From: dyer@spdcc.com (Steve Dyer)
Newsgroups: sci.med
Subject: Re: mitral valve prolapse and need for antibiotics?
Date: 5 Oct 92 08:20:50 GMT
Article-I.D.: spdcc.1992Oct5.082050.27991
Distribution: sci
Organization: S.P. Dyer Computer Consulting, Cambridge MA

In article <BONNIE.92Sep29190907@aigyptos.nmsu.edu> bonnie@nmsu.edu (Bonnie Hargrave) writes:
>OK.  That does it.  I have many other reasons for questioning this
>particular doctor's advice.  Yes, she did pooh-pooh the candida
>question.  She also thought a hypoglycemia test was unnecessary since
>"everyone reacts to sugar".  Her explanation of the latter seemed
>reasonable to me.

Sounds like you've got a gem so far (and there's no sarcasm intended.)

>But, her _lack_ of knowledge of recent findings by the Center for
>Disease Control (re:EBV and CFS),

What recent findings?  EBV are CFS don't have much to do with each other.

>her inability to handle basic
>questions (for example, would ibuprofen or acetaminophen in large
>doses affect the uric acid level),

_Basic_ question??  Um, Gordon, David and Ken: is this a basic
question?  I'd think not.  Most MD's, unless they're specialists in the
treatment of gout, might think way, way back to their pharmacology
course and remember that aspirin has a complex effect on uric acid
excretion depending on the dose (low doses cause retention, very high
doses such as you might see used in rheumatoid arthritis can cause
increased excretion.)  But I doubt that the actions of either
acetaminophen or ibuprofen are on the tips of anyone's tongue; that is,
sufficiently to speak absolutely authoritatively.  A good first guess
would be that neither has a big influence on uric acid excretion,
because they're not mentioned in the common literature as having this
problem; at the least, acetaminophen is not an organic acid, a factor
which plays a large role in such effects.  I've never seen ibuprofen
mentioned as being contraindicated in gout.  In any case, this is not
the kind of question which would disqualify any of my doctors if s/he
couldn't give me an answer right away.  What's the matter with "I'm
not sure?"

>and MOST of all her assumption that
>my symptoms are merely mental led both my husband and me to believe
>she is, well, in my husband's word, "hopeless."

What's wrong with "merely mental"?  Does that make it less of a problem?
Not that I'm claiming that that's the situation.

>I've had occasional chest pains since childhood and never thought much
>about them.  I asked the doctor about them mainly because my husband
>was so concerned.  And it took both he and my mother-in-law two years
>to get me into a doctor's office for a complete physical because I
>keep thinking these other symptoms will clear up eventually.  Once
>they got me to agree that my health was indeed deteriorating I got
>into gear.

How is your health deteriorating?

>On the assurance that doctors appreciate seeing the whole picture, I
>made up a list of symptoms I've experienced in the last two years.  I
>asked the doctor to look over the list and tell me what she thought.
>Her reply was that the list indicates a "preoccupation with illness"
>and that I should be seeing a psychiatrist.

You seem to think this is an insult.

>When the patient loses trust in either the doctor's competence or the
>doctor's ability to even _care_, that patient starts to question every
>thing the doctor recommends.

Well, don't do that.  What makes you think she doesn't care?
Would it be better for her to have strung you along giving
you sublingual sensitivity tests to "allergens"?

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer