The Undiagnosed

I caught a couple of Mystery Diagnosis episodes on Monday and Tuesday.

What struck me was the fact that 3 of the patients were given the suggestion by their doctors that they had psychosomatic problems.

In one case, a fit runner started to feel fatigued, and then started to get arthritic symptoms. As time wore on, he could no longer run, because depressed, and overweight. Despite the fact that the patient came to see his doctor at least a year before he became overweight and depressed, the doctor still suggested that it was psychosomatic. As I heard this, I asked the TV screen, “wtf?!” but alas, the TV did not answer me. I should mention that this doctor did end up diagnosing the rare problem… but in many cases, the patients end up having to go to multiple other doctors.

In another story, a young woman was forced to go to school every day despite near crippling migraines, because the doctor told her parents that she was making it up. Why did he assume this? Pretty much just because he couldn’t find the problem. If they can’t find the problem, you know, there obviously can’t be one.

The girl then went blind in school. Only at that point was she taken to a doctor that was able to diagnose the problem.

It occurs to me, that all these cases on Mystery Diagnosis- those are people who at the end, found their diagnosis. How many people out there are still undiagnosed? Will they ever be?

I just kinda gave up for a number of years, realizing that I wasn’t being taken seriously. I too was indoctrinated with the idea that doctors know all. Thankfully, in my 20's, I've learned otherwise.

Most doctors are more like... your regular cop. The detectives, those are harder to find. And even some detectives aren't that great at their job.

As far as the thyroid goes, I find it disappointing and irresponsible that so many doctors only test the TSH- I am most certainly not the only case where that one test did *not* find the problem. That was dangerous- I should have been getting flu shots. You bet I would have been if I'd known I had a problem with my immune system!!

Check out this MSN article (2006) with Dr. Judith Reichman, that still purports that unless TSH levels are elevated, no further tests should be run:

http://www.msnbc.msn.com/id/12244306/

I’m becoming increasingly fond of Mary Shomon who writes for About.com -these are her articles in response to an earlier article by Dr. Reichman (I could not find this earlier article).

http://thyroid.about.com/cs/publicawareness/a/todayshow.htm

http://thyroid.about.com/library/weekly/aatodayshow2.htm

How would a TSH test tell you if T4 isn't being converted into T3 properly, for example?

The thyroid- there are complex issues there. The TSH test doesn't cut it. Technically, since the pituitary produced the TSH, you aren't even looking at the directly at the thyroid or it's products, you presume that the pituitary gland and negative feedback system are working properly.

I realize the symptoms of hypothyroidism can be hard to put together. The thing is, two of my doctors did put it together enough to test my TSH. Unfortunately, that was not the only test they needed to have run.