Of course, don't let them confuse you. If your arms and legs aren't showing their usual strength and mobility like they used to, what exactly is he trying to claim? The fact that a diagnosis might be temporary doesn't change much—it's still a description of the state of your brain. Regardless, if your leg feels weak, there’s usually a specific term for it, like paresis, though I won't go Googling right now to make sure I'm using the exact right word.
Are you out on medical leave? If you're on leave or simply unable to work due to disability, and your job requires you to be mobile on your feet, then there is definitely some rehabilitation to be done. If the doctor starts getting philosophical with you, just remind him about your patient rights regarding that phone of yours.
As for this "temporary" diagnosis, looking at how these things are categorized lately, they all seem to boil down to the same thing, and as you can see, the symptoms remain identical. It really just comes down to how things progress from here. I'm keeping my fingers crossed for you that things stabilize.
When I had my first episode, nobody even mentioned the possibility of MS, and it didn't even cross my mind because it was centered around my eye. A year later, I had a second one. That's when they ran an MRI, which showed demyelination. I didn't bother with any more tests back then because, just like the first time, everything seemed to resolve on its own—even though I did agree to the steroid pulse therapy just to be safe.
Six months later, during a checkup with a private neurologist, everything looked perfect. He reviewed the results and told me not to stress about it, to just live life normally, take some vitamins, and come back in a year for a follow-up MRI.
However, when that new scan showed things had worsened, he sent me straight to the Mayo Clinic for the remaining tests, and that was finally when the diagnosis was confirmed—two and a half years after my very first symptom appeared.
The passage of time is such a critical factor in establishing a diagnosis; unfortunately, you can't rush it. Or perhaps, you're lucky you can't. 😉
So, there's an official diagnosis: G37.9 Demyelinating disease of the central nervous system, unspecified. Isn't that a legitimate diagnosis? Once you include the physical symptoms, shouldn't a doctor be able to use that to write a referral for a physiatrist and physical therapy?
Alright, would you mind sharing the specific diagnosis you were released under? Even just the code would be helpful. Maybe it was CIS? Generally speaking, I’ve seen cases where people were diagnosed with MS despite having clear spinal fluid results; usually, if there's any doubt, doctors insist on continuous neurological monitoring.
What kind of follow-up or recommendations did they give you?
If those demyelinating lesions you mentioned are present, they’re actually one of the primary markers used to diagnose MS. However, doctors also look at other specific criteria to confirm everything—things like lumbar puncture results, VEP tests, and certain subjective symptoms (by the way, all the ones you described are common in MS cases). Crucially, the involvement usually needs to span at least two different bodily systems.
What was the provisional diagnosis they gave you, and what specific findings did they use to officially rule out MS? I ask because, in the early stages, doctors often issue a temporary diagnosis that actually carries the exact same code as MS: disseminated encephalomyelitis (G35). It’s treated and managed just the same way, but it isn't considered "definitive" until something else happens—like a secondary flare-up or seeing how those lesions progress over time and space.
In any case, even if a diagnosis isn't set in stone yet, once neurological symptoms show up, the standard protocol is usually a short but intense burst of corticosteroids (typically about 3-5 days), which is known as pulse therapy.
Regardless of the specifics, there's no way they could have just discharged you from the hospital without providing follow-up instructions, recommendations, or some form of a treatment plan.
Nancy Ortiz42 said:1. Actually, true psychotherapy is incredibly draining for the therapist; seeing more than two patients a day doesn't result in high-quality therapy (again, we are talking about ideal conditions here). Anyone saying otherwise clearly doesn't grasp what psychotherapy really entails.
2. I am speaking about the general consensus among therapists. I personally know enough professionals to stand firmly behind my words.
4. Normabel, Apaurin, Valium... those are all just brand names for the exact same generic medication— diazepam. I used the brand names specifically so it would be clear which medication I was discussing. My point remains that diazepam should only be prescribed to pregnant women if there is a compelling, undeniable medical reason, not as a preventive measure (it’s certainly not "normal," routine, or standard practice, especially since a situation involving a threat of miscarriage isn't a "normal" situation). If you disagree, I can provide the full name of my pharmacology professor.
1. That's incorrect. The information I shared (4-6) comes from a psychiatrist-psychotherapist with nearly 30 years of experience—a chief physician who has worked both abroad and within our national healthcare system. He states this is the standard. Happy to provide his name upon request. 😉 Or are you suggesting that he doesn't understand psychotherapy? Also, your math doesn't quite add up because a therapy session doesn't last 2 hours; it's usually closer to 45-60 minutes:
2. "General opinion" is subjective. For instance, as someone who has been a long-term user of psychotherapy within the public system due to circumstances involving two different therapists, I hear the other side of the story too. And I'm not the only one—you aren't the only person who "knows enough" professionals. 😉 Yes, it's more lucrative to see private practitioners, and many people do move to private care, but there are also those who stay in the public system because they genuinely want to and love their providers—not just because they lack other options. We should be grateful to them for that.
3. I didn't actually say Normabel is given to pregnant women as a precaution; you either misunderstood me or I phrased it poorly. By "normal," I meant that it can be given if there is a specific medical indication. I didn't realize it was the same thing as Apaurin; that was my mistake.
Anyway, getting back to the main topic. I absolutely agree with the new, stricter regulations regarding prescription controls. Primarily because patients shouldn't have to guess what is safe to take, and self-medicating can often cause more harm than good. The fact that it has become common practice here for everyone to act as their own doctor or pharmacist is dangerous, and it was high time we brought some order to the situation.
Nancy Ortiz42 said:1 The public system is the way it is because most therapists should really only be seeing a maximum of two patients a day if they're doing actual psychotherapy to stay effective,
2 And let's face it, psychotherapy is the hardest part of the job. There’s this prevailing attitude that "no sane person would do this under government insurance; leave that to the private practices," mostly because in our healthcare system, quality therapy is treated like a luxury item.
3 It's also true that some psychiatrists take the path of least resistance, where they just hand out prescriptions left and right without much thought.
4 Your use of Xanax is extremely unlikely to cause a situation like this (that's basically the only "psychiatric" med that even pregnant women can be prescribed if absolutely necessary).
I think your post is fine and I agree with most of what you've said, but a few points aren't quite accurate or feel like a bit of an overgeneralization. Here is my take:
1 For psychotherapy, the ideal number of patients per day should actually be closer to 4-6, rather than just 2.
2 Contrary to what you mentioned, it isn't just a few "crazy people" working in the public sector; those dedicated professionals are actually concentrated (among other things) within specialized clinics focused specifically on psychotherapy. You can definitely receive high-quality psychotherapy through a standard medical referral.
3 While it might be true that some psychiatrists take the easy way out, you really can't claim that everyone does and just pushes pills on every patient. Personally, I know plenty of people—myself included—who attend regular therapy sessions and have never been prescribed a single pill.
4 That's not quite right; the medication typically prescribed to pregnant women is Normabell. It helps calm things down and reduces the risk of premature contractions or miscarriage.
But there is another issue here that really stands out, and that is how much you are neglecting your own health. Engaging in unprotected sex, or giving oral to a guy when you already have doubts about his status—all while staying quiet just so HE doesn't get nervous because he's "shy"—is incredibly risky. You’re continuing to provide these "services" even when you notice something looks off*.
Dear, if you keep going down this path, you’re eventually going to end up passing something like herpes to someone else.
Basically, smart people understand the purpose of a condom. Even smarter people know they need to have an open, honest conversation with their partner before getting intimate, and ideally, both parties should get tested and cleared before anything happens.
*And are you aware that some infections aren't even visible, like HPV? That can actually lead to cancer. Or how certain bacteria might be invisible but can still cause infertility? So many women today are dealing with HPV and various other infections, and so many couples struggle to conceive simply because they were young, reckless, and too shy to speak up, only to realize it was too late later on.
Exactly. It’s incredibly difficult to pin down a diagnosis based on just one isolated symptom. Take Multiple Sclerosis, for example—even specialists can struggle to get a clear answer for years. It feels wrong when people try to scare everyone by suggesting every single minor symptom is definitely MS. Where does it end? For instance, if someone feels dizzy, there are dozens of potential culprits: high blood pressure, inner ear issues, poor circulation, anxiety, or indeed, MS. Or take numbness in your limbs; that could stem from circulatory problems, spinal issues, an old injury, anxiety, or yes, MS. Even shoulder pain could be anything from a simple strain or inflammation to rheumatism, neuralgia, or—in the case of certain political figures like Clinton—something much more serious like cancer. Imagine if someone typed "shoulder pain" into one of those online diagnostic tools and it immediately flashed "cancer" at them...
Actually, I have a few ideas on how to make those tools more effective. You should input your symptoms, but then the tool should ask you follow-up questions to narrow things down. That would be much more useful!
It’s entirely possible they intentionally left out the heavy-hitting diagnoses just to prevent people from turning into massive hypochondriacs. I’d bet that if you select symptoms like "tingling in your hands or feet," it won't suddenly flag Multiple Sclerosis. It’s probably not programmed to trigger anything like cancer or other serious conditions either. But then again, if it avoids all the major stuff, what is the actual point of this "diagnostic" tool?
The thought process is to create a dedicated space for the health anxious—you know, those people who are convinced they’ve caught something serious before they've even seen a doctor, or even after a physician tells them they're fine but they just can't quite wrap their heads around it. It would basically be their own little corner, which prevents them from cluttering up the main boards with threads about things like lupus or MS. As long as everyone plays by the house rules and follows the community guidelines, anyone should be able to post there, right?😛
And honestly, I want to help break the stigma around this. Even with my own (unfortunately) confirmed medical issues, I still find myself spiraling into hypochondria from time to time. So, there it is. Next topic!
Honestly, the internet is a double-edged sword. On one hand, information is everywhere, but on the other, not everyone has the actual expertise required to make sense of what they’re reading (myself included). There’s a reason people spend years studying medicine; the reality is that a single symptom could point to ten different diagnoses, though most of the time it doesn't mean anything at all. Unfortunately, nobody warns you about that before you dive headfirst into self-diagnosing with Dr. Google. And of course, professional hypochondriacs are having a field day now, since they can spend all day analyzing every tiny twitch of their left eyelid... 🥳
Beyond probably driving their own friends and family crazy, they’ve now got an entire army of forum users at their disposal. There’s always going to be some overly sympathetic soul willing to offer reassurance and comfort for at least five or six posts before they finally lose their patience.
Does your big toe feel just a little bit twitchy, making you wonder if it’s actually MS? Is there a weird tingling sensation in your left cheek that has you spiraling about a potential stroke? Does your heart skip a beat or feel tight in your chest, leading you to certain death by heart attack? Did you find a tiny lump and immediately decide it’s definitely cancer?
Lupus, rheumatoid arthritis, every flavor of cancer under the sun, heart attacks, strokes, multiple sclerosis, mono, asthma... honestly, you name it.
Well, this is the spot. This is where you can vent to one another, swap advice, or maybe find a kind soul to offer some comfort and—hopefully—talk some sense into you, because let's be real, you aren't actually calling a doctor.
Or, perhaps you visit the doctor so frequently that you're single-handedly threatening to bankrupt Medicare with all those tests, even though every single lab result comes back perfectly normal. But you don't believe them. It has to be SOMETHING.
I hereby declare the hypochondriac chat officially open! Let it rip.
Generally speaking, I believe a system is only as good as the individuals operating within it.
I’ve been lucky enough, and persistent enough, to find specific professionals who have truly earned my complete trust and respect through their genuine expertise and care. Unfortunately, I’ve also run into those types of people who use "the system" as an excuse for their own lack of professionalism and basic humanity—but I’ve learned how to navigate around them.
If I had to point out what I consider the weakest link in the chain, it would probably be the nursing staff. In my experience, both growing up and as an adult, I’ve encountered the most coldness and arrogance from them. Honestly, I’d venture to say that out of every ten nurses, maybe only two or three actually live up to the title. At least, that’s been my personal experience. On the other hand, I haven't had any issues with the doctors at all.
Karen Young17 Asks: I suppose I don't see why I should ever have to resort to prayer just to get someone to explain exactly what I came here for.
Because that’s just what decent people do. I mean, it's not like you showed up to a local farmers market specifically to buy lettuce, only to have a bunch of little gremlins jumping around you trying to hawk their products; even if you did go there for groceries, I guess having a bit of basic politeness wouldn't actually hurt anyone.
Well, exactly. That medical report is intended specifically for your physician, which is why it’s written in a technical language and filled with terminology that seems completely foreign to most of the general public. I guess you should just ask whoever ordered the test what they actually found. After all, that report is only one small piece of the puzzle—it's just a fragment of the full picture. Only a doctor can see the whole thing, since they are the only ones with the actual expertise required to interpret those images correctly.
It feels a bit harsh to make assumptions like that, but I suppose the doctor is actually quite skilled. Maybe you’re just feeling frustrated because of your smoking environment; those surroundings probably aren't doing you any favors, I guess.
It’s probably for the best that his grandmother is the one canceling the appointment, though I suppose I should hope she's actually a physician. But then again, as strange as it might sound, I guess the stomach lining really does need protection if the treatment ends up being overly aggressive. Look at it this way—if you go by the data available online, like from UC Berkeley, the average life expectancy for an American man following something like World War I was only about 53 years. So, I guess, without those pills—even considering they might be eroding his stomach lining—he’d most likely be six feet under right now, resting under a marble slab and serving as nothing more than a feast for the worms.
I guess I start getting a little worked up whenever I watch my doctor click through the exact same thing for the millionth time, just pounding away at the keyboard with her fingertips like she’s operating some old-fashioned typewriter.
It's probably because that entire generation grew up learning how to use typewriters, so they might actually be better at it than you or me! (And you know, you only use one finger on those old machines anyway). But look, she isn't clicking and typing like that because she enjoys it, nor is she being paid based on her click count... she's doing it because you approached her for help, so maybe try showing a little respect!
Aha, great. Well, in my book, the bare minimum of politeness and professionalism would be for the technician performing an ultrasound not to discuss the findings out loud with a nurse as if there were a cadaver on the table rather than a living patient who isn't deaf. It’s called RESPECTING the patient.
If they have no intention of EXPLAINING what they see, then at least don't scare me half to death with comments about mortality.
Case one—about 15 years ago, during a pelvic ultrasound, the doctor loudly remarks to the nurse that the left ovary is MISSING. Of course, he says this out loud, but not to me. When I (politely!) ask, absolutely shell-shocked, what it means that it's gone, I get this smooth, arrogant response: "Ask your gynecologist... next!"
Naturally, I head home on the bus, completely in tears—one ovary missing. And I had two. Just a little while ago. Where did it go??? Epilogue: Through private channels—basically using a connection—I was able to get an emergency scan later that very same day (specifically at 10 PM), and both ovaries were present and perfectly fine. They just couldn't see it past the intestines. Was it really that hard to just say that, or is causing shock and stress for a patient just part of the job?
Case two—a private cosmetic clinic, a routine checkup, all paid for by the company... Abdominal ultrasound: once again, ignoring the fact that I am not under general anesthesia and can hear everything being said, the doctor coldly dictates to the nurse that I have a 3-centimeter mass on my liver. Upon my questioning—again, met with a brush-off—I go home in tears because my grandfather passed away from liver cancer. But hey, I guess I should just wait for the "ordering physician." Epilogue: It was a harmless hemangioma. Since then, I avoid routine checkups because there's a higher chance I'll die from the sheer shock right there in the office.
So, "missing left ovary" and "3cm liver mass" fall under technical language incomprehensible to the masses, but commenting as if the person undergoing the scan (while fully conscious) isn't even in the room is perfectly acceptable? Human and professional? ☕
And for the record, 40-year-olds aren't elderly, nor are we technologically illiterate. And yes, people used to type on typewriters with ten fingers. Personally, I use two on my laptop, but I'm faster than some people who use ten. Regardless, poking away with a single finger on a keyboard is certainly not a relevant issue within our healthcare system.
Of course, that’s the absolute bottom line—the absolute prerequisite for anything to move forward, I suppose.
It all comes down to something incredibly basic, really—it’s just a matter of entropy, the second law of thermodynamics, and that one-way flow of time that we can't escape. ☕ I mean, look, I’m just saying that a primary care physician is really the only one who maintains a continuous view of a patient's history. He has access to a level of oversight that specialists simply can't provide, because, let's face it, our hypothetical patient didn't develop all these ailments simultaneously; first it was heart issues, then it was pulmonary. So, you have a pulmonologist finding himself in this awkward position where he's basically trying to override the cardiologist's treatment plan. You know what I mean? I guess I could come up with a mountain of examples because this kind of situation happens all the time, really. It’s much like how medical checkups work; some people have to wait in line forever, while others somehow manage to get seen right before an inspection, and then there are those who face endless waiting periods... I suppose you just need someone else involved besides the specialist.
That sounds nice in theory, I suppose, but it isn't exactly simple in practice. You’re only looking at two medications, whereas there are countless Americans over sixty-five who are juggling three or four different prescriptions daily... not to mention seeing just as many specialists. And then you have to consider those people who don't really prioritize their health—which, let's face it, is most of the population—and they probably don't even realize when they have an appointment or when it's actually time to see a specialist.
Well, just imagine a system like this: you only ever deal with your own family doctor. They know everything about you—they're practically your confessor (if you can even wrap your head around how intimate that level of trust is). In such a setup, if a complication arises that exceeds their expertise, they consult a specialist—someone detached and objective. That specialist examines you and then sends you back to your regular doctor, accompanied by a letter ad manum medici (confidential, for the physician's eyes only). This letter would detail the examination, what was found, any suspicions, and provide specific advice to your doctor on how to proceed. It would suggest which medications to prescribe or which further tests to run. In that kind of framework, your primary doctor acts as the central pillar. You know, our system used to be somewhat like that, except... people seem to have forgotten. The entire concept has been inverted.
And here's another thing: supplemental insurance basically only exists to waive copays. It isn't actually extra insurance; it's just a perk for repeat customers so they spend a little less out of pocket—nothing more than that. Its sole purpose is to pad the Medicare budget.
I totally get your point, and in principle, you're absolutely right.
But in practice, at least in my experience, it doesn't work that way. The kind of relationship you're describing—where you rely heavily on a GP—is actually what I have with my specialists. And that's what I pay for. But that's my choice; once you have a certain diagnosis, you know you aren't going to leave things to waiting lists or assembly-line checkups. It's in my best interest to have a person I can reach out to at any hour of the day or night, and I'd much rather pay for that than buy a new pair of jeans. As for the primary doctor, they mostly write down what's necessary and act more like an administrator. You can tell how little time they have by the fact that they see anywhere from 60 to 100 patients in a single day; try being a family doctor instead of an administrator! Also, typically, they aren't the ones advising when or why I need to see a specialist, nor do they meddle in or comment on my medications unless I specifically ask them to. They just note when a follow-up is needed, what to take, and handle the prescriptions and referrals.
(For instance, if I start gasping for air, do you really think that after X many years, I need my GP to tell me it's an asthma attack? No. At that point, I don't even need a specialist; I need the ER. Similarly, if my leg starts going numb, I'm not running to my GP just to get a referral for a neurologist. I'm not booking through some "brilliant" centralized scheduling system and waiting three or six months for an appointment while I'm clearly in a relapse—I'm seeing my neurologist the very next day. That's the reality I'm talking about.)
Otherwise, she is wonderful, and it's truly a shame that she (like everyone else) is completely overwhelmed with patients. I suppose that's just the fate of anyone who is actually good at what they do. And I agree regarding the importance of continuous monitoring. However, there has to be some way to reduce all this unnecessary back-and-forth travel.
Maria Gomez4 said:Like I said before, patients dealing with chronic illnesses are a bit more complicated. But just imagine if you were prescribed a medication for asthma that actually makes your MS worse?... what then? Well, in a functional system, the family doctor steps in to figure out the best path forward. Look, a huge portion of Americans only have a basic education, maybe some high school, but certainly nothing advanced. Many people simply aren't equipped to connect how their various health issues interact. They get lost in a sea of different medications!
Here’s an example: someone has a heart condition, so their cardiologist puts them on something like a beta blocker. Then they see a pulmonologist for asthma, and that specialist realizes the beta blocker is actually bad for the asthma. So what does the pulmonologist do? Do they stop the beta blocker and risk the patient's heart, or do they leave it alone and do nothing? They'll stop it. And then they give the patient a referral to see their primary physician. If it's just about managing blood pressure, the GP can handle that adjustment and keep things steady, while also explaining why the beta blocker was a bad idea. It happens more often than you'd think—patients staying on meds they shouldn't just because "it feels fine." Essentially, we need a doctor who acts like a captain, guiding a person through the healthcare system to reach a goal. Unfortunately... unfortunately... nowadays, doctors are mostly just glorified ATM machines for referrals, and that's what really hurts. So, regarding what Susan Rodriguez4 is saying; yes, we need better management, but that's only one part—actually a pretty small part of the problem. The crisis is systemic. You see it most clearly in those massive MRI machines they buy... which, according to reports, are 90% unnecessary. An MRI costs roughly $667, and if you asked any average American to shell out that kind of cash, they'd probably lose their mind! In my opinion, if we looked into who authorized all those useless MRIs (an MRI is safe enough, but a CT scan hits the body with HUGE amounts of radiation—like 150 times more than a standard X-ray!), I suspect we'd find that the system is fundamentally broken somewhere, and that's what needs to be uncovered. Because, sure, kudos to a hospital for being managed successfully; that's great! Absolutely. But someone has to pay for every single one of those MRIs, and a "successful" hospital like that will paradoxically just end up drowning in debt. (Which is why I suspect there's a dedicated group behind all this bad healthcare, trying to prevent debt accumulation by pushing people away from public services and driving them toward private healthcare😁)
e, I suppose that’s exactly what I was getting at when I mentioned how certain medications are strictly earmarked for specific conditions, and how Medicare essentially shackles doctors, preventing them from acting solely in the patient's best interest. Interferon is actually a drug that could potentially help with a vast array of conditions... but unfortunately, it hasn't been prescribed for those cases here... so I guess people just have to find their own ways to manage.
hm, I wonder why there isn't some kind of recurring referral? I'm not entirely sure, since I've never personally referred anyone to psychotherapy, though I do know that certain services allow for multiple visits, or like people getting wound care at the ER who can visit several times under one referral... that was a new thing last year. I suppose you should probably ask a therapist; maybe the family doctor knows the specifics.
I'm concluding that you must be a primary care physician. 😉
First of all, every specialist SHOULD take a full medical history and know exactly what medications the patient is currently taking and what other conditions they might be dealing with. Why would you think a primary care doctor knows which drugs interact, but a specialist wouldn't? For instance, when I see my pulmonologist once a year, she gets a complete report from me regarding my other diagnosis. I ask her if Singulair interacts with interferon, just like I ask my neurologist the same thing. Plus, I read the instructions for both medications myself.
But let's assume not every patient will remember to do that. I still believe specialists should have the authority to prescribe medication and order follow-up tests directly. That same specialist could easily be digitally linked to the primary care physician, rather than us running around with piles of paperwork and wasting both our time and theirs by duplicating work.
It’s not that I have anything against my own GP—not at all—but it’s exhausting to think that for every single test or check-up, I have to go to them first, wait for the appointment, wait for the booking, and then go back to them again, in an endless loop, all while the waiting rooms are always packed.
That’s exactly why I handle quite a few things privately. And I pay for supplemental insurance too. You really have to piece everything together just to get adequate treatment.