instead of spiraling down into concerns about your worst case scenario.
You might also like to research on the internet but be careful where you surf. Places like NIH.gov, the Mayo Clinic website, and Emedicine are good. Some aren't so good.
If you believe in God, never ever underestimate the power of prayer. God bless you.
DRJ,
I think part of my problem is that I was too involved in understanding what was happening to me. I read every book and website I could about my condition--I can recite for you every term and test for heart rhythm problems etc. you would want to hear. In fact, when I was in the hospital, I had a roommate and as soon as she came in, my husband and I were like, she has viral cardiomyopathy and sure enough, she did!
I think there is such a thing as too much information--in fact, I read an article recently about people who become cyber hypochondriacs from reading too much on the internet about their conditions and panicking. You are so right about having to be careful where you surf--some of the sites leave you feeling like you'll be a gonner in 15 minutes.
I am really sorry to hear that you and your family are dealing with serious illness--it is stressful but I think those of us who adapt to it as you seem to have done have the highest chance of a positive outcome.
I'm sorry for the lecture. What works for me might make not work for you but that's the beauty of personal choice - it lets each of us handle it in our own way.
Thank you for your kind words. We're doing well and there are even good results that have come from our illnesses, including things the doctors have learned that are helping other people. God works in mysterious ways and we're grateful to be part of His plan.
drj,
I didn't take that as a lecture--I took it as a kind gesture. It's nice to know that there are so many kind people in the world who are trying to make others feel better! Those of us who deal with medical problems can always use the support. Thanks!
I love this post. If there is one thing I may be obessive/compulsive about it's my health. While my health is excellent, I dread that when I go to the doctor that'll hear some message of impending death.
I can only imagine what it's like when you have an actual heart problem such as yours. Best wishes for your continuing good health.
Helen ... got to look out for those worrisome self-fulfilling prophecies.
I've done the same thing many times. The best thing to do it just relax, do what you're doing at the time, and let it happen, since it's going to anyway. Nothing else really makes any difference, except to make it all harder to maintain (your sanity) under.
Methinks thou dost try too hard ... and worry too much. It's not healthy.
.
Dr Helen, have you heard of DrElaine Aron's book on the highly sensitive person?
I've only discovered your site a week ago, but I suspect you could be a highly sensitive person ( I am definitely one ).
The book does not offer some miracle cure, or any cure for that matter (because there is nothing to cure!), but it makes one feel better about it's own highly sensitive nature, which in western societies is seen as something bad, a weakness or something...
Take a look at what DrAron says;
* Being an HSP ( Highly Sensitive Person ) means your nervous system is more sensitive to subtleties. Your sight, hearing, and sense of smell are not necessarily keener (although they may be). But your brain processes information and reflects on it more deeply.
* Being an HSP also means, necessarily, that you are more easily overstimulated, stressed out, overwhelmed.
* This trait is not something new I discovered--it has been mislabeled as shyness (not an inherited trait), introversion (30% of HSPs are actually extraverts), inhibitedness, fearfulness, and the like. HSPs can be these, but none of these are the fundamental trait they have inherited.
* The reason for these negative misnomers and general lack of research on the subject is that in this culture being tough and outgoing is the preferred or ideal personality--not high sensitivity. (Therefore in the past the research focus has been on sensitivity's potential negative impact on sociability and boldness, not the phenomenon itself or its purpose.) This cultural bias affects HSPs as much as their trait affects them, as I am sure you realize. Even those who loved you probably told you, "don't be so sensitive," making you feel abnormal when in fact you could do nothing about it and it is not abnormal at all.
* This trait is normal--it is inherited by 15 to 20% of the population, and indeed the same percentage seems to be present in all higher animals.
...
Hey DrAron I'm just a technician! I'm into electro-mechanics not into psychology! I don't pretend I can diagnose a person from her blog on the net!
I just thought it might be of interest to you DrHelen, that is it...
" Hey DrAron I'm just a technician! " should have obviously been;
" Hey Dr Helen I'm just a technician!"...
Should have re-read myself...
that is why there is a preview button I know I know...
Can't say I've ever felt this way going to a doctor. But your accuracy in translating what your doctor was saying seems about as accurate as my last gf interpreting what I said.
After 7 years of bloodletting, I have still not gotten used to the needle. I have noticed that there is a wide range of skill among the blood drawers.
White Coat Syndrome is at least close, though generally references the inability to get an accurate blood pressure reading because it spikes in response to a medical professional.
I once needed to have a tooth extracted. I took my BP in the car in the parking lot, with a device that was reliably within 10 points of what my doctor would get (I've gotten used to having my BP checked over the years, so the White Coat thing is as minimized as it's going to get). Went into the dental specialist's office and it was 30 points higher. Pretty sad. I ended up requiring both nitrous and a valium before he would do the extraction, on top of having drugged my blood pressure partially under control by the time it was done. Spent 3 months on antibiotics for the infection under the root of the tooth, while they waited and tried to coax my BP down to a level acceptable for the few minutes in the chair for the tooth to be pulled.
I love your translations!
Mostly I'm inexplicable to the doctors, who see someone pretty healthy with absurd blood pressure (the highest uncontrolled reading was 220-something over 140) that has no identifiable cause (salt, pheochromocytoma, etc...) and has left no apparent damage (eyes, kidneys, heart...) and is highly treatable with the right drugs (atenelol, hydrochlorothiazide, lisinopril). Thus my own translation:
Doctor: You look good!
Translation: I have no idea why you're not dead!
Heh.
A simple thing to do might be to take notes while the doctor is talking to you. I find that when I am listening to write that I listen more objectively, and am not as emotionally involved in what is being said.
I have a severely autistic son so we are often in meetings with medical and educational professionals who are telling us quite significant things quite quickly. When I am writing it down, I have the presence of mind to ask them to repeat what they said if I didn't catch it or didn't understand it. When I just listen without writing, I tend to only remember the emotions, not the facts.
teri lester,
Notes are a good idea, they are less threatening to the doctor than a tape recorder and it would give me something to do! When I first got sick, I faxed my questions over to the doctor's office before he saw me so he would know what I wanted to ask in advance. I also took a copy with me so I could just go down the list instead of trying to remember important issues when nervous or panicky.
This post is wonderful. I hope you submit it to Grand Rounds. (The next one is at Kevin, MD.)
p.s. thanks for the link!
shrinkette,
I already submitted it. Hope it might help some of the docs out there have a little more mercy on some of us dealing with pretty serious illnesses.
p.s. You're welcome. I enjoy your blog.
I think there is such a thing as too much information--in fact, I read an article recently about people who become cyber hypochondriacs from reading too much on the internet about their conditions and panicking.
Heh. (As they say.) You don't need the Internet wfor that. We did it in medical school before the Internet.
I know exactly how you feel. While a little embarassing... here is my tale of my last visit to the doctor a year ago.
"Doctor: Your potassium is a little low.
My Translation: You're lucky your heart is beating at all."
As someone who had a "cardiac incident" a few months ago caused by his potassium and magnesium levels being (very) low, you have no idea how much reading that line made me laugh... in fact, my co-workers are looking at me like I've gone mad.
I'm still a little twitchy after the Incident, I guess...
nick and wonderduck,
Not that misery loves company in my case--I sure don't want others to have to deal with serious medical problems-- but it was comforting to read that others can feel scared by medical procedures--my guess is that anyone can--especially if you have gotten bad news before--glad you are both okay. Here's to our continued good health!
LOL - Your translations are great. Although White Coat Syndrome is generally used to identify people's blood pressure rising in response to medical personel - I don't see why that can't be extended to other facets of medical treatment - including just getting information.
Most people certainly don't retain what a doctor tells them when they're in the office, even if they aren't about to hyperventilate. Taking notes is great, and goes along with having someone else there with you (although that would depend on the other person being a reliable listener), and even calling the doctor at a different time and going over the talk again when you aren't in the office.
Anyhow, here's hoping you remain in good health even if doctors make you nearly blue in the face.
In an era when health care eats up an ever increasing percentage of our economic output, there is a societal cost to this sort of thing. Doctors have less time to spend with patients explaining things and calming anxieties.
I saw a glaring example of this when I was writing software for MRI systems. There was a limited development budget for the next generation machine, and projects that could save lives such as new cardiac and stroke protocols, got pushed back to free up funds for the all important task of making the magnet shorter, because of patient claustrophobia. People will demonstrably die who could be saved, in order to compensate for patients who can't/won't "cowboy up" and hold still for a few minutes of a scan. There is a cost to becoming the "nervous" society.
Sorry dweeb - I know people who are claustrophobic... it's not a matter of being able to "cowboy up" and hold still - they literally can NOT be in enclosed spaces. I've known people who have broken doors down off their hinges when they are enclosed in a small room. It's a very very serious consideration.
Could some of the people who claim to be claustrophobic be "pushing" the matter - making more of it than it really is? Yes certainly - there are always people like that. But considering the wide range of diagnosis the MRI is capable of making possible... it is certainly worth it to make the process possible for those who can't use the old fashion tube MRI's.
Oddly enough I could make the same argument in reverse right back to you. Old fashion MRI machines could cause people to demonstrably die because claustrophobic people can't use them.
There are always trade offs in what types of budgets are available for development. At any point in any project - you could always say that - it's not worth it to spend the money "here" when it could be put to better use "there".
I'm more concerned with whether my doctor is thinking when I'm talking.
DOC: Well, what brings you here today?
ME: Dr. Smith, I'm concerned about the blood coming out of my ears.
He hears: Are thouse clouds getting lighter or darker?
DOC: It is light or dark?
ME: Well, its . . . the color of blood.
He hears: Yeah, they're lighter. Good.
DOC: I see.
ME: It started after I went skiing over Christmas.
He hears: I love the Big Bertha my brother gave me at Christmas.
DOC: I see.
ME: I fell down the Bunny Slope and hit my head.
He hears: The huge head on that club makes it impossible to miss the 'sweet spot'.
DOC: I see.
ME: Since then, whenever I turn around, I get dizzy.
He hears: If I can get rid of him right now, I can still get a round in before dusk.
DOC: Well, good. Everything looks fine. I'll see you back in 6 months.
Helen,
The funniest thing about my experience... was that the doctor seemed surprised that my blood pressure was elevated. Given my particular condition, and where I was feeling my particular pain, I would have shocked to find out it wasn't elevated.
Teresa,
The extremity of people's reaction to being in small places does not necessarily constitute evidence more of their intrinsic ability to deal with it than their willingness to deal with it. There's been a change in thinking shift in the past 50 years or so from viewing whether a person overcomes an anxiety as a function of their effort to do so to viewing it as a function of the intensity of the anxiety, but BOTH ways of looking at it are equally dependent on assumptions that can't be verified absent the ability to read minds. It's taken as holy writ today that anyone who doesn't "cowboy up" simply can't. However, the fact that our culture has shifted to collectivist thinking on where the burden lies in dealing with such things, thus diminishing any sense of personal responsibility for doing so, tends to support the idea that it's more "won't" than "Can't."
聊天室交友aio 網路交友愛情館aio 網路交友愛情館視訊交友愛戀之999成人站999成人站999成人性站999成人性站919sex色片直播網919sex色片直播網940aa成人影院940aa成人影院919sex色片直播網919sex色片直播網視訊交友9073985cc免費影片85cc免費影片85cc免費影城85cc免費影城831成人831成人777美女dvd777美女dvd777成人777成人視訊交友90739
Post a Comment
<< Home