Comment by DoreenMichele | Hacker News Reader

Comment by DoreenMichele | Hacker News Reader

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After a full workup, the doctors had no explanation, so they resorted to what doctors often reach for when confronted with mystery ailments: psychiatric illness.

Yeah. This is a big problem for people with serious and complicated health issues. They are all too often told "It must be in your head" the subtext being "If it were real, I, a super smart doctor type, would be able to figure it out already." It's ugly stuff and it ruins lives.

Also, the lady was prescribed vitamin D and then took it without adjusting the dosage or having a follow-up about it for 5 years. This is a big problem as well. Doctors all too often don't follow up with patients and this is probably in part because of our issues in the US with how we pay for stuff and so on. But it was also a problem for some things when I was a military wife and could see a doctor for free.

I am a writer by trade and I have a serious medical condition. I'm glad to see this piece and I'm glad to see Deva Boone posting on HN, but I will suggest that statements like "Vitamin D is a medication" don't constitute good communication.

The latter part of the piece makes it clear what is intended by that, but it's not currently classified as a medication and I think it is generally more helpful to try to educate people that "life is chemistry" and there is no clear cut demarcation between "drugs" and "not drugs." Sometimes the difference boils down to dosage.

There are lots of things available in small quantities in food items that are "drugs" if you take a large enough amount in one shot and are "drugs" if prescribed in pill form that are "food" when part of your diet. And we need to get a lot savvier about things like that.

Hopefully, this is taken as helpful feedback and not an ugly attack. It is intended as the former and not the latter.

Thanks! It is very helpful. These are great points. I actually tell my patients that every supplement or vitamin should be thought of as a medication. I had written "should be thought of" in the article and then just switched to "is a medication" to make the sentence simpler. It probably changed the meaning too much. It's been very interesting to read the responses on here, and I appreciate the feedback.

What do you think of the idea that doctors don't follow up on their patients? I have a friend who is a physician that can not practice because of medical reasons, he is now experimenting with a business where he reviews peoples medical dossiers to check whether their doctors have missed anything that could be important.

He's got crazy stories of doctors skimming dossiers because of time constraints. A poignant case he described was where a doctor did not notice his patient was 100kg lighter than the last time she visited. How do you miss you've got only a third of the patient you had before he exclaimed when he told me this story.

When I worked at Aflac, there was a quadruplegic former surgeon who came in like once a week and reviewed records for the really hard things that we, in claims, were having trouble figuring out. Because he was quadruplegic, someone brought him upstairs on the elevator and you had to print your entire claim out and someone turned pages for him. He only read it and made a determination. I got to see it firsthand once when one of my claims went to him.

I run a google group called Health Techies and your physician friend is welcome to join, if he is interested. It doesn't see much activity, but, you know, sometimes you get enough people and conversation breaks out, at long last. Or new people show up, have questions, and then conversation happens. Voila!

Huh. So, it sounds like your friend is essentially trying to be House, MD, but, hopefully without the surly attitude, the Vicodin addiction, and a tendency to nearly kill patients at least 3 times an hour.

I had this until I was treated for an autoimmune condition. I was literally on crutches because my knees hurt so badly, it was excruciating. GP was like "we see your autoimmune markers are up a bit, but we don't see anything else, probably in your mind" . I had never had any issue before and I was an avid hiker. The condition would come and go and last a month or so. I ditched him and went to an autoimmune specialist. Along with a couple of other symptoms he diagnosed me and within two weeks it was all gone and never came back. I was on the medication he gave me hydroxychloriquine for about 3 years and he after weaned me off of it and I haven't had any remissions, and I just eat a restrictive diet and avoid wheat and dairy products and I'm perfectly healthy. It's not "in your head" if you have pain and no extreme external stressors that might be affecting your mind/body connection, seek out someone who knows what they're talking about, GPs are good for diagnosing things that show up easily in standard tests otherwise they might just tell you that you're a hypochondriac.

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