To tell or not to tell?
Does your health history help or hinder proper diagnosis and treatment following brain injury, stroke, brain dysfunctions, injuries or any type of illness? I refer to illness as both physical and mental. Either way, these are health conditions that should be treated without prejudice, but they are not. It is assumed that giving an accurate health history helps, and it should. However, biases may come into play and prevent the proper treatment. As a result patients and families suffer immensely without proper treatment.
Most nurses will agree that during report at change of every shift the patient’s health history is given. Unfortunately, many nurses make negative comments as they listen to these reports. It’s slanderous and not helpful to the patient. They have no idea how hurtful this is to the patient. These comments are based upon their perceptions and their life experiences, and not the patient’s. These biases can be passed down to other healthcare professionals caring for this patient. It’s a ripple effect.
How often have we heard of people suffering repeated concussions throughout the years and they suffered symptoms from mild to severe? Some symptoms lingered, others totally cleared, and yet many became permanent. Obviously these problems were ignored. Otherwise, all the media-hype would not be relatively new to the TBI community and professionals.
Symptoms have been and continue to be labeled as: “neurotic”; “malingering”; “hypochondriac”; “head-case”; “mental-illness”; and others to name just a few. What are the chances that you will be seen by a healthcare professional well-versed and educated with the time to connect all the dots from your health history? Likely, you won’t! It’s about money and time management.
These professionals are far and few between given the size of this world, lack of education and understanding, and the time constraints on healthcare professionals. How can we enhance our well-being by preparing ourselves and families to get the most out of healthcare? You or a trusted friend or family member better connect the dots yourself. You need to seek healthcare with the answers already in hand, and then you might still be labeled.
Here is only one example of what happens within our healthcare system. Think about this….it could be you (may be it already has been)!
Health history includes: carbon monoxide poisoning age 10; assault back of head age 16; head-on motor vehicle accident age 32. No permanent known deficits with full recovery after each event. Owing the recovery to the strength of that individual as a person.
What would a healthcare professional expect when they hear this history? Maybe a lunatic? Maybe a nut-case? Just disbelief? Ah…the bias has just begun!
People live through these types of events all the time. Remember everyone wasn’t sheltered throughout their lives. People not only survive these obstacles and challenges, but they also excel and become successful citizens, well-educated, healthy and happy. It could be that person sitting next to you today, standing in a line with you, or it might be your friend or relative.
So this person is working full-time as a nurse. Ah…another red flag! It must be conversion-reaction! After all, the medical books point that this is frequently found in nurses. As though anyone would spend 8 years at university, studying diligently, and spending an insurmountable financial burden to think up symptoms! Think again. That’s an entirely different diagnosis and it’s not even part of this scenario, but it easily can for some.
Even if the diagnosis does not fit…they will make it fit! Maybe it’s the “God Syndrome”, where healthcare professionals believe they know it all, and forget to listen…some just think they are God. They make the diagnosis fit at whatever cost to the patient.
Stepping off a curb while taking a walk and fell onto concrete. Dislocating the right shoulder and injuring right knee. Went to ER since couldn’t go to work. Because the injury was on the right side it was assumed to be a “stroke” according to doctors. No one heard this patient say: “I injured my right shoulder and my right knee when I fell” even though it was clearly stated. It just wasn’t heard, they already had a diagnosis in mind. No one looked at the injured right leg or injured right arm.
The physicians kept assessing their diagnosis of a stroke by coming in and lifting up the arm and dropping it and doing the same to leg. Ever know what it’s like to have a dislocated shoulder and have someone do that? A fractured knee and have someone drop your leg? How much further injury could that cause? Most likely significant injury will occur. Ten years later successful surgery corrected the badly torn shoulder.
In this case instead of listening to what the patient and husband was saying one was admitted to neurology unit and never once treated injuries. Was it a surprise that an MRI of brain didn’t reveal a stroke? NO! Conversion reaction? NO. Physicians, “God Syndrome”, YES! This patient was also told “this happens to your patients, not you”. Ridiculous, every nurse has a history too!
So think before you reveal a health history? Do you really believe it will help you? This nurse did. Will it hurt you? One never thought it would. That judgment call is up to you. You should trust your doctor, but trust yourself first!
Everyone would like to believe that giving an accurate health history would help with timely and proper diagnosis and treatment plan. In reality, does it help or hurt us? If it helps so much, why are we so far behind on understanding brain injury, neurological diseases and injury, illnesses?
We would all like to believe it only helps to give your health history. In some cases it does help. In others, it may hurt. It’s a possibility that it will be a hinderance hence, the real problem can be ignored. Think about what you reveal. Prejudice does happen in your healthcare.
Related articles
- Adult health history example (arlenhammond.typepad.com)
- What patients think is not trivial (kevinmd.com)
- Comprehensive family health history questions (nicholasappel.typepad.com)
- Sample complete health history (isaiahhobbs.typepad.com)
- Narrative nursing health history (tobyraynor.typepad.com)
- Example of nursing health history format (melvynbergeron.typepad.com)
braininjuryselfrehabilitation 
meesher
June 18, 2012 at 1:02 am
When I had pre-existing conditions, I told my husband to lie his a** off about any pre-existing conditions that did not show up on any “screening at the hospital” crap. I still think this is a darn good idea. When my physician demanded (on his form filled out by husband before I could see him) “How many abortions have you had?” (What? What?) I was presented as a brain damaged/epileptic person, a person who was semi-conscious, a person who was not lucid. They (so says my hub) commented to each other about the quality and color of my UNDERWEAR, as they used those mechanical scissors to cut them off—no, they were not black, red, or racy. I was unable to scream at them. True, when your life is on the line, it is likely that no one is going to scream at the idiots in the ER, but STILL? Three pairs of my jammies are now missing their tops, now, nursie, what is up with that? They had buttons—it’s not like I had them glued on. Sorry, your article got my Irish up.
brain injury self rehabilitation (BISR)
June 18, 2012 at 5:32 am
First, I wanted to address the issue that even though someone appears to be unconscious, comatose, etc. the hearing is the last to go. Research proves that patients hear what is being said and happening around them. All healthcare professionals know that, but it doesn’t excuse their behaviors. You point out that comments are made at the bedside as well as in report. It’s a frequent occurrence.
As far as the missing clothing, that also is a common issue especially if you are admitted for any length of stay in a hospital. Family needs to keep track, because sometimes missing items can be found if reported asap. But, families have much more on their minds then accounting for clothing.
I apologize for these things that are happening, and there is NO good excuse! It is standard procedure that in the ER all the belongings, except for valuables are put in a bag, labeled with the patients name. Valuables are usually handed to a loved-one. Patients should also get their cut-off clothing back! Nothing should ever be missing, but that is why they don’t like people to have valuables in a hospital.
wendy
June 19, 2012 at 12:36 pm
I feel lucky that more things haven\’t happened that prejudiced some doctors against me because of my health history. Unfortunately, there are some things I have to list because I\’m on medication for them. I have Bipolar I. Have I ever felt that was used to make it seem as if I was making things up, or simply over reacting….yes. When they can\’t find reasons for things, I think they look at that and think..it\’s all in her mind. Of course, when I feel like that, I fire that doctor and find one who understands that Bipolar I, that has been under control for over 15 years, is not going to effect my opinion of my pain and symptoms. (I was asked once…do you really want to get better? What? of course!)
I also don\’t know why doctors/nurses ask you questions if they aren\’t going to believe you. The last time I had surgery I was asked if there was any way I could be pregnant. I said \”No\” They asked a number of time….I finally said, \”Let me put it this way, I haven\’t had a penis in me in about a year!\” (my husband was not in the room at the time, so there was no reason for me to lie, if they were thinking that.) OK…they said that was good. Then right before the surgery, they said the doctor said it was hospital policy that a woman who is menstruating has to have a pregnancy test. So the surgery was delayed while we waited for the results of my pregnancy test. So why ask? Just give me the dang cup!
My husband said, \”I guess they have to make sure you aren\’t pregnant with the next Messiah.\”
That was a huge laugh in Pre-Op. And it made me feel much better.
As always, a great post, and great advice.
wendy
brain injury self rehabilitation (BISR)
June 20, 2012 at 1:29 pm
You make a great justifiable point. Why are patients asked questions if they aren’t going to believe the patient’s answers? The redundancy of questions is an ongoing problem as well. I understand that each healthcare professional may fall within a different discipline, but patient’s are sick of repeating the same questions and answers. I say “Read the chart” before seeing the patient! It sure would help and eliminate so much frustration.
I also have a dear friend that has been diagnosed as Bipolar and ADD about 20 years ago. She no longer feels it to be advantageous providing information or medication info because of discrimination, at least routinely. If it’s questioned later, the information is provided. An emergency situation is different.
You do the right thing by firing your doctor! No one wants to be a patient … isn’t that a sick thought that one doesn’t want to get better? I think any healthcare professional that even mentions this has a deep seated problem. I love your husband’s comments about “I guess they have to make sure you aren’t pregnant with the next Messiah”.
I have had surgeries, but will not take any sedation at all! I have stayed awake for rotator cuff, foot fusion, and thumb repair. My brain is too fragile, and I’m not willing to risk anesthesia to mess it back up. No one cares, once you leave what happens later. I almost walked out of pre-op because anesthesiologist stated “no one has rotator cuff surgery with sedation”. I told him that’s the only way I’m having the surgery, or I’m leaving! It was already approved by the surgeon. I approved sedation if it became an emergency. I talked throughout any surgical procedures. I want to know what’s going on…and again, my brain is too fragile to let anyone or anything mess it up more.
During a breast biopsy the lab called 3 times into surgery and told them they missed the proper sample. They needed to re-open and get more tissue samples. When they told my husband I needed to come back, for another biopsy he stated “She won’t be happy”, and the surgeon said “she already knows”. I just want people to be aware of what’s really happening.
Thanks for providing great insight into what is happening in our fragmented healthcare system and good ways to make the most of it!
meesher
June 20, 2012 at 2:24 am
As i read this, I thought back to some go-away-to-sleep-away tabs my mother (definitely not a cook-cookie-vacuum type), had thoughtfully sewn into the necks, undies, shorts, socks (whatever) of my clothing items. Now, those silly little tags (3 left now) are kept in my own jewelry box. I suspect that I would have easily been able to lose my gold rings, but I am really ticked off that I do not now have matching tops to all of my bottoms of PJs, which are my wardrobe staple. Things do change. And we now have a huge sign over the kitchen phone, on the actual front DOOR that says the “head injured, NOT STUPID” sign, along with who I am (when I am alone in this house) whether the little dog is friendly (NOOOOO) and what phone numbers TO call. Luckily, we live in a small place (attached to a larger city) where all the firefighters & paramedics have ALREADY had to show up at my house and”litter” me. When I am well enough to leave the house, we bring them ice cream–it’s amazing how much we all still look like the same person who used to live inside of us. Unfortunately we also have had to TELL all of them that NO, unless I have a diced artery, or they suspect a heart attack, they may NOT take me to my local hospital, but to one at which neurology is actually practiced. When I got (as you did) a high fever, and was transported to that damn little hospital, I actually TOLD a male nurse that yes, he HAD seen me before, as he passed his thoughts about my mental condition onto the oncoming slew of nurse-persons and ER docs, I felt so smug telling him that yes, he had and yes, his name was Stan.
brain injury self rehabilitation (BISR)
June 20, 2012 at 1:56 pm
I am hopeful that someday healthcare professionals will understand TBI and other chronic conditions. I’m also thinking that they may not understand them until someone very close to them suffers a TBI or other illness. With the percentage of documented TBI increasing people are eventually going to learn. Unfortunately, with all these medical conditions every individual is unique, and no one has the exact same symptoms. So…I guess that leaves these “closed-minded_ professionals?, in the dark and prejudicing patients. Thank goodness there are some exceptions professionals, but the others make it so bad … patient’s dying as a result of improper treatment.
Vickie
June 24, 2012 at 2:28 am
Reblogged this on Real Estate Savant …. Justice for Marcus, a Brain Injured Young Man With Aphasia. and commented:
I just met a man, age 45, who had gone to a hospital out in LA, CA. He went to the ER because he thought he was having a stroke. The ER doctor showed in his past history he had been to the hospital for vertigo so instead of doing a CT or MRI he once again diagnosed him with vertigo. He was sent home. He was only 45. When he got home his wife also thought he had had a stroke and called 911 and he was taken to Cedars Sinai where he was diagnosed with a stroke, but the critical window of 3 hours to give any TPA (clot buster) for strokes was gone. He now cannot work and is undergoing rehabilitation for a stroke. If you think you are having a stroke. Demand everything that is supposed to be done if you are having a possible stroke. It’s better if after all tests it says no then you to go home and have a stroke that can do so much damage to your life if not handled properly.
What can’t be seen is not always believed.
You or a loved one has to tell them what you want and need.
Hope, Health, and Happiness,
Vickie
ca
brain injury self rehabilitation (BISR)
June 24, 2012 at 10:50 pm
Thank you for giving such important and life-saving information. Grateful that this man’s wife called 911 and got him back to a hospital, even though the window for TPA was already too late. Another patient, another statistic to misdiagnosing leaving him and his entire family suffering. Many people never return, because they can’t (too ill) or they think the doctor is right…then they live with all the problems and since they didn’t diagnose it, it “never existed!”. I love your comment “What can’t be seen is not always believed”…SO TRUE! Take Care and Stay Safe, Edie