There are several different types of medically induced PTSD, which range from life-threatening medical emergencies/illnesses to extensive surgeries but also include negative experiences with healthcare providers. It is the last group that I wish to talk about, because I now have three patients who have been formally diagnosed with medically induced PTSD because of the negative experiences with healthcare providers.
Two of the patients have a chronic inflammatory state due to mold exposure. The third had several years of chronic sinusitis due to an immunoglobulin deficiency that went undiagnosed because her sinus headaches were dismissed due to her being a math major. I wish I could make this up, but I can’t. Her story has been published in my book The Manual for the Medical Management of Chronic Sinusitis: A Holistic Approach.
I have a fourth one on the horizon. Again, a patient complaining of chronic fatigue and headaches with a recurrent vesicular skin rash who had been to multiple physicians for the past two years. So far, she’s been diagnosed by me to have chronic sinusitis (CRS), severe obstructive sleep apnea (OSA), and recurrent shingles. Currently, we are waiting for confirmatory testing to see whether or not she has an underlying immunoglobulin deficiency.
What I find particularly frustrating about the fourth case is that the patient had been evaluated by both neurology and otolaryngology (ENT). Both of these physicians have a working understanding of evaluating patients for OSA, yet a sleep study was not offered to the patient until she got to my office.
In all four cases, the patients presented with physical and/or radiographic findings of underlying pathology. One patient presented with hives, another with purple discoloration of their feet due to a hypercoagulable state, which was easily corrected with low-dose aspirin. The CRS patient’s ENT threw his hands up in frustration when the patient’s sphenoidectomy hadn’t healed after six months of post-op care. The OSA patient had complete obstruction of her oropharynx, or a Malampatti Grade IV, and a neck circumference of fifteen inches, both considered risk factors for OSA.
Ironically, all four patients were told by other physicians that they couldn’t find anything wrong with them. Sadly, by the time they got to me, they were scared, angry, and frustrated. They were afraid that this visit would just be another waste of time. In some instances, they showed up with family members for support and protection because they were afraid that they might be browbeaten by the physician, which had occurred in the past. Patients have told me
several times that other healthcare providers told them it was all in their head and to get over it. About a decade ago, I had a young patient who was told by a specialist at CHOA (Children’s Healthcare of Atlanta) that there was nothing wrong with her except that she was a wimp and too afraid to tell her parents that she didn’t want to be a competitive swimmer anymore.
Afterwards, she was diagnosed with POTS (postural orthostatic tachycardia syndrome) by an expert in autonomic dysfunction and an IgG deficiency by me. Since correcting both chronic illnesses, the patient moved to Colorado and is back swimming and running.
Sadly, we see this all around us. There are constant articles of patients who had legitimate concerns of medical illness, many times cancer, but were ignored by physicians. The patient finally finds a physician who is willing to listen, and the medical illness is corrected. And that is the sixty-four thousand dollar question. Why didn’t the other physicians listen, look, or test the way we did?
The answer? It’s the Healthcare Industrial Complex (Academia, Health Insurance, Big Pharma, and Corporate Hospital Organizations). This complex wishes for a one-size-fits-all approach to medicine. One problem, one solution, all in a nice, neat little package. Point and click on symptoms, spit out a diagnosis in a matter of minutes, here’s your prescription, and there’s the door. Unfortunately, many studies exclude patients from their studies if they have other underlying illnesses, so in many instances, the protocols work well in trials but fail in the general public because physicians don’t have the luxury of excluding patients.
With over eight billion people on the planet, we are seeing more and more genetic diversity, and with it, more atypical presentations of illnesses. This will require more time and laying hands on the patient, not less. The art of taking a good history and physical is dying, and it needs to be resuscitated if we physicians wish to deliver the excellent healthcare our patients deserve.
