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agonyaunt2022-10-29 09:06 pm
ermingarden) wrote in agonyaunt2022-10-29 09:06 pm
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Dear Prudence: The Plot Thickens
Two letters that seem to be about the same incident, and which offer very different perspectives.
The first letter was published October 3:
Q. Hypochondriac In Love: Is it a red flag that my partner initially refused to take me to the emergency room? I am a young woman who is living with my boyfriend of over six years. We are very happy except for my chronic medical issues occasionally causing me great pain and some tension between us. The other night I was having serious abdominal pain and vomiting. I begged him several times to take me to the ER and he refused, reminding me that I’ve gone to the ER before for what my insurance considered non-emergencies and charged me extra for it. Finally, I called 911 for an ambulance and he took the phone from me and told them not to come. He drove me then to the ER and was angry when I threw up in his car. They did a CT scan and diagnosed me with acute colitis, cystitis, and a kidney infection. I apologized to him and I admit I can sometimes be a bit of a hypochondriac and he’s normally compassionate about my illnesses. I love him very much but I wonder if I should take this as a bad sign.
A: No, you shouldn’t take it as a bad sign. You should take it as a relationship-ending, unforgivable sign.
The second letter was published today, October 29:
My wife (“Laura”) and I have been together for 10 years and we’ve mostly had a good relationship until the past couple of years. Laura is a hypochondriac. In the beginning, it was really minor and barely noticeable—she insisted any cold she got was actually pneumonia or an upset stomach was appendicitis. As time went on, she became convinced she was suffering from an undiagnosed illness and after years of seeing doctors and getting tested, a doctor diagnosed her with a syndrome that mostly consists of a collection of symptoms with no other cause, no test to confirm the diagnosis, and no treatment except lifestyle and diet changes. I had hoped by getting a diagnosis her hypochondria would calm down.
It has not and I fear it is getting worse and turning into Munchausen syndrome. It was brought to my attention recently that Laura may have written into this column about an incident that happened a few weeks ago where she was vomiting and I wouldn’t take her to the hospital and prevented an ambulance from coming to get her. In the letter, she changed some identifying information—but the other details matched an incident that happened between us. My concern with the letter was her presentation of her diagnosis with medical terms derived from the CT scan and not the actual diagnosis the ER doc gave her, as well as leaving out key information, such as the questionable leftover chicken she had eaten earlier that day and the UTI she was diagnosed with earlier in the week and was supposed to be taking antibiotics for. She wrote that she was diagnosed with “acute colitis, cystitis, and a kidney infection”, however, except for alluding to her UTI moving into her kidneys, the doctor told her that she likely had food poisoning (acute colitis) and needed stronger antibiotics for her UTI because of the slight bladder and kidney inflammation (cystitis). He gave her new antibiotics for the UTI and when I went to throw away the old ones when we got home, I noticed that they were much fuller than they should be and asked her if she’d been taking them. She said that she may have missed a “couple of doses” but there were a lot of pills remaining.
I’m really scared that she is trying to make herself sick. If she did write the letter, then I am also scared that she is trying to get public validation and sympathy and that she may continue to escalate. I’ve alluded previously that this is all in her head and it did not go well so I hesitate to ask her outright but I need to do something. I don’t want her to hurt herself and I want her to get the help she needs. Should I try to talk to her therapist about my fears? I know he can’t break doctor-patient confidentiality but can family members tell them about their fears so they can do some probing? Should I mention my fears to her physician? Her family? Even before this incident, I knew some sort of intervention needed to happen as we have nearly $10,000 in medical debt from her various tests and medical visits. Her health is more important than the money, but if this is Munchausen and it can be fixed by therapy, then I’d prefer that than to keep adding to our debt.
—In Love With a Hypochondriac
Dear In Love,
Well this complicates things… Sorry for telling her to leave you. I don’t know what a therapist or doctor will do with the information you provide, but it can’t hurt to share your concerns with them as well as a couple of trusted family members. I will add that, whether she made herself sick or not, she was actually sick and you should have helped her get to the hospital. If your suspicions are true, I hope she can get help but in the meantime, you should make it a priority to respond to her very real illness and suffering, despite your belief about its origins.
The first letter was published October 3:
Q. Hypochondriac In Love: Is it a red flag that my partner initially refused to take me to the emergency room? I am a young woman who is living with my boyfriend of over six years. We are very happy except for my chronic medical issues occasionally causing me great pain and some tension between us. The other night I was having serious abdominal pain and vomiting. I begged him several times to take me to the ER and he refused, reminding me that I’ve gone to the ER before for what my insurance considered non-emergencies and charged me extra for it. Finally, I called 911 for an ambulance and he took the phone from me and told them not to come. He drove me then to the ER and was angry when I threw up in his car. They did a CT scan and diagnosed me with acute colitis, cystitis, and a kidney infection. I apologized to him and I admit I can sometimes be a bit of a hypochondriac and he’s normally compassionate about my illnesses. I love him very much but I wonder if I should take this as a bad sign.
A: No, you shouldn’t take it as a bad sign. You should take it as a relationship-ending, unforgivable sign.
The second letter was published today, October 29:
My wife (“Laura”) and I have been together for 10 years and we’ve mostly had a good relationship until the past couple of years. Laura is a hypochondriac. In the beginning, it was really minor and barely noticeable—she insisted any cold she got was actually pneumonia or an upset stomach was appendicitis. As time went on, she became convinced she was suffering from an undiagnosed illness and after years of seeing doctors and getting tested, a doctor diagnosed her with a syndrome that mostly consists of a collection of symptoms with no other cause, no test to confirm the diagnosis, and no treatment except lifestyle and diet changes. I had hoped by getting a diagnosis her hypochondria would calm down.
It has not and I fear it is getting worse and turning into Munchausen syndrome. It was brought to my attention recently that Laura may have written into this column about an incident that happened a few weeks ago where she was vomiting and I wouldn’t take her to the hospital and prevented an ambulance from coming to get her. In the letter, she changed some identifying information—but the other details matched an incident that happened between us. My concern with the letter was her presentation of her diagnosis with medical terms derived from the CT scan and not the actual diagnosis the ER doc gave her, as well as leaving out key information, such as the questionable leftover chicken she had eaten earlier that day and the UTI she was diagnosed with earlier in the week and was supposed to be taking antibiotics for. She wrote that she was diagnosed with “acute colitis, cystitis, and a kidney infection”, however, except for alluding to her UTI moving into her kidneys, the doctor told her that she likely had food poisoning (acute colitis) and needed stronger antibiotics for her UTI because of the slight bladder and kidney inflammation (cystitis). He gave her new antibiotics for the UTI and when I went to throw away the old ones when we got home, I noticed that they were much fuller than they should be and asked her if she’d been taking them. She said that she may have missed a “couple of doses” but there were a lot of pills remaining.
I’m really scared that she is trying to make herself sick. If she did write the letter, then I am also scared that she is trying to get public validation and sympathy and that she may continue to escalate. I’ve alluded previously that this is all in her head and it did not go well so I hesitate to ask her outright but I need to do something. I don’t want her to hurt herself and I want her to get the help she needs. Should I try to talk to her therapist about my fears? I know he can’t break doctor-patient confidentiality but can family members tell them about their fears so they can do some probing? Should I mention my fears to her physician? Her family? Even before this incident, I knew some sort of intervention needed to happen as we have nearly $10,000 in medical debt from her various tests and medical visits. Her health is more important than the money, but if this is Munchausen and it can be fixed by therapy, then I’d prefer that than to keep adding to our debt.
—In Love With a Hypochondriac
Dear In Love,
Well this complicates things… Sorry for telling her to leave you. I don’t know what a therapist or doctor will do with the information you provide, but it can’t hurt to share your concerns with them as well as a couple of trusted family members. I will add that, whether she made herself sick or not, she was actually sick and you should have helped her get to the hospital. If your suspicions are true, I hope she can get help but in the meantime, you should make it a priority to respond to her very real illness and suffering, despite your belief about its origins.
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and said "Hi, I'm a fully qualified and currently practising GP but we're discouraged from writing our own referrals, I've found a lump in my breast and I would like a referral for a breast ultrasound"
The Dr she saw scoffed at her and told her she was far too young to have breast cancer, she must be Depressed (on no evidence except wanting a breast ultrasound) and wrote her a script for anti-depressants
Fortunately, she then went and saw a different Dr, because Guess what? It was breast cancer!
I heard that story and thought "God, if even fully qualified GPs get brushed off for being women, what hope do other women have?"
She's an excellent Dr because she vowed to never, ever do that to her own patients, so now if she thinks there's a 10% chance of a problem, she still gets people tested to rule it out
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And I also always think, you know who behaves like a hypochondriac? Frequently seeking medical attention, researching their symptoms, maybe even deliberately worsening their symptoms in the hope they'll be harder to dismiss? *Sick people who can't get their symptoms taken seriously.*
I've done things to deliberately flare up symptoms before a doctor's appointment in the past, in the hope that if they're at their worst when I'm actually in front of the doctor they'll take me more seriously. It took *years* for me to get a doctor to consider that dislocating joints and a standing heart rate of 160 might actually indicate a problem rather than just hysteria. Turns out I have EDS, not Munchausen's, but if they'd ever found out that I sometimes deliberately triggered the tachycardia before seeing them, I never would have been diagnosed. But I also probably wouldn't have been diagnosed if I hadn't done it, you know?
I'm willing to bet LW is an abled person who doesn't believe sick people ever get dismissed or go undiagnosed. And even if she does have health anxiety, which came first, the knowledge that doctors and her husband wouldn't take her seriously or help her if she was sick, or the anxiety?
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And, yes, I’ve never FAKED a symptom, but I absolutely have had to do things that are intended to make an intermittent symptom actually show up to be observed by a doctor.
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Yeah, I think it's an experience most disabled and chronically ill people have and very few abled people get - you have to *perform* your symptoms just right to get taken seriously, and from the outside it can sound like "faking" or exaggerating. Who knows what's actually happening with this letter, but that's definitely one plausible read.
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It took two years for me to manage to get a gallbladder full of stones (described "chock-full of pebbles" by the surgeon who removed it) removed, because I was diagnosed with hypochondria. \o/
Now I am a hypochondriac, because I know that if I have something wrong with me, I'm going to have to catch it early and fight fight fight for my care.
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I'm lucky. My mother's a doctor. It gets me places sometimes when nothing else will.