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Jennapause(AT)aol.com wrote:
>
> What can I do.
> Please help me out.
Jenny:
To begin to solve the problem with the Doctors you will have to take
some action. The action will have to involve you scheduling an
appointment with the Doc's in VT and having a little chat with them.
Begin by telling them you have done a little research and you have a few
questions. Tell them you went to your Dorland's Illustrated Medical
Dictionary and looked up a few things that you want clarified. Tell them
you looked up DIAGNOSIS and you found that a "clinical diagnosis is
based on signs, symptoms and objective clinical findings (laboratory
findings during life). Refresh them that a "sign" is an indication of
the existence of something; any objective evidence of a disease, i.e.,
such evidence as is perceptible to the physician, as opposed to the
subjective sensations (symptoms) of the patient. Based on your note you
want to tell them that they would include some incontinence, (if he'd
care to watch), inability to walk/weight bear, inconsistent reflexes,
loss of balance (guess he doesn't understand the meaning of loss of
proprioception ((where a limb is in space)), and dragging your left leg.
Then refresh their memory that a "symptom" is ANY SUBJECTIVE evidence
of disease or of a patients condition, i.e., such evidence as perceived
by the patient; a change in a patients condition indicative of some
bodily or mental state. Your list would include numbness in your hands,
arms and legs, pain, coldness in your legs, and "feelings that something
was inside my legs eating them from the inside out" (formication).
Finally, there is their beloved, "objective clinical findings". Based
on what you've said you have had most of the tests, blood, spinal taps,
MRI's and either an EMG or ENG. As far as I know a Dx should involve all
of these factors. Now comes the hard part. Simply ask him which of the
variables did he focus upon. If he says that the lack of "objective
clinical findings" is the key it is time to tell him, "NO, NO" and
proceed to remind him that TM is not always visible on an MRI and that
he might want to focus on the "signs" and "symptoms". I know that he
eventually gave you a diagnosis of TM but if I were you I sure would
want to know how he arrived at it. You and others may want to use this
methodology when encountering your Doc or a new Doc. Attached are the
definitions for Transverse Myelitis which may also help them.
I also believe the same criteria should be used to confront the
neurologist and the psychiatrist. If they insist on the Dx of a
"hysterical reaction" there are a few questions to be answered. First,
unless they found something in your blood work (some mind altering drug,
LSD, or a lot of cocaine, heroin, booze or marijuana) or they gave you a
psychological test like the Minnesota Multiphasic Personality Inventory
(MMPI) they have NO "objective clinical findings". This of course poses
an interesting dilemma for them if they were insistent on having
"objective clinical finding" to make their physical diagnosis why aren't
they as adamant in having them for the psychological diagnosis.
Secondly, I would want to know which "sign" they used in formulating
their diagnosis ? About the only thing I can think of as a "sign" would
be the absence of a smile and of course we are always smiling after the
skins has been pealed off of our feet, we've had a spinal tap, we are
taking who knows what combination of drugs, we have IV needles stuck in
our arms and spent who knows how long in the old MRI tube. Now we must
focus on the subjective evidence, "symptoms" that you reported to the
psychiatrist. Unless you told him that you had a burning bush you talked
with and that you had a bunch of rabbits at your feet while you were
talking with him we can probably rule out psychosis with auditory and
visual hallucinations. The term hysteria is in diagnostic terms a
"Conversion Disorder". You don't meet the Dx criteria because you
ultimately received a Dx so your illness is no longer a "hysterical"
reaction to something, ergo, some depression seems to be your only
psychological problem.. Also, isn't it a bit disconcerting to think that
unbeknownst to you that you conveniently developed all of the symptoms
that fit a specific Dx which you had never heard of before in your life
so you could gain the attention of a Doctor and your husband..... dah
NOT.
I'm not sure what else you can do or say unless you want to suggest that
they polish their diagnostic skills and not be threatened when someone
suggest that they have a certain physical condition, i.e., TM. They are
fallible and someone just might know a bit about their own physical well
being since they are merely talking about themselves. I've briefly
mentioned that I had and still have a problem with the Chief of Medicine
at the local VA Hospital. He lied to me about one of the symptoms I
experience, fatigue, and then told me the fib that fatigue was a symptom
with MS and not with TM. He really wasn't fibbing just exposing the
fact that he did not know what he ws talking about. A simple I don't
now would have been appropriate.
I'd be more than happy to discuss this with them but remind them that I
did not go to deity school and that I would hope that they could loose
the arrogance and innuendo and gain a little empathy and understanding
before we talk.
I know this is a lot but if they and hubby were to take just a few
minutes learning about TM it would go a long way in their gaining a
better understanding of you and what your problems are.
Hope this helps.....hang in there.
Doc
PS. When this e-mail goes to $%#(AT)## AOL the body of the message
is repeated, with errors and who knows why, before the
attachment.
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<!doctype html public "-//w3c//dtd html 4.0 transitional//en">
Jennapause(AT)aol.com wrote:
What can I do.
Please help me out.
Jenny:
To begin to solve the problem with the Doctors you will have to take some action. The action will have to involve you scheduling an appointment with the Doc's in VT and having a little chat with them. Begin by telling them you have done a little research and you have a few questions. Tell them you went to your Dorland's Illustrated Medical Dictionary and looked up a few things that you want clarified. Tell them you looked up DIAGNOSIS and you found that a "clinical diagnosis is based on signs, symptoms and objective clinical findings (laboratory findings during life). Refresh them that a "sign" is an indication of the existence of something; any objective evidence of a disease, i.e., such evidence as is perceptible to the physician, as opposed to the subjective sensations (symptoms) of the patient. Based on your note you want to tell them that they would include some incontinence, (if he'd care to watch), inability to walk/weight bear, inconsistent reflexes, loss of balance (guess he doesn't understand the meaning of loss of proprioception ((where a limb is in space)), and dragging your left leg. Then refresh their memory that a "symptom" is ANY SUBJECTIVE evidence of disease or of a patients condition, i.e., such evidence as perceived by the patient; a change in a patients condition indicative of some bodily or mental state. Your list would include numbness in your hands, arms and legs, pain, coldness in your legs, and "feelings that something was inside my legs eating them from the inside out" (formication). Finally, there is their beloved, "objective clinical findings". Based on what you've said you have had most of the tests, blood, spinal taps, MRI's and either an EMG or ENG. As far as I know a Dx should involve all of these factors. Now comes the hard part. Simply ask him which of the variables did he focus upon. If he says that the lack of "objective clinical findings" is the key it is time to tell him, "NO, NO" and proceed to remind him that TM is not always visible on an MRI and that he might want to focus on the "signs" and "symptoms". I know that he eventually gave you a diagnosis of TM but if I were you I sure would want to know how he arrived at it. You and others may want to use this methodology when encountering your Doc or a new Doc. Attached are the definitions for Transverse Myelitis which may also help them.
I also believe the same criteria should be used to confront the neurologist and the psychiatrist. If they insist on the Dx of a "hysterical reaction" there are a few questions to be answered. First, unless they found something in your blood work (some mind altering drug, LSD, or a lot of cocaine, heroin, booze or marijuana) or they gave you a psychological test like the Minnesota Multiphasic Personality Inventory (MMPI) they have NO "objective clinical findings". This of course poses an interesting dilemma for them if they were insistent on having "objective clinical finding" to make their physical diagnosis why aren't they as adamant in having them for the psychological diagnosis. Secondly, I would want to know which "sign" they used in formulating their diagnosis ? About the only thing I can think of as a "sign" would be the absence of a smile and of course we are always smiling after the skins has been pealed off of our feet, we've had a spinal tap, we are taking who knows what combination of drugs, we have IV needles stuck in our arms and spent who knows how long in the old MRI tube. Now we must focus on the subjective evidence, "symptoms" that you reported to the psychiatrist. Unless you told him that you had a burning bush you talked with and that you had a bunch of rabbits at your feet while you were talking with him we can probably rule out psychosis with auditory and visual hallucinations. The term hysteria is in diagnostic terms a "Conversion Disorder". You don't meet the Dx criteria because you ultimately received a Dx so your illness is no longer a "hysterical" reaction to something, ergo, some depression seems to be your only psychological problem.. Also, isn't it a bit disconcerting to think that unbeknownst to you that you conveniently developed all of the symptoms that fit a specific Dx which you had never heard of before in your life so you could gain the attention of a Doctor and your husband..... dah NOT.
I'm not sure what else you can do or say unless you want to suggest that they polish their diagnostic skills and not be threatened when someone suggest that they have a certain physical condition, i.e., TM. They are fallible and someone just might know a bit about their own physical well being since they are merely talking about themselves. I've briefly mentioned that I had and still have a problem with the Chief of Medicine at the local VA Hospital. He lied to me about one of the symptoms I experience, fatigue, and then told me the fib that fatigue was a symptom with MS and not with TM. He really wasn't fibbing just exposing the fact that he did not know what he ws talking about. A simple I don't now would have been appropriate.
I'd be more than happy to discuss this with them but remind them that I did not go to deity school and that I would hope that they could loose the arrogance and innuendo and gain a little empathy and understanding before we talk.
I know this is a lot but if they and hubby were to take just a few minutes learning about TM it would go a long way in their gaining a better understanding of you and what your problems are.
Hope this helps.....hang in there.
Doc
PS. When this e-mail goes to $%#(AT)## AOL the body of the message
is repeated, with errors and who
knows why, before the attachment.
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name="TMDefined2.txt"
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filename="TMDefined2.txt"
Some TM Definitions
=2E...... I got out my trusty Dorland's Illustrated Medical Dictionary an=
d looked up the term "transverse" and it says "placed crosswise; situated=
at right angles to the long axis of a part". In my case the transverse a=
spect lies in the fact that one leg is more spastic than the other, I fee=
l heat or cold more readily in one leg than the other and this holds true=
for pin prick etc. This is what Dr. Lynn explained in her article. I wen=
t back to Dorland's and looked up "myelitis". Dorland's says "myelitis - =
inflammation of the spinal cord. The symptoms of myelitis vary with the l=
ocation of the lesion and include pain in the back, girdle sensation, hyp=
eresthesia (abnormally increased sensitivity of the skin or an organ of s=
pecial sense), formication (a sensation as of small insects crawling over=
the skin), anesthesia (loss of feeling or sensation), motor disturbances=
, paralysis, increase of the reflexes, paralysis of the sphincters, decub=
itus ulcers and in later stages, spasmodic contractions of the paralyzed =
limbs". This definition also referred me to "mylopathy". So I went to "my=
lopathy" and under transverse mylopathy" it says "mylopathy which extends=
across the spinal cord". =
I decided to dig out the very first thing I read on TM more than 17 years=
ago. The
Merck Manual says, "Inflammation affecting both gray and white matter in =
one or several adjacent cord segments, causing sudden local back pain fol=
lowed by symptoms of spinal cord transection that develop over a few hour=
s". Some cases are associated with...." but usually no cause is found. Th=
e deficit is usually severe with global sensorimotor paraplegia below the=
level of the lesion, urinary retention and loss of bowel control. The th=
oracic area is most often involved, so that abdominal paralysis also occu=
rs. Eventual improvement is only slight, except in cases caused by viral =
encephalo-myelitis or an acute inflammatory edema". A quick read of a new=
er Merck Manual was basically the same. Transverse Myelitis is exactly wh=
at is stated in the definition. If some physicians are confused or uninfo=
rmed it is our responsibility to straighten them out not contribute to th=
eir errors.
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