A girl in her thirties gets a bunch of symptoms sees a bunch of doctors.

Discussion in 'Medical Topics' started by Girl1, Apr 16, 2018 at 12:00 AM.

  1. Girl1

    Girl1 Guest

    A girl in her thirties comes down with a bunch of strange symptoms. Insomnia, pain, digestive problems, lightheartedness, depression. She goes to a bunch of doctors, half of whom think she is nuts. Those that don't interpret the symptoms as diseases in the areas they treat. rheumatologist says she has raynaud's and tests her for lupus and other autoimmune diseases. Everything comes back negative. They bill it under the diagnosis code for autoimmune unspecified. Integrated medicine thinks it is a gut disorder. Puts her on macrobiotics bills under cronic fatigue. primary care doc puts her on ambien "take as needed," and SSRIs. Writes visit as for depression. Someone has the bight idea to give her a inhaler so she can test herself for sports induced asthma.

    I can go on and on. and an going to doctors, having them investigate some symptom and coming up empty with a negative diagnosis.

    Then she finally sees a good internal medicine doctor. who finally finds a chronic viral disease that previously went undetected. This is the correct diagnosis. For the sake of this hypothetical matter, let's call it chronic Epstein-Barr virus. When properly treated with antivirals over a few months recover is made and the underlying symptoms disappear with time.

    It could have been an autoimmune disease, arthritis, a gut disease, or anything else. But as medical care goes for women (and some men too) that struggle to get a diagnosis, they get a very long medical history and a lot of conditioning getting labeled in their medical record that are replaced by the correct diagnosis when it is eventually identified months or years or decades later.

    Here is the challenge. She now has had 30 doctors appointments in the last year with 12 different doctors.


    This is an extremely normal pattern for diagnosing diseases in women taking years (and some men too)

    What is the correct way to report all this information to the FAA --without lying --but also without over reporting? Is it proper to just list the diagnosis as EBV infection and leave out the pages and pages of incorrect diagnosis and symptoms? (but obviously listing the doctors visited as required and stating "symptoms reported. no diagnosis discovered)
     
  2. Salty

    Salty Pattern Altitude

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    I’ve seen exactly what you describe happen to people close to me. Good luck getting past it.
     
  3. SCCutler

    SCCutler Administrator Management Council Member

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    Work closely with an AME who SPECIALIZES is exceptional/unusual issuances, and will be best-situated to present the data in the least-harmful light.

    Consider Dr. Bruce Chien ( www.aeromedicaldoc.com ).
     
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  4. PaulS

    PaulS Final Approach

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    Sccutler just gave you the guy to use to avoid the same experience with the FAA. Consult with him to get an idea where you might stand, pay his fee to get ALL your records reviewed by him, disclose everything, and he will let you know if he thinks you can get a medical. Follow his instructions closely and for your circumstances I would travel to him for your exam when it gets to that.
     
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  5. Let'sgoflying!

    Let'sgoflying! Touchdown! Greaser!

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    Not to inappropriately defend, but having seen and experienced this - it reinforces that medicine is not as cut and dried as we would like.
     
  6. bflynn

    bflynn En-Route

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    This is a condition for an AME consult if I ever heard one. Contact an AME and tell them you need a consult. In the consult, tell the story of your odyssey and how 11 doctors didn't understand it and the 12th one got it right. Basically a consult is an opportunity to talk with the AME about your conditions without doing a medical, so you can prepare for your medical correctly. The AME cannot tell you how to answer the questions on your medical, but can help you understand the FAA standards so you can meet them.

    The way I would think is to list each doctor visit and list the same reason for visiting - Insomnia, pain, lightheadedness, unresolved. I would not include the intermediate diagnoses or treatments as they really are irrelevant guesses. On the final doctor visit, list the same reason and the diagnosis. The final doctor should have a report explaining the cause, the treatment and the potential for incapacitating recurrence.

    In the end you had a viral issue and it was successfully treated. Along the way you need to report all the doctor visits, but make sure you note that they did not solve the problem you were having. Your reporting should tell that story.

    With all of this, you still might get a denial just because it's unusual. In the end, you might have to go back to 11 doctors and ask them to write a report explaining their diagnosis and treatment, the fact that the treatment did not work and therefore the diagnosis was wrong...11 times. Unfortunately, modern medicine requires doctors to make a diagnosis in order to provide treatment and you can get those stuck to you even if the diagnosis is completely wrong. Keeping the wrong things from getting stuck to you is your secret sauce here.
     
  7. steingar

    steingar Touchdown! Greaser!

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    Vague multifocal symptoms are the world's most difficult thing to diagnose, especially for medical science that is broken up into subspecialties. Human beings are way, way more complicated than machines, and half the time we can't tell what's wrong with them when they break.

    The important thing is the subject of the thread go the right medical assistance to get better. The rest is secondary.
     
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  8. SkyDog58

    SkyDog58 Final Approach

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    What goes here?
    Having both lightheartedness and depression seems like a strange combination. I’m surprised you didn’t end up with a psychological diagnosis along the way. Glad you didn’t.

    I do wonder though if your PCP sent you to all of these various specialists or if you did it on your own. Running around from specialist to specialist on one’s own versus having a PCP manage it is a recipe for disaster. If your PCP did send you all over, get a new one.

    As to navigating the FAA medical process, I agree with everyone else. Set up a consultation visit with an AME to discuss before submitting online.
     
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  9. AggieMike88

    AggieMike88 Touchdown! Greaser!

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  10. wrbix

    wrbix Cleared for Takeoff

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    As a recovering Internist myself, all I can say is the diagnosis of “chronic viral illness” is often a wastebasket diagnosis made based on serologies that are rarely definitive. Good luck with your health and FAA medical.
     
  11. SCCutler

    SCCutler Administrator Management Council Member

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  12. SkyDog58

    SkyDog58 Final Approach

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    What goes here?
    :rolleyes:

    :lol:

    Too funny.
     
  13. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Thanks, Spike.

    I recognize that there are still some circumstances that will be a deferral even if the applicant has all of their required items with them on their initial exam, and in office issuance won’t happen. But these few instances won’t be a denial because the applicant worked with the AME to be as prepared possible to not become a denial.

    But we know that many applicants appear before the AME totally uneducated about the process. Hopefully that post will help a few avoid the frustration of getting on CAMI’s bad side.

    The PoA gang is encouraged to save that URL so it can be shared with others as the need arises.
     
  14. ralarcon

    ralarcon Pre-takeoff checklist

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    https://rarediseases.info.nih.gov/diseases/9534/chronic-active-epstein-barr-virus-infection

    Cheers
     
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  15. James331

    James331 Ejection Handle Pulled

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    Small town hospitals?
     
  16. Sac Arrow

    Sac Arrow Touchdown! Greaser!

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    OP, I'm sure you've considered it but I'll ask the question anyway; is Basic Med an option for you?
     
  17. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    Good question.

    But what is not yet in evidence is if this is first time application, or a renewal.
     
  18. bbchien

    bbchien Touchdown! Greaser!

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    This is one of those situations in which a good PCP can cut through 95% of all the muck.