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Archive for the 'Mental Health' Category

Informed Consent Called Into Question

A new post by my blog guest Anonymous, poses a question, “Informed consent is just a cruel joke, isn’t it?”

This gentleman, who underwent surgery, was given Versed as anesthesia, despite stating that he did not want to be given any drug that would render him unconscious.  So, not only did he deny consent, he stated that he did not want to be put to sleep at all.

We don’t know too many of the details, and we have not been given the other side of this story.

But it does call patients rights into question.  And our understanding of Informed Consent.

Take a read — see what you think — and if you have ideas for what could have been done differently?  Please post your comments, too.

Versed, PTSD and Questions About Informed Consent

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Ulterior Motives for Eating Disorders, Too

I had lunch today with a long-time friend, Mindy.  (No, of course that’s not her real name…) It’s been at least a year since we saw each other, and probably two since we had a long conversation.

My heart broke as I learned that her daughter, Lindsay (not her real name either) has, for lack of a better description, gone right off the deep end.  I’ve known Lindsay since she was only 11 or 12 — a bright, articulate and curious adolescent.  In more recent years, I knew Lindsay had developed eating disorders.  She is anorexic and bulimec, and is almost 18 years old.

Lindsay’s eating disorder is only one in a long list of problems she has acquired during the past few years.  She has abused drugs, has been in trouble with the law, and is dealing with some other mental health issues as well.

Her mom, Mindy, has struggled to do the right thing, but of course, as parents, we never really know if we are doing the right things by our children.  Mindy shared some aspects of how they have tried to help Lindsay.  Her findings sounded remarkably like some of the advice I share with you on occasion.  It bears repeating, with this different light.

At one point, Mindy contacted programs for girls with eating disorders.  There are at least four of them within 150 miles of where Mindy and Lindsay live. Some are day programs.  Others are residential programs.  Mindy contacted them all — in fact, visited them — and learned that each one happened to be exactly the program Lindsay needed!

At least, that’s what they each told her.  Each program was different, using different approaches to treatment, but according to the people who ran them (and, do I need to add, the people who would be paid by Mindy’s insurance if Lindsay attended their program?) each of their programs was just right.

This should sound vaguely familiar.  I’ve blogged before about doctors who advise us about treatments, but may have ulterior motives for their recommendations. My misdiagnosis odyssey was my first experience with this.  I accused my oncologist of insisting I begin chemo because it was the only way he could make money from me.

My friend Max was told he needed prostate surgery and he should undergo a minimally invasive procedure.  After studying options on the internet, he learned that an even less invasive, and less trying form of surgery using a robot might work even better.  So he asked his surgeon about it, and was told that NO, he certainly didn’t need to have the robotic surgery…. then learned later that the surgeon he was asking didn’t know how to do the robotic surgery.  Hmmmm…..

The literature is rife with examples of doctors making money, sometimes discreetly or even under the table, from the treatment recommendations they make.  Whether they are investors in specific medical device manufacturing companies (think artificial body parts) or drug prescriptions (think subsidies from pharma drug manufacturers) — the recommendations being made to you may have more to do with lining a professional’s pocket than your treatment success.

One disclaimer here — I do not believe a doctor would knowingly recommend a treatment that would harm you just to make money.  But, I do believe there are times when, all else being almost equal, the first consideration would be money, followed by your success or with little regard to the expense to you.

For example, if you had a history of knee pain, your doctor might recommend your knee be replaced today, even though therapy might help you for another year or two.  Of course, he wants to replace it using the brand that pays him a kickback fee.  But you don’t know that, nor does your insurance.  And don’t forget, most of these artificial joints have a shelf life — meaning — if you get one two years earlier than necessary, you will need a new one two years earlier, too.

It seems to be true enough in healthcare — whether we are talking about brain surgery or eating disorders — that we need to find someone who can help us consider the evidence much more objectively.  That means we either have to find someone who can help us with all the options, or — even preferably — someone who won’t handle any of the options.  In Max’s case, he was able to find a surgeon who did both the minimally invasive surgery AND the robot surgery.  He told Max the robot would serve him quite well.

And in Mindy’s case — she was able to find an advisor in anothor city who had no ties whatsoever to any of the available programs — one who knew all about the other programs in that 150 mile radius, and who was able make a recommendation based on that knowledge.  The advisor wasn’t in a position to benefit her own program, so she was able to make a more objective recommendation.

Let’s learn from both scenarios.  If you are in a position to need difficult, invasive or long term treatment, make sure you get at least a second opinion.  Then find someone who either can provide you with ALL the choices, or someone who doesn’t have a stake in ANY of the choices to help you get more objective advice before you make your final decision.

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The Bully Psychiatrist from Naples, FL – Follow Up and Lessons Learned

A few months ago I told you about an addiction psychiatrist from Naples, Florida who is a bully. Well — he is still bullying. I heard from him again today.

At that time I shared with you a story about a comment that had been made about him by someone who had read my blog. Nothing I had said, rather, commentary by someone else about how she felt she had been sexually harrassed, stalked and mistreated by this man.

I told you how, behind my back, he had pulled my WordPress blog offline and had contacted my About.com colleagues to ask them to make me pull THIS blog offline — but he had never even contacted me! He never asked me if I would remove the comment, which — if I had known there was a problem — I would have. The comment was a he-said, she-said type of thing. I don’t know either of the parties. I would have pulled the post. All he needed to do was send me an email to request it — and as you can see — my email address is front and center on every page of this blog. I’m a reasonable person. No excuses for his bullying tactics.

In frustration, this Naples psychiatrist finally sent me an email DEMANDING I remove the comment. Aha! He did find my email address! He cited all kinds of federal laws and trademark infringements he thought I was violating. At that point, I replied to him, and told him I don’t respond well to bully tactics. He had found my email address just fine at that point — so why didn’t he contact me before contacting my colleagues?

And then, I asked him for an apology. I just wanted him to take responsibility for all his bullying. With an apology, I would removed the post and that would be the end.

The apology was never forthcoming. Nope. Instead he threatened me some more — so I published my first post which you can find here.

You can imagine then how I felt about another email arriving from the bully psychiatrist today. Here’s an excerpt — copied and pasted — the typos are his:

Subject: YOU ARE BEING SUE

PLEASE BE ADVISED IF THE FOLLOWING CONTENT IS NOT REMOVED WITHING 3 WORKING
DAYS, I WILL ADVISED MY ATTORNEY TO INCLUDE YOUR WEB COMPANY AND
AFFILIATES IN A LIBEL SUIT FOR $1,000,000 DOLLARS FOR DAMAGE AND EMOTIONAL
HARM. YOU CONTINUE HAVE METAGS THAT APPEAR AS FOLLOWS IN GOOGLES AND OTHER
SEARCH ENGINES

Hmmm…. so the question is…. what happened to all those cyberstalking laws he cited in his first contact with me? Now — who is stalking whom? All I asked for was an apology from the bully. He can’t handle an apology — so now he’s stalking me. Never mind that I live more than 1,000 miles away.

But — what he doesn’t know is that I spend quite a bit of time in South Florida — not far from Naples, Ft. Meyers, Marco Island… I have family there and I’m there several times a year. In fact, I’ll be there within the next few weeks, so while I’m there, I plan to make a trip up to the Naples police department to see what kinds of restraining orders or other paperwork there may be on him. If he contacts me again, I’ll add a restraining order to their records.

I will not be bullied.

And what does it mean to you, the reader of this blog? Patients need to be able to protect themselves from dangerous doctors, whether those doctors are addicted to alcohol or other substances, bad surgeons, guilty of making mistakes with their patients — or even bullies.

Here is a good way to do it:

Sometimes all it requires is a general google search to get the information you need. If you know the doctor’s name, then search on that first, plus the word “blog” or the word “problem” or even “malpractice.” You may need to use your location, too, because there may be more than one doctor who has the same name.

Even if you don’t know his or her name, Just input your location, the type of doctor you seek (family practice, orthopedist, whatever) — and then those words: blog, malpractice, problem, even “error” or “mistake.”

Be sure to look down through five or six pages of google results — and you have a better chance of finding the information you need. Even if there haven’t been lawsuits, you can get general impressions of a doctor if someone has had a very good or very bad experience and chose to share that information online.

Bullying is never acceptable. I’m still waiting for that apology. I refuse to respond to bullying tactics.

I hope you will follow my lead.

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When the Psychiatrist is a Bully

(Find a follow up to this post, Lessons Learned)

What you are about to read is my own personal experience, having taken place over the past 10 days with a psychiatrist from Naples, Florida who works in addiction psychiatry through his “Healing Institute.”

Many of you regular readers know that my blog used to be located at WordPress. About six weeks ago, I moved it so I could have more flexibility with its look, etc. All the posts were moved from the old location to this new location, but many visitors continue to find the old location first because it is so accessible through the search engines. In fact, I still get many more visitors in the old location than here in the new.

Ten days ago, I went to check the statistics on the old blog location, and — the blog had disappeared! It had been pulled offline by WordPress, with only a page that said I was in violation of the Terms of Service. What?? I had no idea why or what I had done wrong!

A day later, I got an email from WordPress saying my blog had been pulled because they had received a complaint from a man who didn’t like a comment made to one of my blog posts. Mind you — not anything I had written, but what one of my readers had written. Here is a link to that comment.

In order to put my blog back online, I had to remove his name. So I removed it from the old blog — and WordPress put my old blog back online. Truth was, I don’t know the man, I don’t know the woman who wrote the comment, I don’t know who is telling the truth — in fact, I didn’t even know the comment was there!

Two days later, I got an email from the psychiatrist himself, demanding I remove his name from the new blog, too. He was clearly frustrated that there was no one else to complain to — God forbid — he had to ask me directly. He cited all kinds of trademark laws he thought I was breaking, cyberstalking laws, etc — bottom line, his email was quite threatening and indulgent.

But — I was mad. What right did this guy have to get my blog pulled offline? And if he could find my email address NOW to make his demands, then why didn’t he do that politely to begin with? (I ask you — don’t you see my email address, front and center at the top of this blog, easily found?)

If he had asked me first, I would have gladly removed his name — as I said — I don’t know who is right or wrong, he-said, she-said, and I didn’t even know his name was there.

So I replied to him with just that — that I thought he was a bully, and that he couldn’t simply demand I remove his name. That he should have contacted me before he contacted WordPress. Then I very clearly told him: if you apologize for contacting WordPress, and embarrassing me, I will remove your name.

He replied to me: no apology, of course — instead, how is he supposed to support his children? No recognition whatsoever that he had interfered in my work by pulling my blog.

I replied once again — as clear as you see it here — “apologize to me, and I will remove your name.” I also asked him, “If you can’t own up to your own responsibility in this matter, how can you ever expect to teach your patients to own up to their responsibilities?”

As you can guess — no apology has been forthcoming — still. No — instead, he got in touch with my colleagues about About.com and demanded THEY get me to remove his name. Can you believe it? They thought it was as ridiculous as I do.

So — from the sublime to the ridiculous. This man has real problems, in my opinion, and based on my interface with him. Think of it this way. He can’t apologize for his rude and ridiculous behavior, he invokes his children in his plea (who even knows if he has kids?) — but they aren’t important enough for him to type two words — “I’m sorry.”

Oh — and one other thing. I got to thinking I might not be the only one he has bullied. So I did a little research and learned that I am not. In fact, there is quite a bit of evidence online that indicates he has problems, including the fact that he has only practiced in South Florida (Naples and Ft. Myers area) for a few years. He was in Indiana before that, and for some reason, his license is listed as “Expired. Non-renewable.” In checking with friends who are psychiatrists, that “non-renewable” thing may mean much more than that. It’s hard to tell for sure.

But you know what? I can’t be party to this anymore. No time. I need to spend my time helping patients.

A message to The Bully Psychiatrist from Naples, Florida: you have won!

Your name is removed from that comment. I hope people who find you at your Healing Institute move on. Nobody needs a bully for a doctor, especially when they have addiction problems.

Lessons learned for patients: Doctors are human beings, too — with all the foibles that go along with being human. A doctor who can’t apologize has no empathy — and if you have an emotional problem that needs addressing, if you are battling addiction in particular, you need someone with empathy.

And — if you are looking for a psychiatrist in Naples, Ft. Myers or South Florida, there are many others to choose from not located in a Healing Institute: http://www.ucomparehealthcare.com/drs/florida/psychiatry/Naples.html

I truly hope this is the end of this. As my grandmother used to say, I’ve got bigger fish to fry.

(Find a follow up to this post, Lessons Learned)

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