To you they're time wasters maybe. Cutting someone off from medical help because they've 'cried wolf' too many times is moronic and selfish. If the doctor is the only interaction with other people the cosequences of cutting them off can be fatal. So do the tabloids, they just leave out a lot of details to make their point.
This is very true. The flipside is that it would be nice if the doctor, once you were there, was able to accurately diagnose the problem, as this also adds greatly to the burden on the medical system. I have been misdiagnosed many times, by many different doctors... from pneumonia (where the emergency docs gave me a really GREAT cough suppressant and sent me home... leading to my return several days later when my lungs were half-filled and my O2 levels through the floor hence causing me to spend a week in the hospital) to a torn ACL in my knee (misdiagnosed as something much more minor that should heal on it's own... finally figured out what it really was after I reinjured it about 8 months later, thus delaying me getting the problem fixed for nearly a year). Then there's my wife, who went into the emergency for acute appendicitis, went into surgery almost immediately to remove it, and was told later on by the surgeon that it didn't look like the appendix was inflamed (he hadn't gotten any of the lab results back at this point), which meant it was most likely PID... which is usually caused by untreated sexually transmitted diseases, so her husband was probably cheating on her and yes, it would affect her ability to have children (we were trying at the time). Then he left, and wouldn't come back when my wife sent the nurse literally running after him to get more info. Guess what? When the labs came back, it was an inflamed appendix after all. :bang: :bang: :bang: :bang: (and for the record, no, I had not cheated on her, and we now have two gorgeous daughters)
Nobody has suggested cutting anyone off from medical help when they cry wolf. There's a difference between clinical depression and being unhappy. A tiny minority of the people who present for being "depressed" are actually clinically depressed or at any risk of suicide. In many cases medicalising things tends to make matters worse rather than better. The views that I present probably represent the views of the majority of people who work in the health service. Anyone who has worked in a frontline service will be able to tell you what a drain on resources the "worried well" are.
So you were just complaining then, not offering any kind of solution? Because I can't see any solution by your statements other than that. How do you think those clinically depressed people started? Putting someone in low risk of suicide doesn't mean they don't need help. Best to ignore them then? Please show me where I have said they aren't a drain on resources. What I have been saying is that classifying people as time wasters is a bad solution.
I don't think that MAP would be an effective venue to address this kind of problem, I'm just being realistic. Generally, if someone is clinically depressed that's how they present from the beggining, it's an illness not some form of extreme unhappiness. That's the policy that most A&E departments adopt, give them a quick checkover to keep the lawyers happy and then kick them out of the door. Of course even that minimal input does take away from the resources for treating people with reall illness and injuries. As I've said it's not realistic to be looking for a solution on this forum. But some people are timewasters, and a good kick up the backside is IMHO after many years working in healthcare and a large part of that specialising in mental health, the best solution.
i tend to agree that people are too quick to assume the worst... BUT. i also often wonder about what happens when someone gets, for example, a brain tumour. often we hear the line, 'if only they could have been diagnosed sooner' or, 'it was lucky we caught it so soon'. How do people know that their headache is just a headache and not something more serious? We as patients aren't qualified to diagnose our symptoms and pain is pain. Now i very seldom get headaches, but recently i've been getting them more regularly... is this down the unusual amount of work pressure i've got right now, or is it a sign that something is more serious? Should i go the docs and get it checked out, only to 'waste' a GP's appointment slot when he tells me to chill, get work in perspective and get some more regular sleep? Or i should i wait six months only to be told that if i'd come in sooner they could operate, but now i'm on a ticking bomb and i'd best give up work and do all things i want to do before its too late? (i don't think i've got a tumour btw, i'm just using it as an example, but i have been getting alot of headaches in the last month ) it easy, once we know someone is ok to say, 'there, your just being a worrier' but lots of people everyday go in to doctors surgeries with minor ailments/symptoms only to discover they are actually very ill. How do we as patients know which course of action to take?
Well you did bring it up in the first place. The causes of MDD are still in debate, whether it's genetic, a chemical imbalance or the menopause. Living conditions, including social conditions, are a common cause as a trigger for depression. If it's working so well in your opinion then what's the problem? So how would you go about realistically administering a "good kick up the backside" to every time waster in the country?
Only to voice my opinion, not to change the world. Whilst there is some debate about the causes of clinical depression (I'm not sure what MDD is?). The signs and sypmtoms are not debated, and the vast majority of people who think they are clinically depressed aren't. The problem is an attitude that pervades our culture that life is not full of physical and emotional pain, and that lack of a pain free life is a disorder that can be treated. If I were in a position to set policy, I would start with a big public education campaign, that put the message across "man up you big woose and stop whinging" in a subtle way. I would also make sure that everyone who wasted health service time was sent away with a leaflet giving them the same message in clear terms. People who turn up to A&E with minor injuries should have to pay for treatment, just as they would for a prescription. Finally I would make it a fineable offence to waste NHS time, although this would be reserved for the kind of muppets that call an emergency ambulance when they've sprained their ankle.
On Thursday I got a really solid crack to my head that made everything go white for a second and gave me a headache for a couple of hours afterwards. It could have been a subdural haematoma that was causing the headache. On Friday morning the headache was long gone but I did have an ache in my arm, that may be related to my training on Thursday night, or it could possibly be the first signs of bone cancer. Today I'm feeling a bit under the weather, it could be the begginings of avian flue, on the other hand it may be related to the amount of alcohol I drank last night. Sometimes you've just got to take a chance. The biggest problem isn't people not going to see a doctor when something serious is wrong, it's the fact that they have to wait in a long queue behind the worried well before it can be attended to.
I dont know about other places but at least in our district Hospital there is a color chart going from mild to critical, mild injured people get put into a queue behind everyone else, the critical people get seen to immediately and the colors inbetween them have varying waiting times.
All A&E departments in the UK operate a "triage" system, where people who present are assessed by an experienced nurse and prioritised. It certainly isn't the case that if you are having a heart attack you have to just wait in the queue with everyone else. However, that doesn't alter the fact that medical services are a finite resource, and every minute that a professional spends with the worried well is a minute that they could be spending giving life saving treatment.
"The problem is an attitude that pervades our culture that life is not full of physical and emotional pain, and that lack of a pain free life is a disorder that can be treated." Can i just say that the the above quote deserves some kind of award. Bill Gee, you mind if i save that one for future reference if i promise to reference you?
i'm with you bill, believe me. i've been smoking for 18 years and i get chronic refered back pain in the bottom of my rib cage at the back, sometimes it feels different and i worry maybe it isn't always the result of my injuries, maybe its cancer, but unless i go and get it checked, how will i know? in '95 while i was waiting for three months to get my symphis pubis grafted back together after it split again, bending the internal metal-work, i was taking about 16 co-proxomol a day for those months instead of the prescribed 8 (damn stupid i know, but constant pain makes you very desperate and when its with you from the minute you wake to the minute you finally fall asleep, you just want it to GO AWAY and give you some peace :bang: ) now, my refered pain sometimes goes from the muscles around my kidneys through to my groin and when it does i end up fetal for about 4 or 5 hrs. But is it the refered pain? maybe i screwed my kidneys with the excessive paracetamol dose via the co-prox all those years ago? i'm simply not qualified to make that assesment. if i went the docs whenever i felt bad, i'd need a bed in the waiting room, so i don't go at all. Once i got out of hospital the first time, i'd seen just how stretched the NHS was first hand, so i took responsibilty for my own healing and over the years i've developed my own coping stratergies. my question is simple this, what advice would give about when someone should go to the docs? the problem with 'if only we'd caught it sooner' is that often, in the early stages of a serious condition, the symptoms are so general, people could just shrug them off and not go for the check-up. How are we supposed to know when it is important to be checked and when we are just being mardy? (in my case, i'll take my chances, i'm sick to death of hospitals, i'm in bits anyway most of the time and it cost the NHS about £500 a day to keep me alive for the first week, plus the next 8 weeks free bed and board and then the subsequent stays with all the follow up surgery, so i've had my fair share of the countries support, best to let someone else get the chance now)
Yeah, ruining my Amulet thread like that :/ I think its safe to say through unanimous opinions that no one here believes in any 'magical powers' of an Amulet but it can be considered to give a Placebo effect, which I agree with.
hmmm... really? In what capacity and for what length of time? For that matter in what city? You don't strike me as the medical type... though male nurse might fit. Flattery will get you nowhere. :love:
Sorry, MMD is major depressive disorder, I assumed with your background in medicine you would have come across the term. I'm sure there's plenty of people who get a checkup for something which turns out to be nothing that don't have a physical and emotionally pain free life. Some people might, but unless you can guarantee that everyone who has nothing wrong with them is suffering from this problem it doesn't stand up. So you'll use a costly public campaign and financial penalties to deal with the consequences of the problem instead of solving the problem itself?
Ok in an attempt to put this thread back on topic... (shocker!) Here are some shots of traditional Thai amulets - they are massively popular in the countryside and city alike and many of them command hundreds of thousands of Thai baht... there are (last time I checked) no less than about 15 different weekly magazines on the Thai newsstand dealing with these amulets. Muay Thai fighters usually have one or more.... in addition to mystical tattoo's. The mixture of Buddhism and 'magic' in Thailand is generally quite strong. Much like the mixture of animism and the Catholic church amongst the Mexicans and the South Americans. Many other cultures have a similar type of amulet as well. In Thailand they hold such a promenant place that the government recently issued a series of stamps with different styles of amulets on them. note: the 9 baht refers to the face value of the stamp - the amulet itself goes for some insane amount if it can even be bought.
