Disease was once thought to be due to sin. We now know more, but not enough.
By Paul Goldfinger, MD, FACC. Editor Blogfinger.net
Most people have high hopes when they go to a doctor with a problem. They want to believe that their physician will do some tests, find out what’s wrong, and then fix the situation. That is usually what happens.
However doctors sometimes do not recognize their own limitations. They may not like to admit to themselves or to patients that they do not know what’s wrong and what to do. The fact is that there is much that doctors do not know and there is much that they do which is unproven.
Sometimes a physician will suggest a second opinion. That is always a good idea, but the patient should go to someone who is a known authority in the field, even if it means a trip into New York or Philadelphia. Seeing a real expert may help put a halt to doctor-shopping.
But what happens when no doctor knows the answer no matter how many you consult? What happens when a situation hits the wall of the unknown?
There is a parallel universe where people live with persistent symptoms despite the best efforts of doctors. I know someone who has chronic vertigo. He has seen multiple specialists in New York City and has had every possible test for this condition. No diagnosis or effective treatment has been found. The patient is still dizzy. He has been seen by professors without answers as well as charlatans who waste his time and money.
He makes the best of it, but he keeps looking for another doctor who might help.
He scours the internet for solutions, and that can lead him into a morass of expensive unproven snake oil or nutritional remedies. Some are drawn to a world of ancient remedies such as my friend found in Chinatown. (NYC).
Most everybody has some physical complaint that bothers them, and if there is no definite diagnosis, then usually there is no specific treatment. So they try to get by, one way or another, often accompanied by arbitrary diagnoses and therapies.
Some get conventional care from their doctors which might be tried on a trial basis, while others resort to alternative therapies and OTC medications. The FDA has no control over OTC medicines.
Before giving up, the patient and his doctor must review what he is taking: side effects of all therapies must be reviewed along with monitoring for drug interactions.
Many simply accept their fate and lead their lives without further tinkering by the medical establishment.
But the ones who keep bouncing around from doctor to doctor, without diagnostic or therapeutic success, are the ones who need the most guidance from the medical profession.
Physicians sometimes need to stop snowballing tests, opinions, and treatments. A primary physician who is doing his job properly will monitor what his patient is doing on his own.
Stopping means to admit that the patient’s problem cannot be solved, so the doctor needs to shift gears and focus on attentive and supportive symptom relief. It’s difficult to judge when that time has come. It has to be a decision made by the doctor and his patient. But once the decision is made, the physician should continue to follow the patient, because you never know when an answer might appear.
A friend of mine was suffering from recurrent hives. (itchy skin bumps). His doctor couldn’t figure it out, so my friend was resigned to the situation.
I asked him about his diet and his meds , because allergic reactions can cause hives. He was taking a drug to help him urinate. I suggested he stop it on a trial basis, but he said, “No. It can’t be that because I have been taking it for 5 years without any problems.”
I said, “Sometimes an allergic side effect to meds can appear after a long time without hives.” So he stopped the drug and he was cured.” Doctors should never give up.
“High Hopes:’