medical ignorance

My Doctor Is an Expert

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He knows there may be other, better and much more likely explanations for my hair loss, my low body temperature, my inability to lose weight, low blood pressure, skin problems, mood swings, low T3/high rT3, iodine deficiency, brittle nails, memory loss, migraines, excessive ear wax, fatigue, carpal tunnel, allergies, lichen sclerosis, elevated LDL, low ferritin, insomnia, DHEA deficiency, erratic cortisol, PMDD, estrogen dominance, PCOS, obesity, vision problems, vertigo, tinnitus, moles, hemorrhoids, constant nausea, menorrhagia, loss of libido, coital pain, inability to labor, long gestation, high birth weight, baby with developmental delays, kidney cysts, cervical cancer, hypoglycemia etc. etc. etc. than a malfunctioning thyroid. He knows this, because he is an expert.

Yes, he is an expert in explaining why all these clinical signs and symptoms are present – and actually normal! According to him, one single cause cannot be at the root of them all. Even if there was a single cause, the thyroid hormone deficiency that I insist I have cannot – CANNOT – be it! Not even with my significantly iodine deficient status now, always and in utero. No. That doesn’t explain a thing.

“Is there anything you DON’T attribute to iodine deficiency???!” he asked with little effort to hide his expertise.

He suggests I am depressed and prescribes antidepressants. Yes, of course, why didn’t I think of that? I need antidepressants.

Antidepressants will cure it all. Even, I suppose, the iodine deficiency? And antidepressants will make my body hair grow back right?  – I’ll not shave!

When I lost all my body hair, my doctor suggested this was an advantage, as many women would be delighted to be spared having to shave or wax. Yes, of course, I did a little (imaginary) happy dance around his office when he pointed out my bit of luck. In fact, I was so overcome with gratitude, I plain forgot that having hair might help me keep warm, as I am always frightfully cold.

The Brain Blind Spot – Where Hysteria Rules

I have come to the conclusion that modern medicine must be based on a theory of a Brain Blind Spot. This is the spot in your brain where your Imagined Symptoms and Inexplicable Clinical and Biochemical Signs that Will Not be Diagnosed originate. Since these symptoms affect mainly women, it is likely that the Blind Spot is governed by Hysteria – you know – Greek for Womb Related.

The Brain Blind Spot is 100% unaffected by what goes on in the body, otherwise, blood tests would pick up on it. Basically, the Brain Blind Spot produces pain, fatigue, depression and other spurious ails by itself and for no discernible reason. Luckily, there is one magic pill option; the one medicine, that can enter into the Brain Blind Spot and work its magic. It’s called an antidepressant. Antidepressants are apparently the only medication to reach the Brain Blind Spot.

TSH AKA Truly She’s Hysteric

So, when the TSH (aka Truly She’s Hysteric) test falls within range, it is a sure sign that antidepressants are the path to take. Perhaps also weight loss and exercise, which are the other two tools in the expert doctor’s tool box. And these must be insisted upon even if the patient claims she “eats healthily and exercised regularly until crippled by her condition” – because we ALL know, we ALL sin. Until that last bit of chocolate is eliminated from our diets, we cannot claim to be truly healthy.

As an example, I shall again use myself. My doctor, who is an expert, suggested I eat less and exercise more. He’s right, of course. No one weighs more than their calorie intake allows. I just didn’t realize it was considered “normal” as he said, to weigh 84 kg (that’s 185 pounds for you Westerners) on a strict 1200 calorie a day diet. A diet, which is of course low GI, sugar free, organic, gluten free and generally really antisocial and – well – hysteric in the eyes of most people I know

He has two theories, which he has shared with me. First, he suggested that I was lying. This is, of course, the most plausible theory. Because if it were true that I am sustaining obesity on 1200 calories a day, it would suggest there was something awry with my metabolism, which according to the doctor there is not. However, rather crazily, I have actually kept a diary on sparkpeople.com of everything I have eaten since January 2009. I have weighed every morsel and ounce on my trusty kitchen scales and meticulously input it on the computer every day.  I can document an average daily calorie intake of 1200. I told him that. I even offered him a printout of the entire 1762 days so he could see exactly what I’d been eating. He declined, and instead, offered another expert opinion: The 84 kilo is a normal weight for someone eating 1200 calories because how much we can eat depends largely on our activity level. So he concluded I must just be really, really inactive.

I should perhaps mention here that I actually walked from my car and to the doctor’s office myself. He didn’t come to my house. I am not bed bound. I still work, have three children, a husband, a home and a pretty normal daily life

In fact, reading on the side of pretty much every packaged food product I have in my house, a “normal” woman should be able to eat 2000 calories a day. Food manufacturers, gyms and government officials that stipulate guidelines are not experts and guidelines are just guidelines. Not facts based on expertise. This is evident. Because according to their calculations, I should be half the weight I am if I were to maintain my weight on 1200 calories.

Did I mention I’m also breastfeeding?

No?

Don’t get me wrong. Although it would be nice to be slimmer, I am not vain. This is not vanity. I simply resent the assumption I meet from the broad public that I must be eating more than the 2000 calories that packaging and national guidelines propose is maintenance sustenance for me at my age, body weight and activity level. Otherwise, I would be slim. That’s the rule. You eat more than “normal” therefore you are overweight. Well, I don’t. And I am.

Luckily, my doctor now agrees. The guidelines are wrong. Calorie needs are individual, he reassures me. My inability to lose weight signifies nothing. He is, after all, the expert. Yet again, he manages to reassure me: There’s nothing abnormal in my weight versus calorie intake.

Of Dragon Tales and Beauty Products

Nor is there anything wrong with my resting pulse of 34. Or my dragon scaled legs. My son actually believed me when I claimed I had come out of a dragon’s egg. Okay, he’s nearly six years old now and has stopped believing it, but I did go through a phase of extreme temper outbursts, so with the coarse, wiry hair and the scaly legs, I couldn’t really blame him.

My doctor says I need better beauty products. You know, shampoo and moisturizers. My mum tells me she was told the same when I was a baby with scaly legs. No baby soft skin on me, so perhaps I did come from a dragon’s egg after all – a dragon that never bothered investing in some really good beauty products.

And What Do the Signs Say?

When I first presented my symptoms to my doctor, I thought the 1200 calorie a day diet, the hair loss, the pulse, the scaly legs and so much else on my list were actually “clinical signs”. My doctor says they’re not. It’s only a clinical sign if it can be verified by him, the expert.

It took me a while, actually, to realize the difference – in doctor speak – between clinical signs, biochemical signs and symptoms.

A clinical sign is one that the doctor can subjectively determine. You know, like a goiter. A biochemical sign is blood, urine, saliva, poo and other bodily excretions tested against laboratory standards, like the Truly She’s Hysteric test (Gold Standard, I hear). The symptoms are how you feel. The debilitating reality of your life that the doctor can’t see, the blood doesn’t tell and which can therefore be brushed aside, ridiculed and given spurious labels and diagnosis depending on the level of expertise of your doctor. Of course, my doctor must prioritize signs over symptoms. It is, after all, more important what he sees, than how I feel. My Brain Blind Spot is playing tricks on me again. I understand that now.

Anyway, enough about me and my symptoms. I’m just so relieved it’s not my thyroid. I hear that thing is a bitch to get right, so it’s nice my symptoms are not thyroid related and can be sorted with antidepressants.

YAY for antidepressants! Three cheers for the cure-all! Hurray for my expert doctor!

Did I mention, antidepressants cause weight gain? Maybe, he forgot about that.

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13 Comments

  1. As far as I’m concerned, I’ve yet to meet, nor encounter through the internet, medical journals or articles a “Doctor” that’s not an expert. They’re not interested in you being well, they’re interested in a lifelong, profitable sick patient. The Art of medicine has been reduced to illegible scribbles on a notepad for an overbloated cost.

  2. Joan,

    That’s a brilliant blog. Your doctor expert is suffering hyper ego syndrome IMO. He certainly is not going to get you well.

    Have you considered self-medicating? Thyroxine, Liothyronine and NDT are readily available on-line, affordable and it is legal to import them into UK.

    Patient advocate sites like ThyroidUK advise working with medical professionals but offer support and advise when that isn’t possible.

  3. Been there!! Just weaned my son. Felt like garbage. Slow, sluggish, began to live on coffee and sugar. Gained 15 pounds in one month. My skin was dryer than the Sahara Desert with cracks that resembled canyons. Sex?? Forget it! I had absolutly no interest and had a hard time remembering why we ever did it in the first place. Brain fog. Offered antidepressants more times than I can count. Never went back to any doctor who said I was just nuts. TSH kept coming in at 5 and 6. I finally did some research on my own and found that the American Academy of Endocrinologists had determined anything over 3 on the TSH test was suspect for hypothyroid. Had just started with a new doc. Shoed him the information and asked if I could just try some thyroid medication under his supervision? He agreed as long as I came in regular for lab work. Within 2 weeks the brain fog began to lift and I began to sleep through the night. My skin became smooth and supple – no sign of the cracks. My husband started to look interesting again. The doc was astonished at how much improvement there had been!! Took about a year to get stabilized on thyroid meds, but I had my life back! Find a new doctor anyway you can!!!!!

  4. Thank you for all your comments.

    This commentary is actually a summary of all my National Health Service doctors over the years – in the UK as well as in Denmark, where I live now. I have long embarked on a journey to find a private doctor, who can and will help me.

    I’m doing 99% of the work myself – I “only” need the last 1%. I am a firm believer in self care and responsibility for my own health (not guilt, though. Never guilt!). But the final 1% eludes me still and the bank balance is suffering greatly.

    There are no insurance company to cover part of the cost and I’m having to travel abroad for help.

    It shouldn’t have to be like this and I feel desperately sorry for all the women (and men) who have “expert doctors” and a diagnoses of Truly She’s Hysteric and believe it to be true and go — or who can’t afford to go looking and haven’t the support I have from friends, family and work. And you! 😉 x

  5. Joan, Thank You for this article. I do agree with the majority…..find yourself a new doctor….preferably an herbalist or naturopathic doctor. You must be treated on a nutritional basis in order to correct your obvious endocrine imbalances. Physician’s over prescribed the use of antidepressants for young and old women in the US also. This does NOT address the cause of imbalance. I hope that you find the assistance you need.

  6. I too would advise her to “fire” that doctor however, she appears to live in the UK where she doesn’t get to see her choice of doctors…she gets who she gets. I agree, fire that doctor and MOVE to someplace where you have a choice…

  7. Thank you for this article – a dash of humor helps when dealing with the pain! By the way, the tests that are traditionally run have far too wide a range! Fire that doctor and find now with a bit more compassion!

  8. Please fire this doctor!!! I have fired too many to count. I refuse to be treated as you have. I will hold out a few visits, but that’s it. If the doctor doesn’t turn it around by then, he/she is fired! I am treated like you describe all the time for my many ailments. I nearly died two years ago because a doctor refused to test me for Sphincter of Oddi Dysfunction, allowing me to get down to 90 lbs, barely any blood pressure, fainting all the time, etc. He insisted I was anorexic or bulimic (by the way I LOVE food and despise puking), had post partum depression, and was an alcoholic drug addict (I made the mistake of disclosing I quit drinking and “partying” 15 years and had been clean and sober ever since). We MUST start a page or organization dedicated to these loser egotistical docs who treat us like crap. In closing, I hope you run from this doctor and at lightening speed. Throw in a report to the state health department while you’re at it for medical neglect. I’m working on a few of those myself. Hugs!

  9. Oh I love this article.
    The worse I encountered – when i was hyperthyroid (i have hashimotos and we didn’t know that then – i was getting medicine to treat hypothyroidism at the time – my Truly She’s Hysteric (TSH) levels were very low, I lost a lot of weight, I had vision/eye sight problems, tachycardia… etc ) – and the high level ‘expert’ doctor I saw suggested, before running any tests, that maybe you know, I wasn’t having enough sex because one must have sex everyday , and – of course as we all know don’t we – that this must be the source of imbalance and health problems I encountered, and that it was probably all in my mind, as he insisted he relies on first impressions, obviously I had an overly active mind. Yes hysteria. He was also all too keen on knowing whether I could climax or not. Truly hysterical. I really don’t understand how my sexual life relates to the hyperthyroid episode i was going through. We need better doctors! And yes, second opinions, third opinions, fourth opinions etc are to be sought. I distrust MDs (sorry to those MDs out there that are good, and I am sure there are a number of you who are good doctors).

  10. I don’t know what supplements you take. Besides why the doctor is talking about you appear to have some great symptoms for dysautonomia disorders as well as metabolic issues and another possible muscle amino acid deficiency that can cause coital pain, loss of memory, thyroid issues and more. Some of this could also be considered mito related as well as another skin muscle disorder. IMHO your doctor has a limited scope of education and you may need to repackage your issues and find a a specialist.

  11. I have not got much faith in Doctor’s….as long as it is nothing serious you will be OK. I was seen by two different NHS gynaecologists in the UK in the year before I was diagnosed with cervical cancer and they both sad I was fine and all was good and it was probably the HRT that was causing me problems I explained I had had Parathyroid Disease and just had an operation and that my endocrine system was out of whack. All they said was perhaps some antidepressants might also help my mood as at my age a low mood was quite common. I was only low because I felt unwell. I wasn’t unhappy. I eventually went to see a Professor who was an expert on women’s health who said straight away he needed to do tests as he believed something was wrong! How many Doctor’s do you need to see before you get the correct diagnosis?? in my case 3!

  12. I love this piece. Thanks for sharing and for bringing awareness to the diagnostic laziness and delusional expectations for resolution of symptoms that the antidepressant prescribing represents.

  13. Great article! I love the snarky, but not mean, tone! Well done! I too, along with thousands of other people suffering from fluoroquinolone toxicity (an adverse reaction to Cipro, Levaquin, Avelox or another fluoroquinolone antibiotic), have run into the attitude among medical professionals of, “if it can’t be verified with a test, and if there’s no specific diagnosis – if it can’t be fixed – then it doesn’t exist.” It is beyond frustrating. What matters is how we feel and a test that comes out “normal” does not mean that I feel normal, thank you very much. Yes, the failure of their tests makes them feel impotent, but maybe they should take a viagra – for their impotence – and listen to their patients. We know our bodies better than the tests ever will. I hope that you find healing for all that ails you. I’m so sorry that the medical system that is supposed to be of service has failed to recognize that you even have a problem.

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