I have nothing to say but God bless you. Now bring on any Jaundice patient and test me. 😄

Medicine is the art of probabilities , not a science of absolutes. It’s a shame that not many lay persons or even doctors understand this. It make the practice of medicine intolerable 😢

Great job as always But regarding 5:37 did they respond to your email?

Why does the PAWSS score use 30 days in the first item? It seems that after about 3-5 days of abstinence the withdrawal would either be obviously in progress or not an issue... Or over.

As a young doctor and patient myself, thank you so much for this video. Even though I have experienced my symptoms being dismissed as a result from stress myself until I got an actual diagnosis and treatment, I have wondered about the „other side“ as well. Not that I come in touch with these cases too much myself - it is rather the chronic illness communities online that often have me asking how I should respond to certain scenarios where I might worsen the patient‘s condition by uncritically give in to demands of certain diagnostic tests or procedures. I appreciate this summarization of your thoughts as a seasoned professional!

Hi Dr. Strong: this is a really well thought out and produced video. Very educational. Thank you. Do you have a video(s) on physician burnout or resident burnout? Would ‘burnout’ be classified as a ‘functional illness’?

Nice

He used to be so smart. ☹️

One of my friends made up having cancer for attention. This was back in the late 2000's. More than once. She finally went to therapy and got on a medication, not sure what exactly. It seems like a really odd thing to make up. You can't fake it very well with people you know if you try to take it too far. Online though, there's millions of gullible people out there.

I'm one of those crazy non-medical people who are fascinated by all things medical. I have been a member of your channel for a while. This is a great video. I remind myself that doctors are human, like us all. I may have heard, "this is likely anxiety," more times than I'd like to count, but it was one GP who told me, "that isn't normal," and helped me find out what was wrong. I concentrate on him, remember him, the compassionate doctor who listened to me. We are a composite of our experiences. Thank you, Dr. Strong.

This is a clear and well presented video. Thank you.

I’m glad that I don’t have a taste for alcohol. I just have a beer here and there. Weed is my problem. 💀

Do migraines and epilepsy go hand in hand? Does one lead to the other?

I'm a member of the disability community, and I was pleasantly surprised by the level of nuance and empathy towards patients. Although a few comments show where it could be improved, I appreciate your discussion of the complexity of real cases that aren't outliers like "faking a brain tumor to get out of jail" or "GoFundMe scammers." I appreciated your emphasis that once a patient has the label of "factitious disorder" they will no longer be able to get diagnosis for existing OR future conditions!

You know how to choose the best topics ... Thank u doc ❤

Thanks!

i am having pain in stomach after taking some medicine i am also taking stomch mdcne .please suggest

This is a really good video. I am an emergency physician and see cases like these described a lot. It’s really hard to talk about this without 1000 people immediately telling a personal anecdote about how they have been ignored. It’s really frightening to think I’m mislabelling someone. I often don’t meet people for long enough to make a definitive assessment of a somatoform disorder but I see people who return to the unit dozens and dozens of times . One thing you didn’t mention is an ‘unpleasantness bias’. Quite often these patients, for a mixture of reasons e.g bad previous experiences, substance use disorders, frustration, behavioural disorders etc, can be very hard to interact with. It’s really difficult to genuinely and sincerely empathise with someone who is being really horrible to you or to the nurses, and it’s much easier to dismiss these people. These people can often have their organic disease lumped in with non-organic disease because you just don’t want to see them again. One of my trainers taught us that if you feel yourself not liking a patient you should spend twice as long with them

I had to see four neurologists before anyone would take me seriously. This was in the 80's, before MRI was widely available. I was accused of faking, because I had a previous diagnosis of depression. No one would take me seriously because of that history. Turns out I have MS, as an MRI in 1990 finally showed. I knew something was wrong, but I went through years of symptoms and disbelief before it was ultimately diagnosed. By the time of the scan, I had more than thirty lesions. I've heard lots of stories from other MS patients who were treated this way before MRI. In our case, it took technology to catch up. It turns out it was "all in my head;" in the form of brain lesions.

Very interesting thank you. I have followed r/illnessfakers for a while now - a separate video on that would be great!

I was on the other side. My h/o depression, coupled with going through menopause, slowed down any recognition of primary hyperparathyroidism until my calcium finally broke the 10.6 threshold. My MDs didn't recognize that my calcium had increased to the 10s going back to 2018, and my PCP had no idea that a PTH can be normal but too high related to a normal or high calcium. Thankfully, I got the Endocrine consult when I asked a couple of months later. This was after years of trying to get ahead of joint pain with my Rheumatologist for an unclear inflammatory arthritis. Post-surgery, I'm being listened to much better; including re-addressing the sleep study put on hold (by me) in favor of attending to pain, a pituitary tumor, bowel issues, etc.. Started CPAP last Thursday for moderate sleep apnea. Maybe now I'll actually be able to lose some weight that I kept mentioning was too easy to gain, starting back around menopause. You're crazy and you're just getting old and lazy, woman, are not clinical diagnoses. Work ups still need to happen. EDIT: I should add, I'm an RN so I kept pushing forward. I also highlighted when things came to light and treatment was effective in the hopes that there were lessoned learned by my practitioner when next looking at someone with a similar presentation to mine.

Sticking with Twitter/ X

Quite interesting. Trying to find the root cause of an illness can be tedious and hard on a pt, where they decide to give up. If a physician cannot, after doing test after test, find a cause, I give up. Yet, when I was seeing a specialist for a specific reason, he listened to my complaints, sent me for the right testing, and with written confirmation from the lab, my specialist and the CDC, I finally felt that my journey was then transformed to healing. Long journey, understanding my body and symptoms and how to holistically help myself, I no longer feel like a burden to my care team. ...except of course when I have something going on. I used to feel unheard, still do to a degree as a result due to the lack of available time, and have had to step away for my mental health. Healthcare is about healing, and when one feels like a cash cow, they step back. Sadly, this means people will not get the care they need. In addition, with the cost of healthcare, mostly elevated due to how insurance companies are no longer paying/covering the costs, it becomes a financial decision of whether to continue seeking an answer. That being said, and I am not a healthcare provider, albeit I have worked as a LNA and CST, I understand completely what you have shared. I've even removed myself from some of the social media groups that somehow have mysterious "masters of illness" who tell the pts to ignore their docs and suggest their theories and treatment. Some are downright mean if you question and not follow their advice. My theory, my preference to healing, is that of authenticity by the pt and MD, both respecting each other, to work as a team to find resolution, even if that means accepting something that cannot be healed or completely resolved, but working towards making ones life productive again, with tools available to combat the symptoms.

I eally like your videos, but I'm a bit disappointed by a few points. I appreciate that you are not dismissive, but I do think it's easy to forget the "Seeing the Elephant" theory. Your FND example does fit my personal case. I understand there are outliers, but in my instance, I was diagnosed with Cervical Dystonia and finally correctly treated after a decade of neck pain (labelled somatic by GPs, while the visible spasm would send physiotherapists reeling) turned into unwanted movements (labelled FND and then later called tic disorder and OCD). While you bring up psychiatric illness as being separate from organic/functional, all physicians need to remember that the brain is part of the body, and in many instances psychiatric symptoms can be related to physical causes. Since being correctly treated I have not had a "tic" since (nor have I spiraled about it!). I also think that while you indicate a primary care physician should be overseeing someone with this complex intersection of illness, many GPs do not understand said complexity and in their attempts to reassure or not 'over test', they in fact minimise, and therefore prolong someone's path to diagnosis. A "better safe than sorry" outlook is the best way to honour the Hippocratic Oath.

I hate having chronic pain and illness. I have a lot wrong with me and a lot of doctors havent been the greatest at making me feel heard. They dismiss how i feel. Im a disabled veteran who suffers from so much stuff that it drives me crazy. At least my blood tests show something is going on but who knows what. Always have markers of low level inflammation which is fun but idk why. It doesn't help that i have a sinus disease and tbi so my head pain doesn't present as expected. I get migraines with left side numbness and weakness which means i get told im faking it for attention. I have really good hearing and ive heard nurses talking behind my back in the ER. Because of me insisting on them checking stuff they found arthritis in my neck which explained why sometimes it hurts to move it and many drs told me nothing was wrong. Im only 38 but its not my fault my body is doing dumb stuff. I dont enjoy feeling sick 24/7. I miss working but i cant maintain a schedule super well. Ill go days without sleep and then sleep for the most of 3 days. I wish more medical professionals were just a little more understanding is all.

I would like to hear about the adjacent topic.

MBI, that's a nice term. Extremely representative of Reddit to be the first example, as an open country for self-indulgents

very interesting video!

This topic may lead to a strong reaction from some viewers. I know that some of you have felt dismissed and even traumatized by medical professionals due to misdiagnoses occurring when symptoms of physical disease were attributed to anxiety. This is a serious problem that medicine acknowledges and is trying to fix. I have a related video on medical gaslighting here: kzbin.info/www/bejne/a6rdc6mEgtuKaqM Before leaving a comment based on just what you expect I’ll say, I encourage you to actually watch the whole video. However, I recognize that 37+ minutes is a long commitment, so here is the transcript from the conclusion: “In summary, the intersection between chronic physical illness, psychiatric disease, and malingering is complex. Sometimes it’s easy to spot who falls into which category, but it’s often not. And patients who live and interact in this general space often defy clear categorization altogether. We, as medical professionals, can risk serious mistakes by telling them their illness isn’t ‘real’, just like we can risk serious harm by blindly accepting everything that a patient tells us and acquiescing to their requests for specific treatments that are not indicated. But what is true of these patients - short of the pure malingers - is that they are all experiencing anxiety, fear, and other forms of emotional distress. Acknowledging that distress and treating them with respect and empathy is never going to be the wrong thing to do.” A few additional notes: I think this is implied by the overlapping nature of the final version of the Venn diagram, however, I probably could have been clearer that based on DSM5 criteria, somatic symptom disorder (SSD) does not require the exclusion of physical illness, which is a change from how somatoform disorders were characterized in the DSM4. Symptoms present in SSD still qualify for that diagnosis even if due to physical illness, if the patient experiences disproportionate and persistent thoughts and anxiety about those symptoms. Although they debatably could fit into this discussion, I did not include delusional disorders (e.g. delusional parasitosis) and psychogenic non-epileptic seizures, as those diagnoses are usually easy to distinguish from the others.

I knew this was coming. Dr. Strong is evidently more political than medical, and his disdain for 47 is an open secret. Sorry, I won't abandon X just because Dr. Strong suggests we all do. 😊 See you on #MedX

❤

i have been workin as a scaffolder for years. and every time i lift a or walking i feel dizzy or hen the guys are staning and talking i have to sit down and they can stand up with no problem

I'm familiar with a black cloud colleague😂

Best explaination of pulsus paradoxus. I am grateful for your lecture sir!

Was able to create my Bluesky account prior to the full public launch, but I've only just started posting there primarily within the last few weeks. I am hopeful that it can become the new place for those in medicine to build community, though I do think that a wide social media presence utilizing multiple different platforms is probably going to be the way to go given the changing landscape. I also am waiting for larger players like medical societies, journals, and hospitals to either move their presence to Bluesky or at least create an equivalent presence to what has previously existed on Twitter. And with regards to politics in medicine, I am reminded of the adage, often attributed to Rudolf Virchow, that medicine is inherently political, especially given the systems that doctors and patients have to work under that affect the delivery of healthcare.

thanks for this introduction to bluesky

My friend died from this.

I ve never used twitter ... But i m coming to bluesky

Can you do a video :how to become a good doctor?? plz

Mi hija esta en san francisco California diagnóstica h l h hoy ayuda por favor crystal marlene gutierrez cobarrubias 15 de Noviembre 2024

Greetings Doctor Strong, I am very much interested in your EKG book, did you write it?

I'm sitting on the toilet for 25 days now. Been to 2 doctors and no relief in sight. Help!?!

Love your videos!

Full support - good move

the reason med twitter is declining is because the medical establishment has never been more hated and distrusted by people in general. both my parents died of cancer and in both cases i found their oncologists to be self-righteous A holes who cared more about their career than their patients. everyone i know has had a similar experience with a doctor. and here you are, responding to all of this by advocating the creation of an echo chamber where you can continue to trade in your patients health for money and status without facing criticism.