E
Eye
Guest
I have seen far too many hospitals and doctors in my life, and though I can see your point, pibbur, I am so grateful internet was invented.
There once was a time I had (too) much faith/trust in medics and medical science. But then I learned there are plenty of professionals that make mistakes, that forget important things - hey, they are human - that are biased, and a few that imo simply are not fit for the job, because they are not even willing to actually listen to a patient. (If you can not hear me out, how can you be sure you have heard what my problem is?)
I learned the hard way: I paid the consequences of awful and avoidable mistakes.
Since then I help them, I remind them, I check the results, I hand them my long, unusual medical CV (in the medical terms they use) but written by me (NO mistakes), I question whatever I like, I ask whatever I want, I speak my mind. I am not there to make it easy for them - I am there to get into the least amount of trouble myself.
Since then I see the patient-doctor relation as a communication between equals: me, having knowledge about the (un)usual peculiarities of my body and past diseases/operations/tests/treatments, and a doctor having knowledge about general stuff.
S/He'll need to listen to me, and s/he'll need to explain to me. If not I won't listen to him/her. I'll find myself another one.
The internet gives me the opportunity to prepare a consult, to set some hypotheses, to ask about specifics. Also it'll allow me to find information about a specific doctor: reviews. After having met him/her, I can look up on the internet to find more background about what s/he said.
I have met several doctors who really enjoy, what they called, "an informed patient". They find such a patient easier to talk to; just having to focus on the things that are not clear yet (for that specific patient).
Yes, the info they provide meets a critical eye and raises more questions than with a docile patient, but they are not afraid of explaining themselves - on the contrary, they appreciate the openness: patients' desires, doubts or unwillingness to follow the proposed approach/treatment is not obscure but crystal clear, right at the start.
Imo turning to the internet to see what might be the matter with you is not a bad thing - as long as the sites are offering objective, quality information and not unfounded BS. (Yes, one has to be able to see the difference).
And you have to be willing to put your findings to the test, to put your hypothesis in front of someone who has more experience with disease and organ malfunction as an outsider.
Only a fool would trust his own findings more than the findings of a (well) trained outsider, and only a fool would trust the professional outsider more than his own gut - if the outsider can not silence successfully your gnawing gut, go to the next professional.
To me it seems Dart has done a thorough job. In one thing I am certain he is right: the medical circus can be quite an ordeal. Sometimes more of a hindrance than a help (in getting to the actual help needed).
There once was a time I had (too) much faith/trust in medics and medical science. But then I learned there are plenty of professionals that make mistakes, that forget important things - hey, they are human - that are biased, and a few that imo simply are not fit for the job, because they are not even willing to actually listen to a patient. (If you can not hear me out, how can you be sure you have heard what my problem is?)
I learned the hard way: I paid the consequences of awful and avoidable mistakes.
Since then I help them, I remind them, I check the results, I hand them my long, unusual medical CV (in the medical terms they use) but written by me (NO mistakes), I question whatever I like, I ask whatever I want, I speak my mind. I am not there to make it easy for them - I am there to get into the least amount of trouble myself.
Since then I see the patient-doctor relation as a communication between equals: me, having knowledge about the (un)usual peculiarities of my body and past diseases/operations/tests/treatments, and a doctor having knowledge about general stuff.
S/He'll need to listen to me, and s/he'll need to explain to me. If not I won't listen to him/her. I'll find myself another one.
The internet gives me the opportunity to prepare a consult, to set some hypotheses, to ask about specifics. Also it'll allow me to find information about a specific doctor: reviews. After having met him/her, I can look up on the internet to find more background about what s/he said.
I have met several doctors who really enjoy, what they called, "an informed patient". They find such a patient easier to talk to; just having to focus on the things that are not clear yet (for that specific patient).
Yes, the info they provide meets a critical eye and raises more questions than with a docile patient, but they are not afraid of explaining themselves - on the contrary, they appreciate the openness: patients' desires, doubts or unwillingness to follow the proposed approach/treatment is not obscure but crystal clear, right at the start.
Imo turning to the internet to see what might be the matter with you is not a bad thing - as long as the sites are offering objective, quality information and not unfounded BS. (Yes, one has to be able to see the difference).
And you have to be willing to put your findings to the test, to put your hypothesis in front of someone who has more experience with disease and organ malfunction as an outsider.
Only a fool would trust his own findings more than the findings of a (well) trained outsider, and only a fool would trust the professional outsider more than his own gut - if the outsider can not silence successfully your gnawing gut, go to the next professional.
To me it seems Dart has done a thorough job. In one thing I am certain he is right: the medical circus can be quite an ordeal. Sometimes more of a hindrance than a help (in getting to the actual help needed).
P
pibbur who
Guest
Oh, I'm all for patients seeking information on line. What I wanted to get across was that you have to be a bit careful when evaluating and applying what you find. As for trusting the gut feeling - in many cases, good. Not necessarily so good for those with real(!) hypochondria tendencies. I've been there.
pibbur
PS. Observe that I'm talking about patients who really are (more or less) hypochondric. I'm well aware that symptoms may be falsely attributed to hypochondria. DS.
pibbur
PS. Observe that I'm talking about patients who really are (more or less) hypochondric. I'm well aware that symptoms may be falsely attributed to hypochondria. DS.
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Eye
Guest
I am sorry to hear you had real hypochondria tendencies, pibbur, and I do know about the medical student syndrome, but sometimes I think the problem is exaggerated.
According to Wikipedia (I did not look further for a second/better source): "[…] Hypochondriasis", as a somatoform disorder[4] and one study has shown it to affect about 3% of the visitors to primary care settings".
One study, 3 percent. Now how many of those cases will still be labeled hypochondriacs in say, ten years time.
I think one may put next to the "hypochondria tendencies", the far too easy "nothing-to-be-found-thus-not-somatic tendencies". People fear the label, they fear not being taken seriously when nothing is found.
Though I get the impression more people seem to understand todays medical knowledge has not reached its terminus; medical views, focuses and findings change.
According to Wikipedia (I did not look further for a second/better source): "[…] Hypochondriasis", as a somatoform disorder[4] and one study has shown it to affect about 3% of the visitors to primary care settings".
One study, 3 percent. Now how many of those cases will still be labeled hypochondriacs in say, ten years time.
I think one may put next to the "hypochondria tendencies", the far too easy "nothing-to-be-found-thus-not-somatic tendencies". People fear the label, they fear not being taken seriously when nothing is found.
Though I get the impression more people seem to understand todays medical knowledge has not reached its terminus; medical views, focuses and findings change.
E
Eye
Guest
I have reacted a bit too soon yesterday. Would not have replied to pibbur again today, well, not in the same way. 
We all have our sensitivities:
Pibbur, responding in this thread with his past hypochondria problems in mind - I guess. Which, btw, to me, seem awful: how do you, as a real hypochondriac deal with any future situation and differentiate between a serious and an innocent complaint ('am I imagining things AGAIN'), and will the GP, who knows your hypochondriac past look at future complaints in the same way as a doc who is unaware of your past?
And me, with my past of medical mistakes and hurdles.
So, for me, seeing the word 'hypochondric' and 'medical student syndrome' in a thread about someone turning to the internet after having some serious complaints, touched a sensitive spot. I reasoned: "One can be too cautious too". If people, because of a few having a possibility of imagining things, already start doubting themselves, even before getting to the doctor, things might get really dangerous.
Like Dart has shown us, turning to the internet might clarify what you have and what not by getting an extensive list of the related, possible symptoms. Ticking a list is sometimes easier than having to think about what exactly you are experiencing yourself and thus might give a better/complete picture to the doctor.
I am sorry, Pibbur if I offended you somehow by yesterdays reply, dropping the word 'exaggerated'.
I understand your intent, and I (think) I can see where you are coming from, it must be awful to read different symptoms and wonder if you are experiencing the same thing.
We all have our sensitivities:
Pibbur, responding in this thread with his past hypochondria problems in mind - I guess. Which, btw, to me, seem awful: how do you, as a real hypochondriac deal with any future situation and differentiate between a serious and an innocent complaint ('am I imagining things AGAIN'), and will the GP, who knows your hypochondriac past look at future complaints in the same way as a doc who is unaware of your past?
And me, with my past of medical mistakes and hurdles.
So, for me, seeing the word 'hypochondric' and 'medical student syndrome' in a thread about someone turning to the internet after having some serious complaints, touched a sensitive spot. I reasoned: "One can be too cautious too". If people, because of a few having a possibility of imagining things, already start doubting themselves, even before getting to the doctor, things might get really dangerous.
Like Dart has shown us, turning to the internet might clarify what you have and what not by getting an extensive list of the related, possible symptoms. Ticking a list is sometimes easier than having to think about what exactly you are experiencing yourself and thus might give a better/complete picture to the doctor.
I am sorry, Pibbur if I offended you somehow by yesterdays reply, dropping the word 'exaggerated'.
I understand your intent, and I (think) I can see where you are coming from, it must be awful to read different symptoms and wonder if you are experiencing the same thing.
P
pibbur who
Guest
@Eye: I was not offended, not at all. That you supposedly were too harsh with me or something like that - didn't cross my mind. So definitely no problem.
pibbur who realizes he is derailing the thread, which actually is about dart and how he has handled his health problems (very well). It's not about pibbur.
PS. My hypochondric days are long gone, and it was mostly due to negative thinking. During depressive episodes I didn't care. But between those episodes, when I felt (to some degree) good - I didn't believe it could last. So perhaps it wasn't real hypochondria, but it was still troublesome. It culminated when I started referring myself to specialists, which I have the right to do, but it's not wise. That changed things, made me realize that this couldn't go on, and I decided to trust my GP, and to be nothing more than a patient. There is actually an informal healthcare service for doctors in Norway. Not that we get better treatment than others, but there are GP's that have long experience with treating doctors. My GP, is one of them. She doesn't discuss with me what to do, she tells me, which is exactly what I need. While in general, involving the patient is necessary, for me it's not. DS.
pibbur who realizes he is derailing the thread, which actually is about dart and how he has handled his health problems (very well). It's not about pibbur.
PS. My hypochondric days are long gone, and it was mostly due to negative thinking. During depressive episodes I didn't care. But between those episodes, when I felt (to some degree) good - I didn't believe it could last. So perhaps it wasn't real hypochondria, but it was still troublesome. It culminated when I started referring myself to specialists, which I have the right to do, but it's not wise. That changed things, made me realize that this couldn't go on, and I decided to trust my GP, and to be nothing more than a patient. There is actually an informal healthcare service for doctors in Norway. Not that we get better treatment than others, but there are GP's that have long experience with treating doctors. My GP, is one of them. She doesn't discuss with me what to do, she tells me, which is exactly what I need. While in general, involving the patient is necessary, for me it's not. DS.
N
NewDArt
Guest
By all means, derail the thread
The more information we can share about health and how to (potentially) treat all these horrible disorders, the better!
Even if some of it is imagined, it's no less horrible for the person in question.
The more information we can share about health and how to (potentially) treat all these horrible disorders, the better!
Even if some of it is imagined, it's no less horrible for the person in question.
P
pibbur who
Guest
Exactly. Even if the cause is not somatic, but psychic, the patient still suffers.
BTW: I don't subscribe to the nothing-found-so-it's-probably-just-nerves thinking. A psychiatric diagnosis should not be an exclusion diagnosis (what's left when we've eliminated everything we can think of), but should be based on positive findings. Observe that the term "positive" is used when we find something in a test. It's a bit macabre, in the sense that a positive finding, may be negative for the patient.
pibbur who once again agrees with the dane.
PS: I seem to present a very nice picture of myself here. Actually I wasn't a very good doctor. I was good on medical theory, but not that good when it came to applying it to real people. I wasn't bad, but I could and should have been better. I know, partly from my grades in med school, partly because my colleague got more patients than I did. One of the reasons behind it was of course that I didn't like working with patients. I'm glad that I quit. Much more fun working with computers. DS.
PPS. Heh, I'll give you one example: I was the top of my class in my written (does that make sense?) surgery exam. But I scored fairly low on my oral exam, when presenting a patient wth prostatic cancer. I was asked about the side effects of the surgical procedure, and after listening to me for a while, the professor suddenly asked: Where did you read that? You don't want to hear that during your exam.
DS
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Eye
Guest
I'm curious: what did you say?PPS. Heh, I'll give you one example: I was the top of my class in my written (does that make sense?) surgery exam. But I scored fairly low on my oral exam, when presenting a patient wth prostatic cancer. I was asked about the side effects of the surgical procedure, and after listening to me for a while, the professor suddenly asked: Where did you read that? You don't want to hear that during your exam.
So, why not dead patients?
And by doing so the man missed out on a glorious career: Pibbur the world famous forensic pathologist.
P
pibbur who
Guest
@Eye: I actually don't remember what I said - it's 37 years ago.
And yes, I considered pathology. Or microbiology. But ended up with a master in informatics. Still working in healthcare, developing software for integrating patient systems. So I actually have some use of my medical background.
pibbur who watches doctor G, but wouldn't mind a few more in body details.
PS: At 62, looking back at my careers and non-careers, I see a lot of missed opportunities. But while I regret a lot of things in my life, I don't regret those things (much). When quitting medicine I decided (took me a year) that I would not regret seeking that education. I made my choice based on what I knew back then. Knowing what I do now, I would have chosen differently, but if I were to spend time regretting it, I could easily end up in the "union of resentful men". DS
And yes, I considered pathology. Or microbiology. But ended up with a master in informatics. Still working in healthcare, developing software for integrating patient systems. So I actually have some use of my medical background.
pibbur who watches doctor G, but wouldn't mind a few more in body details.
PS: At 62, looking back at my careers and non-careers, I see a lot of missed opportunities. But while I regret a lot of things in my life, I don't regret those things (much). When quitting medicine I decided (took me a year) that I would not regret seeking that education. I made my choice based on what I knew back then. Knowing what I do now, I would have chosen differently, but if I were to spend time regretting it, I could easily end up in the "union of resentful men". DS
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NewDArt
Guest
But, Pib, you and I both know that your disorder is being chronically hard on yourself
What else is there to make one grumpy when one's old?
N
NewDArt
Guest
So, another update:
I've been experimenting a bit recently - because I need to know the exact mechanics of this f*cking thing.
If I wasn't certain before, I'm all but certain now. This IS LPR or silent reflux. I've been reading more about it, and it's just a perfect match.
Turns out it's a relatively recent discovery and (of course) much more complicated than regular GERD.
Meaning, there's not much hard evidence available - and there's absolutely no way the average doctor will be of help unless I'm extremely lucky. Will try that route all the same, though.
Yesterday, I had to take my supplements like always - but I grew overconfident (as well as deliberately experimental) and I drank a cup of coffee and I ate a couple of "hindbærsnitter" which are apparently called raspberry slices in english.
Anyway, I paid the price. Strong nausea which lasted for 3 hours - and I had to go to a party with that feeling.
Stupidly, I drank a "welcome drink" which consisted mostly of juice. Now, I'm well aware that juice is acidic and bad for GERD/LPR. I simply completely forgot about that, and my nausea had just about disappeared just as I took the first sip. Boom, instant nausea again.
Thankfully, that lasted no more than 30 minutes - and I was able to eat a somewhat decent meal at the party - though I was careful to pick only low-fat and "mild" stuff. No real issues and I could even have a couple of glasses of red wine, which surprised me.
Anyway, interesting lesson.
Another interesting anecdote: My sister was at the same party and we got to talking about this disorder. At first, she made fun of me for going insane on the googling but, wouldn't you know it: after I started going in-depth about my symptoms - she revealed that she had the exact same tingle/pressure/tightness in her throat under the exact same circumstances (starting when she gets in the car in the morning).
Suddenly, it was less funny
She'd had a doctor perform an endoscopy - and of course he/she found nothing at all. So, my sister had just chosen to "live with it" for years. Never knew that.
I wonder if there's a genetic component, as my mother also recently revealed that she has classical GERD.
Isn't that something.
---
I've decided to keep a detailed diary of what I eat, when I eat - and how it affects me.
There's no way I'll just "live with this". No way.
Today, I've established that coffee is 100% certainly a trigger. Had to drink two cups spaced out - just to be absolutely certain. Not very fun, but necessary.
Not sure about those raspberry slices - because coffee didn't give me much nausea - it just strongly reinforces the tingling/pressure sensation.
I've been able to eat other unhealthy stuff with no or only mild responses - so there's really no "key" so far.
But I'm going to get to the bottom of this, and I'll be reporting here. Not that I expect anyone to really care - but it could be useful for some of you, as this condition (GERD/LPR) is MUCH more common than you might suspect and can have a TON of symptoms that people might confuse with other disorders.
If there's some way I can help others alleviate the crap, I'm glad.
One good thing about this is that I'll be in perfect shape pretty soon. I was already in pretty good shape, but for obvious reasons I'm not eating that much - and I'm eating almost exclusively healthy stuff.
I've already lost 5 pounds or so since I started this diet. I'll be one fit dude with a terrible disorder once this is over
I've been experimenting a bit recently - because I need to know the exact mechanics of this f*cking thing.
If I wasn't certain before, I'm all but certain now. This IS LPR or silent reflux. I've been reading more about it, and it's just a perfect match.
Turns out it's a relatively recent discovery and (of course) much more complicated than regular GERD.
Meaning, there's not much hard evidence available - and there's absolutely no way the average doctor will be of help unless I'm extremely lucky. Will try that route all the same, though.
Yesterday, I had to take my supplements like always - but I grew overconfident (as well as deliberately experimental) and I drank a cup of coffee and I ate a couple of "hindbærsnitter" which are apparently called raspberry slices in english.
Anyway, I paid the price. Strong nausea which lasted for 3 hours - and I had to go to a party with that feeling.
Stupidly, I drank a "welcome drink" which consisted mostly of juice. Now, I'm well aware that juice is acidic and bad for GERD/LPR. I simply completely forgot about that, and my nausea had just about disappeared just as I took the first sip. Boom, instant nausea again.
Thankfully, that lasted no more than 30 minutes - and I was able to eat a somewhat decent meal at the party - though I was careful to pick only low-fat and "mild" stuff. No real issues and I could even have a couple of glasses of red wine, which surprised me.
Anyway, interesting lesson.
Another interesting anecdote: My sister was at the same party and we got to talking about this disorder. At first, she made fun of me for going insane on the googling but, wouldn't you know it: after I started going in-depth about my symptoms - she revealed that she had the exact same tingle/pressure/tightness in her throat under the exact same circumstances (starting when she gets in the car in the morning).
Suddenly, it was less funny
She'd had a doctor perform an endoscopy - and of course he/she found nothing at all. So, my sister had just chosen to "live with it" for years. Never knew that.
I wonder if there's a genetic component, as my mother also recently revealed that she has classical GERD.
Isn't that something.
---
I've decided to keep a detailed diary of what I eat, when I eat - and how it affects me.
There's no way I'll just "live with this". No way.
Today, I've established that coffee is 100% certainly a trigger. Had to drink two cups spaced out - just to be absolutely certain. Not very fun, but necessary.
Not sure about those raspberry slices - because coffee didn't give me much nausea - it just strongly reinforces the tingling/pressure sensation.
I've been able to eat other unhealthy stuff with no or only mild responses - so there's really no "key" so far.
But I'm going to get to the bottom of this, and I'll be reporting here. Not that I expect anyone to really care - but it could be useful for some of you, as this condition (GERD/LPR) is MUCH more common than you might suspect and can have a TON of symptoms that people might confuse with other disorders.
If there's some way I can help others alleviate the crap, I'm glad.
One good thing about this is that I'll be in perfect shape pretty soon. I was already in pretty good shape, but for obvious reasons I'm not eating that much - and I'm eating almost exclusively healthy stuff.
I've already lost 5 pounds or so since I started this diet. I'll be one fit dude with a terrible disorder once this is over
Good luck DA.
I'm lucky enough that I have nothing serious with me or my wife. Only slight annoyance once in a while.
I know I do not eat healthy enough, but no major side-effects (yet).
I'm lucky enough that I have nothing serious with me or my wife. Only slight annoyance once in a while.
I know I do not eat healthy enough, but no major side-effects (yet).
Thrasher
Wheeee!
I have a related condition Dart. Some sort of acidic stomach and reflux issue with symptoms that sometime feel like a heart sttack or just burpy heartburn. Easy solution for me is to take a Pepcid AC generic.
N
NewDArt
Guest
I'm considering some kind of antacid, but it seems they're not as effective against LPR, because it's not actually the regurgitation or "acid damage" that's causing my problems. It's more minor "splashes" and specifically the digestive enzymes (called Pepsin) that have caused damage to my throat. Supposedly, it can happen in aerosol form too - meaning even with very low stomach acid, it will still happen - and it will keep irritating my throat.
Hopefully, I've managed to stop the damage by realising this and minimizing the reflux. My hope is that the damage will eventually heal - and maybe I can steer clear of further problems by managing my diet.
I could reduce the acid in my stomach and perhaps reduce the issue somewhat, but that's supposed to be quite unhealthy at length - and I don't want to deal with other related problems later on.
What I don't quite understand is how "normal" GERD with real acid regurgitation and heartburn doesn't cause LPR symptoms. I mean, if acid actually enters the esophagus like that - then one would assume the digestive enzymes would be much more prone to reach the throat. I guess, for LPR victims, it's the upper esophageal sphincter that's allowing for it to happen.
It's some weird shit.
I'm glad you were able to find something useful in all this Dart. I still would highly recommend seeing a gastro specialist to be sure that all avenues are taken care of. In a small percentage of those with GERD, the scaring in the esophagus can increase the risk of cancer in that area. Only an endoscopy with biopsy can give you a proper diagnosis of this, and there could possibly be other silent issues forming (not to scare you, as this is a small percentage).
My individual case, GERD resulted in what's called a Schatzki Ring. Over time, acid that I couldn't feel would rise up and cause a ring of scaring in the esophagus, eventually narrowing the passageway after a few layers. This made it so I couldn't swallow certain foods properly (had to drink water with my food). I went for a long time unchecked because I had no GERD symptoms, so I just assumed this was a normal and I just wasn't chewing properly (that and I just had ortho work done, so I assumed it had to do with my new bite). Then one day I swallowed some chicken, and it stuck there for hours before it went down. They just did an xray with a barium swallow and found nothing. So they didn't pursue it. Finally when I changed doctors, she did some digging and couldn't believe I hadn't been to a gastro yet. Finally did some tests, went on PPIs for a while and things were ok temporarily. Then I went off them about 6 months later and the issues came back. Even one point where I was in the hospital and needed a probe in my throat because of a piece of steak that wouldn't budge. He was able to fix some of the ring scaring at that time too. After being on a diet now for a while and paying attention to my chewed food, I haven't had an issue in a few years.
One thing my gastro doctor pointed out to me, is that in his experience, everyone is different. He gave my a list of 4 types of food to stay away from which was:
-Dairy
-Soy
and 2 others I can't remember. And the reason why is that right after he told me that the list keeps changing, and everyone stomach has a different composition of enzymes and a different metabolism, so it might be trial and error (he was instantly accommodating of the fact that I wanted to fix this with diet rather than drugs, even though he never mentioned it, until I asked).
What i've noticed personally, is that fatty foods have no impact on me. And by this I mean healthy fatty foods (avocado, olive oil, eggs, chicken with the skin on it, fish, nuts, cheese, whipped cream, high fat unsweetened yogurt which is almost impossible to find these days, even fatty meat cuts). Even spicy foods are fine, unsweetened soy was fine. My problem foods were wheat (especially pasta, or white flour products like bread/buns/donuts/muffins/cookies), Caffeine and coffee as you mentioned. Surprisingly, while I can't tolerate milk in pretty much any form (except small amounts of buttermilk and eggnog), i'm completely fine with cheese, sour cream, heavy whip cream and butter. Most things deep-fried are a no-no, like fries, chips, (and i'm going to miss deep fried Oreos and Twinkies), although deep fried chicken/turkey is fine if it isn't too breaded. Chocolate is ok but only if it's dark and the 70% cocoa variety. Rice seems to be fine, especially the long grain variety. Oatmeal is ok. Tropical and Citrus fruits I have an issue with in large amounts. I thought i'd share in case this gives you a roadmap for your diet experimentation.
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