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Old 04-20-2013, 04:40 PM
 
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Quote:
Originally Posted by bluedevilz View Post
There are valid reasons for getting a COMPLETE medical history from patients no matter what the presenting problem and it doesn't just have to do with medications and their interactions...
This thread is specifically about disclosing mental health issues. Many doctors discriminate against people with mental health issues and easily disregard their physical symptoms and illnesses as "all in their head." If the patient isn't on medication, there are limited reasons for a medical doctor to be informed of current or past mental health issues unless they are relevant. Patients who would question if it's relevant are more likely to be more informed about medical issues than the general public.

Doctors today are blessed and cursed with very educated patients who actively participate in their diagnosis. As a matter of fact, a good percentage of patients wouldn't quickly be diagnosed if they weren't involved in their diagnosis. I'm fortunate to have a doctor that appreciated my research when I finally decided I needed to figure out what was wrong with me. I ultimately found my own diagnosis of a B-12 deficiency. He merely confirmed it via tests. If I had not become involved in the research, I might not have ever been diagnosed.

This is how mental illness can hinder a diagnosis. 10 years prior to our figuring out I had a B-12 deficiency, I went to the very same doctor for fatigue. He told me I was depressed (based on the fact that I had been diagnosed with depression in the past). That lead me to a few years of antidepressants even though I knew darn well I wasn't depressed. I wasn't sad about anything but not having energy. One morning, I was standing in my living room, having a conversation with my husband, I was the one talking, and I fell asleep. Standing. Talking. Fell asleep. In the morning, after a whole night's sleep.

We figured out after-the-fact that I've had this deficiency my entire life. My mother used to drag me off to the doctor to have my iron levels checked when I was a child and teen. My iron always came out high. Nobody ever checked my B-12. My "depressions" weren't depressions at all. But seeing a past diagnosis of depression made it easy for doctors to assume I was depressed. I was even diagnosed as dysthymic after this went on for decades. I ended up with permanent neurological damage that wasn't able to be reversed because this deficiency went untreated for so long.

Nobody will ever convince me that a medical doctor needs to know past history of mental illness. It's only relevant if it's current and it could possibly be a symptom. If someone has something wrong with their kidneys, it's not relevant to that diagnosis, nor the treatment if the person isn't on medication.
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Old 04-20-2013, 04:47 PM
 
Location: Lake Station, IN
96 posts, read 250,309 times
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Quote:
Originally Posted by 20yrsinBranson View Post
Doctors ask all these questions to cover themselves from future malpractice litigation. Nothing is worse than being on a witness stand and having someone ask you a question about a patient and you have no knowledge of the condition. It makes you look inept and incompetent. So they try to find out as much as possible about you.

If you feel that it does not impact your kidney health at all, I would not mention it. But that is just me.

20yrsinBranson
Not good advice. A good nephrologist (kidney doc) will want to know all aspects of your health including mental. OP didn't say why they were seeing a neph but generally they deal with kidney disease which eventually leads to kidney failure.

There are 5 stages of kidney failure. Stage 1 being the beginning stage with hardly any symptoms and stage 5 being ESRD (End Stage Renal Disease) meaning dialysis or transplant. The worse your kidneys get, the more it might affect you mentally. Almost every patient that starts dialysis or even finds out they will need it soon will end up developing depression. Meds that help slow down progression of kidney failure may interact negatively with other meds. When your kidneys aren't functioning properly, you may have electrolyte imbalance which will affect you mentally. Some meds, whether prescription or OTC, may hurt your kidneys even more.

It's not enough to just tell the neph what meds you take. Yeah they can look up the meds to find out what they are for but many are for more than one thing. Different mental problems may be affected differently by kidney problems. Tell the neph exactly what your health issues are including mental.

I never knew exactly how much work the kidneys do for different areas of your body until my husband was told he had kidney failure. 4 1/2 years of dialysis and I see how it affects him mentally plus all the other patients at the clinic he goes to.
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Old 04-20-2013, 04:57 PM
 
43,012 posts, read 83,590,205 times
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Quote:
Originally Posted by amberlina26 View Post
Not good advice. A good nephrologist (kidney doc) will want to know all aspects of your health including mental.
Moderator cut: rude

Quote:
Originally Posted by amberlina26 View Post
Meds that help slow down progression of kidney failure may interact negatively with other meds.
Nobody said patients shouldn't disclose medications.

Quote:
Originally Posted by amberlina26 View Post
Different mental problems may be affected differently by kidney problems. Tell the neph exactly what your health issues are including mental.

I never knew exactly how much work the kidneys do for different areas of your body until my husband was told he had kidney failure. 4 1/2 years of dialysis and I see how it affects him mentally plus all the other patients at the clinic he goes to.
That's different. That's a mental symptom that results from the physical illness and treatment.

Mental health, depression, and anxiety in ... [Iran J Kidney Dis. 2010] - PubMed - NCBI

Since it is heavily related to kidney disease and treatment, "a good nephrologist" will take the time to talk to patients and educate them about this instead of just having a box to be checked on an intake form.

Last edited by SouthernBelleInUtah; 04-20-2013 at 06:07 PM..
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Old 04-20-2013, 05:46 PM
 
Location: In a house
13,263 posts, read 32,182,843 times
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Quote:
Originally Posted by Hopes View Post
Moderator cut: rude

Nobody said patients shouldn't disclose medications.


That's different. That's a mental symptom that results from the physical illness and treatment.

Mental health, depression, and anxiety in ... [Iran J Kidney Dis. 2010] - PubMed - NCBI

Since it is heavily related to kidney disease and treatment, "a good nephrologist" will take the time to talk to patients and educate them about this instead of just having a box to be checked on an intake form.
Thing is, Hopes, a holistic approach to medicine would include mental health, and never automatically rule out the possibility the mental problems and physical problems might be significantly connected. So it's important for a doctor to know both. At least one who is more concerned about treating the whole patient, rather than just medicating individual symptoms.

If I go in for a stomach ache, and it turns out I've also been suffering from lethargy and depression, there's a distinct possibility that the two might be related to a blood disorder. But the doctor wouldn't think to test for that blood disorder, unless he knew that all those symptoms were present.

Often, mental disorders DO correlate with physical disorders. Sometimes, one isn't even an actual disorder, but rather, a symptom of something else. Such as the situation with the friend I've posted about a couple of times on CD - he was diagnosed at the time with schizophrenia and multiple personality disorder. He ALSO craved milk.

Now you might think this is just a mental problem.

Until you learn he was allergic to ALL milk (not just cow milk) when he was born, and no one knew that, and he was breastfed, and it caused damage to his brain. He continued to be fed milk as a kid, and no one knew to put "drinking a glass of milk" and "having a multiple personality attack" together and realize the two were very profoundly related to each other.

So they medicated him, but still didn't take him off dairy.

Once he got older, his family realized the error and took him off all dairy products. He still had to be medicated for the rest of his life but wouldn't suffer allergic attacks the way he did when he was a kid. Unfortunately, sometimes he'd forget to take his meds, and he'd have dairy cravings, drink milk, and immediately disappear for up to a month, only to return with plastic bags on his feet and mumbling incessantly about how he's a member of the secret service protecting me from the commies. And - he would show up - armed with either a gun or a knife. Stark raving insane.

All because he had a physical problem (a pretty simple allergy to dairy) that manifested in a very scary, very dangerous psychiatric result.

No, this kind of thing isn't common. But it does happen. It is in the best interests of the patient AND the doctor for the doctor to have at least a listing of all the ailments and symptoms, and not merely the medications being taken. Especially since so many meds are taken off-label these days.

Last edited by SouthernBelleInUtah; 04-20-2013 at 06:08 PM..
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Old 04-20-2013, 06:13 PM
 
43,012 posts, read 83,590,205 times
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AnonChick, I'm well aware of how important it is for a doctor to see a whole picture.

I do not believe PAST mental illness diagnoses are relevant whatsoever in that overall view of a patient and can cause doctors to be prejudice when making a diagnosis.
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Old 04-20-2013, 06:21 PM
 
43,012 posts, read 83,590,205 times
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Quote:
Originally Posted by amberlina26 View Post
Yes it's a symptom but if you had problems before, they can be made worse. My husband went through depression a few years before he knew he had kidney problems. When he went on dialysis, it was a whole lot worse. His doc had warned about depression but because my stubborn husband never said he had already gone through it once, his doc didn't know he would need extra help dealing with it mentally. How about the new patient that no one was informed had ADHD, developed severe anxiety, and kept trying to get out of his chair and pull his own needles out. If you don't check that box on the intake form, how the heck is the doc supposed to know you might need extra help??? Or that the normal symptoms such as anxiety or depression might make your other mental problems worse?
My experience has been that very few medical professionals take it into consideration when they are treating patients, even then the patient tells and is begging for it to be taken into consideration.

I'll never forget when I had my son in the Children's Hospital emergency room because the doctor punctured his lung during a biopsy. My son had anxiety. We told them he had anxiety. He was having outright panic attacks because he was in pain and he couldn't breath. All I wanted was Benadryl for him. They blew it off until I decided I was transferring to another emergency room. If he didn't have a strong willed mother like me, he would have suffered endlessly, not just for a few hours. I've had better luck with dentists understanding my son's anxiety since many people have dental phobia. The best thing that ever happened was his turning 18 so he could be seen by my internist.

But now we're discussing current mental illnesses. That's a different ballgame because it can be a symptom, and it does need taken into consideration for treatment (even though many doctors don't).

What I'm opposing is the need to disclose past mental illnesses because they aren't relevant if they're not current.

Last edited by Hopes; 04-20-2013 at 06:36 PM..
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Old 04-20-2013, 06:27 PM
 
Location: In a house
13,263 posts, read 32,182,843 times
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Quote:
Originally Posted by Hopes View Post
AnonChick, I'm well aware of how important it is for a doctor to see a whole picture.

I do not believe PAST mental illness diagnoses are relevant whatsoever in that overall view of a patient and can cause doctors to be prejudice when making a diagnosis.
Ah okay I get that. If you have "a history" of mental illness, that isn't the same as "a past diagnoses." A history would be if you have, and have had, diagnoses of mental ilness for a long time. Not just once 20 years ago and you were treated and the problem is over. It would be like - someone having a history of quitting jobs. Yes, they did quit their first job 20 years ago. And that is definitely "past" and not relevant to looking for a job today. But they ALSO quit their 3rd job, and their 5th job, and their 9th job, and their 12th job, and now they're trying to get job #15. Past history is the best predictor of future behavior.

But yes I totally agree with you that a previous experience with mental illness (such as post-partem depression when you had your 1st baby back in the 1990's and that kid is now in college and you clearly have recovered from it by now, and have had two more kids without any mental strain at all) - should have no relevence to a current medical visit at all, unless there is a repeating pattern of mental illnesses (even if they all come with different diagnoses).
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Old 04-20-2013, 09:25 PM
 
219 posts, read 230,778 times
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Quote:
Originally Posted by Hopes View Post
My experience has been that very few medical professionals take it into consideration when they are treating patients, even then the patient tells and is begging for it to be taken into consideration.

I'll never forget when I had my son in the Children's Hospital emergency room because the doctor punctured his lung during a biopsy. My son had anxiety. We told them he had anxiety. He was having outright panic attacks because he was in pain and he couldn't breath. All I wanted was Benadryl for him. They blew it off until I decided I was transferring to another emergency room. If he didn't have a strong willed mother like me, he would have suffered endlessly, not just for a few hours. I've had better luck with dentists understanding my son's anxiety since many people have dental phobia. The best thing that ever happened was his turning 18 so he could be seen by my internist.

But now we're discussing current mental illnesses. That's a different ballgame because it can be a symptom, and it does need taken into consideration for treatment (even though many doctors don't).

What I'm opposing is the need to disclose past mental illnesses because they aren't relevant if they're not current.
Hopes, I am sorry that you have had such poor experiences with doctors and the medical establishment in general. You represent the type of patient that is incredibly difficult to deal with. You have lost faith in the medical profession and you are wary of placing trust in medical professionals. There is nothing worse than meeting someone for the first time who has already decided to hate you and everything that you stand for.

I am sure many can relate to this. Imagine trying to do your job when you have a client who comes in who has had nothing but bad experiences with your entire profession. They do not respect you or your field of work. You find out that they have been seen by all of your other colleagues and have fired all of them. This client has done their own "research" and has a "list of demands." They are openly hostile and they proceed to tell you exactly what you need to do. Anything you suggest is met with skepticism and oftentimes sharp criticism. You do your best to help this person and you do everything in earnest to help this person. But at the end of the day, this person leaves your office still hating you and unappreciative of anything that you have done for them..

It sounds like you had a problem with several doctors who you feel missed your diagnosis and that has made you wary of the medical profession in general. You must remember that doctors are human beings as well. Medicine is not infallible and doctors make mistakes. If something has been missed by several doctors yes there may be an issue with the doctors, but there may even be issue with the nature of the disease itself.

Last edited by Swack; 04-20-2013 at 09:35 PM.. Reason: name correction
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Old 04-20-2013, 09:33 PM
 
219 posts, read 230,778 times
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Quote:
Originally Posted by Hopes View Post
AnonChick, I'm well aware of how important it is for a doctor to see a whole picture.

I do not believe PAST mental illness diagnoses are relevant whatsoever in that overall view of a patient and can cause doctors to be prejudice when making a diagnosis.
Hopes, diagnoses of past mental illnesses are still relevant to the whole medical picture. Say the OP was diagnosed with bipolar disorder in the past and this diagnosis was later corrected, however the OP received lithium for several months. This information may be critical because lithium is kidney-toxic and the OP may have suffered permanent kidney damage from it's use.
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Old 04-20-2013, 11:45 PM
 
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Originally Posted by Hopes View Post
What's CTA?
Cover Their Ass
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