Be careful about filling out those sleepiness questionnaires

Guest wrote:

49er wrote: to BlackSpinner :

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

Biting my tongue.

As a "Guest" should be.

BlackSpinner wrote:

archangle wrote:

Julie wrote: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.

BS - I can understand your argument to a point, however, LIFE is not always as clear-cut as the examples you are mentioning. While I can agree that (IMO), a medical professional and/ or employer should do his/her best to keep others safe on the road, assessing and determining impairment and abilities on a permanent, day-to-day basis can be incredibly complicated and difficult, to say the least. For example, where does one 'draw the line' for apnea sufferers? Let's say a person is diagnosed and using prescribed treatment, yet not having consistently improved results; some days the user feels rested and some days, not. Do we take away their driving privileges just because they have diagnosed sleep apnea? Did your doctor report you to your employer as having sleep apnea? If not, why not? And even though you may be retired - shouldn't your doctor report your apnea to the DMV in case you try to drive anywhere? How would losing your driver's license affect your daily living abilities and/ or employment capability?

In my opinion, the Epworth Sleepiness Scale is not an accurate tool to diagnosis sleep apnea with, mainly because of its subjectivity. What I might think warrants a '3'' or '4' response may only be designated as a '0' or '1' level by someone else observing my behaviors. I think there needs to be a more definitive test or screening for this sleep disorder.

I can understand what the OP is indicating about filling out the Epworth; I thought the exact same thing when I first saw the question about falling asleep while driving. I did not have to 'lie,' as I will not put myself in that situation if I am not rested. Yet knowing a medical doctor has the right to suspend a driver's license due to medical conditions, I suspect there are many who will not admit to feeling sleepy behind the wheel.

chunkyfrog wrote: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.

Hi CF - understanding mental illness and/ or other biological conditions is an art, not an exact science. Fifty years ago, schizophrenia was theorized to be caused by overly critical mothers. As humorous as that sounds in the light of new brain and genetic studies indicating otherwise, mankind did not have the tools we have today to research these often quite serious maladies.

BS - as 49er and others have pointed out, there are still MANY stigmas and stereotypes surrounding mental illness. Being treated differently by medical professionals (and others) due to a mental health diagnosis/ prescribed psychotropic medications is not an uncommon occurrence. Any treating practitioner should ask patients: 1) if they are using any prescribed treatment for a diagnosed mental health issue; and 2) if the patient feels their illness is adequately being treated with the prescribed regimen.

Mental health is only one part of the whole health picture; it should be treated as such so that people are given appropriate and/ or medically necessary care.

SleepyEyes21 wrote:...as 49er and others have pointed out, there are still MANY stigmas and stereotypes surrounding mental illness. Being treated differently by medical professionals (and others) due to a mental health diagnosis/ prescribed psychotropic medications is not an uncommon occurrence. Any treating practitioner should ask patients: 1) if they are using any prescribed treatment for a diagnosed mental health issue; and 2) if the patient feels their illness is adequately being treated with the prescribed regimen.

Mental health is only one part of the whole health picture; it should be treated as such so that people are given appropriate and/ or medically necessary care.

How I wish it really worked this way...

The ED doc I saw said my arterial dissection was a panic attack when he saw I had an anxiety diagnosis.

BlackSpinner wrote: 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.

As someone who suffered years misunderstood and misdiagnosed by multiple physicians, this comment struck a raw nerve. Without evidence (not opinion) of a person's suffering being fake or manipulative, reckless inference seems unnecessarily cruel - even in the midst of a sh#@t throwing contest.

Paralel wrote:

SleepyEyes21 wrote:...as 49er and others have pointed out, there are still MANY stigmas and stereotypes surrounding mental illness. Being treated differently by medical professionals (and others) due to a mental health diagnosis/ prescribed psychotropic medications is not an uncommon occurrence. Any treating practitioner should ask patients: 1) if they are using any prescribed treatment for a diagnosed mental health issue; and 2) if the patient feels their illness is adequately being treated with the prescribed regimen.

Mental health is only one part of the whole health picture; it should be treated as such so that people are given appropriate and/ or medically necessary care.

How I wish it really worked this way...

The ED doc I saw said my arterial dissection was a panic attack when he saw I had an anxiety diagnosis.

And here is another good example of why all treating professionals need to keep the 'whole health' emphasis in mind..

Are you doing okay now Paralel, or do you have ongoing medical complications due to this ignorant physician?

kteague wrote:

BlackSpinner wrote: 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.

As someone who suffered years misunderstood and misdiagnosed by multiple physicians, this comment struck a raw nerve. Without evidence (not opinion) of a person's suffering being fake or manipulative, reckless inference seems unnecessarily cruel - even in the midst of a sh#@t throwing contest.

Hi kt - I can empathize with you on this one. It galls me to no end that people have to fight to get basic and decent medical/ mental health care

Even when manipulating or feigning illness is suspect - physical and/ or emotional- this can often be an indicator of more serious things, many of which can be life-threatening.

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

I'm not saying a "law" answer is the wrong solution.

I'm pointing out that a "law" answer can very easily make the problem worse, not better. "Law" answers need to be though out very carefully. Also, we can't put a lot of faith into our current government system with our corporately owned two party system. "Law" answers from our current system often make the situation worse.

Remember that the nanny state often comes about through the best of motives.

archangle wrote: Remember that the nanny state often comes about through the best of motives.

I have to take exception with your continuing abuse of the term "nanny state".

that's more meant for places like great britain where there are many annoying laws and regulations that are there not to protect innocent people on the highway from being run over by someone asleep at the wheel, rather the nanny state is full of regulations that are there to protect you from yourself.

PailRider wrote:

archangle wrote: Remember that the nanny state often comes about through the best of motives.

I have to take exception with your continuing abuse of the term "nanny state".

Thank you. He is intent on entirely ruining what was once a good phrase.

kteague wrote:

BlackSpinner wrote: 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.

As someone who suffered years misunderstood and misdiagnosed by multiple physicians, this comment struck a raw nerve. Without evidence (not opinion) of a person's suffering being fake or manipulative, reckless inference seems unnecessarily cruel - even in the midst of a sh#@t throwing contest.

Ditto
and as always, well said!!!

kteague wrote:

BlackSpinner wrote: 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.

As someone who suffered years misunderstood and misdiagnosed by multiple physicians, this comment struck a raw nerve. Without evidence (not opinion) of a person's suffering being fake or manipulative, reckless inference seems unnecessarily cruel - even in the midst of a sh#@t throwing contest.

Ditto from me, too. It looks to me like a lot of doctors are really childish when it comes to frustration and puzzlement. Take the example of stomach ulcers -- for generations doctors told their patients that this was caused by stress. In other words, the patient's bad thoughts were tearing up his/her stomach lining. Then it turned out that ulcers are caused by a bacterial infection -- OOPS! -- and quickly cured with antibiotics. I wonder if any of those patients who got the "bad thoughts" lectures over the years ever heard a "sorry" ?

Or the girl in Massachusetts who spent 16 months imprisoned in a psych ward because some resident 6 months out of medical school decided that any disease not understood personally by the resident must be imaginary.

Or the doctors doing back surgery even though dozens of scientific studies have shown that the surgery makes the problems worse.

Or back on topic here, the doctors who tell people complaining about snoring that they should sleep on their sides. (Sometimes without even bothering to ask if the person ever sleeps on his back!) Or tell people that they should sleep with their mouths closed. Or that they should remain totally motionless to avoid disturbing a mask. Apparently they don't teach them in med school that people who are asleep are unconscious and can't choose to do or not do these sorts of things!

I think that some doctors believe that they MUST have an answer, and if they can't have a correct one, they will just make up some crap that sounds authoritative.

My former doctor misdiagnosed a bad gall bladder for six months and kept telling me it was panic attacks, due to my history of PTSD. And a male doctor told me that my bleeding from the bladder was "spotting" and I was over-reacting (at 53 and female, I pretty much knew he was wrong, but he wouldn't listen - I personally mailed him a copy of the urologist's report when I went on my own).

My current doctor is great, and we joke about whether my symptoms are PTSD related or real. She takes everything seriously if I am not experiencing stress at the time I have symptoms and goes not give me a rough time about any concerns like the last docs did.

On the other hand, I tend to use my mental illness diagnosis to my own advantage when having medical procedures. Cystoscopies are not usually done with "happy juice" but the urologist ordered it after hearing about my incest history.I could probably have survived without it, but why have the pain if I don't have to. My anesthesiologist will do the same for my cataract surgery because I advised that the surgery will go a lot better for all of us if I am more sedated than the average patient.

Bons wrote: . . . why have the pain if I don't have to. My anesthesiologist will do the same for my cataract surgery because I advised that the surgery will go a lot better for all of us if I am more sedated than the average patient.

You should feel as comfortable as possible for any surgical procedures. Sometimes less anesthesia than necessary is the goal, but it should not be.
The last time I had surgery, I reminded the anesthesiologist that I had previously been conscious while being intubated.
This comment is now on my "permanent record"--as it should be!

The last time I had surgery, I reminded the anesthesiologist that I had previously been conscious while being intubated.
This comment is now on my "permanent record"--as it should be!

How the heck did that happen? The thought makes me shudder.

49er