Just Tell It To Me Quick Doc – I’ve Got Places To Be

Posted: November 10, 2011 in ADHD, Life
Tags: , , , , , , , , ,

“You’re having trouble urinating? Here’s a script for OxyContin.  Won’t help the problem, but you won’t care anymore.”

You wouldn’t trust a doctor who treated you this way, and neither would I.  Some patients are looking for just such treatment though – and for them, a doctor who did this would be a god-send.  There are likely as many different motivations for a visit to the doctor’s office as there are patients.

Unfortunately, the first visit to the doctor’s office about a single symptom (or usually, a combination) might not be as simple as one would hope.

A friend of mine – who happens to be a medical doctor – has been branching out into the alternative medicine area.  Normally, this is forbidden territory for doctors, as there are a great many quacks out there, touting their substandard snake oil remedies.  However, in amongst the frauds are those folk who have re-discovered traditional remedies from other cultures, notably Indian and Chinese, some of which appear to work.

The cynic would suggest that maybe some of these remedies work because of their placebo effect, and I would tend to agree.  Then the question is:  what’s wrong with placebos, if the patient gets better, or his symptoms begin to subside?  It doesn’t necessarily suggest he was psychosomatic, or was faking his illness.  It speaks to a fundamental truth (well I think it’s a truth, though really it’s just a good guess or opinion) that the body has an amazing ability to heal itself.

Full disclosure:  though not a cynic, I tend to lean that direction.  People who complain about illness all the time bore me, mostly because I have a hard time believing their ailments are real.  I know that sometimes they are, but I know that for every person with a legitimate complaint, there’s another one right behind him who is subconsciously looking for attention.   I’ve been privy to their conversations too, which go something like this:

“I’ve got a headache”

“Oh yeah?  Well I’ve got a headache and a backache. ”

“Well that’s too bad, but guess what?  I’ve had my headache for two weeks.”

“I know what you mean.  I’ve had this backache since I was born.”

“Really?  And the doctors haven’t figured out why?”

“No.  I’m supposed to go in for an MRI next week.”

“Wow.  Yeah.  The doctors haven’t figured out why I have so many headaches either.  My great-grandfather had them so it’s probably genetic.  My kids will probably have them too.  I keep asking little Cindy if her head hurts.”

“You shouldn’t do that.  You’ll get her thinking she should have a headache.  That she’s not normal unless she has one.”

“I’m not worried.  I do see her putting her hand to her head sometimes though.  Just like I do.  It’s why I ask her.”

“Well I—OWW!”

“What?”

“My back.”

“Oh.”

“Yes, see you later.  I’ve got to get some pills into me.”

“Oh?  What kind?”

“Demerol”

“That’s kid stuff.  You should get your doc to prescribe Oxy.  It’s the BOMB, man.”

“Huh.  Maybe I will.”

(a.k.a. Dance of the Aching Fairies)

My doctor friend, in pursing the road less travelled, is exhibiting all kinds of courage, I think.  She has given credence to the fact that modern medicine doesn’t have all of the answers (though it often pretends to), and that some alternative remedies have been proven to work, above and beyond the placebos effect.   Her belief is that modern medicine has its place, and that non-traditional medicine should not be so easily dismissed.  I believe her, actually, even though I don’t always agree with what she has to say about some things.  More on that later.     Her blog, by the way is here:   http://www.bloomingwellness.com/

Today, she wrote a status update on her Facebook page – http://facebook.com/BloomingWellness – which pointed to an article about how some bizarre behaviours might be indicative of internal organic issues, rather than mental problems.    She had this to say:

I just finished an interview for Alternative Mental Health with Attorney Beth Maloney, who was recently featured on this segment of The Doctors and author of the book, Saving Sammy. We talked about how her son was misdiagnosed with OCD, put on SSRIs, when in fact he had PANDAS- an autoimmune disease caused by an antibody to Strep. Pneumo. that attacks the basal ganglia in the brain. Parents should be aware of PANDAS, a disease we don’t really learn about in medical school ( we don’t) , because certain behavioral issues in kids ( like ADHD ones, OCD, Tourettes, etc…) can actually be due to PANDAS, and doctors miss it all the time. A simple blood test may differentiate a true psychiatric issue from an autoimmune one so your child can receive the right treatment instead of a mess of drugs that are wrong.

It seems to me that the root of the issue – not about such an innocuously named condition called PANDAS, but about the initial wrong conclusion – has its basis on a culture which likes to speed everything up.  Got a problem? See a doc and get a diagnosis so that you can get some pills and get rid of it.   Most of us want that – though some would prefer a prescription of exercise or a change in diet over taking pills.  Not many of us consciously wish to remain bound by a condition or disease which limits us.  Even those who subconsciously enjoy the attention, really are miserable, and know they’d be better off if they were well.

I’ve heard stories from a few doctors about patients who come to their office, pretty much demanding antibiotics because of a scratchy throat.   In addition to a fast-paced society which can’t tolerate downtime due to illness, this presents yet another problem:  patients who think they’re doctors.  We can probably blame the internet for this, and sites like Google and mayoclinic.com .

We have all heard stories about teachers with imagined qualifications in psychiatry who diagnose ADHD in their children.   Many people use this abhorrent behaviour to cast doubt on ADHD altogether.  I can’t tell you how many times – since receiving my own diagnosis – people have said “oh EVERYONE has ADHD” – by which they mean that no one does.  My doctor friend and I have disagreed publicly about a lot concerning ADHD but to be fair:  she’s a medical doctor and I’m not; and some of her objections are I think quite valid.

She worries that too many people are looking to medications to resolve their issues with ADHD, and she wonders about the motivation of drug companies in this respect.  The same could be said of cancer and drug companies for that matter – and I’ve already heard a repeated cynical comment about this:  “the cure for cancer is already out there but isn’t being shared because too many organizations will lose money.”   I’m not sure I completely disagree.  I truly believe everyone has a motive for what they do, and that no one spends money building products without expecting some kind of return at the end of the day.

This does not equate to non-altruistic motivations though.  A doctor needs to make a living and gets paid accordingly, yet many often come close to burnout in doing so.  The extra mile they take often has nothing to do with money, and has everything to do with patient care.  Ditto those doctors who travel to remote parts of the earth to volunteer with Doctors Without Borders (or Médecins Sans Frontières).   I have to believe the same kind of ethic holds true for many in the drug companies too.

Some doctors and drug officials are of course totally in it for the money.  I’m just not convinced the paint brush is that wide.

When it comes to mental issues, there’s a harder diagnostic road to travel.  Unlike cancer or an enlarged prostate, you can’t open the brain and say “oh there’s the problem.  This part of the brain is green while the rest is gray and so that’s why this patient is schizophrenic.”  Instead, doctors must look at a whole host of reference material, which includes but isn’t limited to patient behaviours.   In my case, the hours of testing included looked at my childhood, genetic factors, and behaviours that everyone has experienced on one occasion or another.   The testing was designed to eliminate other factors or conditions or medical problems, in order to come to a robust conclusion.    This was NOT a case of my family physician hearing my complaint in one session and then coming to a diagnosis.

Much had to do with my own motivation as well.  The first surprise was realizing that everything I thought was normal – and something that everyone struggled with – was not normal.  Until then, I was convinced that my problem was a combination of laziness and even early onset of Alzheimer’s.   I had no idea why others in school progressed so quickly and retained so much, while I struggled along, barely making it.  I knew I was intelligent but you know – for a while there I thought I was incredibly stupid.   I learned how to work around my symptoms, and found creative ways to avoid circumstances and work that would highlight my deficiencies.   Really creative – which is how I figured out I wasn’t stupid.

Ultimately, it was the body of behaviours that indicated a deviation from the norm.  Whether we call it ADHD or “Yellow Pickle” is immaterial.  The issues are:  what’s the cause; and then, what’s the treatment?

Even this seems to vary, depending upon the patient.  Some fellow ADHDers swear by increased exercise, copious amounts of coffee and stern attention to diet.  Others have taken the behaviour therapy route, which goes like this:

  • I have trouble focusing, which means:
  • I often lose my keys; or
  • I am late for appointments; or
  • I forget I even have appointments; or
  • I can’t remember important details in a work project; or
  • I often look for stimulants, like illegal drugs; or
  • I put myself in harm’s way too often, because I need the rush; or
  • ….any number of other behaviours (there’s quite a list, actually)

Any of these can be mitigated by any of the treatments mentioned above.  Some of the behaviours might be rooted in causes other than ADHD.  There could be chemical issues.  The science on this is not yet perfected.  About the only thing doctors seem to agree is the body of behaviours.  Thank God for that.

The bottom line is what I told my doctor friend:  the path to diagnosis and treatment is neither as quick or as easy as patients (and occasionally doctors) would like it to be.  It’s not simple, and much depends upon the expertise and experience of the doctor (which is why my own GP didn’t want to treat me – she had neither), and upon the willingness of the patient to wait until all of the facts were in.

Your comments are invited:  have you or anyone you know (no names please, let’s keep it anonymous) struggled with getting a diagnosis about anything?   What are you thoughts about people who diagnose themselves?  What about alternative medicines – what are your thoughts on that?

Comments
  1. You know, I tend to agree with everything you say (big surprise)… I think alternative medicines along with Western “traditional” medicines are the best way to go — I am so lucky because I have a GREAT doctor who I’ve had for years and he’s one of those who doesn’t believe in medicating if you don’t have to. Love him for that. I also think the “placebo” effect or “mind over matter” makes sense and I don’t dismiss it. It’s like you said earlier, the body has an amazing ability to heal itself and sometimes that’s what’s taking place there. Really nice informative piece Wolfie! Love when you blog! :)

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    • wolfshades says:

      Agreed Carmen. Only recently have companies and medical insurance companies climbed on board with some alternative medicines – although there’s still a long way to go yet. Right now my insurance company won’t acknowledge (read: pay for) acupuncture unless it’s administered by a medical doctor. It’s hard to believe that at one time, even massage treatments were considered “alternative”. How weird is that? And I have to tell you: I enjoy the heck out of massage – the tension that builds up in the neck and shoulders can certainly instigate a full blown migraine. I’m convinced that massage limits that.

      Thanks too for your note on the blog. It’s weird: this is probably the first one I’ve written where I haven’t struggled with focus. The style is a bit different. I’m on the fence right now as to whether that’s a good thing or not. :)

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  2. Maggie L R says:

    My son was diagnosed as “hyperactive” (before ADHD) He hated the ritilin the doc gave him. He did not like how it made him feel spaced out. He found a book talking about the effects of the artificial colours and flavours causing hyperactivity. He was 11 at the time (now 41) and decided, at that young age, to avoid these chemicals. What a huge huge difference it made to him. He was able to concentrate, his marks improved drastically and his hyperactivity all but disappeared. He would read labels as if looking for poison (which it was to him).
    Interesting how eating plain meat and potatoes, real fruit etc made a difference.
    Shouldn’t we all be eating naturally? I wonder how many medical problems would disappear if we did?

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    • wolfshades says:

      I wonder the same thing. In particular, I wonder about the rates of cancer in particular, and why they’ve increased over the years. Maybe it’s the fact that people are living longer, which would naturally mean the rates would go up. Or it could be our diets. Why are Canadians and Americans so obese (despite our diet fad) when people in France are so thin? I’ve been to France – they eat very well there. But they don’t buy their groceries all at once for the week. They buy what they need every day, while it’s fresh. And they eat pastries for breakfast. (That kind of shocked me).

      It’s great to read about your son. I don’t have the hyperactivity problem as he did – but the inattentive part of ADHD. Still, it’s worth exploring – maybe there’s some research out there about other causes. It would have to be something similar to what your son found: something that is present throughout a lifetime. Something simple – because my diet has changed drastically over the years – so it would have to be something common to most foods. Worth checking out, anyway.

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  3. Jack says:

    I think adult ADD, or ADHD is very difficult to diagnose. Bi Polar disorder takes on average five years to correctly diagnose, but I haven’t seen the figures for ADD. I’d imagine they would be similar. A good friend of mine has the diagnosis, and it was a relief for him to get it and start treatment. Since he has been treated it’s been a slow improvement, but now he has a full time job, something I’ve never known him to have. It’s taken a big toll on his relationships but hopefully that will improve in time as well.

    Just curious, have you ever tried practicing mindfulness? I’m not saying this flippantly because the body of research around mindfulness is growing every day. The mind is very plastic and obviously studies have shown that people who meditate have very different brains compared to those who don’t. Just wondering if these changes would go some way to restoring attentiveness and focus – even if it enabled longer bursts of attention it would still be a big plus..

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    • wolfshades says:

      I had to look up “mindfulness” to see what it was about. I have encountered it in many different ways (as it turns out), just not by that name. Meditation, a singing therapy, and CBTs have all been a part of the picture, long before even the idea of ADHD was brought up. Evidently I knew there was something wrong – but it wasn’t until the collective behaviours were identified that I finally got a handle on it. I do believe mediation in particular will help in a big way as time goes on, because medication alone is clearly not the answer.

      One psychiatrist put it bluntly: meds provide a window of opportunity to change the course of the condition, but other behaviour-based tools need to be employed, with the end goal of stopping the drugs. He said “when you hold a pen, you’ll eventually get to the point where you’re aware of the feel of it in your fingers, and how it feels when you press against the paper, because you’ll be able to take the time to experience it.”.

      It didn’t take very long to get a diagnosis for me. Well, not relatively long anyway, even though it took a fair length of time from my own perspective (about a year). As mentioned, there was a battery of testing that had to take place, and examination of my history. Having lived with it all of my life, I was finally aware that my experience was out of the ordinary, relatively speaking. It was just such an amazing break through, and I’m so grateful now for having explored it.

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      • Jack says:

        Yes the idea of being able to feel the pen and the sensations it makes on the paper is indeed an act of mindfulness (as is writing). Mindfulness is basically about attending to our thoughts and feelings and sensations around us with curiosity, acceptance and kindness. It makes us truly “present” as an observer and it’s quite a beautiful way to live….

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  4. […] Just Tell It To Me Quick Doc – I’ve Got Places To Be (wolfshades.com) […]

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  5. I’m linking this to my blogpost “The Top Ten Stupid Comments from [supposed] ADD Professionals.” on my ADDasmm blog
    THANKS!
    Madelyn Griffith-Haynie, SCAC, MCC – (blogging at ADDandSoMuchMore and ADDerWorld – dot com!)

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  6. […] Just Tell It To Me Quick Doc – I’ve Got Places To Be (wolfshades.com) […]

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