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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by JTR on February 22, 2000, at 9:55:38
If one suspected a mis-diagnosis of bi-polar how would one go about convincing a patient to seek re-evaluation given the bond between patient and therapist is strong?
If the drugs used to treat/manage bi-polar disease can in and of themselves cause behavior usually associated with the disease, how does a professional distinguish the disease from the drug as affecting the patient's behavior?
Posted by Mis-Diagnosis on February 22, 2000, at 19:50:34
In reply to Mis-Diagnosis, posted by JTR on February 22, 2000, at 9:55:38
> If one suspected a mis-diagnosis of bi-polar how would one go about convincing a patient to seek re-evaluation given the bond between patient and therapist is strong?
>
> If the drugs used to treat/manage bi-polar disease can in and of themselves cause behavior usually associated with the disease, how does a professional distinguish the disease from the drug as affecting the patient's behavior?JTR - Thanks for your insight. Very succinct. Thing is
I didn't have a bond with the Dr. It was a first-time
visit. I requested the psych consult from my gp for a
medication check. I had been on Prozac for depression.
It wasn't doing much for me when my situation changed at home and
I developed panic symptoms. After two more visits with that
Dr. and one antiseizure med and four anti-depressants (Wellbutrin,
Paxil, Effexor and Zoloft) later I switched to a different shrink
who thought I should take Lithium and maybe a little Zyprexa.
I said NO to both. But am continuing with the Zoloft. Doing okay by the way.
See the shrink in a couple weeks with the news that I dropped
the Topamax and want the diagnosis changed.
Maybe all I needed was a little VALIUM. I'm 40 yrs. old,
my husband's in law school full time, our income has dropped
by 3/4, I work at home - have my own business, can't keep up,
usual family problems,4 dogs, 2 cats, $70,000 in school loans
- I had some anxiety! Thanks for listening.
Posted by Mis-Diagnosis on February 26, 2000, at 10:47:53
In reply to Mis-Diagnosis, posted by JTR on February 22, 2000, at 9:55:38
> If one suspected a mis-diagnosis of bi-polar how would one go about convincing a patient to seek re-evaluation given the bond between patient and therapist is strong?
>
> If the drugs used to treat/manage bi-polar disease can in and of themselves cause behavior usually associated with the disease, how does a professional distinguish the disease from the drug as affecting the patient's behavior?JTR - Actually, the misdiagnosis went beyond that. On my last visit to see the psych doc (a new one - same health systmem) I had to sign a "face sheet." My diagnoses were listed at the bottom. I was HORRIFIED at what I saw. Two diagnoses listed that in no way, shape or form applied to me. I brought the issue up to the Doc I was seeing that day - he ignored my requests to discuss it, and proceeded to prescribe meds based on the info on the "face sheet." I refused to take them. I discussed the situation with my therapist - who was also quite appalled and concerned. I prepared a very lengthy written history of my meds, symptoms, doc visits, etc., to send to the health plan carrier, with my insistence on an outside evalation not associated with their system. However, before I sent the letter I thought I woulld call the Psydoc who originally diagnosed me and let her know of my concern and intent to follow-up with the health carrier. She called back, was also upset. "Someone" had entered the wrong diagnostic code into the computer. What's really frightening is the second psychdoc wouldn't listen to me and wanted to give me meds based on misdiagnoses. Thank God I said no. I did find out from the first psychdoc how to get the diagnoses changed. Sooo - I will do that first, if it doesn't work, then I'll just have to report everything to the powers that be.
What is really FRIGHTENING is often does this happen. I'd bet big bucks I'm not the first. And how many people who are really distressed and don't have the strength mentally or emotionally to discover these errors. What's happening to them? Are they getting f---ed up on meds wrongly prescribed like I was. The information in their systems goes directly into an insurance data base and is on your records forever, if not checked, and validated by the patient.
That's my situation. I'm getting stabilized on a different anti-depressant - not for the two wrong diagnoses they gave me. I think I'll have my care switched back to my GP and keep on with my therapist. Don't have a lot of faith in psychdocs, as my only two experiences have been HORRENDOUS.
Posted by Brenda on February 26, 2000, at 10:50:56
In reply to Re: Mis-Diagnosis, posted by Mis-Diagnosis on February 26, 2000, at 10:47:53
> > If one suspected a mis-diagnosis of bi-polar how would one go about convincing a patient to seek re-evaluation given the bond between patient and therapist is strong?
> >
> > If the drugs used to treat/manage bi-polar disease can in and of themselves cause behavior usually associated with the disease, how does a professional distinguish the disease from the drug as affecting the patient's behavior?
>
> JTR - Actually, the misdiagnosis went beyond that. On my last visit to see the psych doc (a new one - same health systmem) I had to sign a "face sheet." My diagnoses were listed at the bottom. I was HORRIFIED at what I saw. Two diagnoses listed that in no way, shape or form applied to me. I brought the issue up to the Doc I was seeing that day - he ignored my requests to discuss it, and proceeded to prescribe meds based on the info on the "face sheet." I refused to take them. I discussed the situation with my therapist - who was also quite appalled and concerned. I prepared a very lengthy written history of my meds, symptoms, doc visits, etc., to send to the health plan carrier, with my insistence on an outside evalation not associated with their system. However, before I sent the letter I thought I woulld call the Psydoc who originally diagnosed me and let her know of my concern and intent to follow-up with the health carrier. She called back, was also upset. "Someone" had entered the wrong diagnostic code into the computer. What's really frightening is the second psychdoc wouldn't listen to me and wanted to give me meds based on misdiagnoses. Thank God I said no. I did find out from the first psychdoc how to get the diagnoses changed. Sooo - I will do that first, if it doesn't work, then I'll just have to report everything to the powers that be.
> What is really FRIGHTENING is often does this happen. I'd bet big bucks I'm not the first. And how many people who are really distressed and don't have the strength mentally or emotionally to discover these errors. What's happening to them? Are they getting f---ed up on meds wrongly prescribed like I was. The information in their systems goes directly into an insurance data base and is on your records forever, if not checked, and validated by the patient.
> That's my situation. I'm getting stabilized on a different anti-depressant - not for the two wrong diagnoses they gave me. I think I'll have my care switched back to my GP and keep on with my therapist. Don't have a lot of faith in psychdocs, as my only two experiences have been HORRENDOUS.Dr. Bob - What do you think?
Posted by Noa on February 26, 2000, at 11:15:20
In reply to Re: Mis-Diagnosis, posted by Brenda on February 26, 2000, at 10:50:56
Good thing you were so assertive and persistent.
This is dangerous. The wrong dx on permanent records bothers me, but what alarms me is the immediate danger to the patient! The practice should be reported for encoding the first doctor's dx incorrectly. Bad mistake. Did the doc write both the numeric code and the verbal name of the dx? That would allow the person doing the inputting to confirm the code matches the name. If he did not, only putting the code, that leaves more room for error. But, the doc that you raised the issue with and who dismissed your concern should definitely be reported. Much worse mistake. Mistake is even the wrong word. He made a DECISION not to listen to your concern seriously and not to check it out to make sure the records were correct, and made the decision to prescribe meds knowing that the patient had reason to believe a medical error had been made. This was arrogant of him, and I think could be considered malpractice. If you had taken the wrong meds and had been harmed by them, it would have been on his head.
Similar errors seemed to be happening between doctor and pharmacy, with doctors' handwritten scrips being misread. Easy to do, because the handwriting is bad, and because so many of the meds have similar names (with Zs and Xs and Ys in the name?).
Posted by Brenda on February 26, 2000, at 11:25:53
In reply to Re: Mis-Diagnosis, posted by Noa on February 26, 2000, at 11:15:20
> Good thing you were so assertive and persistent.
>
> This is dangerous. The wrong dx on permanent records bothers me, but what alarms me is the immediate danger to the patient! The practice should be reported for encoding the first doctor's dx incorrectly. Bad mistake. Did the doc write both the numeric code and the verbal name of the dx? That would allow the person doing the inputting to confirm the code matches the name. If he did not, only putting the code, that leaves more room for error. But, the doc that you raised the issue with and who dismissed your concern should definitely be reported. Much worse mistake. Mistake is even the wrong word. He made a DECISION not to listen to your concern seriously and not to check it out to make sure the records were correct, and made the decision to prescribe meds knowing that the patient had reason to believe a medical error had been made. This was arrogant of him, and I think could be considered malpractice. If you had taken the wrong meds and had been harmed by them, it would have been on his head.
>
> Similar errors seemed to be happening between doctor and pharmacy, with doctors' handwritten scrips being misread. Easy to do, because the handwriting is bad, and because so many of the meds have similar names (with Zs and Xs and Ys in the name?).JTR, Noa, I must apologize. I am mis-diagnosis. My first time on a chat board/room. Didn't know the protocol. Leary of using my name. Okay now that's taken care of.
Yes, one was miscoded. Used an ICD9 code (I don't know what that is)instead of DSM IV code. Apparently the two codes don't translate into the same diganoses. The diagnoses on the form were listed as "Psychosis NOS and Manic Depression," neither of which I have. The first psychdoc never meant for the psychosis nos to be there and she thinks I'm Bipolar II, but didn't code it that way. Also, don't think I'm BPII. Since I quit the Topamax I feel 100% better. The Zoloft is working fine. I will try to get this straightened in a civilized way - if not I'll call some of those snakey lawyers we've talked about.
BTW - this is a really big step for me. I'm not very assertive and have a HUGE HISTORY of minimizing stuff. Took big courage for me to stand up for myself. I was "high" all day yesterday with my new assertiveness. To myself - GO GIRL.
Posted by Noa on February 26, 2000, at 12:08:06
In reply to Re: Mis-Diagnosis, posted by Brenda on February 26, 2000, at 11:25:53
and to you, Brenda, from me, GO GIRL!!!!!!
Posted by Brenda on February 26, 2000, at 14:46:43
In reply to Re: Mis-Diagnosis, posted by Noa on February 26, 2000, at 12:08:06
> and to you, Brenda, from me, GO GIRL!!!!!!
Noa - Thanks - I'll carry that with me.
This is the end of the thread.
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