HI!

So here is Livey, yelling at me to post.

heh. What are adopted blog sisters for, anyway?

Don't worry, we're fine. We've been a bit quiet the last few days but although we were up to our mutual derrieres in alligators, they weren't really bad ones. A bit snappish, but puny enough to beat back with a good big stick.

See Pico the Cat up there, snoozing away on my banner? Once I got back from Door County, I thought a day or so would do it for the sleep effort. But no. I really do know better than to try to forecast Required Days of Sleep any more. Why I ever blithely predict only one day of it is beyond me.

So first I slept for several days, then Livey did. She's been pretty sick. On top of that, part of what's exhausting her goes beyond her physical ailments. It's the fallout from trying to get her medical problems treated, and getting frustrated in those efforts.

Her primary doctor is a first-class jerk. Livey suspected for a while that Dr. Jerk had written something in her file about Livey being a hypochondriac.

This is absolutely ridiculous. Just take my word for it, okay? I've been here watching her for three months. I've been with her now on several doctor's appointments. I googled and reviewed a fair amount of surfed up literature on hypochondria. Without laying out all the gory details, Livey clearly does not meet the criteria. Any simpleton could see that. It's way off base.

Last week, Livey finally reviewed her medical file. Here are the results.

If any of you have ever had a so-called health professional say that about you, when you truly were sick, then you know how awful it is. It knocks your feet out from under you. Unfortunately, one result is that you tend to respond in ways that incorrectly appear to verify their suspicion. You get anxious and depressed and object to what they're saying. You're worried about your health, and say so. You want them to run diagnostic tests instead of just ASSUMING it's *only in your head.* When they *reassure* you that there's nothing wrong, you don't believe them and don't trust them.

Because you SHOULDN'T.

But all those reactions? Why, they're listed in the DSM-IV-TR - the psychiatric *go-to* diagnostic manual - as symptoms of hypochondria!

I took one of the supposedly *standard* tests for hypochondria myself. I know, and anyone who's seen either my body or my chart knows, that my medical problems are genuine and serious; and that I don't have hypochondria. Yet when I took that test, I scored way high for hypochondria. I do have to spend some time thinking about and working on my health concerns. Sometimes I worry about them, or get depressed for a while, whatever.

That's extremely reasonable for someone with my health problems. In fact, if I didn't react that way, I'd need psychological help. I'd also have much worse physical problems than I already do, because that's what happens when you fail to manage your illnesses as best you can.

Dr. Jerk first put that *hypochondria* bit in Livey's chart in 2005. But you see, Dr. Jerk is not qualified in psychology.

So what the hell was she doing making a diagnosis she's not qualified to make?

Especially without even performing any psychological tests?

Let's assume for a minute that Dr. Jerk really did believe her own trumped up diagnosis. The fact remains that a patient with hypochondria can still have serious and real medical problems that must be treated. Psychological issues need to be treated too - not just used as a handy excuse when a doc doesn't want to bother to figure out what's physically wrong.

The appropriate course of action would run something like this: Test the patient for physical ailments. Refer the patient to a qualified psychologist, who then runs psychological diagnostic tests. Work with that psychologist to determine what is and/or is not physically wrong with the patient.

Dr. Jerk, the *physical* doctor, would then treat any genuine physical ailments; the psychologist would treat any genuine psychological ones.

If I - totally not a doctor, me - can learn that from a fairly brief internet search, surely Dr. Jerk could too.

One thing that disappointed me during my search was the lack of medical literature about the misdiagnosis of hypochondria among patients with real ailments. Yet both myself and many others have had that happen to them. The internet abounds with anecdotes from patients about it, including many examples of misdiagnoses where a patient was sent home with that *reassuring* pat on the head, then almost died from the genuine, and untreated, medical problem.

Not to mention cases where the patient, unfortunately, did die.

But medical studies conducted to find how and why docs misdiagnose hypochondria? Not. If there are any, they certainly weren't easy for me to find.

So I'll make a perfectly unqualified diagnosis here, based on nothing but observation and my understanding of human nature. I diagnose Dr. Jerk as a lazy nasty creep, who doesn't want to be bothered with a patient with multiple symptoms - a *high maintenance* patient - and instead of honestly saying,
--Sorry, you aren't the patient for me because I'm too busy to deal with you just now-, she blames the patient for her own illnesses instead.

You'd think that it wouldn't be hard to find another doctor. You might also think that a doctor that nasty would lose her client base to other doctors, just due to good old market forces. Yes. They should lose patients to good docs. Doctors that have good skills, that they're willing to apply, and are able to do so with a courteous bedside manner.

Unfortunately, up here, there is a dearth of good docs. Not many people. Not many patients.

No competition.

See, most docs have a lot of bills to pay. Medical school ain't cheap, and neither is malpractice insurance. Good ones tend to gravitate to more populated areas with a larger patient base, where they can make enough money to pay those bills.

So here in the Northwoods, finding another doctor to go to isn't easy. At this point, though, it's essential. That will be one of Livey's tasks in days to come.

If a doctor fails you, FIRE THEM. Go hire someone else.

Over and over, I get this sense, here, of subtle forces at work. I've been planning another little camping trip, up to the UP, the upper peninsula of Michigan. I want to do some more agate collecting. I'd planned to leave on Monday.

I got rained out.

That was good news, though. Livey's car had a flat tire, and she needed the Saturn to get to her appointment to see her psychologist. This shrink isn't an MD, but is a nurse practitioner. Livey was referred to her by a previous excellent therapist who'd moved away to Minnesota. The new shrink knows Dr. Jerk full well.

I desperately wanted Livey to keep that shrink appointment because there was so much riding on it, you'd be amazed. Her whole health treatment! Getting her GI problems addressed, dealing with the total BS *hypochondriac* garbage in her medical file, the allergies - all this totally untested but obvious symptomology.

When I saw Livey come back in the house after that appointment Monday, she was surrounded by this almost tangible aura of settledness.

I cannot tell you enough what a relief that was.

The shrink is qualified to make psychological diagnoses. Yes. Livey is not a hypochondriac. No.

But that Dr. Jerk? Guess what. Between you, me, and the lamppost, she's got some psychological issues. Not to mention, she's said to be well known for the nasty, dismissive creep that she is.

When you've gotten a false diagnosis of *hypochondria* from an unqualified physician, having a qualified psychologist explain how, and why, you are not a crazy hypochondriac can be the most comforting thing in the world.

Now that's what I call reassurance.