Saturday, February 14, 2009

The Patient With Too Many Issues

You never know if blog comments are real or not, but I choose to take them at face value. The comment from "tina" on my "I am sick" blog is worth writing about. Here's what tina said:

"hi, I have been everywhere and seen a lot of doctor's and no one can seem to help they just say it's all in my head as i continue to get worse and worse. Sometimes things are so bad i feel like i am going to pass out,my b/p goes higher and heart beats so fast i think i am going to die. The pains are so severe they knock me down and now my legs are starting too they feel like they are bruised or sunburn but they are not and my heart beats in my throat not my chest. This all started when i was 33 years old and found out i was pregnant for my last child but i am now 42 and it is worse not better they say anxiety/panic attacks but the meds did nothing except make me gain 70 pounds or more. I am lost and at my ends wits no one can help me. My symptoms included: low energy, poor stamina, sore throat, unexplained menstrual irregularity, upset stomach, abdominal pain, chest pain, rib soreness, shortness of breath, cough, heart palpitations, pulse skips, heart murmur, joint pain, joint swelling, stiffness of the joints all over my body, muscle pain and cramping, twitching of the face or other muscles, neck pinches and cracks, neck stiffness, neck pain, tingling, numbness, burning or stabbing sensations, shooting pains, skin hypersensitivity, facial paralysis, (Bell's palsy), double, blurry, increased floaters, light sensitivity, buzzing, ringing, ear pain, sound sensitivity, increased motion sickness, vertigo, major facial flushing and bizarre skin rashes, poor balance, lightheadedness, wooziness, panic attacks, anxiety, tremors, confusion, difficulty in thinking, difficulty with concentration, forgetfulness, poor short term memory, poor attention, disorientation, getting lost, going to wrong places, difficulty with speech or writing, mood swings, irritability, depression, disturbed sleep, too much sleep, too little sleep, the overwhelming need to sleep for 4 hours every afternoon, and a complete intolerance to alcohol.sore on scalp,dry mouth and lips,burning to head,pins and needles in hands and feet,pain(like charlie horses) in the legs,pain,bottom of my feet pain,IBS,gas,heartburn,no libio,sex hurts,stiffness and cramps in fingers and toes,hot flashes,chills and cold, constant urge to pee,bones crack easily,disrealization,disoriention,lightheadness,dizziness,muscle twitching,feeling like a cat is purring inside my body,pain if i push on my skin bones or anything on my body,sometimes a weird taste in mouth,rib pain,eyes pain,back pain,feelings of doom and death,quickly angered,heaviness in stomach,weight gain,no motivation,afraid to leave the house, 8 years of hell,tired alot or never goes in spans,MEAN MEAN BITCH ALOT,littlest things set me off,ear/jaw pain,type the same words over and over yet type them mixed up?,hair never grows (same length since i was 10) pale skin,NO ONE WANTING TO HELP ME!!!!!!!!!! days where i can do everything and then some days where i can move and i am dying,groin pain,itchy skin,if i open my mouth i can hear my heartbeat,headaches,depression,bi-polar,crying all the time, pain in legs,pitting,weight gain,blurry vision,stomach pain,nausea,fatigue,heartburn,stomach pain,twitching,muscle aches, 1/29/09-vomiting,diarrhea,stomach pain,heartburn,weight gain,numbness,shakes,leg cramps,high eosinophils,disoriention,bloating,sick! please if you can have a heart and try to help me i am so close to just ending it that pain is soooo bad.................god bless..tina"

Folks, tina has a LOT of issues. In fact, too many issues to be resolved in less than several months. I would suspect she has been doctor shopping and gets discouraged when a cure isn't forthcoming. Patients like tina require a lot of patience and a doctor who does not get discouraged easily either.

I advised her to pick one good Internist and one good Psychiatrist and to stick with them as they sort through her many problems. Taken as a whole, these are quality of life problems, not serious life threatening problems and they will take a long time to sort out. She should make sure she is eating only organic, healthy food and getting exercise every day. She should not use alcohol or any other drugs not prescribed by her physicians.

I've had patients like tina and they can be exhausting because of the "list". They often go from physician to physician and have test after test. Once a test is negative, that test does not need to be repeated. But healing relationships can occur and they can get their lives back if they stick with their physicians.


ERP said...

This is the reason I did not go into primary care. One person like this in my office and I would be throwing myself off a bridge. I don't know how you do it!!1

Toni Brayer MD said...

ERP: Yup!

CountryMidwife said...

Hope SOMEONE has tested for Lyme and Babesiosis.

Though the blatant "web checklist" nature of the symptoms concerns me.

Toni Brayer MD said...

CountryMidwife: Yes, the list is indicative of a psychiatric disorder. You are correct about testing for Lyme and Babesiosis also.

tracy said...

Yipes! But, Hey, welcome back, Dr. Brayer! Hope you are feeling better!

It would definately take at least a couple of physicans, with a great deal of patience, working together, to help this poor woman. i hope she does get that help. Thyroid, i'm sure is on "the list". (of tests)

tina said...

never been tested for lymes or the other one when i brought them up to my doctor he said 10 years of this (yes it's more then 10 years now and ALL this and MORE are going on now) once again no doctor is able to help and yes i stayed with one head and gp doctor so far.But they are hasted not to listen and wow after findinig this i see why! this is NOT in my head as my body feels it and i should know my body.It is breaking me physically and metally i was NOT crazy til this all started and I am still with NO answers so thanks for me being your joke.oh by the way ERP if you were my doctor i probably would off jumped off that bridge too..tina

Anonymous said...

It could be fibromyalgia.

viagra online said...

The problem with patients that they are virtual. you don't know that they are telling the true and you need to check their symptoms

Coffee, Tea and Heart Disease