Diagnosis

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“Ten” (10) is an easy number to remember.

I have no doubt, although many years have passed, that 10 grams per decileter was the laboratory value at which I had to prescribe a blood transfusion for everybody. Read more on Where Do They Get Those Numbers For Blood Tests?…

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She was a well-known and respected matron in Orange County who called at 10 PM with a “health concern” so I called her right back so I could sleep easier.

The problem was an easy one.  She had her first “abnormal” blood test and had been diagnosed with what those defeatist doctors call “prediabetes”  and started on metformin which is about the safest thing that exists to lower blood sugar.  I mean some blood sugar medicines and lower blood sugar so much that they make people nervous and shaky and worse.  But this one wouldn’t hurt her. Read more on Diabetes Is Not A Death Sentence…

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I always considered myself a naive person in many ways.

From my overprotective family, who had serious worries about my crossing the street without someone holding my hand even when pushing forty, I moved, through several exotic domiciles, into a marriage where my husband would never dream of permitting me to cross a street without holding my hand. Read more on You Think YOU Got Stress?…

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“The whole world has ADHD.”

No, he was not a mental health practitioner speaking with us.  He was a professional fund-raiser.

His sentiment, however, was one I had heard before, in other kinds of jargon. Read more on The Whole World Has ADHD …

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Sexual harassment has been making the news lately.  Dozens of powerful men in Hollywood (especially) and business and government are being accused of misconduct by vulnerable young women (and men in some cases).

Post Traumatic Stress Disorder can result from any trauma. Car accidents, animal attacks, a bad fall — not just sexual assault or war.

A high-school student doing a report for school recently wrote to me asking about PTSD.  I thought my answers might be of interest to others, so I’m sharing them with you. Read more on Student Questions About PTSD…

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He was in his mid-fifties, quiet and fairly good-looking.  I did suspect he was balding or maybe just plain bald as few men would wear a turn-of-the-last-century newsboy-type cap indoors these days. He sat on my couch and told me he thought he had ADD (attention deficit disorder). I interrupted him right there, as I do everyone who comes into my office thinking they have this disorder. Most people professing this diagnosis who are adults and walk in alone to a psychiatrist’s office are looking for stimulants — the amphetamines and the Ritalins of life. I don’t prescribe these.  I used to — at least as long as it took to get people weaned off them.  But nobody wants to get off them, not ever.  I have seen people who have been on them from earliest childhood through middle age, for no clinical reason I can discern.  Usually they were just being kids and bugging the adults, so they were put on drugs to control them. Read more on The Regular Looking Guy…

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Many illnesses have support groups and even official organizations that help sufferers and families understand and cope with that illness.  You know, like The Arthritis Foundation and the Diabetic Association. Read more on “Accomodating” or “Taking Advantage Of?”…

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I saw one of my brink-of-divorce patients yesterday.  I have plenty of them. They tell me how horrible their men are but they seem mysteriously held to this person who is generally, by their descriptions, a devil on the way to hell so he can commiserate with his demonic colleagues. He devalues her in front of the children or cheats on her of has more drugs in the medicine cabinet than your average pharmacy except they are not the kind where insurance pays for the prescription. And they tell me for all the world about what sounds like an incurable lout who has declined, avoided, or failed every available treatment for a condition she is convinced he is somehow enjoying or profiting from.

I had a colleague, allegedly my preceptor, who would treat woman patients by writing on a small piece of paper the words “Divorce the bastard,” and simply, but ceremoniously, handing it to her. Me, that’s not my style.  I would tell her, “You need to know where you came from, who you are, and what you believe.  You need to know the situation you are in.  And you need to know what you want for the future.” My current patient’s  marriage counselor (she still showed up for sessions.  Her husband had stopped) told her to weigh the “pros and cons.”  Rational.  Great. Read more on Divorce Is Not Death…

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She was an active patient, who I am still trying to see once a week until I direct her in how to survive and flourish in the universe. She was in her forties, depressed and anxious.  She had “a little panic attack,” some chest pain and the feeling her breath was cut off. I wasted no time sending her to an Emergency Room, (or, if she really did not feel it was that bad, to an Urgent Care — what we used to call it a “doc in a box”) because it is cheaper, sounds less foreboding, and any doctor who is sentient and has a pulse and is on duty would send her to an Emergency Room if anything was really wrong.

Chest pain or tightness or shortness of breath or a “tight feeling, like a vice” could always be a heart problem, and could always be life threatening until proven otherwise.  I tend to send  even the most mild discomforts of this nature, that people had for years to primary physicians for a “cardiocentric examination.”  For “auscultation,” the old fashioned Latin-origin word for a good listening to the well as generally an electrocardiogram and sometimes even an echocardiogram.

Read more on Don’t Ignore Chest Pain…

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Too many Americans can’t afford to and simply do not–take their medicines as prescribed. That estimate is based on information from the (American!) Centers for Disease Control). I have had patients come into my office who take their medications –in both cases, for life-threatening infectious diseases — only every other day, simply because that is all they can afford. I explained to each one individually the idea of the half-life of a drug. They only stay in your body for a certain length of time, then they leave your body in waste products.  That is why taking a drug every other day is not really effective. They both gave me almost exactly the same response — It was all they could afford, and it was probably better than nothing. Read more on Big Pharma Is Capitalism Out Of Control…