Sunday, June 28, 2015

Treat the Patient, Not the Disease

A teenager presented with years of bed wetting (enuresis) problems, nearly every night.  As a result, he was socially isolated and had no experience of sleepovers, etc. because of his condition.

He is a very athletic, active, and academically strong teenager boy, an outstanding kid actually. Upon further examination and questioning, it appeared the boy had anxiety issues because of his mother. His mother would go to work every morning at 4 am. As a result, his father took care of him during the day. The father was apparently very strict with him.  Mother would come back home very late so as an only child he was mainly with the father and raised in a very strict environment.

One obvious solution was imipramine which is the common treatment for bedwetting as well as depression.  But the Doctor decided to forgo that usual treatment because she was concerned about side-effects, and frankly, he was not depressed.  Bed-wetting was a subconscious issue.

Instead, the Doctor asked that the patient write a monthly schedule of when he wets or doesn't wet on that night. If he doesn't wet the night, Doctor told the mother to reward him at the end of each week. Within 6 months, the patient did not have any more bed wetting problems and without the use of drugs.

I thought about this and realized that the patient had basically cured himself by visualizing on his chart his progress.  The things that caused his issues, an absent mother, a strict father, could not be changed, but the patient could be.


Too often in today’s medical environment, few doctors would take the time to understand the patient, a more difficult and more time consuming process than understanding the disease, especially since drug companies make it easier for doctors to just medicate. But that method only serves as a temporary solution not a permanent one. The Doctor went beyond that and systematically solved what was affecting the patient, psychosomatically by treating the patient rather than treating the disease.

11 comments:

  1. I find it curious as to how many disease people may have that are psychosomatic. The mind does control the body in strange ways. Speaking for myself, I note how anxiety marks my physical being at that time.

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  3. Sounds like a great approach. However, how many doctors have the time to get to know their patients?

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  4. My doctor is just like the doctor in this story. He knows me inside and out/

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  5. My doctor is just like the doctor in this story. He knows me inside and out/

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  6. True, not every doctor will probably take the time to find out what was causing the problem and would probably treat with drugs first. A similar case to this is the growing sentiment amongst doctors not to prescribe antibiotics at the first symptoms of an infection. NSAIDs are recommended first so although the analogy is not exactly the same, the fact remains that there are doctors who would like to treat patients without resorting to prescription or stronger drugs.

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  7. I am a believer in so many issues being subconscious and doing things in this manner actually cured the patient of his enuresis via psychosomatic's. It is Intriguing although most doctors would be quick to simply medicate.

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  8. I think, in my own life, anxiety is all about control. If I understand and can control something, then I can control my anxiety. However, if I cannot control the things causing anxiety then medication is good to allow me to function. Good for the doctor in helping his patient control his issues - that is why we pay them the big bucks.

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  9. True, most doctors today are so concerned with the illness, but does not necessarily take the time to know or understand why someone is sick in the first place. Not every health condition can be treated with synthetic medication. Often such conditions are symptoms of other underlying problems that are never addressed. And yes, doctors so quick with their prescriptions are just pandering to pharmaceutical companies.

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  10. It is really important for the doctors to know their patients first. So that they would have an idea how the patient gets the disease. It would be easier for them to treat the disease if they know the reasons of its occurrence.

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  11. True ,if there is a good relationship with a doctor and a patient , and the doctor able to understand him the treatment becomes much more easy.This makes a feel of confidence in the mind of patient about the disease and its treatment.

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