The Medical Thread

[AKA_Monet]

Originally Posted by BigRedBeta

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

I thought you guys hate the Ph.D.'s... LOL

What was it besides switching meds that you did not like about psych? Just asking? There is a new field called behavioral genetics that has a lot of neurology involved... And there is a nice article in Newsweek about children that are severely emotionally disturbed and their treatment. They basically say their amygdala is malformed or has a birth defect that exacerbates their behavioral processing... And they also point out that the meds are not studied in clinical trials with children.

[BigRedBeta]

I didn't like the fact that some of the providers (not just MD's but also NP's and PA's) I was with made changes to medications when the patient was experiencing some improvement (but not total) after only 4 weeks - even if they were handling the side effects okay (though they had some) and had room to go up on doses. Several times the provider literally said, "I think we're doing okay, but we might get better results if we switch it up". When you throw in the amount of time to taper off the meds, start the new one, wait the appropriate 4-6 weeks to see a response, adjust the dose from there, it's nearly a 2 month process.

The most egregious moment was when a woman came in saying, quote "I feel great, I can't remember the last time I felt this good, I'm not having any side effects at all", and the NP then spent the rest of the appointment telling this woman what they'd do if she did start having side effects. He seriously went over the side effect profile of Drug A (which she was on), told her they'd go to Drug B, went over the side effects of that med, went on to explain that Drug C was in a different class, went over the side effects of that pill, and ended up on Drug D and the possibility that at that point they might have to reconsider her diagnosis because she'd be refractory to treatment at that point. It was seriously like he looked at his watch, saw that only two minutes had been spent finding out that she was doing great and decided that he needed to fill the remaining 18 minutes of the visit talking about something. The thing is that this was at the County Health Dept, and this woman wasn't extremely high functioning before her illness, so I know she left absolutely confused about the single side effect she was supposed to be watching for in regards to the drug she was on.

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...

[AKA_Monet]

Originally Posted by BigRedBeta

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...

Don't know that much about prescribing folks the correct drug and dealing with the side effect symptoms. As someone who has suffered a strong side effect and an adverse reaction, I am just happy the ER physicians figured it out and I was able to have some relief...

As far as your observation, doctor--I agree. LOL. But, I have seen it work and when it does, much is accomplished... It should not be that animosity. I never walked into a basic science lab thinking the physician was clueless, in fact, they were my best pupils when I've had to teach them a technique. Whereas, other Ph.D.--yeah, they are some asshats that are clueless about the benefits of the greater society. I am sorry you are encountering that...

I usually get the physicians wondering why I did not go to med school. I tell them my dad was a dentist, and then ask them, what do you do when you find out a patient is allergic to penicillin, and you ASKED her what her allergies were, so this patient sues you for malpractice (a day out your life) and on the claim, it says "allergic to ALL the 'cillins' " Ampicillin, Amoxicillin, Penicillin--ALL of them!!!

I had a whole row of residents fallin' out over that one...

[cheerfulgreek]

I've known a friend of the family's since I was a kid. She's my mom's friend. She's had these two prairie dogs since I was a kid and I used to go over to her house to play with them all the time. Well, recently, one of them died, so she got three more. Well, anyway my mom called me this past weekend and told me that one of the prairie dogs she had gotten hadn't been eating properly. She had taken him to the vet for the 1st time about 3 months ago.

Anyway, their teeth grow throughout the life of the prairie dog similar to the way they do in rabbits. Well, the growth is normally kept in check by normal wearing action by chewing and grinding of opposing teeth. Well, to make a long story short, like I was saying, she took her pet to her local vet to have his teeth trimmed down a bit. The vet was supposed to anesthetize the prairie dog, but for some odd reason he didn't. After the procedure, he brought the pet back out to her, and told her that anesthesia wasn't needed. What also made it look bad, was his little nose was bleeding too. I don't know what would have caused that though. Anyway, that's not the big problem. That was over a month ago, and now his teeth are growing in a different direction causing major problems in his eating habits. The vet charged her $30.00. She didn't want to go back to that vet, so she'd been calling around to different vets to see if they could fix the problem, but none of them like dealing with prairie dogs. (they're illegal) not to have but to transport or purchase. Anyway, she did end up finding one. The vet she found charges $120.00. She had the procedure done again, properly this time. The problem is the teeth are still growing in the wrong direction. I told my mom that she's either going to have to pay $120.00/month to continue the trimming because I doubt they're going to grow back the right way now. They're eventually going to grow to the point where he won't be able to eat or drink properly. She's probably going to have to put him down. Some vet.

Unlike people, animals are unable to describe their symptoms and signs. I read some of the ealier posts, and was reading about some of the medications that are prescribed to patients. What I've posted above reminds me of how things can go wrong. Like when we go to the doctor, we assume that the drugs that are prescribed to us have been carefully tested to make sure they're both safe and effective. Most of the time they are, but sometimes the drugs can cause more problems then they solve. Probably because the FDA hasn't adequately monitored the pharmaceutical industry.

[RaggedyAnn]

Originally Posted by cheerfulgreek

I've known a friend of the family's since I was a kid. She's my mom's friend. She's had these two prairie dogs since I was a kid and I used to go over to her house to play with them all the time. Well, recently, one of them died, so she got three more. Well, anyway my mom called me this past weekend and told me that one of the prairie dogs she had gotten hadn't been eating properly. She had taken him to the vet for the 1st time about 3 months ago.

Anyway, their teeth grow throughout the life of the prairie dog similar to the way they do in rabbits. Well, the growth is normally kept in check by normal wearing action by chewing and grinding of opposing teeth. Well, to make a long story short, like I was saying, she took her pet to her local vet to have his teeth trimmed down a bit. The vet was supposed to anesthetize the prairie dog, but for some odd reason he didn't. After the procedure, he brought the pet back out to her, and told her that anesthesia wasn't needed. What also made it look bad, was his little nose was bleeding too. I don't know what would have caused that though. Anyway, that's not the big problem. That was over a month ago, and now his teeth are growing in a different direction causing major problems in his eating habits. The vet charged her $30.00. She didn't want to go back to that vet, so she'd been calling around to different vets to see if they could fix the problem, but none of them like dealing with prairie dogs. (they're illegal) not to have but to transport or purchase. Anyway, she did end up finding one. The vet she found charges $120.00. She had the procedure done again, properly this time. The problem is the teeth are still growing in the wrong direction. I told my mom that she's either going to have to pay $120.00/month to continue the trimming because I doubt they're going to grow back the right way now. They're eventually going to grow to the point where he won't be able to eat or drink properly. She's probably going to have to put him down. Some vet.

.

OK, I know nothing about prarie dogs-but can she just have those teeth pulled instead of putting it down? The reason I ask is one of my cats has maybe 12 teeth left because of dental disease. I just had the vet remove the teeth and it's been 6 years. He's a very happy, spoiled cat.

[kstar]

Originally Posted by RaggedyAnn

OK, I know nothing about prarie dogs-but can she just have those teeth pulled instead of putting it down? The reason I ask is one of my cats has maybe 12 teeth left because of dental disease. I just had the vet remove the teeth and it's been 6 years. He's a very happy, spoiled cat.

Rodents are very different when it comes to teeth. But she shouldn't be making pets out of wildlife anyways. Way to abuse an animal for its whole life.

Not to mention, the CDC has banned the sale, trade, breeding, and new capture of prairie dogs.

[cheerfulgreek]

Originally Posted by kstar

Rodents are very different when it comes to teeth. But she shouldn't be making pets out of wildlife anyways. Way to abuse an animal for its whole life.

Not to mention, the CDC has banned the sale, trade, breeding, and new capture of prairie dogs.

kstar if you see this, did you know the ban on prairie dogs have been lifted? I'm not quite sure though if it's in every state or not. Now, they're probably going to be sold in pet stores and if/when this happens, people are going to buy them thinking it's the same as buying a gerbil or hamster.

ETA: But they are SO adorable.

[cheerfulgreek]

Originally Posted by RaggedyAnn

OK, I know nothing about prarie dogs-but can she just have those teeth pulled instead of putting it down? The reason I ask is one of my cats has maybe 12 teeth left because of dental disease. I just had the vet remove the teeth and it's been 6 years. He's a very happy, spoiled cat.

RaggedyAnn, kstar is right. Most rodent and lagomorph species do well on diets based on commercial laboratory rodent pellets or rabbit pellets. Prairie Dogs can and usually are maintained on rabbit pellets, alfalfa or grass hay as well as assorted vegetables, so without their teeth, it would make it quite difficult for them to be able to eat. Plus, a few years ago pet prairie dogs were involved in an outbreak of monkeypox disease. Like kstar said, the Center for Disease Control and Prevention and the Department of Health and Human Services issued a joint order that banned the transport, sale or release of pet prairie dogs. Shortly after that, I think the CDC along with the Food and Drug Administration made the rule permanent. I think there also may be some new restrictions as well, but I'm not all the way sure.

[AKA_Monet]

Where's that picture of the possum again where the person posts on a telephone pole about a "lost cat"...

Seeing my husband's face reading the sign--now that was funny...

It's like the Jack in the Box commercial were they had a spelling bee and the kid was asked to spell "Ciabatta" and he starts it off with "J"...

[SoEnchanting]

Originally Posted by BigRedBeta

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

Originally Posted by AKA_Monet

I thought you guys hate the Ph.D.'s... LOL

I think I was really lucky with my Psych rotation. With the exception of a few random days at the hospital doing admissions and **shudder** ECT, I spent the most of my time with a child/adolescent psych who made all his appts 30-60 minutes. I got to see a lof of therapy, where some of my rotation partners did not. They just saw med refills, and.. well that's about it. Anything else was handled by their counselor. That stinks. I wasn't aware there was any love lost between the two fields, though. Maybe we're sheltered here...

[AGDee]

I spent 13 years as an Occupational Therapist with 9 of them in child/adolescent psych and the other 4 with adult.. mostly inpatient although I worked partial day treatment in adolescent for quite a while. I concur that the child/adolescent psych is much more rewarding. The bottom line is this: In adult psych, most of the problems are more biochemical (schizophrenia, bipolar, clinical depression) so it's "medicate, medicate, medicate" whereas with the kids, while a few are biochemical, more are having situational problems like coping with abuse, dysfunctional families, etc., so therapy is more useful and many of them can work through things and develop healthier coping strategies. Their thought processes are easier to work with also. While therapy definitely helps in conjunction with medication for the more biochemically oriented, it's geared more toward coping with mental illness, the importance of staying on meds, when to call your doctor, etc. Additionally, given the type of disorder, their thought processes are more difficulty to work with in a therapeutic way. Until Mr. Doe stops seeing hallucinations, it's going to be pretty difficult to do much "talk" therapy. Yet, they only get to stay inpatient for 3-5 days these days and that isn't enough time to get anywhere. They used to stay in for two months so you had that whole time to work with the meds, observe differences and side effects first hand, etc. The best psychiatrists I worked with were the adolescent psychiatrists because they were more versed in talk therapy too. They didn't just medicate. I would think it would get boring to just medicate all the time, but that's what a lot of them do.