help me address these comments

Wow, Calist, looks like you've stepped right in the middle of "it"! I worked most of my adult life in either the medical field or social services, and after a while, frustration from the predictability led me to make some pretty harsh judgements on the clientele. Not sure if that was insight or being jaded, but while I could state what was obvious to me, there were dynamics at play I could not begin to comprehend. (Though I admit I often thought I did.) My personal health journey this past several years has taught me more than an entire career about the many ways the health system fails us and the ways we fail ourselves. I actually find a lot of what you say to have merit. You say what you see, and you've seen a lot. Just don't discount the role of other perspectives on the issues, or paint with such a broad brush. Your observations will be a reality check to some, a source of indignation to others - or some like me will find both within your post. Thinking of the admonition of generations past to not "throw out the baby with the bath water", thank you for your observations.

Ahh Calist, it's a dilemma for some of us. I will never forgive my old doc for not twigging to my OSA in '01 when I gained 50#s for no reason I could determine, my stress level was astronomic, my exhaution was extreme -- what did he say? You're diabetic...with normal blood sugars? So, I go for yrs with increasing exhaustion, unable to drag myself outta bed, sleeping thru multiple alarms, often more tired when I woke up than when I went to bed...never heard of apnea back then, who knew I was a poster child for it ? 2007, new doc debates admitting me with BP of 215/110...who knew? My BP had always been low like rest of family. Doc IDs OSA as a cause and sends me to sleep doc for consult & PSG. Split study: severe OSA, "profound snoring on back"...I loved the sleep I got masked up, wanted more, a lot more & demanded a machine. Got it 10 days later (dumb dataless CPAP), pillow mask....I was clueless there were options in machines & data, my inner geek woulda loved data. What I got worked 'cause I got great sleep sleep after the first 4 night from hell. Must admit I quit peeing my usual 8-10 times/night the first night...thank goodness. Slowly lots of other things got better too. I was clueless that I might have been getting better/more effective therapy 'cause I slept well & was 100% compliant from day 1. Wasn't until I was 17 mos in as a hosehead & has lost about 45#s that I started backsliding into apnea...I didn't know that was happening, I was that clueless at the time...all I knew was that I started feeling really, really bad again even tho I was sleeping well (I thought). Finally started hunting symptoms on the 'net and discovered this forum and got educated really quick about what was happening thanks to the help & support here. Was I stupid? Not sure how to answer that...I was compliant and sleeping well recovering from the damages that apnea had wrought in body & brain. Someone shoulda educated me in the beginning 'cause I was certainly too muddleheaded to make sense of much of anything back then.

cflame1 wrote:

Calist wrote:
This is soo not the place to tell us as patients that we're stupid... and who are you to presume because somebody hasn't had a heart attack that we haven't watched somebody we love have one? And known why they had it. Or watched them die! Wish that you'd take your attitude to the cleaners.

Emotional reactions have no place in medicine. Take your tears to church.

Let me tell you something about death. Before I got into sleep I was an EEG tech at a trauma hospital. 80% of my patients were bloodheads. They were people who had smoked two packs a day well into their fifties, gained about 200 extra pounds and worked themselves to death while family members looked on with out thinking anything was the matter and when they stroked out and ended up being wheeled in front of me... so that I could confirm what everyone already knew... I was all business. The only way to approach medicine is by means of logic. If I ever develop a serious illness, I want a team that has ice water in their veins that knows their stuff forwards and backwards. I don't want a doctor that will hold my hand and cry while he watches me die. Ignorance will get you killed.

But don't listen to me. Seriously, take everything I say with a grain of salt. The best thing you can do is find yourself an EEG tech to shadow at Baptist Memorial Hospital in Memphis. Then you can come back and tell me you've seen death.

BlackSpinner wrote: Right stupid - Do you drive? do you know exactly what is happening under the hood? Do you tell your mechanics how to fix your car? Can you write the software for your computer? Can you fix it? Do you understand exactly how the stock market works so that you can make informed purchases and never lose money? Do you know where your food comes from? Can you hunt down your own meat and clean it? Can you raise all your own food? Can you make your own clothes from scratch? Can yo make dyes from the materials around you?

If the answer to any of these things is NO the yes, you are STUPID according to your definition!

Lack of information is not stupidity - You were HIRED to provide a service and information you were trained for, just like a car mechanic or an electrician or a house cleaner or a doctor.

So far the stupidest people I have met have been the people running the DME's.

1: I do drive and no, I haven't the slightest idea as to how it works. I also don't advise mechanics as to how they should fix my car. I don't tell them what is acceptable and what is unacceptable, I don't root around under the hood after they have finished telling them that they did it wrong or that they could have done it a bit better. I pick a mechanic I trust and then I simply trust him. (People changing CPAP machine settings and toying with these devices seem to be equivalent to mistrust of treatment. I wonder if they tell their mechanics how to fix their vehicles as well)

2: Can I write the software on my computer? Yes, but it would take a REALLY REALLY long time. I haven't been in computers for decades.

3: Can I fix a computer? Yes, I do it all the time in my spare time. I used to be in computers after all.

4: I enjoy playing the stock market. I have recently made a good chunk of change off of citigroup, AIG and more recently Revlon.

5: Do I know where my food comes from? This is starting to sound a bit sad, but yes I do. It sounds as if I have no life and I just sit around reading about things I should be disinterested in. I am very picky about my food and I will not eat it unless I know every single thing about where it came from and how it was processed. I'm a bit OCD okay?

Correct me if I am wrong however, I think your point is that we, as humans can not possibly know everything about everything. And because of this we should not be labeled as stupid simply because there is something that we do not know. I agree with you on this. The point that I made is that there are people in this country (not so much outside of America) that do not have an interest in persueing subjects they know little about because they are content in their belief that they know all that they NEED to know. They heard a rumor, compared it against a myth and now they want to tell the mechanic how to fix the problem before the mechanic has even become involved.

It is the classic story of the guy who walks into the ER with a knife sticking out of his head and he asks for Tylenol for his 'Splitting Headache' only to have him get angry when no one gives him what he wants. I know very little about urology. If I were to go to a Urologist for a urinary tract infection, I would not question his recommended treatment or his ability to diagnose me. I would make sure that the physicians I trusted, trusted him and then I would trust him as well.

Likewise if he came to me for sleep problems, he would trust me and do what I told him. He is the expert in his field as I am the expert in mine. For me to suddenly decide that I should take treatment into my own hands without research or efforts to learn the material, I could only expect disaster.

Much like fixing your own car, computer or even CPAP device. That is not to say we could not do those things safely. It would simply take a great deal of classroom time and I would even recommend some hands on experience afterward.

BTW- Ignorance = Voluntary rejection of education.

kteague wrote:Wow, Calist, looks like you've stepped right in the middle of "it"! I worked most of my adult life in either the medical field or social services, and after a while, frustration from the predictability led me to make some pretty harsh judgements on the clientele. Not sure if that was insight or being jaded, but while I could state what was obvious to me, there were dynamics at play I could not begin to comprehend. (Though I admit I often thought I did.) My personal health journey this past several years has taught me more than an entire career about the many ways the health system fails us and the ways we fail ourselves. I actually find a lot of what you say to have merit. You say what you see, and you've seen a lot. Just don't discount the role of other perspectives on the issues, or paint with such a broad brush. Your observations will be a reality check to some, a source of indignation to others - or some like me will find both within your post. Thinking of the admonition of generations past to not "throw out the baby with the bath water", thank you for your observations.

I was going to respond to each post individually but I honestly can not go any further than this one. Thank you Kteague and yes I often do throw out other perspectives if I find them lacking in any way. Most times I would probably call it a character flaw but in this instance I just think I have become so incredibly jaded over the years. When I got out of EEG and into Sleep I thought 'This is so fantastic, I am finally in a field where I can help people.' In EEG I was just reporting braindeath every day but in sleep I could actually make a difference. Maybe even catch some of those people before they end up in front of an EEG tech.

My patients are so self destructive though. They don't want to hear the truth they just want some one that will tell them what they want to hear. Either that or a magic pill. Some nights I get people that have been torn apart by these disorders and I feel so fantastic after helping them. Other nights I have to listen to people that want to tell me about the things a columnist proved with statistics in people magazine. Just makes me want to quit. I have rejected promotions more times than I can count so that I can stay here and help people but damn it some times I wonder just how many of these self destructive fools deserve to be helped.

Everyone! Let me see if I can get your attention for just a minute. I'm going to give you the secret to medicine right here.

1: Find a doctor you trust. Some one that is really really good at what he does. It doesn't matter how his attitude is. There are a lot of doctors who comb their hair and look like a Calvin Kline model that don't know what they are doing. Stay away from them. There are a lot of them that look like hell and will call you names. It is fine so long as they know what they are doing.

2: Once you have found this doctor, trust him and everything he says unless he screws up or otherwise gives you a reason not to trust him.

3: Only see other physicians that he recommends. Do not see anyone that he has not approved. Doctors run in packs and it is usually the medicine vs profit seeking. You don't want to ask the wrong one whether or not you need your septum removed because he will say 'Yes... five or six times in fact.'

4: Do everything they tell you and do not question their treatment unless you are ready to turn your back on them completely and find another physician.

This is a really interesting thread. I do not trust doctors. I have had too many that ignored the problems I was having. As a kid I ended up taking illegal drugs to stay awake in school because the doctors I had been to just told me that my sleep habits were wrong and I should go to bed earlier. As a young adult I had brain scans MRI's even a CAT scan to find out why I couldn't stay awake. Still nothing. I was told take vitamins, take drugs, take this, take that, don't drink, All the time my health was suffering. It wasn't until I was 29 that a Dr. suggested I might have a sleep disorder, but even he was more worried about my low sugar levels than the chance that I had sleep apnea. 15 years and many other doctors and every test except sleep study known to man and still I could not stay awake through a meeting at work. Finally this year I went to my doctor and demanded that I have a sleep study. We had tried everything else so she gave in. My AHI was 90 on my back and 53 on my side! I had 3% REM sleep. I was waking up almost every minute!
Did I know much about sleep apnea? no. But I have learned. After titration at the sleep study my AHI was brought down to 14 at a pressure of 10 straight cpap. I got a machine, was having tons of trouble with mask etc. but since the machine didn't tell me what was going wrong I couldn't solve the problems. All I knew was that I was still tired. I read and learned about different machines. I talked to several DME's. In fact I spent 6 to 8 hours every evening reading about it. The sleep dr was nice enough to change my prescription to APAP and I got a machine with the software. The Dr. had the machine set up with pressure from 6 to 10. I couldn't breath at 6 so I bumped it up to 7. My AHI that night was 8. I then bumped my lower pressure up by 1 each week and bumped my upper pressure to 12. I stopped with a base of 10 and a top of 12 and a AHI of 1.5. I informed the sleep dr of what I had done and he thought it was great. I think he was surprised that I could get my AHI so low. Yes most of us are ignorant when we start but that certainly doesn't mean we stay ignorant. I spent 2 hours quizzing my sleep dr. I wanted to learn as much as possible from him. I listen to Dr's because they should know more than me, but I question EVERYTHING. "Trust but verify"
I do appreciate that you have come on this site. I hope you stay around because I am sure there is much that myself and others can learn from you. Just don't lump everyone into the "stupid" category.

sleepyb wrote: I listen to Dr's because they should know more than me, but I question EVERYTHING.

Doctors should know more than you but unfortunately there are some that do not. I have heard a lot of horror stories about docs that jump into sleep science thinking they can just pick it up as they go. Ignorance applies to them as well unfortunately. AHI of 15? That was a horrible technician, probably a traveler, the only people that would have employed a traveler is a horrible lab. The only docs that send patients to horrible labs are horrible docs. I'm sorry you had to go through all that but I have to say that I've seen worse.

I had a patient who lived in Texas and was passing out all through out her childhood. Her doctor thought it was a cardio problem and got her all kinds of cardio testing. They couldn't find anything wrong with her but at the age of 18 they put a pacemaker in her. 18 year old girl with a pacemaker.

She had narcolepsy, continued to pass out through her early 20s. We diagnosed her, put her on meds and she is fine now... well... she still has a pacemaker but she doesn't pass out anymore. That is why I can not stress enough that you have to find a good doctor to start with. Bad doctors will reffer you to other bad doctors because only bad doctors will work with bad doctors. Once a patient gets into the system it is hard for them to escape the cycle of ignorance that these guys display.

Where as I don't agree with you adjusting the settings on your machine, I find a larger fault with the physicians that treated you. You were in more danger from them than you were from treating yourself and that is rather sad. Especially coming from me. I hope you have gotten a new primary since then. Please don't tell me you still see these guys.

ahhh... so we're now going to have to list to you call us names and say that we're stupid all over the board... you're just plain condescending.

I repeat my earlier statement... your attitude needs to be taken to the cleaners.

I don't care that you work in sleep... people are people and deserve to be treated like people... not like you've been treating them (which is basically to say that you've got a Dr's "God" complex and I won't tolerate it!)

So Calist, first you complain that your patients are stupid and do not do any research:

Calist wrote:I hate to say this but... patients are stupid.

I wish my patients would do a little research and not stroll into the lab asking "Is this some kind of new fad thing?"

Then you advise them to remain stupid:

Calist wrote:Likewise if he came to me for sleep problems, he would trust me and do what I told him. He is the expert in his field as I am the expert in mine. For me to suddenly decide that I should take treatment into my own hands without research or efforts to learn the material, I could only expect disaster.

Everyone! Let me see if I can get your attention for just a minute. I'm going to give you the secret to medicine right here.

1: Find a doctor you trust. Some one that is really really good at what he does. It doesn't matter how his attitude is. There are a lot of doctors who comb their hair and look like a Calvin Kline model that don't know what they are doing. Stay away from them. There are a lot of them that look like hell and will call you names. It is fine so long as they know what they are doing.

2: Once you have found this doctor, trust him and everything he says unless he screws up or otherwise gives you a reason not to trust him.

3: Only see other physicians that he recommends. Do not see anyone that he has not approved. Doctors run in packs and it is usually the medicine vs profit seeking. You don't want to ask the wrong one whether or not you need your septum removed because he will say 'Yes... five or six times in fact.'

4: Do everything they tell you and do not question their treatment unless you are ready to turn your back on them completely and find another physician.

Just select a trusted doctor and do everything he says, eh?

So which is it going to be? Do you want patients who are fully involved in their therapy? Or do you want stupid patients who are involved only to the point of selecting a doctor?

Have you done some self-examination and fully thought through your rants?











Now you say emotions have no place in medicine:

Calist wrote:Emotional reactions have no place in medicine. Take your tears to church.

While at the same time you are posting some of the most emotional diatribes I have seen on the forum:

Calist wrote:Let me tell you something about death. Before I got into sleep I was an EEG tech at a trauma hospital. 80% of my patients were bloodheads. They were people who had smoked two packs a day well into their fifties, gained about 200 extra pounds and worked themselves to death while family members looked on with out thinking anything was the matter and when they stroked out and ended up being wheeled in front of me... so that I could confirm what everyone already knew... I was all business. The only way to approach medicine is by means of logic. If I ever develop a serious illness, I want a team that has ice water in their veins that knows their stuff forwards and backwards. I don't want a doctor that will hold my hand and cry while he watches me die. Ignorance will get you killed.

But don't listen to me. Seriously, take everything I say with a grain of salt. The best thing you can do is find yourself an EEG tech to shadow at Baptist Memorial Hospital in Memphis. Then you can come back and tell me you've seen death.


I have become so incredibly jaded over the years.

So which way do you want it? No emotions or emotions spilling over so badly that you have become jaded!

Your rants here are worthless. Unless you can step back, do some self-examination, refresh yourself with a new view, and push forward. Or you can continue to live in your narcissistic angst. The choice is yours.

Every single one of us on this forum "works in sleep medicine" and many of us are Professors on the subject. I suggest you start reading as much as you can on this forum, veterans and newbies alike, and you might change your mind about who's "stupid"! Of my many accomplishments in life,and I've lived a long time, becoming knowledgeable here in the causes and treatment of OSA has made me very proud and has probably added years to my husband's life. I keep learning every day and more than once my "sleep specialist" and the "RT" at my DME have admittedly learned a thing or two from me as well. They would definitely not call me stupid!


"Everyone! Let me see if I can get your attention for just a minute. I'm going to give you the secret to medicine right here.."

You really need an "attitude adjustment"! Many here have devoted years learning and perfecting this therapy and then pay it forward patiently and kindly to all those who come along afterwards, and then those newbies do the same. You're preaching in the wrong church and you have lost my attention! Sorry!!

DoriC wrote:Every single one of us on this forum "works in sleep medicine" and many of us are Professors on the subject. I suggest you start reading as much as you can on this forum, veterans and newbies alike, and you might change your mind about who's "stupid"! Of my many accomplishments in life,and I've lived a long time, becoming knowledgeable here in the causes and treatment of OSA has made me very proud and has probably added years to my husband's life. I keep learning every day and more than once my "sleep specialist" and the "RT" at my DME have admittedly learned a thing or two from me as well. They would definitely not call me stupid!


"Everyone! Let me see if I can get your attention for just a minute. I'm going to give you the secret to medicine right here.."

You really need an "attitude adjustment"! Many here have devoted years learning and perfecting this therapy and then pay it forward patiently and kindly to all those who come along afterwards, and then those newbies do the same. You're preaching in the wrong church and you have lost my attention! Sorry!!

Very well said, DoriC. You go, girl!

TL

calist wrote:

There are a lot of them that look like hell and will call you names. It is fine so long as they know what they are doing.

I can't let this one pass by. While what a doctor looks like has nothing to do with the quality of his medicine, I would refuse to continue seeing a doctor that called me names. Such a doctor will only hear what he/she wants to hear concerning my symptoms and my overall health instead of what I'm really saying. A doctor who cannot relate professionally to his/her patients is one who likely does not actually listen to them either. And such a doctor cannot possibly "know what they're doing" with regards to their patients' health issues.

Just my two cents: But I expect my doctors to treat me professionally and not call me names. I expect them to carefully and actively listen to me and not dismiss what I report as symptoms just because it makes no sense to them. Very few doctors, in my humble opinion are actually good active listeners. And I think that problem does lead to misdiagnoses and missed diagnoses all the time.

And finally an overall comment on the general tone of calist's posts and many other posts here concerning sleep apnea patients: There seems to be a tendency to "blame" the patient on a number of levels for their sleep apnea: Overweight (often morbidly obese); physically inactive; physical problems with the structure of the person's throat/airway/sinuses that can be be "easily" corrected by surgery, etc.

Well, I don't fit any of the stereotypes of a sleep apnea patient: I'm a 5'1'' female who weighs 108 lbs. I'm physically active. I had an MRI done of my head for a different reason two summers back. It showed a very slightly deviated septum which the ENT said "It's so slight and you have no problems breathing through your nose that it's not a problem." Everything else in my head was NORMAL--adnoids, tonsiles, upper airway, etc. Should I consider invasive surgery to correct a very slighty deviated septum on the small chance that it might improve my moderate sleep apnea? No thanks: The risk of surgery is too great for the small probability of a positive result. So what's causing my apnea? Well, my sleep doctor, the sleep tech, and the RT's I've talked to can't come up with anything better than "small airway because you're a small person and it just happens sometimes." Overall, I'll settle for an effective treatment (which CPAP seems to be for me) instead of a wild goose chase for an alternate solution. But because I am having adjustment problems full data about my therapy is critical for keeping me on it.

DoriC wrote:Every single one of us on this forum "works in sleep medicine" and many of us are Professors on the subject. I suggest you start reading as much as you can on this forum, veterans and newbies alike, and you might change your mind about who's "stupid"! Of my many accomplishments in life,and I've lived a long time, becoming knowledgeable here in the causes and treatment of OSA has made me very proud and has probably added years to my husband's life. I keep learning every day and more than once my "sleep specialist" and the "RT" at my DME have admittedly learned a thing or two from me as well. They would definitely not call me stupid!


"Everyone! Let me see if I can get your attention for just a minute. I'm going to give you the secret to medicine right here.."

You really need an "attitude adjustment"! Many here have devoted years learning and perfecting this therapy and then pay it forward patiently and kindly to all those who come along afterwards, and then those newbies do the same. You're preaching in the wrong church and you have lost my attention! Sorry!!

Dori -- Ditto, Ditto, Ditto on everything you've said here. This is one of the many reasons you are so highly respected by everyone here and will be listened to over others that come here with a bad attitude.

I remember the movie "A Fish Called Wanda" where Kevin Kline's character said repeatedly through the movie -- "Don't call me stupid!!!" Even if a person IS stupid (like Kevin Kline's character was), calling them stupid only pisses them off.

Or as someone else said, "I've got my knickers in a knot"!

Thanks, Professor DoriC, I have been helped by several of your suggestions. I am sure many have! Thank You! jlk