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  #1  
Old 01-19-2000, 06:28 PM
Ruffian Ruffian is offline
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Okay, for the sake for Sue and any other MDs on the board, I must clarify: some doctors really piss me off. Unfortunately, it's been nearly every one in my experience. I tend to stick with Physician Assistants or Nurse Practicitioners. They actually listen. And seem to give a shit.

What set me off? 10 years ago (age 16) I was diagnosed with mitrol valve prolapse, a mild heart condition that causes a murmur. The doctor who diagnosed me as an asshole. No really, he was. He misdiagnosed my dad--saying he had a cracked hip when it was in fact broken (and so was his back, we've since learned). As a result, my father's hip and back were largely untreated, healed and set incorrectly, and he is now permanently disabled, cannot work, had radical surgery--and will never live pain free again. (Yes, lawyers have been involved.) Anyway, this incompetent ass who diagnosed me spoke to me like I had an emotional problem. He didn't want to hear about my symptoms. Several months after I stopped taking the lanoxin (a beta blocker, slows the heart rate and eases its workload) I was on--by his recommendation--I had a rare night of uncomfortable palpitations. When I paged him in my distress, he angrily asked if I'd taken my meds. No, I said. "Well, shit!" he snapped at me. But, I said, you told me to stop. He wouldn't hear it, and berated me. Asshole.

Move on to doctor #2, some 3 years later. While going over my medical history a tthe first appointment, he hears of the MVP and listens to my heart. "Your don't have MVP. MVP patients have a clicking sound in their heart." I protest, saying I'd been diagnosed following an echocardiogram (ultrasound of the heart--they actually SEE the damn valve flapping away). He asked if I had the records of the echo, and I did not. The office that did have them closed down, and the echo disappeared. New doc shrugged, said I didn't have it, and let me be. Didn't bother pursuing it more.

Pull forward to now: I need to get a root canal. At the new dentist office, they asked on the questionaire specifically if I had MVP (I'll explain the relevance later). My answer: "Depends on which doctor you ask." They wouldn't touch me until I had a medical release form signed. So, I go to my new office, get the paperwork signed, and get my teeth worked on.

Yesterday I visited my new doc (actually, physician's assistant), saying I wanted to know if I had this blasted MVP thing or not. While repeating my history, I told her the 2nd doc had dismissed the diagnosis and she was actually a little miffed, saying, "Well, he didn't take an echo." This new doc listens to my heart, says she does hear the clicking murmur, and is referring me to a cardiologist to have a new echo done. She heard in my heart what doc #2, the asshole, dismissed. He proved to be an arrogant bastard as well, as other incidents showed. Regardless, I'm getting the care I need now. My symptoms are rarely present, but Tuesday night I had one of the episodes like I hadn't had in 5-6 years. Annoying litle bugger.

What really pisses me off is I have to take antibioics prior to dental work, as I run the risk of getting endocarditis (an infection on the heart valve--somehow, dental work can cause that). The risk is low for my condition, but still--you don't mess with it. For several years I had dental work done, never taking antibiotics because asshole #2 said I didn't need them. This sucks.

I know, what matters is I'm getting good care now. But it royally pisses me off that these arrogant pricks had so much power and potential to seriously fuck up my life, as asshole #1 did to my father.

I do not understand how anyone could ever accept the words a doctor tells them solely on trust. I do not trust most of them, and learned not to before I ever exited my teens.

Assholes.

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  #2  
Old 01-19-2000, 08:19 PM
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I know how frustrated you must feel. I have a problem with endometriosis and I basically had to DEMAND surgery before it was diagnosed. I suffered for years before I could get anyone to take me seriously. My problems aren't over. I still have endometriosis and suffer some pretty severe side effects from it. When I went to my gyno (not the one who finally diagnosed me, it was the surgeon who did that) and explained my problems he acted like he had no idea what I was talking about. I had to hunt down medical records from several different doctors as well as my surgical records and have the whole mess sent to my gyno for him to review. He calls me back 2 months later to say, "Oh yeah, you do have endometriosis, just go on the Pill and treat the other symptoms with over the counter meds." Don't you want to see how far it has spread inside me? "No, because treatment would be the same." Uh, ok. In the meantime, I want to pass out every time I have a bowel movement, and suffer from a few other fun things like that as well. I think I am going to try to find a specialist in the near future. It is just so hard to deal with all the insurance red tape.
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  #3  
Old 01-19-2000, 08:43 PM
Ruffian Ruffian is offline
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Pffffmmmmtphhhht! :::spitting out omelette::: Okay, I can laugh at my own typo: I said: "The doctor who diagnosed me as an asshole." That should be "The doctor who diagnosed me was an asshole." Oh, man.

Michelle--yikes. My mother had endometriosis and didn't have it diagnosed until she went to have her tubes tied. When they opened her up, the scar tissue was so massive they couldn't even find them. My sisters both have similar disorders, and my doc put me on the Pill early to prevent the disease from becoming active in me, just in case it ever will. Sympathy sent your way!

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  #4  
Old 01-19-2000, 08:44 PM
Nutty Bunny Nutty Bunny is offline
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I've had Ulcerative Colitis for about 13 years, so I've been treated with just about every possible medication for it. I have a good idea about when I need medical attention and what meds to take. When I was in the hospital a couple of weeks ago, it took them three days to treat me with steroids (not a fun medicine, but very effective), which is what has always been the first thing I'm given in the hospital. Instead, they just gave me IV fluids and told me not to eat or drink anything. For 12 hours, I was waiting for a surgeon to put and IV in my chest when the original site in my arm collapsed. So, at that point, I had no medicine, no IV fluids, no food and no water. It took my begging the doctor to treat me with steroids for him to finally agree to it, while he mumbled something about "playing doctor". Asshole.

I agree about Physician's Assistants. They are so interested in learning about medicine that they ask a lot of questions and they really hear what you're saying. But it makes me wonder if they turn into assholes eventually, too.
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  #5  
Old 01-19-2000, 09:06 PM
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I can understand your anger. Speaking as a physician I can only say that some are excellent, some are very good, some are average and some are not that great JUST as in every other field.

To judge all the hundreds of thousands of physicians on the basis of several bad experiences in a row doesn't suggest clarity of thought.

Many physician-assistants are excellent and follow in the same categories as the docs. Believe me when your life is on the line or if you are quite ill it's going to be a Dr. that will be there for you. Just check them out in advance.
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  #6  
Old 01-19-2000, 10:18 PM
Ruffian Ruffian is offline
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Quote:
Originally posted by skelton4947:
[B]To judge all the hundreds of thousands of physicians on the basis of several bad experiences in a row doesn't suggest clarity of thought.
B]
*ahem* I said some doctors really piss me off. I did not dismiss every member of the profession. That was in the first sentence in my OP--miss that part? I recognized that it is based on my personal experience, but that does not negate that they were bad experiences, the doctors were assholes, and a skeptical attitude--or at the very least, a cautious one--is a natural response.

"...doesn't suggest clarity of thought." Your comments suggest you didn't read the OP carefully enough but rather read into it. I'm sure you're a great doctor and not an asshole like the ones I've experienced. Feel better?


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  #7  
Old 01-20-2000, 12:11 AM
WallyM7 WallyM7 is offline
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Skelton, your lips seem to be pursed a great deal of the time.

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  #8  
Old 01-20-2000, 12:50 AM
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Quote:
Originally posted by WallyM7:
Skelton, your lips seem to be pursed a great deal of the time.
I give - what's the deal with the pursed lips?

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Experience is what you get when you didn't get what you wanted.
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  #9  
Old 01-20-2000, 01:31 AM
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Ruffian, if you want to know more about skelton's humanistic qualities, read this over.
http://www.straightdope.com/ubb/Forum7/HTML/001030.html

If this is truly a physician saying this, I am embarrassed for my profession.

On to trying to shed a little light on your frustration.

10 years ago, LOTS of people were being told that they had MVP, and that MVP was responsible for all manner of symptoms, associated with an increased risk of sudden death, and required SBE prophyllaxis (antibiotics prior to any procedure in which bacteria could get into your bloodstream to prevent Spontaneous Bacterial Endocarditis).

The truth was:
* The initial studies were based on patients wigh clearly audible murmurs only. They were later extrapolated to patients who fit the "profile" (tall, thin women who were flighty/emotional) with questionable murmurs & and any abnormality seen on ECHOs.
* These studies were largely discredited around 1990-1992. Only audible murmurs were considered significant, needing SBE prophyllaxis.
* There have never been any controlled studies that show that SBE prophyllaxis actually does reduce the incidence of SBE, even in patients with metallic heart valves. It just seems like a good idea, costs little & is low risk (inducing allergies to antibiotics, or inducing resistance in colonizing bacteria), and everyone does it, so it is standard of care, because no one wants to get sued for not doing it.

So it is very possible that both doc #1 & doc #2 were right & treated you entirely correctly for the standard of care at the time. (Being right doesn't negate their reported lack of interpersonal skills, though)

Not to disparage the PA in whom you have faith now, but hearing a murmur is a very subjective thing at times. If you expect to hear a murmur, you are more likely to hear a murmur. Sometimes it's so that they won't look incompetent in your eyes, sometimes it's just a matter of hearing what you expect to hear.

This seems to be very important to you to get to the bottom of. I would recommend asking for a referral to a cardiologist for a one-time evaluation to decide if you do or do not have a murmur that requires SBE prophyllaxis. Or even considering paying out of pocket if need be to get to the bottom of this - the good news is, it shouldn't take another ECHO or anything expensive; just someone to tell you whether you really have a murmur that "counts".

Good luck!

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Sue from El Paso

Experience is what you get when you didn't get what you wanted.
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  #10  
Old 01-20-2000, 08:20 AM
phouka phouka is offline
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I've had good and bad luck with doctors. My dad is retired military, so when I was growing up, we went to Lackland AFB or Fort Sam Houston for medical treatment. I never saw the same doctor twice in a row. Some were good, some were bad. Some took the time to listen to me, others treated me like a piece of meat.

My first gynelogical exam was performed by a very petite woman doctor who explained everything she was doing. My second exam a year later was performed by a strapping Nordic doctor with hands like shovels who joked "don't worry, I'll be gentle" (he wasn't).

I've had several bouts of Pelvic Inflammatory Disease - one so bad that it required emergency surgery to release adhesion scars that had nearly blocked off my large intestine. The first and second bouts, all the doctors involved took excellent care of me. The third bout, when I went to an emergency room with abdominal pains, the doctor treated me like a brainless slut for coming to him with an STD and asking for immediate treatment. The stress of the illness, the expense of going to the emergency room, the doctor's complete lack of empathy, and the circumstances that lead to me breaking up with my boyfriend (who had given me the STD and wouldn't own up to it) ended up throwing me into a bout of clinical depression.

On the other hand, I also found the best doctor I've ever known. The first exam I had, she spent an hour sitting with me, going over my family history, my own medical history, and my concerns. Every exam I've had from her has been gentle and careful. Her staff is incredible. She doesn't accept any HMO policies because they limit the kind of treatments she can give her patients. She's a little more expensive than other doctors, but I would crawl on my hands and knees to get back to her, because I know that she'll take care of me.

When a doctor is good, you have an ally you can trust implicitly. When a doctor is bad, you are in at least as much danger from them as you are from your illness.
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  #11  
Old 01-20-2000, 08:44 AM
Mullinator Mullinator is offline
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Ruffian said
Quote:
some doctors really piss me off
Especially those damn urologists.

Hey, somebody had to say it. I would have expected Wally to grab onto that one.

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  #12  
Old 01-20-2000, 09:07 AM
Ruffian Ruffian is offline
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Hee...cute, Mull.

Anyway...Sue, thank you for the clarification. However, I was never told there was any risk of sudden death, etc. And note, for doctor #1, the murmur was clearly audible. I was told MVP was just the mitrol valve essentially overextending itself, a largely benign condition that may or may not cause leakage back into the heart. In my case, the echo clearly showed the mitrol valve flapping away and leakage was minimal (this is what the doctor told me). Before I was referred for an echo, asshole #1 did detect a murmur, and sent me for the procedure to find out its source. For doctor #1, he murmur was indeed audible. Doctor #2 said it wasn't.

As for the PA, I don't know that she expected to hear a murmur. I didn't come in saying I thought I had it--I just wanted to know whether or not I did, actually hoping I didn't. In any event, she is referring me to a cardiologist to get this thing settled and determined once and for all. Dammit.

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  #13  
Old 01-20-2000, 09:32 AM
SaxFace SaxFace is offline
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Oh, boy. I think I can take the cake on a story about a shitty physician.

My mother has always been a pillar of strength and health. About 5 years ago, she was rushing to pick up my brother from work. As she grabbed her keys on the kitchen counter, she felt a sensation like a veil was covering her and she collapsed. She came to, was a little shaken, and realized that she was really dizzy. Thinking she was having a migraine, she crawled into bed.

She stayed in bed for four days. She was incredibly nauseous, couldn't eat anything and had a blinding headache.

Finally, my brother took her to her doctor.

She was in so much pain that she had to tie a kerchief around her head to walk. She yelled each time the car hit a bump. This is not normal behavior, is it?

First, the doctor made fun of her kerchief, saying she looked like a babushka or whatever. He found out she had blood in her urine and knew that she had had a high fever for several days. He sent her home with nausea pills, telling her she had the flu.

Yeah, right.

I showed up the two days later and took one look at my ashen, hollowed out mother and called the bastard. I said, "um, this isn't the flu." He said, "well, if you're so concerned, take her to the emergency room" and hung up on me.

So I did.

The emergency room immediately took her in for tests. They did a spinal tap and found blood in her spinal cord fluid. They did a CT scan and an MRI.

She had a brain aneurysm the size of a lemon in her internal carotid artery (in her brain, behind her eyes).

Her stupid doctor waltzed into the room and said, "boy, was I ever off". Luckily, my brother in law is a lawyer and he promptly told him that if my mother was to die, he would be in biiiiiiig trouble. The doc knew it, too and pulled some strings to get her an awesome, world renowned surgeon.

Lucky for him and us, Mom survived the 13 hour surgery and is a-ok today.

My mom also has a great sense of humor so she still goes to the same moron doctor. She jokes, "I know I'll always get the best care he can provide".

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Formerly unknown as "Melanie"
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  #14  
Old 01-20-2000, 10:38 AM
Doctor Jackson Doctor Jackson is offline
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Quote:
Doctors piss me off!
Whaaaat? What did I do now?

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  #15  
Old 01-20-2000, 04:24 PM
Narile Narile is offline
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I've been pretty lucky with doctors, when I was growing up, the doctor who delivered me was my pediatrician and doctor until I was 12 or so, then his partner took over and was my doctor until I moved out to CA. Here in CA, I got a referal from a friend of the families for my current doctor.

I think that is the main thing, get referrals from friends, family members, and similar. When you choose said doctor, schedule a visit to have a simple checkup, and make sure you like him/her/it. People make honest mistakes, but such can be minimalized.

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  #16  
Old 01-20-2000, 04:40 PM
WallyM7 WallyM7 is offline
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Quote:
I give - what's the deal with the pursed lips?
I wish I knew, Melin. Skelton said it in a thread I didn't even post in.

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  #17  
Old 01-20-2000, 04:44 PM
WallyM7 WallyM7 is offline
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Oops. I did post there. I said Sue(majormd) is a classy lady.

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  #18  
Old 01-20-2000, 05:00 PM
PUNdit PUNdit is offline
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Quote:
Originally posted by WallyM7:
Oops. I did post there. I said Sue(majormd) is a classy lady.
Then in this thread you answered a question from Sue by saying:
Quote:
I wish I knew, Melin. Skelton said it in a thread I didn't even post in.
I guess people really do think they are the same person. I wish that meant I got to spend Melin's lawyer money, too.


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  #19  
Old 01-20-2000, 05:08 PM
WallyM7 WallyM7 is offline
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I need a vacation.
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  #20  
Old 01-20-2000, 05:27 PM
PITA PITA is offline
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Ruffian,

Gotta agree with you- many doctors are assholes. I'm one. A doctor, not an asshole. There was a recent study that came out that showed that nurse practitioners and physician assistants have just as good outcomes as MD's. I tend to agree. They see less patients per hour, and have more time to devote to each patient.

Don't give up on us, though. There are many wonderful people in the field who actually care. Yes, I've seen some inexcusable and deplorable behavior on the part of physicians- I think that is going to change because nowadays, people are going to medical school because they want to be healers... not for financial reasons cause quite honestly, the money just ain't there anymore. (Thank you managed care). I could make more money getting a job in industry but love medicine and love my patients. Many of my colleagues feel the same way.
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  #21  
Old 01-20-2000, 10:50 PM
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Ruffian -

Sorry if my mention of "increased risk of sudden cardiac death" alarmed you; I may not have been clear that it is not believed to be valid today.

My main point in posting was to convey how changeable medical dogma can be. It sounds like you got caught in the crossfire of changing views of what is, and what is not, MVP, and what does & what does not require SBE prophyllaxis. In the early '90's as an internist, I spent a great deal of time "undiagnosing" MVP in patients who at sometime in their life had been told they had a heart murmur, had an ECHO, and because of poorly defined diagnostic criteria were told that they had MVP, needed SBE prophyllaxis, and had an increased risk of premature death. For the active duty soldiers I was seing, this sometimes was enough to keep them from going to schools they wanted to attend (Special Forces/SEALs have very rigorous health standards) & serious implications on their ability to get promoted.

There is a tendency among a good many young healthy patients (we sometimes call them the worried well) to equate playing it safe and giving them a diagnosis they may or may not have with good medical care. From your second post, it seems clear that my concern that this may have applied to you was unfounded. It also sounds like you are well on your your way to getting this resolved, once & for all.

Bottom line: If no murmur is heard, no amount of prolapse (valve "parachuting" back into the atrium) means anything.
Even if a murmur is heard, the ECHO should confirm that there is mitral regurgitation (blood flowing backwards across the mitral valve from the L ventricle to the L atrium during pumping=systole) before SBE prophyllaxis is required. There are other causes of audible murmurs that are entirely benign, and need no further evaluation or treatment.


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Experience is what you get when you didn't get what you wanted.
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  #22  
Old 01-20-2000, 11:19 PM
Ruffian Ruffian is offline
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Sax--yow! You win! What an unbelievable asshole. No, no, he's far worse than an asshole. He's the puss-filled boil on an asshole. I can't believe he's still in practice. I agree with your mother, though--I'm sure he's extra careful with her now! (Not that I would still want to see him!)

Sue...Regurgitation! That was the term I was searching my latent memory for when I said "leakage." I did a good deal of reading up on this subject when I was diagnosed--and man, there was quite a bit of vocabulary to learn ("syncope"..."dyspnea"...). Anyway, no, there was little to no regurgitation...I dunno, maybe there was. I was put on beta blockers (Corgard knocked me out; I was later switched to Lanoxin). And I wasn't freaked out when you said "sudden death," just clarifying that my form of MVP (or whatever), when it was diagnosed, was told to be mild to moderate. Sudden death (or the surgery to replace the valve) was not a concern as my valve was not so compromised.

I have this fear that the doctors think I'm some paranoid freak who actually wants to be sick (this fear was formed partially in thanks to asshole #1, who treated me that way, although he also blamed my mother). No, really, I don't want this. Tell me all's okay, and I'll be happy. (In talking with my mother tonight, apparently a doctor detected my murmur after I was born; she never mentioned it because he said it wasn't anything to be concerned about. I'm hoping 26 years later, that's really the case.)

BTW, is MVP hereditary? My b/f has Marfan's (well, "probable" Marfans as he displays all the secondary characteristics but fortunately his aorta is normal, though it's checked every year), and in his echo every year they point out his flappy mitrol valve. He has no symptoms from it, though. Yup--we have hiccupy hearts, the two of us. (Lucky him--he has a resting pulse of 50! And he's not even an athlete!)

Would our children, then, have a 100% chance of having MVP, or is it a random thing? (I do know any children would have a 50/50 chance of having Marfans, if my b/f does indeed have it.)

Hey, that sounds like a GQ question, not something in the BBQ pit. Shit! Those doctors really pissed me off!

(but I like Sue)

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I used to think the world was against me. Now I know better: Some of the smaller countries are neutral.

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  #23  
Old 01-21-2000, 12:10 AM
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Ruffian -

I'm going to give you one of my very best hedges - it depends.

I believe, but am not sure, that while MVP is more common in certain body types & that profile may be inheritied, it is not a simple dominant/recessive type of inheritance pattern. Also, assuming your b/f's condition is different from yours, any children could inherit abnormal genes for neither, one, or both conditions.

Here's a link for MVP:
http://www.mayohealth.org/mayo/askphys/qa991217.htm
and http://www.mayohealth.org/mayo/askphys/ww5rn58.htm

You probably know most of this, Laura, but it links to some decent pictures for those not familiar with MVP.

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Sue from El Paso

Experience is what you get when you didn't get what you wanted.
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  #24  
Old 01-21-2000, 07:22 AM
Bucky Bucky is offline
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I've worked with a lot of nurses in my classes and their majority viewpoint is that doctors are, indeed, often assholes. BIG issue for them was that doctors are always called doctor while patients and nurses, regardless of age, are "Sue" and "Harry" and "Bob" and so forth. The nurses report that these doctors often introduce themselves as "Dr. So-andso" even when at social events.

I don't have anyone call me "professor" even in class--I'm sure as hell not going to call anyone "Doctor if I've got a drink in my hand.

P.S. Unfortunately, I also have teaching colleagues who do the same thing--"I didn't earn a Ph.D. just to be called "Mister" Smith."

Bucky

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  #25  
Old 01-21-2000, 10:06 AM
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Bucky, I understand that POV completely! I make a conscious effort to address the doctor the same way s/he addresses me.

-Melin
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  #26  
Old 01-21-2000, 09:46 PM
Angkins Angkins is offline
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One night at my mother's house I keeled over,literally, with a pain on my right side.
The pain did go away that night but my mother insisted I go to the doctor the next day. So to humour her I went and after some poking and prodding he asked me if I thought I could be pregnant. I replied no because I had had a period. So he says "well then I think you must just be constipated, I'd do an internal on you but you'd just be embarassed." Then he proceeded to pat me on the head and left me embarassed at what he had said.
Well a couple of months later I find out I am pregnant!! Five months pregnant!! Talk about surprise ( by the way before anyone asks how I didn't know,...during the time of my pregnancy when I would have had morning sickness and such symptoms everyone including me had a terrible flu that lasted a couple of weeks, and I still had my period for the first few months!)
I immediately contacted another family doctor, a woman this time, and upon explaining what had happened she accepted to take me on as a patient. She is the best!

This same doctor refused to send my grandmother for tests saying "it's all in your head". As it turns out she has a congenative heart disorder, which if we hadn't insisted he send her for tests, we wouldn't have found out.

I'm don't usually hold a grudge but whenever I hear anyone say they are going to go see this particular doctor I make sure to tell them he's a fuckin' quack!!
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  #27  
Old 01-22-2000, 12:39 AM
Random Random is offline
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I agree. Melin, what's your take on the "esquire" issue? I never use it, although a lot of other lawyers do. But in their defense, I've never seen a lawyer use esq. in a social setting. Doctors use their title socially all the time.

Actually, I've just recalled an exception to my comment above about lawyers not using titles in a social setting. In the African American community, at least in Chicago, professional titles are more widely used. For example, an African American attorney might be addressed as "Attorney Jones."
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  #28  
Old 01-22-2000, 10:24 AM
Lucretia Lucretia is offline
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I have to agree with the OP, I've had my share of bad experiences with doctors myself. And run across a few really good ones as well, but one of the main reasons I decided to become a nurse-practitioner was that, in general, most of the nurses I have come in contact with are much nicer, more compassionate people than most of the doctors I have seen.
My own personal bad-doctor story:

When I was in the process of having my first miscarriage, the doc in the ER informed me that "Well, we can go ahead and scrape you (yes, he used those words) if you want." When informed I wanted to attempt to save the pregnancy, he said "Sorry, no real chance of that, go home and treat it like a period."
Sure did make me feel better!
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  #29  
Old 01-22-2000, 06:48 PM
matt_mcl matt_mcl is offline
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Location: Montreal
Posts: 20,196
All three doctors I've had that I can remember have been absolute sweethearts... (Well, the current one is a teense brusque, but that's ok.) Or maybe I just have rosy memories because I've never been seriously ill, and also because the last one informed me that I'm HIV negative.

Also, I have a lot of sympathy for doctors since my mom is one. And I know she's a wonderful doctor because I've heard her at home agonizing about her patients (in a confidentiality-maintaining manner, of course) and about the dreadful underfunding at her hospital.

Both of the only medical practitioners I've seen whom I haven't liked were shrinks, interestingly enough. There was the one person in Winnipeg who diagnised my eccentric nature and (at the time) lack of sociability as Asperger's autism. In other words, my personality was a disease. Ouch.

The other guy didn't go so far but he was kind of unsympathetic and unhelpful when I tried to describe my feelings. Meh.
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