You’re sick alright, but not physically…
One of the benefits of the Electronic Medical Record (EMR) system that we use is that if a patient is seen at any hospital in the country using the same EMR, we can view their records. This includes notes from other providers, test results, etc.
Depending on the number of records, there is often a short delay as the system refreshes. The more records, the longer the delay. “Frequent flyers” can take a long time to load – the truly complicated patient, or the full-blown hypochondriac.
Today we saw one of the latter. The system froze for so long we thought it had gone down. This patient has been at every major medical center in a 250 mile radius, seen just about every specialist possible and undergone more scans, screenings and evaluations than we can count. And there is nothing physically wrong with them. (Unless you want to count the resolved 2013 yeast infection.)
I leave it to the mental health professionals to determine if this is boredom, a cry for help, or some profound need for attention, but it’s rare to see someone so committed to wanting to be sick. With Open Notes being the standard now, where patients have access to read what is in their provider record, I am sure this person has noticed that valetudinarian appears more than once. A few actually commented outright that, “…patient is a hypochondriac.”
I will give her credit, though. In just the last 12 months she has insisted she has Fibromyalgia, Hypothyroidism, Crohn’s Disease, MS, Bacteremia, and COPD. She must be on the WebMD Hall of Fame at this point.
Someone suggested we could always sell her this:
Yikes. Hopefully she decides she is mentally ill at some point.
@queenofegypt The funny part is that she has multiple referrals for psych evaluations. Those are the only appointments she doesn’t keep!
@bedlamhillfarm Go figure. 😄🙄
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I used to have a client who was diagnosed as a “malingerer”. She, too, had every illness under the sun, none diagnosable or present on exam. I felt both sorry for her, and frustrated by her.
@wayward_woman Malingerer is such an evocative term. Sadly, it has fallen out of use in favor of more clinical, but less interesting language.
@bedlamhillfarm That was the dx the military gave her upon discharge, and it stuck through VA … Of course, a dozen years later, and she may now have another dx. It’s sad, really, bc I believe it was a mental issue, undiagnosed, but docs kept pushing the physical aspects of her complaints … I’m not a doctor, but I play one on TV. 😉
@wayward_woman Ah, yes, that was a very popular military term.
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are you a nurse?
@kaliko Physician
@bedlamhillfarm that surprises me that you have to travel so much in the field. not sure why but I thought at first you were a sales person lol or a chief
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ps but I have to admire you for your service! all the doctors I hang around with work ungodly long and horrible hours for really average pay and have huge college debt. Unlike when my grandparents were doctors… they did not have that huge college debt and were afraid of being sued. they were able to make an awesome living. it is sad it is not so much that way now
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I think that woman is our ex-receptionist!! I spent ten years trying to avoid listening to her never-ending …. issues. Nothing was ever fixed, and usually got replaced by a new problem. She supposedly had Chiari, and finally had surgery for that a year and a half ago, which of course did nothing but let her take leave for three months, then come back and regale us with all her problems some more. Then somehow she finagled another leave through HR without mentioning it till the day she vanished, and our dean quickly rearranged the office so that if she does come back to the campus, someone else gets her.
I do think your patient deserves some sort of award! It would be exhausting to manifest all those illnesses!
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When I was a child and fainted, I was fussed at for locking my knees or for holding my breath. When my hands would freeze up and I’d drop my pencil or my fork, I was seeking attention. When my left eye wouldn’t open and I couldn’t jump up out of bed immediately on awakening, I was being difficult. After a day of physical activity and I was being lazy because I was too fatigued to do anything. As I got older, I would get muscle cramps, but it was because I wasn’t drinking enough water. Later severe achiness accompanied by hypokalemia that required hospitalization was due to a poor diet. Then came the code words for hypochondriac and malingerer, like fibromyalgia and chronic fatigue. My tachycardia was due to POTS…Most medical people thought I was just crazy. Until an EP saw me. I have all the skeletal features of Andersen Tawil. I have a documented history of severe hypokalemia with muscle weakness. I have a documented history of long QT Syndrome and ectopic heart beats. So he ordered genetic tests. I have mutations on KCNJ 2 and KCNJ5 that are consistent with Andersen Tawil (LQTS7)and LQTS 13. It was all in my head until someone knew what he was seeing. And I was 55 years old by that time. Go figure. I had every test in the book. Some of them showed things that doctors explained as something else. Some showed nothing at all because they weren’t the right tests. You will probably never see someone with LQTS 7 and LQTS 13. You couldn’t be expected to recognize it. What makes you think that there aren’t other things that you and most people like you won’t recognize?
@emiliasdance One provider or specialist wouldn’t be expected to find the rare condition on the first go-round; it’s statistically unlikely. But when someone has seen as many people as this person has over the years, and had every diagnostic test imaginable, the truth is pretty obvious. You had clinical findings, she does not.
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I can’t stand going to the doctors you have to take me kicking and screaming. I’m so bad about it I’ll end up in the hospital over something that could have been easily taken care of. I irritate the hell out of my doctor because she knows even if I don’t feel well I won’t tell her. Then I argue if she tells me I’m sick lol.
Haha that tomb stone is great. My husband wants one that says : Here lies an atheist all dressed up with nowhere to go.
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I wouldn’t mind the hypochondria scan myself… if it was positive at least I’d have a diagnosis 😋
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