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playing doctor

nonetheless, i persist in checking up online when i have a problem, just to see if i have signs of
anything serious. most recently, i found that my body was showing a lot of signs of a sluggish thyroid. and the thing is, that's something that i can attempt to deal with myself, because there are dietary changes and over the counter supplements that i can try without even making an appointment. seems to me that that actually helps the healthcare system, since, at the worst, it delays the time that it takes me to make an appointment and lets me assure my doctor that i've tried some of the basics.

in the interest of those who'd like to try "helping", i've made this little list of hints on how to consult the internet for health advice without incurring the wrath of the medical system.

1. read from good sources :: the reasons that doctors get furious about self-diagnosis is that so many people are getting their information from blogs that offer only anecdotal evidence, if any at all. if you're going to do this, do it right. reliable sites are ones that provide their sources and link to backup like studies or peer reviewed papers. you can be as skeptical as you want about "big pharma", but the fact is that the only way to determine the scientific validity of treatments for any condition is through carefully controlled testing that is reviewed by others in the field to confirm its validity. [and fyi, that also goes for beauty products, which are notorious for their use of unverified, qualitative data.]

2. understand interactions :: many over the counter drugs, including natural supplements, can interact with prescription drugs. before you take anything, make sure that there is no possibility that it can compromise what you're already taking. this sort of information is readily available online, from reliable sources. and remember to always inform your doctor of any supplements you're taking.

3. remember ockham's razor :: if you hear hooves, think horses and not zebras [unless you live in the african savannah, in which case reverse that]. if something is described as a rare condition, it's because it's bloody rare. whatever the most common explanation is for your symptoms is the most likely answer. and while we're discussing symptoms, make sure that you look at a list of all the symptoms of a condition. symptoms tend to happen in clusters, even if you don't put them together. unless you can say without hesitation [i.e., without thinking "well, i kind of feel that sometimes"] that you have a symptom, assume you don't. that said, if you're able to look at a list of symptoms and realise that while they might not have seemed related, they are all things from which you've suffered in the last thirty days or so, take that seriously. when i "diagnosed" myself with a sluggish thyroid, i had experienced about 80% of the symptoms listed on several reliable websites. no other condition even came close to matching up and it actually linked up symptoms that i hadn't thought of as related.

4. prescribing information sheets are your friend :: these are the "cheat sheets" that are prepared by drug companies for doctors and pharmacists. in practice, pharmacists know them really well, while doctors have a general familiarity. if you're thinking about asking your doctor about a specific drug, you're going to want to know what's on that sheet really well. in fact, the best thing you can do is print it out and bring it with you. prescribing information sheets aren't like marketing pieces. by law, the company is required to disclose all the information it's assembled on its drug, including testing that proved its efficacy and incidence of adverse reactions, as well as potential interactions.

5. get copies of your tests :: blood tests? ekg's? you're entitled to a copy of any physical tests that are done on your person. your doctor gets them automatically, and may charge you to get a copy from them. the clinic, lab, or hospital that does the tests should provide them free of charge. [that's in canada.] get them, read them, look up the results online to see what they mean. the threshold for clinical conditions [like hypothyroidism and anemia] are drawn at a specific point. you can be close to that threshold without meeting it and still be feeling symptoms. ask your doctor to talk you through the results and ask them if there are any areas where you should be concerned, without there being a clinical problem yet.

6. be nice :: this is generally good advice in life, but if you want to avoid alienating your doctor, it's necessary. doctors don't mean to be dismissive of your symptoms, but a lot of them are overworked and are moving too fast to put signs and symptoms together. in an ideal world, they would have time to reflect on every patient's history and develop a profile that allowed them to see the larger picture. in the current reality, that doesn't happen and, in a lot of cases, it's not because they don't mean well. dom had the same doctor for years and he never managed to work out that he had multiple sclerosis. that didn't make him a bad doctor. it made him busy. your doctor is probably the same. ask them if it's possible certain symptoms can be related. tell them that you've read about a condition that could explain your symptoms, but that you'd like their expert opinion. if he or she really won't listen, then you should consider finding another doctor. [easier said than done, i know.] it's one thing to disagree with the information you've found. it's another matter entirely not to take it seriously when you've done real research.

those are really the keys that i've found to success. i will say that i find younger doctors to be a lot more open-minded than previous generations about self-diagnosis and the information available on the internet. having been raised and trained with the technology, they know that some of the information can be useful and appreciate when their patients take the time to evaluate the sources and ask pertinent questions. i'm hoping that's not just my experience.

go forth and play doctor, my friends. but don't give up on actual doctors. 

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