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Original post by MENDACIUM
rapid heart beats upon exercise


Isn't this normal anyway?:confused:
Reply 141
Original post by OU Student
Isn't this normal anyway?:confused:


No. I had very rapid heart beats upon minimal exercise. I.E even walking or minimal physical exertion induced very , very, rapid heart beats and light-headedness.
Reply 142
Original post by OU Student
Many doctors won't automatically know you've got a particular illness, therefore, wouldn't always do the tests for that particular diagnosis.

9 years ago, my dad fell down a flight of stairs at work and ended up with a few injuries. He had an ECG and was told to stop smoking and was banned from driving because they could find nothing wrong with him. 7 months later, he had an episode at home where he struggled to breathe, appeared to clutch his chest and was making some strange noises. He was then given an MRI and 2 EEGs, which showed that he had epilepsy.

I've had similar. My parents were told for years (I was told this too when I asked) that there was no reason for me to have an eye condition I have. Some research I did suggested that some people have no other issue. A few years ago, I had a routine eye test done and the consultant discovered that I had a problem with my optic discs. He asked me to see him again where he did a test for tunnel vision, colour blindness and checked my eye pressure. He then looked at the back of my eyes again and was able to make a diagnosis. I have to admit that I am shocked that over 20 years, no-one had seen that my optic discs are white.

Because there are many causes, (and no cause in some cases) no-one had tried certain things on me.


Commiserations for what you and your father went through and I do understand it takes time to make diagnosis,although on both accounts that is way, way, too long. I had extreme exercise intolerance, where even walking made my heart go to maximum and my resting pulse was rocket high. Only a month before I was able to run and play extreme sports. And not once did the doctor think of referring me for a treadmill test, despite me phoning the consultant and asking for one. What is life long learning when a boy knows his condition better than a 100k a year consultant who by virtue of their job MUST be expected to keep up with the latest medical conditions? POTS has been known since the 90's. It is 2013 , and was 2011 when I had this all.
Original post by MENDACIUM
Commiserations for what you and your father went through and I do understand it takes time to make diagnosis,although on both accounts that is way, way, too long. I had extreme exercise intolerance, where even walking made my heart go to maximum and my resting pulse was rocket high. Only a month before I was able to run and play extreme sports. And not once did the doctor think of referring me for a treadmill test, despite me phoning the consultant and asking for one. What is life long learning when a boy knows his condition better than a 100k a year consultant who by virtue of their job MUST be expected to keep up with the latest medical conditions? POTS has been known since the 90's. It is 2013 , and was 2011 when I had this all.


You've ignored all advice given to you as to why POTS is not simple to diagnose. Your definition of successful diagnosis seems to follow along the realms of "I match these symptoms, I MUST HAVE IT!" --> Goes to doctor, eventually gets diagnosed --> "I'm better than a doctor!".

Just because your hunch happened to be correct doesn't mean you successfully diagnosed a condition. Do you have a tilt table in your house? Did you conduct your own blood test?

It is not a straightforward diagnosis based on symptoms; those symptoms could match any number of diseases. Your GP was correct NOT to refer you immediately for something that is not life threatening in a majority of cases. One has to return to the GP several times in order for a referral to be made (mostly due to economic restraints on the GP), and the GP in this sense seemed to act correctly.

You seem to be incredibly biased on the issue and I worry for you at medical school with this sort of attitude.
Reply 144
Original post by MattKneale
You've ignored all advice given to you as to why POTS is not simple to diagnose. Your definition of successful diagnosis seems to follow along the realms of "I match these symptoms, I MUST HAVE IT!" --> Goes to doctor, eventually gets diagnosed --> "I'm better than a doctor!".

Just because your hunch happened to be correct doesn't mean you successfully diagnosed a condition. Do you have a tilt table in your house? Did you conduct your own blood test?

It is not a straightforward diagnosis based on symptoms; those symptoms could match any number of diseases. Your GP was correct NOT to refer you immediately for something that is not life threatening in a majority of cases. One has to return to the GP several times in order for a referral to be made (mostly due to economic restraints on the GP), and the GP in this sense seemed to act correctly.

You seem to be incredibly biased on the issue and I worry for you at medical school with this sort of attitude.


I have acknowledged several times that i do not expect a G.P to be able to immediately diagnose me. However, when you present with extreme intolerance to walking and even exercise, surely the first thing that needs to be noted is a treadmill test? If POTS is difficult to diagnose (not difficult to diagnose if given the right test), then surely the doctors must refer the patient for the appropriate test.

I know my own symptoms and myself to know that if i go from being extremely athletic to almost unable to even walk, something has happened. If doctor can not diagnose me, then why not refer me to who can?

Why spend two years giving me on and off anti-biotics, inhalers(do not have asthma), medicine for acidity ect?

If you had a patient who played sports regularly, and was now unable to even walk without their pulse reaching extreme rates, would you spend two years and perhaps 10-20 visits telling them it's all in their mind , or would you push for a treadmill test?

Only after the treadmill test (which i was finally referred to two years later!), did they immediately have a hunch i had POTS, and referred me for the tilt test to confirm it.

It is not difficult to diagnose. Your blood pressure often goes down as your pulse races up(was not surprised there) on the treadmill. A tilt test is then given which allows the blood pressure and heart rate, among other factors to be measured with respect to lyingdown/being then made to be vertical.

The consultant themselves was not going to give me these (from what i could discern) until i pushed them.

The G.P made a mistake with me, and acknowledged it(in their own way..) and has never since tried to push down i have 'anxiety' for my other ilnesses. If it is suggested, i kindly point the doctor to this recent fiasco. If/when i get into medical school, i will be humbled and keen and take opportunity to develop my skills and knowledge with an open minded albeit studious nature.

However, i will never expect to be infallible, i will recognize when i mess up, give patients more respect, and be more clinically competent. If one my colleagues is putting a patients life at risk, or i see gross negligence, i won't remain silent.
(edited 11 years ago)
Original post by MattKneale
You've ignored all advice given to you as to why POTS is not simple to diagnose. Your definition of successful diagnosis seems to follow along the realms of "I match these symptoms, I MUST HAVE IT!" --> Goes to doctor, eventually gets diagnosed --> "I'm better than a doctor!".


This is what I was trying to get at. From experience, there aren't tests for certain conditions; so it's all done on ruling out everything else.
Original post by MENDACIUM
I have acknowledged several times that i do not expect a G.P to be able to immediately diagnose me. However, when you present with extreme intolerance to walking and even exercise, surely the first thing that needs to be noted is a treadmill test? If POTS is difficult to diagnose (not difficult to diagnose if given the right test), then surely the doctors must refer the patient for the appropriate test.


Economics. They can't send anyone with light-headedness and tachycardia to a tilt table. It's not economically viable; you do not understand the financial pressures on GPs.

I know my own symptoms and myself to know that if i go from being extremely athletic to almost unable to even walk, something has happened. If doctor can not diagnose me, then why not refer me to who can?


If it was that severe you should have presented to A&E after the first visit to your GP. The fact you didn't, nor the GPs didn't recognise that sort of severity, makes me think you're being a little dubious with your description. Severe tachycardia and breathlessness would inevitably lead to an ECG or a hospital visit. The fact that you're suggesting multiple GPs didn't refer you seems a little hard to believe -- though obviously I can't prove that.

Why spend two years giving me on and off anti-biotics, inhalers(do not have asthma), medicine for acidity ect?


I don't know the ins-and-outs of your case. I suspect your presentation was not as severe as you made out, and I suspect you weren't quite as open with your GPs as you are here post-diagnosis.

Only after the treadmill test (which i was finally referred to two years later!), did they immediately have a hunch i had POTS, and referred me for the tilt test to confirm it.


Time-constraints and economics, as above, limit who can be tested by treadmill and tilt-table. I don't know the root cause of your POTS, nor do I know any of the treatments they specifically prescribed, nor do I know how you actually presented to your GP. It's hard to believe that a crippled teenager who is normally fit and active presented with severe tachycardia and light-headedness and was not referred for more tests. Any GP would. Like I said, you suggesting multiple GPs missed this and didn't refer you is even more incredulous. Either it is massive gross negligence or it's an over-exaggeration on your part. I'd lean towards the latter.

It is not difficult to diagnose. Your blood pressure often goes down as your pulse races up(was not surprised there) on the treadmill. A tilt test is then given which allows the blood pressure and heart rate, among other factors to be measured with respect to lyingdown/being then made to be vertical.


It is hard to diagnose when you lack the treadmill and have symptoms that could coincide with about a million other illnesses. We've already discussed why you can't usually have a treadmill test at most GPs...

However, i will never expect to be infallible, i will recognize when i mess up, give patients more respect, and be more clinically competent. If one my colleagues is putting a patients life at risk, or i see gross negligence, i won't remain silent.


We'll see.
Original post by madfish
yea,

Doctors a definitely losing their respect in society (by me anyway)

I think they should raise the entry requirements in all med schools from AAA to A*A*AA or something very very hard to get. (only a minority of people in society would get this, which would mean A LOT less donkeys would apply for med school)

This would mean only the academic elites would have the ability to be a doctor ( you may argue that academia is not everything blah blah... shut up. If you are not smart I don't want you deciding what illness I have.)

To be frank, some of the people that went on to medicine at my school were complete dumb asses I wouldn't let them look after my gold fish never mind my health

EDIT: I know my views are most likely frowned upon as you would think that I am "just jealous"... this is not case... I want to be a Chemical Engineer, not a medical doctor...I have never considered being a medical doctor as that type of work does not appeal to me


Not gonna lie, memorising the Kreb's cycle to get an A in higher biology won't make a good doctor.
Reply 148
Original post by pauline_lg
Not gonna lie, memorising the Kreb's cycle to get an A in higher biology won't make a good doctor.

fret not

it happens
Let's be honest here, there is never going to be any reasonable conclusion to this thread. Until the OP is (maybe?) a med student himself and has a go at this diagnosis thing himself from the other side of the table, maybe then will this arrogance subside.
My doctor always has to look up on the computer my symptoms. I mean really i could have just done that myself?
Original post by luckylaurax
My doctor always has to look up on the computer my symptoms. I mean really i could have just done that myself?


Well doctors are not medical dictionaries and usually they use the computer (a database) to confirm what they're checking on you. I'd be worried if my doctor thought his head was a medical encyclopaedia.

My doctors have always been brilliant except for a brief time at university where I can't remember it properly. I was diagnosed with stress and given anti-biotics for stomach ulcers which my mother wouldn't let me take and the rest is a blur.. So I'm still unsure what was wrong with me, it eventually went away and I can't remember that much of that year unfortunately... I passed my exams though and university knew nothing of my illness..
Original post by malteser87
Well doctors are not medical dictionaries and usually they use the computer (a database) to confirm what they're checking on you. I'd be worried if my doctor thought his head was a medical encyclopaedia.

My doctors have always been brilliant except for a brief time at university where I can't remember it properly. I was diagnosed with stress and given anti-biotics for stomach ulcers which my mother wouldn't let me take and the rest is a blur.. So I'm still unsure what was wrong with me, it eventually went away and I can't remember that much of that year unfortunately... I passed my exams though and university knew nothing of my illness..


How does that show the doctors weren't brilliant?! It just shows your mother is stupid..antibiotics are standard in stomach ulcers and not taking them carries the danger of fatal bleeds.


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Original post by luckylaurax
My doctor always has to look up on the computer my symptoms. I mean really i could have just done that myself?


If they use technology aids you complain. If they didn't and get it wrong, people complain. What do you want?! Doctors use technology to back up their own knowledge, give them additional detail they don't carry in their memory, or reminders, or updates to their knowledge, or for some additional confirmation. That all complements the history and exam taking and is based on their years of medical experience, it's not anything like a lay person googling their symptoms.


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Original post by Callumhamby
Get of your high horse, you havent even got to med school yet.


And you have?

Whether the OP has or not is completely irrelevant, at least for the majority of his argument/post.

The main point is that GP's seem to be incompetent, and that this is definitely not a single case, but instead becoming a worrying trend.
Original post by luckylaurax
My doctor always has to look up on the computer my symptoms. I mean really i could have just done that myself?


I'd rather they did that than give me the wrong information.
Reply 156
Original post by MENDACIUM
I have acknowledged several times that i do not expect a G.P to be able to immediately diagnose me. However, when you present with extreme intolerance to walking and even exercise, surely the first thing that needs to be noted is a treadmill test? If POTS is difficult to diagnose (not difficult to diagnose if given the right test), then surely the doctors must refer the patient for the appropriate test.


You have been watching a LOT of house haven't you?

Since a treadmill test isn't available, I believe the next house protocol is to stress you in some other way - one time he did it by insulting a guy, another by beating him at chess, I think he also did it by telling some guy his wife was cheating on him...
Original post by Hypocrism
How does that show the doctors weren't brilliant?! It just shows your mother is stupid..antibiotics are standard in stomach ulcers and not taking them carries the danger of fatal bleeds.


Posted from TSR Mobile


did I say that??? No I said I couldn't remember and I got better without the tablets! So **** off saying my mother is stupid :angry:
Original post by malteser87
did I say that??? No I said I couldn't remember and I got better without the tablets!


"My doctors were always brilliant except for..."

What do you expect me to think?!
(edited 11 years ago)
Original post by malteser87
did I say that??? No I said I couldn't remember and I got better without the tablets! So **** off saying my mother is stupid :angry:


You mean we shouldn't think she's stupid for ignoring medical advice from someone better trained?

I apologise.

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