Be careful about filling out those sleepiness questionnaires

[cathyf]

Some years back I read about a survey of doctors of their pet peeves about patients. The top two:

a) Patients who come in having done all sorts of research who have diagnosed themselves on the internet.

b) Patients who come in and talk about trivial complaints and don't mention that they are having some important symptom(s), or don't mention them until the end of the appointment.

Ok, what is it? Do you want your patients to be idiots or not?

(I have a friend who was legend among his high school buddies for being very observant. Get a haircut, new glasses, even new shoes, he noticed right away. He was applying to join a religious community, and there was a psychological questionnaire included. One of the statements to agree/disagree with: "I see things no one else can see." In about 2 milliseconds later he's trying to explain to the shrink that it's stuff that his friends don't notice, not things that aren't real!)

[ChicagoGranny]

Yes yes we should just do away with licenses all together because ---- FREEDOM! They should all be allowed on the road - 13? you need to get to school. Drunk? well how is he getting home? Blind - he still needs to get to work. All those kids on the bus that got killed, those families wiped out - they should have known better then to be on the road or they should get one of those armoured trucks the government is handing out to schools. 33,561 deaths per year in the USA isn't that much anyway.

I second that thought. Denying licenses to those who would kill others is not what is meant by "nanny state".

[archangle]

Yes yes we should just do away with licenses all together because ---- FREEDOM! They should all be allowed on the road - 13? you need to get to school. Drunk? well how is he getting home? Blind - he still needs to get to work. All those kids on the bus that got killed, those families wiped out - they should have known better then to be on the road or they should get one of those armoured trucks the government is handing out to schools. 33,561 deaths per year in the USA isn't that much anyway.

I second that thought. Denying licenses to those who would kill others is not what is meant by "nanny state".

I'm pointing out that there are unintended consequences to the nanny state side of this. If people think they can lose their license due to medical conditions, many of them will decide to not seek help. An apneac who might have otherwise gotten treated may go untreated due to fear of losing their license. If the government pulls 1 apneacs off the road, but ends up with 10 more apneacs who go untreated due to the nanny state, we all end up in a worse situation.

Let me assure you that there are a lot of people, especially big truck drivers, who keep silent about their medical conditions for fear of losing their means of livelihood.

It's very possible that government actions to force apneacs off the road causes you to end up with MORE untreated apneacs driving.

[Julie]

So what do you think is the answer?

[49er]

Black Spinner,

You can flame me all you want but the issue still is that people with psych med histories are discriminated against by many doctors. Regarding my own situation, I have a sleep apnea diagnosis that was made via a home study test a few years ago. Due to my pap therapy intolerance issues, I was looking to have a full scale sleep study and that is why I went to that sleep doctor that I disclosed my psych med history to (which you conveniently ignored) who decided that was the cause of all my problems and didn't want to investigate further. I am now trying other approaches to get the care that I need so I can be on the road to good health like so many other people on this board. I particularly want to start driving again since I have voluntarily grounded myself for quite awhile due to concerns about being able to drive safely. Yup, I am a real idiot.

49er

And you tell me just how a doctor is supposed to diagnose your problems when you withhold information because YOU, the layperson, think it is not important? Psych problems? They are a symptom of sleep deprivation too.

As someone who has done a lot of phone support I can't tell you the number of times I have heard "Oh that? I didn't think it was important to mention." Really? what do you think people pay big bucks for? So I can play guessing games? When I was doing massage I heard "Oh no I didn't mention it because you can figure it out" Like when I ask do you have any problems you say no even though you have major back and shoulder issues, because you think I should know this instinctively, because you think it is some sort of test? And then you bitch that it takes so long for the medical system to diagnose you? And that they don't trust you to take care of your own therapy? Do you think maybe they also are fed up with dealing with idiots?

[archangle]

So what do you think is the answer?

1) This is a problem.
2) We must do something.
3) Proposal X is something.
4) Therefore we must do X.

Getting dangerous untreated apneacs off the road is a good idea.
I may not have a better answer than the current state of affairs.
That does not mean that a poorly thought out, feel good, nanny state solution will improve things over the current situation.

It could be like prohibition. Sounded like a good idea to some. When we tried it, the results were worse than not changing anything.

[BlackSpinner]

Black Spinner,

You can flame me all you want but the issue still is that people with psych med histories are discriminated against by many doctors. Regarding my own situation, I have a sleep apnea diagnosis that was made via a home study test a few years ago. Due to my pap therapy intolerance issues, I was looking to have a full scale sleep study and that is why I went to that sleep doctor that I disclosed my psych med history to (which you conveniently ignored) who decided that was the cause of all my problems and didn't want to investigate further. I am now trying other approaches to get the care that I need so I can be on the road to good health like so many other people on this board. I particularly want to start driving again since I have voluntarily grounded myself for quite awhile due to concerns about being able to drive safely. Yup, I am a real idiot.

49er

Judging the entire medical system due to a few doctors is also a problem.

You say you want to get better however many people often prefer the attention they get from being sick and the status of having an undiagnosed illness.

[Julie]

Having worked in hospitals my entire life, I have to agree with 49'er about psych histories following you forever regardless of reality. It's terrible and the whole system needs a wake-up call to change it.

[BlackSpinner]

So what do you think is the answer?

1) This is a problem.
2) We must do something.
3) Proposal X is something.
4) Therefore we must do X.

Getting dangerous untreated apneacs off the road is a good idea.
I may not have a better answer than the current state of affairs.
That does not mean that a poorly thought out, feel good, nanny state solution will improve things over the current situation.

It could be like prohibition. Sounded like a good idea to some. When we tried it, the results were worse than not changing anything.

Drunk driving - big fines, reporting, public service announcements. I remember when it was ok to drive drunk, it was considered funny. It was considered nasty to take away someones license just because they caused an accident, or even death. Big meanies to take away their license because of an accident.

Driving sleep deprived is the same thing as driving under the influence of alcohol, and it should have the same lack of tolerance we have for that now. If a bartender knows you are drunk and you plan to drive he gets charged too. If a trucking company doesn't have proof you are ok the drive it should get charged. Doctors who don't report people with apnea should get charged. If you are a driver, part of your job is to be alert, same as it is to be able to see, end of discussion. If you as a driver are not willing to stay in control of you abilities you don't belong on the road. IT IS PART OF THE JOB! It is not an accident waiting to happen, it is a choice to put other people on the road at risk. It is the same as standing on an overpass and dropping rocks on cars.

It has nothing to do with "nanny state" and everything to do with law of the land.

[49er]

Black Spinner,

You can flame me all you want but the issue still is that people with psych med histories are discriminated against by many doctors. Regarding my own situation, I have a sleep apnea diagnosis that was made via a home study test a few years ago. Due to my pap therapy intolerance issues, I was looking to have a full scale sleep study and that is why I went to that sleep doctor that I disclosed my psych med history to (which you conveniently ignored) who decided that was the cause of all my problems and didn't want to investigate further. I am now trying other approaches to get the care that I need so I can be on the road to good health like so many other people on this board. I particularly want to start driving again since I have voluntarily grounded myself for quite awhile due to concerns about being able to drive safely. Yup, I am a real idiot.

49er

Judging the entire medical system due to a few doctors is also a problem.

You say you want to get better however many people often prefer the attention they get from being sick and the status of having an undiagnosed illness.

Wow, you don't quit in being extremely mean spirited and judgmental.

[BlackSpinner]

Wow, you don't quit in being extremely mean spirited and judgmental.

That is funny coming from someone who JUDGED the entire MEDICAL SYSTEM based on a couple of doctors and is telling people not to inform their medical practitioners of all their issues.

[Guest]

to BlackSpinner :

"Wow, you don't quit in being extremely mean spirited and judgmental."

Biting my tongue.

[Paralel]

Having worked in hospitals my entire life, I have to agree with 49'er about psych histories following you forever regardless of reality. It's terrible and the whole system needs a wake-up call to change it.

Agreed

[chunkyfrog]

Mental illness is a Catch-22. No one really understands it,
indeed, sometimes the very professionals who claim to be able to help,
and are sometimes torn between helping their charges and continuing to earn a living.

[ChicagoGranny]

So what do you think is the answer?

1) This is a problem.
2) We must do something.
3) Proposal X is something.
4) Therefore we must do X.

Getting dangerous untreated apneacs off the road is a good idea.
I may not have a better answer than the current state of affairs.

There are decent answers. Some companies will soon be moving to annual, random, unannounced MSLTs for all drivers. Fail it (fall asleep too quickly) and you move to the next stage which is a sleep study.

This will be adopted by the industry by 2016.

ChicagoGramps