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  #1  
Old 16 April 2008, 01:57 AM
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Ambulance When the problem is Munchausen's

A young woman seeks treatment for one condition but won't accept help for a different diagnosis.

http://www.latimes.com/features/heal...,7364473.story
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  #2  
Old 22 April 2008, 06:39 AM
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So why not just give the person a psychiatric drug, but lie and tell them that it's the drug they want? Problem solved.

The only other way I can think of helping these people is to conk them on the noggin and drug them until they submit, but I doubt that'll ever be popular. That or killing them if they're too intractable.

Ah, if only there was some way of preventing mental illnesses like that. Some way of screening the population.
These illnesses are a terrible burden, and I think the medical establishment and the general public should use every means necessary to eliminate them.

- Pseudo_Croat
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  #3  
Old 22 April 2008, 06:53 AM
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Originally Posted by Pseudo_Croat View Post
So why not just give the person a psychiatric drug, but lie and tell them that it's the drug they want? Problem solved.
Because I suspect that would be considered highly unethical. Anyway, the article pointed out that drug therapies are not effective in these cases anyway.

me
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  #4  
Old 22 April 2008, 07:10 AM
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Ambulance

Also, a lot of sufferers of Muchausen's tend to be quite medically literate. Any attempt to give them medicine under false pretenses might well fail. ("Doctor, you said that you giving me Sylimedium, but these are round white pills while Sylimedium are greep caplets.")

Most of the time, the people 'know' what their 'problem' is and pretty much have determained themselves what the 'treatement' should be.
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  #5  
Old 22 April 2008, 07:24 AM
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Quote:
Originally Posted by Pseudo_Croat View Post
So why not just give the person a psychiatric drug, but lie and tell them that it's the drug they want? Problem solved.

The only other way I can think of helping these people is to conk them on the noggin and drug them until they submit, but I doubt that'll ever be popular. That or killing them if they're too intractable.

Ah, if only there was some way of preventing mental illnesses like that. Some way of screening the population.
These illnesses are a terrible burden, and I think the medical establishment and the general public should use every means necessary to eliminate them.
Judging by the style of your postings, you would also have been screened out. Lying about which drug you are giving a person is unethicalk and in most jurisdictions is illegal. It also means if they seek help for a side effect, the A&E dept of the hospital won't know what drug they are really taking because what is in the bottle doesn't match the label. That could mean they are given an emergency treatment that is lethal in combination with the drug.

Genetic screening won't work because many illnesses are acquired during life. Viral infections can cause mental illness. The same factors that can, in some individuals, lead to mental illness will, in others, lead to creative genius.

You oversimplify matters. Things are not simple black and white however much you want them to be that way. Isn't it time you accepted that life comes in shades of grey and your simplistic solutions won't work?
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  #6  
Old 22 April 2008, 12:05 PM
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Originally Posted by Pseudo_Croat View Post
Ah, if only there was some way of preventing mental illnesses like that. Some way of screening the population.
These illnesses are a terrible burden, and I think the medical establishment and the general public should use every means necessary to eliminate them.

- Pseudo_Croat
Do you feel the same way about, say, autism spectrum disorders?
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  #7  
Old 22 April 2008, 12:29 PM
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Do you feel the same way about, say, autism spectrum disorders?
Especially when you consider the burden of an autistic/Asperger individual living in a world of neurotypicals, plus the terrible burden parents of autistic and Asperger children must cope with. It's terrible suffering for the individual unable to fully appreciate a world so rich in metaphor, double meanings and shifting rules and a dire burden for society. Such dire burdens surely warrant screening to eradicate the burden for all concerned and to ensure conformity to the neurotypical type which is so much better suited to human society.

Genetic screening wouldn't work for many of the mental conditions because the development of the brain is dependent on in utero conditions as well as genetics. In early life, the brain continues to adapt (pruning or growing neurons) so you might not see signs of mental illness until the child is several years old. Screening out children at several years old once the brain organisation is established and it is possible to look for signs of potential future mental illness is variously called infanticide, homicide or simply murder. Illness, injury nd environmental toxins can also cause mental illness. So can temporary upsets in a person's own internal chemistry.

The flip side of mental illness may be genius, so by screening and removing anyone who might possibly develop a mental condition we might condemn the human race to stagnation.
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Old 22 April 2008, 12:43 PM
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While we're "fixing" society, many physical injuries and illnesses create suffering and are a burden to society. Maybe we should just shoot people when they break their legs.
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  #9  
Old 22 April 2008, 12:58 PM
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From the story, the woman didn't seem to have Munchausen's so much as she had an addiction to painkillers. Perhaps there was something more to the story that wasn't mentioned, but all of her actions sounded like things done by a drug seeker looking for a fix.

The thing that worries me so much about the diagnosis of Munchausen's is all too often (if the medical reality shows I watch are to be believed) a doctor is more willing to believe a patient has a mental problem causing them to imagine themselves to be sick than to believe he or she is unable to come up with the correct diagnosis.

It frightens me how often people with rare disorders go years bouncing between doctors (or accepting one doctor's diagnosis that there isn't anything wrong), only finally getting help when they are near death or in crippling pain. The stories are as alike as the plots of romance novels: patient has symptom intense enough to send them to the ER or GP doctor; doctor runs tests, which show up either normal or the doctor misses or ignores a value that suggests a problem; doctor prescribes a drug or treatment he thinks might work; patient's symptom does not improve, so patient returns to doctor; doctor decides it's all in the patient's head; patient goes to specialist, or patient has new symptoms that cause them to return to original doctor; wash, rinse, repeat.
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  #10  
Old 22 April 2008, 01:04 PM
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Quote:
Originally Posted by llewtrah View Post
Judging by the style of your postings, you would also have been screened out.
I just stepped in the sarcasm that is dripping from P-C's post.
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  #11  
Old 22 April 2008, 01:06 PM
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Quote:
Ah, if only there was some way of preventing mental illnesses like that. Some way of screening the population.
These illnesses are a terrible burden, and I think the medical establishment and the general public should use every means necessary to eliminate them.
SO is a nurse. And in her career she's nursed several severely disabled children. Children who can't hear, can't speak, can't see, can't even think, really. Children with such massive birth defects that they will never be able to live on their own, or even comprehend much. They require 24/7 nursing.

We paid our mortgage off of your state and federal tax dollars. Your insurance premiums were raised to pay for SO's salary.

The amount of medical care even one of these children used could have paid for dozens, if not hundreds, of low income kids' normal medical care.

Your school systems paid for SO's salary, the money for the 'special bus', the teachers and teachers aides, that 'taught' these children, the special technology they needed, and the physical, occupational and speech therapists who worked with them in school.

Got any suggestions for eliminating these terrible burdens?

OK, just caught on to the sarcasm. Bang me with a fish. But there are people who actualy think like that (in my more despairing and cynical moments, I've sometimes been one of them).
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  #12  
Old 22 April 2008, 01:08 PM
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Quote:
Originally Posted by damian View Post
I just stepped in the sarcasm that is dripping from P-C's post.
Are you certain she's being sarcastic? I'm not, based on thing she's posted in the past.
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  #13  
Old 22 April 2008, 01:17 PM
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Quote:
Originally Posted by mags View Post
From the story, the woman didn't seem to have Munchausen's so much as she had an addiction to painkillers. Perhaps there was something more to the story that wasn't mentioned, but all of her actions sounded like things done by a drug seeker looking for a fix.
From my years of medical training*, I would guess that a junkie would be looking for a hit ASAP. They would claim to be in excruciating pain and also get a prescription for refills.





* I've seen every episode of both Scrubs and House.
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  #14  
Old 22 April 2008, 01:44 PM
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Quote:
Originally Posted by damian View Post
I just stepped in the sarcasm that is dripping from P-C's post.
Except that isn't sarcasm, that is how P-C sees the world (she has autistic spectrum disorder)
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  #15  
Old 22 April 2008, 01:55 PM
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Quote:
Originally Posted by ULTRAGOTHA View Post
But there are people who actualy think like that. . .
Yes, and as Llewtrah has said, PseudoCroat is one of them. I'll bet real money she was not being sarcastic.
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  #16  
Old 22 April 2008, 01:58 PM
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I wonder if the woman in the article could be charged with fraud, somehow, for lying about her health and family condition in order to get drugs. (It didn't say in the article, but I'm guessing none of those family members died, or possibly ever existed.)

I realize that's a dangerous path to go down - I'd hate to be charged with fraud if the doctor couldn't prove I had pain where I said I had it. (Actually I've BTDT - not the fraud but spending years telling doctors it hurts and them finding no cause, until just recently - nothing dangerous btw. One big difference being I always went to the same two doctors.) But if they could track down several hospitals she's been to, using the grandmother as a witness, that might help the case and convince the woman to get the help she needs.

Last edited by Eve MG; 22 April 2008 at 02:08 PM. Reason: remove double negative
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  #17  
Old 22 April 2008, 04:13 PM
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Problem is, I wasn't being sarcstic. All I was suggesting it that people should find cures or preventative measures for things that are burdens to society that have no positive upside (e. g. Munchausen's) and leave alone things that are a mixed blessing (e. g. high-functioning autism). I wasn't advocating anything eugenic, just an extension of preventative medicine.

After all, diseases like polio are (were) just as much a burden on society as mental illnesses; should we, then, have not spent the money to eradicate them?

And I get what ULTRAGOTHA said; all the money we spend on helping those who are incurable burdens on society could go to better causes, like insuring the uninsured.
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  #18  
Old 22 April 2008, 04:36 PM
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Quote:
Originally Posted by Pseudo_Croat View Post
Problem is, I wasn't being sarcstic. All I was suggesting it that people should find cures or preventative measures for things that are burdens to society that have no positive upside (e. g. Munchausen's) and leave alone things that are a mixed blessing (e. g. high-functioning autism).
And who gets to decide what "things" are purely burden and what "things" are mixed blessings? You?

What things besides "high-functioning autism" do you consider a "mixed blessing"? And what about people with autism who are less high functioning? Are some of them a burden? If so, who decides where along the spectrum the line will be drawn? You?

Quote:
After all, diseases like polio are (were) just as much a burden on society as mental illnesses; should we, then, have not spent the money to eradicate them?
If you think you can develop a vaccine to protect humans against mental illness, I'll be happy to recommend you for a grant. Of course, so far we haven't even determined the causes or practical treatment for most of these illnesses, but I'm sure that won't stop you.
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  #19  
Old 22 April 2008, 07:40 PM
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Quote:
Originally Posted by Pseudo_Croat View Post
Problem is, I wasn't being sarcstic. All I was suggesting it that people should find cures or preventative measures for things that are burdens to society that have no positive upside (e. g. Munchausen's) and leave alone things that are a mixed blessing (e. g. high-functioning autism).
I'd consider high functioning autism a terrible burden, a sort of mind-blindness - the inability to empathise and the reduction of life to black-and-white. I wouldn't consider it a mixed blessing (many of the Aspies at work have been deeply unhappy and frustrated at their limited inability to understand and interact naturally with neurotypicals), but YMMV as you have no experience of being any other way. And so would the mileage vary of people whose mental illnesses, temporary or permanent, makes them incredibly creative individuals or who function well in society in spite of a mental illness. Until you develop the ability to understand what goes on in other people's minds, I really don't think you are in anyway well-placed to judge, especially given your persistent simple reduction of complex issues with multiple interacting causes to a screenable detectable decision.
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  #20  
Old 22 April 2008, 07:46 PM
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There are lots of mental illnesses that have "no benefit": anorexia, schizophrenia for example.

Shouldn't those be eradicated as well if we're trying to eliminate Munchausen's?
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