Source
r/askdoctors•
LUClEN

What kind of advice would you give a young man looking to address physical issues that doctors do not seem to care about because i'm not dying, just seeing declines in life quality and strength?

In short, I'm experiencing unilateral strength loss. It's been months and months where doctors don't seem to care much now that stroke has been crossed off the list of possibilities. What kind of specialists would I see besides a rheumatologist or a neurologist? How do I explain the issue? What kind of things can I say to drive up some interest on their part on helping me get back to optimal?

Posted Jan 4, 2019, 11:46 PM UTC

66
anoddhue•

See a rheumatologist and neurologist as you mentioned, and the in the meantime a physical therapist. I am not a doctor but have been through similar problems and sometimes GPs, ortho, sports med, etc. type of doctors might not take notice until you go through a round or two of physical therapy and the problem continues or worsens.

2
LUClENOP•

I've seen both. The rheumatolgists keep reordering blood work. An EMG seems to show i'm fine. I did physiotherapy for a long time to deal with neck and upper back pain, as well as a round of massage therapy. These helped with pain and discomfort but the strength is still gone. I am also getting conflicting opinions from these people which makes things harder.

Normally I would think my GP would be the person to help push things along but she has no expertise in these things and is the one who suggested physiotherapy and an EMG. A CT scan shows that my neck is fine. I'm trying to convince the rheumatologist I saw last that the neurologist suggested it's a soft tissue problem. His decision was to get more blood work done rather than ultrasound.

How did you make your case to these professionals?

2
anoddhue•

I kept consistently seeing the sports medicine/Ortho people and doing PT. After seeing problems with a number of joints they started looking for some systemic stuff before my rheum did.

What's your GP specialty?

1
LUClENOP•

Her specialty is family medicine.

I've never seen a sports medicine doctor. I'm not sure it's covered under my insurance, either. I guess I should try it

1
anoddhue•

I would see if she can refer you to sports med or PT to work on strengthening, and perhaps refer you to a different specialist to check out other possibilities (endocrinologist, internist) diagnostically. If you go to PT continuously and things continue to progress, doctors tend to take notice. I got the vibe after going back to the doctor to be prescribed a second round of PT, that everyone just assumed I hadn't kept up with an exercise routine. After going back to the doctor _again_ with even more issues, they started ordering more tests.

2
Anthonyphysio•

Okay, here is the most logical bit of advice you are going to get about health and wellness. What you seem to be looking for is wellness related and not health related. Sounds confusing, but please bare with me.

Physicians are excellent at emergency medicine, cause and effect type interventions.

If you have a gunshot wound or were stabbed – emergency medicine to the rescue

Heart attack – CPR and the defibrillator

Bacterial infections – antibiotics

A growth or lump on your body – Diagnostic tests along with a referral to a specialist

In such cases, modern medicine excels and I would want a doctor and a hospital nearby.

When you go to a medical doctor and ask for help their first reaction is to run tests and if they can’t figure out what’s wrong they will refer you to another medical doctor – a specialist. If that specialist doesn’t find anything wrong with you then there isn’t anything wrong with you.

Sound familiar?

Not only is it familiar, it is a perfectly logical course given that physicians are trained in referring to medical specialists.

With regards to health and wellness, which seems to be where you are headed, as a society, we have it backwards.

It should be Wellness and Health and physicians are not the professionals who improve wellness since wellness is not what they do best.

Here is why we have it backwards: there is no health without addressing wellness first. Wellness is what you seek. Unfortunately you’re asking the wrong people.

Our physicians are trained in emergency type interventions, not wellness and prevention. For those insights you need to seek out the advice of Allied health professionals such as physiotherapists, dieticians and psychologists.

I am a registered physiotherapist and when it comes to physical issues this is where we excel. If you are feeling out of shape or weak due to muscle imbalance it may be time to look at your body as something you have let deteriorate a little too much.

Although you may seem “healthy” in terms of blood tests and so on you may need a little advice on posture or muscle imbalances that a physiotherapist can help with. A dietician is also important to help you change diet habits that can contribute to your sluggishness. Maybe even speaking to a psychologist to address how stress can be a factor.

As you get older we don’t bounce back as easily from the things life throws at you and those small things tend to add up, these constant assault on us physically through work activity, stress and improper diet do manifest themselves as physical symptoms.

Seek out allied health professionals such as physiotherapists, dieticians and psychologists to assist you. Even if you think I don’t know what I am talking about, what have you got to lose?

In my own life, seeing a dietician was one of the best things I ever did.

I'm Anthony Grande, Registered Physiotherapist and Clinical Manager at Focus Physiotherapy Brampton, Mississauga, Bolton, Etobicoke, Yorkand North York. Please visit our site for more information or email us directly at [email protected].

1