Ever heard of capitation? In healthcare, it can mean that a clinic makes more money by following more patients. Payments are per person, rather than per service. I guess I shouldn’t be surprised, then, that they refused to dismiss this guy from their care.
He was a 32 year old young man who was diagnosed with an anxiety disorder. He had been working independently as a pool cleaner but he couldn’t stand it anymore. He was always nervous. As a matter of fact, this man was nervous about everything he did. Perhaps it was a generalized anxiety disorder, but surely something a great deal more. He wasn’t having panic attacks, and he exhibited far more than the usual one or two things found in generalized anxiety disorder.
I tried to start him on some medications — as much as I didn’t like the medications he had been started upon. He had been given regular Xanax in slowly increasing doses. As nervous as he was, he wasn’t stupid. He said, “It’s really funny. The medication makes me sleep, but it sure doesn’t stop me from being nervous.” Read more on The Nervous Pool Cleaner…
Filed under Diagnosis, Disease, Doctors, medicine, prescription drugs, Psychiatrists by on Sep 27th, 2012. 2 Comments. 
I read a joke once about a husband’s preemptive strike in the bedroom. He walks in holding two aspirin and a glass of water. When his wife asks what it’s for he says it’s for her headache. She replies “But I don’t have a headache.” “Gotcha!”
Headaches are no fun, so we might as well get a little chuckle at their expense. And if you suffer from sinus headaches, there might be quick and inexpensive relief your doctor hasn’t shared with you.
Listen, I have had allergies since I was small but sinus headaches have been rare. That is, until I got my complete dental implants. They have wildly improved my quality of life, but I have had more intense and regular sinus headaches as a result. My surgeon had removed teeth prior to the implants and freely admitted he had been up in my sinus area. He said I could see an ear nose and throat specialist if the sinus headaches became too much of a problem. He tried to ignore my laughter as I told him I could fix this myself. Read more on What Your Doctor May Not Tell You About Sinus Headaches…
Filed under Alternative Medicine, Diagnosis, medicine by on Sep 3rd, 2012. 1 Comment.
There’s a joke about a woman whose blood pressure was 180/90. She didn’t think she had reason to be concerned. After all, she argued, 180/90 is the mathematical equivalent of 2/1 and that doesn’t seem so high, does it?
I once treated a young man of color, obese and sad looking, whose numbers were close to this – 170/100. And I was not laughing.
This young man was schizophrenic for sure, but pretty harmless. Life had beaten him down enough that his jail experiences — assault, as directed by disembodied “voices” — had him so frightened that he would never do anything the voices said. Not now, not ever, and I believed him.
As a psychiatric physician, I always managed to get “vital signs” on all patients. That should not have been a battle, but it was. I did not understand nor relate to the medical assistants who took them. Why? 18 months training after high school and they had not been nice to me — not at all — criticizing my lunch and the fact they did not think I worked hard enough.
I was concerned when I saw a blood pressure of 170/100. Patient said he had been on some kind of medicine. The best I could get with one of my “naming medicines and seeing what it sounded like” was hydrochlorothiazide — maybe. And of course the relevant parts of the chart were missing, as was the case more than actually finding anything.
He said he had stopped his medications a couple of days before because they gave
Filed under Uncategorized by on Jun 20th, 2012. Comment.
Recent research by the Centers for Disease Control and Prevention’s National Center for Health Statistics has confirmed a longstanding trend — namely that whites live longer than blacks pretty much consistently, and have for a long time. People have attributed this to the increased difficulty of containing blood pressure in black people — probably a genetic difficulty– which leads to increased rates of both stroke and of heart disease. Both have long been established as being deadly. Plenty of well meaning people have at least tried to deal with this. One of the well-meaning people is me. Many times I have seen people of color for other reasons, checked their blood pressure, been concerned, and referred them to appropriate blood pressure followup by general medical personnel. Of course, I have no way of knowing how many (if any) went where I told them, but I tried.
I mean, I would tell them, “If there is something extra that can be done to make sure you are around for a few more years, to see the grandchildren grow a bit or whatever is precious, then it should be done.” I usually have no problem getting the person to agree, at least in my presence. Menthol cigarettes are a different kind of issue, and therefore a little tougher to be unequivocal about. Read more on Ban Menthols? Our Government To The Rescue!…
Filed under Addictions, Diagnosis, Disease, Government by on Mar 21st, 2011. Comment.