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Re: Self-medicatiom

Posted by JohnL on October 19, 2001, at 4:12:33

In reply to Self-medicatiom, posted by Gracie2 on October 18, 2001, at 4:59:09

I agree with everything said here about technical expertise required for good X-rays. I do not however believe comparing that situation to self medication is at all a good comparison. Apples and oranges. X-rays are a known finite science based on facts. How drugs work in the brain, and how they vary from one person to the next depending on unique chemistry, is a totally different story. There are no concrete facts to work with, and bucketfulls of unknowns variables. With X-rays, the best that can be done is based on science. In psychiatry, the best that can be done is more based on intuition, instinct, educated guesses, art, but not so much science or procedure. In short, getting good X-rays is a skill. Getting good psychiatric treatment is more a lucky guess, even for the most qualified psychiatrists.
> I know ya'll have just been waiting on the edges of your seats for my opinion on self-medication.
> First, I don't consider myself a nit-picker but as some people on this board are fond of covering every base, I have to say that no intelligent person can be 100% against self-medication (diagnosing, prescribing and treating oneself with drugs, and monitering their own symptoms and adjusting medication without legal medical advice). Under this premise, the emergency rooms would be filled with people complaining of minor aches and pains that could easily be treated by Tylenol or some other OTC medication. In extreme cases, patients would continue to take prescription medication as directed despite alarming allergic reactions because they were instructed to finish the medication by their doctor. Stopping the medication on their own would be an act of self-diagnosis.
> With that silliness out of the way, I was not at first opposed to patients who order non-narcotic drugs from overseas. This was because I can understand the hopelessness and frustration of someone who has experimented with drug after prescribed drug, first adjusting doses and trying different cocktails, waiting the 6 or 8 weeks for the drugs to take full effect, and ending up with unsatisfactory results time after time. For a seriously anxious or depressed patient, 6 or 8 weeks can be prolonged
> torture. The Pulitzer Prize-winning author of "Sophie's Chance", William Styron, admitted that he had no words to describe the horrors of serious depression in his autobiographical work, "Darkness Visible". To a person that has sunk to such depths, the morality and ethics and legality of ordering overseas drugs becomes irrelevant, because the only alternative is suicide. Ordering these drugs is a sheer act of desperation, a last straw to grasp.
> We must remember that people who self-medicate who suffering, and they deserve our compassion. Alcohol abuse is also a form of self-medication, yet one poster on this board proclaimed all alcoholics to be "disgusting". This poster is a sociopath (hopefully she will look up the word) if she is actually aware of how dangerous such remarks can be. It would be interesting to know if this Valley Girl has ever heard
> of John Berryman, Dylan Thomas, Lord Byron, Samuel Taylor Coleridge, Edgar Allen Poe, Ernest Hemingway, Jackson Pollock, and the countless other disgusting drunks that have added immeasurably to the richness and beauty of our world.
> A well-adjusted person will pay little or no heed to such an ignorant remark, but it may be enough to cause an unbalanced person to self-destruct. Such a remark only affirms their sense of worthlessness. Many people on the edge of suicide hang from this earth from a filament, a mere spiderweb, and the most inconsequential action can make them decide whether to go or to stay - a hurtful remark, or a child's cough from the bedroom down the hallway. Horton hears a Who.
> After all that, I have to admit that I have changed my mind about self-medication for one reason, and that is because of my own profession as a radiologic technologist. It may surprise most people to know that it is not illegal for a nurse, a medical aide or a janitor to order x-rays and perform x-ray examinations.
> This is a shameful practice by doctors who put money and time ahead of their patient's well-being. If the nurse is allowed to order x-rays before the patient has been seen by the doctor, it saves him time on performing a preliminary examination. If he "teaches" his nurse to operate x-ray equipment, it saves him the expense of hiring an RT. Doctors themselves, aside from radiologists, are not trained to operate x-ray equipment and are therefore unable to train nurses. The result is a poor-quality x-ray that is usually so bad, the doctor cannot make an accurate diagnosis and may miss anything from a fracture to malignant bone damage. Nurses know nothing about correct positioning, proper shielding or adjusting the machine's controls to improve x-ray quality, as they are unaware of what a good x-ray is supposed to look like. They also do not know enough about x-rays to order them, which means that a reputable doctor with an RT on staff must repeat the x-ray, resulting in unnecessary expense and radiation exposure to the patient. While most, if not all, hospitals hire only registered and licensed technologists, many private offices do not wish to spare the expense. Podiatrists and chiropractors are particularly notorious for this practice.
> 1.) If a nurse orders an x-ray before you have seen the doctor, politely decline. Tell them you wish to see the doctor before your x-ray.
> 2.) Feel free to ask the person performing your x-ray if she is licensed with the ARRT. If not, have your x-ray performed elsewhere, unless there is an RT on staff.
> A poor-quality x-ray infuriates me. In this light, I can understand the impatience of Cam and others with people who wish to order drugs from overseas. You deserve the best medical care by trained personnel.
> Climbing off the soapbox-
> Gracie
> P.S. Every patient deserves at RT.
> Climbing back off the soapbox-G.




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