A list of maladies

It's been a busy week at Disability Physicals - almost no no-shows, and people amazing keeping their appointments have really caused my work load to pick up.  In lieu of writing a large diatribe about individual people, I've elected tonight to compile a list of the myriad "illnesses" people have used as their source for disability.  I'll try and do this once-a-month or so, providing there are enough unique entries.  When possible, I've tried to put the maladies in the claimant's own words.  That said, let the listing commence!

1.) "I have to sleep on my back to sleep."
2.) "I have to sleep on my side to sleep."  (I'm hoping that someone will "have" to sleep on their stomach to sleep..but that might be too much to ask for).
3.) Photophobia
4.) "Cryptics in my shoulders" (When asked further about "cryptics," the pt couldn't say more...just that they were there).
5.) "I keep having picnic attacks."  (I think she meant panic...but who knows, maybe she's afraid of bears?)
6.) Poor self esteem
7.) "I died three times, but I came back."
8.) "My head is constantly there."
9.) "I get annoyed with annoying people."
10.) "When I get angry at my boss, I get fired."
11.)  "I've got maniacal depression."  (I think she meant manic depression...but maybe she's a maniac, maniac, too)
12.) "I keep seeing shadows in my permhairyal vision"  (Once again, I think she meant peripheral).
13.) "When I get mad, I turn into Heckle and Jive"  (Not Heckle and Jive!!!)

Whew, that's a pretty inclusive list of diseases...I think they need to teach a couple classes in med school on Picnic attacks and the dangers of Permhairyal vision, if not write a new chapter in Harrison's Internal Medicine. 

And now, for the disability quotes of the day:

Me:  "So does anything make your pelvic pain better?"
Elderly woman:  "Well, my husband bought me this vibrating thing, and if I sit on it for a while, it makes all my pain go away."

Me:  "Do you hear or see things other people don't?"
Man:  "Not really, but my spirit guides often try and help me solve mysteries."
Me:  "Do you succeed?"
Man:  "I'm no Matlock, but we do pretty well."

Be wary of Heckle and Jive,
-DD

Dictablog

I'm trying something new - using combinations of Dragon dictation and the blog software on my iPhone. This is just a test post to see if this works. If it does, we'll have more frequent updates since I can just update when I'm thinking about it

Crabbed age and Youth

Short entry tonight. Last week yielded an alarming number of young (18-22 y/o) applicants for disability, with the majority of them stating some sort of mental illness for their main complaint. Now don't get me wrong, I know that depression is a serious medical illness, and can definitely have life-threatening consequences if left untreated. That said, it frustrates me to no end when some 18 y/o comes in, states "I'm just too tired or sad to work," and then proceeds to tell me that they've never been on medication, had counseling, or done any other number of things to try and treat their disease...if they even really have one. I know that I'm not a Psychiatrist, but it just doesn't make sense that feeling "ho hum about most things" should qualify you for free money for the rest of your life. In addition, the wonderful diagnosis of ADHD seems to be tacked on to most young applicants, who then seem to have no difficulty sitting still, answering my 10 minute question barrage, and then following instructions. Maybe they just all took their medication that morning, I don't know, but something starts to smell pretty rotten when every ADHD patient calmly cooperates for 30 minutes without acting like that dog from the movie UP.

The unfortunate (or fortunate, depending on who you are) thing is is that most of the young, "emotionally troubled" individuals end up getting disability in the end. Whether that's because they live long enough to re-apply 6 or 7 times, whereas the actually sick people don't, I don't know, but it just doesn't seem right that our tax dollars are going towards paying for people who would rather, as one person this week put it, "just sit around and smoke weed all day," than work for their money. There needs to be some better indicator of disease process severity than just asking the usual Depression questions, although I admit, I don't know what that would be. There's a research project for some of you budding physicians out there.

If the above thoughts come across as bashing mental illness, then I apologize. There is no doubt that depression, bipolar disorder and all the psychoses in between affect a large portion of our population. What I am bashing, however, is the blatant labeling of people with said diseases, who in all honesty, are not depressed, bipolar and so on. Validation is a powerful tool in the hands of the lazy. Going around and saying "you're sad? I'm sorry, here's some free money" does nothing to actually help that person, and in the grand scheme of things, ends up hurting society as a whole.

And now for the disability quotes of the day:

Patient's written response to the question "how are you disabled?"
"Gingivitis got me good."

Angry woman: "You said that this form only takes 30 minutes to fill out? I spent 23 hours over two days, and peed on myself four times trying to complete it."

Me: "So you say that you see things that other people don't?"
18 y/o girl: "Yeah, I see shadows a lot."
Me: "Is there any time that you see the shadows more?
Girl: "Usually at dusk or dawn."
Me: "...Alrighty."

Until next time,
-DD