This article appears in Fall Boomers magazine.
There’s nothing more frustrating than struggling with an illness or a set of symptoms that cannot be diagnosed by a physician.
It’s discouraging and disappointing for both patient and doctor, said registered nurse Teri Dreher, a board certified patient advocate and owner/founder of NShore Patient Advocates in Chicago.
“Doctors like to fix things and get frustrated at their own failure as well as the patient’s displeasure,” said Dreher, author of “Patient Advocacy Matters.”
A failure to diagnose occurs for a variety of reasons, including that every human being is different and symptoms may manifest differently in different people, Dreher said.
“When tests turn up negative, the doctor is just eliminating possibilities,” she said. “People also experience pain and discomfort in different ways; there is definitely a mind-body connection. Chronic stress not only causes anxiety but physiological changes in the body. Chronic inflammation is a good example.”
Sometimes symptoms are difficult to identify. It could be that there is more than one medical problem at work or that symptoms are the manifestation of early disease that isn’t yet diagnosable, Dreher said. Some illnesses have no definitive test to make a clear diagnosis, while others are exceedingly rare, she said.
Because no physician knows everything, an undiagnosed patient may need to consult a different kind of doctor.
“Specialists are often called for to take a fresh look; even naturopaths, chiropractors and nutritionists have been able to help people with symptoms not well managed by traditional medicine,” Dreher said.
Some common illnesses that are underdiagnosed include endocrine disorders, cancer, spinal issues and joint problems, Dreher said.
If you or a loved one have gone months or even years without a diagnosis, be an advocate.
“Be persistent in seeking an answer, but be polite. Ask the doctor who he would recommend to take another look. Ask what the ‘differential diagnosis’ is and do your research,” Dreher said.
Just don’t turn to “Dr. Google.”
“It is infuriating to doctors when patients self-diagnose based on something they have read on the internet. Medicine is an art and a science and there is no replacement for a good doctor,” Dreher said.
It’s time for a change if you feel dismissed by your doctor or if he or she tells you “It’s all in your head,” Dreher said.
“Leave that doctor and seek help in a different hospital system, if possible, that does not share medical records; the second doctor may not want to disagree with the first who could not find anything,” she said. “Doctors depend upon each other for referrals and they protect each other. In today’s litigious health care environment, they are apt to protect each other.”
As a patient you are responsible for taking care of yourself and making sure you do all you can to stay healthy and be compliant with doctor’s orders, Dreher said.
“If the doctor prescribes a medicine and you do not want another pill, tell him and talk honestly about your concerns,” she said. On the other hand, “some patients feel they have had a failed appointment if they don’t walk out with a prescription.”
Polypharmacy, which is defined as taking five or more drugs on a regular basis, is a serious and growing problem.
“Patients should not encourage doctors to hand out prescriptions casually. The more medicines you are on, the more risk of dangerous interactions,” Dreher said. “Intensive care units are filled with patients who got there by smoking, drinking to excess and overeating. Take care of yourself and do the best you can to stay healthy.”