"So you're saying I have to live with it?!"

[101N]

The catastrophizers/drug-seekers refrain.

http://doctorskeptic.blogspot.com/2016/10/yes-you-do-have-to-live-with-it-and.html?spref=tw

---

Members don't see this ad.

 

[BobBarker]

Yea, I told one to tough it out last week. That went over well. My reviews haven't taken a ding yet but the library is closed on the weekend.

 

[hyperalgesia]

If someone incredulously asks me something in an accusatory way, I defer. There are a lot of other docs they haven't seen who may have other options.

 

[101N]

Hot potato: a controversial issue or situation that is awkward or unpleasant to deal with.

 

[hyperalgesia]

Hot potato: a controversial issue or situation that is awkward or unpleasant to deal with.

Even a hot potato eventually cools down after it passes through enough hands. Eventually it's, "I've seen 3 other docs and they all say the same thing, that I have to deal with it. Is that pretty much the reality?" At this point, the potato can be leveled with...

 

[ampaphb]

This is one of the few instances where I tend to side with 101N. Not with his absolutist position that we have nothing to offer you, but where those of us who are willing to try non literature-based approaches need to be transparent with our patients.

Sure, go ahead and do pulse mode radiofrequency. Inject steroids into the disc. Address the GRC or the basivertebral nerve. Peripheral stim. PRP, amniotic tissue, or stem cells. But only after you've told the patient there is no literature to support our efforts, or at the very least, that it's no better than placebo. Anything less is fraud.

 

[drusso]

This is one of the few instances where I tend to side with 101N. Not with his absolutist position that we have nothing to offer you, but where those of us who are willing to try non literature-based approaches need to be transparent with our patients.

Sure, go ahead and do pulse mode radiofrequency. Inject steroids into the disc. Address the GRC or the basivertebral nerve. Peripheral stim. PRP, amniotic tissue, or stem cells. But only after you've told the patient there is no literature to support our efforts, or at the very least, that it's no better than placebo. Anything less is fraud.

Ditto for mind-body interventions, alternative medicine, hypnosis, EMDR, and psychologizing in general.

 

[101N]

"Sure, go ahead and do pulse mode radiofrequency. Inject steroids into the disc. Address the GRC or the basivertebral nerve. Peripheral stim. PRP, amniotic tissue, or stem cells. But only after you've told the patient there is no literature to support our efforts, or at the very least, that it's no better than placebo."

As we all know there are far too many of us out there who are more than willing to rationalize the rampant over utilization of interventions under the guise of patient advocacy. Don't try that BS with me.

 

[Aether2000]

Not only will they live with it, they will also die with it. Most chronic pain is until death but the degree to which they suffer with it and they let it rule their lives is a choice.

 

[Ducttape]

Hot potato: a controversial issue or situation that is awkward or unpleasant to deal with.

doh. my definition of hot potato was "a tuber warm enough to melt cold butter"

one key difference between pRFA, GRC injection, periph stim vs. CBT, biofeedback, pain psychology is that the latter may have long term benefit and has very little potential harm.

 

[GH253]

Whoever agrees with that blog post doesn't belong in medicine, the purpose of which is to ameliorate disease. The limits of medical technology aside, the author is trivializing patients' suffering and the potential loss of everything that makes life worth living, if not implying that they somehow deserve to suffer or that suffering should be accepted as the default state of life. If a disease ruins your life, knowing that there are other people who also suffer will not help you. It's easy to mouth off like the author when you're healthy, but when it's your own life that's being shattered, you'll come to appreciate how utterly worthless doctors like him are.

 

[ampaphb]

"Sure, go ahead and do pulse mode radiofrequency. Inject steroids into the disc. Address the GRC or the basivertebral nerve. Peripheral stim. PRP, amniotic tissue, or stem cells. But only after you've told the patient there is no literature to support our efforts, or at the very least, that it's no better than placebo."

As we all know there are far too many of us out there who are more than willing to rationalize the rampant over utilization of interventions under the guise of patient advocacy. Don't try that BS with me.

Explain to me how performing a procedure which has a 30-35% chance of success, after first making the patient aware of these numbers, constitutes " rampant overutilization".

Sent from my SAMSUNG-SM-N930A using SDN mobile

 

[ampaphb]

Whoever agrees with that blog post doesn't belong in medicine, the purpose of which is to ameliorate disease. The limits of medical technology aside, the author is trivializing patients' suffering and the potential loss of everything that makes life worth living, if not implying that they somehow deserve to suffer or that suffering should be accepted as the default state of human life. If a disease ruins your life, knowing that there are other people who also suffer will not help you. It's easy to mouth off when you're healthy, but when it's your own life that's been devastated, you'll come to appreciate how utterly worthless doctors like that author are.

Sent from my SAMSUNG-SM-N930A using SDN mobile

 

[GH253]

The catastrophizers/drug-seekers refrain.

http://doctorskeptic.blogspot.com/2016/10/yes-you-do-have-to-live-with-it-and.html?spref=tw

It's the perfectly rational reaction of someone with a serious medical problem confronted with a complacent doctor.

 

[GH253]

Don't feed the deadbeat doctor. Take your business elsewhere.

 

[101N]

< solicitous --- supportive ---adversarial >

When dealing with chronic pain it's key to understand this continuum. You don't, so read about it. Advocacy can backfire and serve to entrench maladaptive coping.