Have I Gotten It Wrong?

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Executive Producer: Doctor Mike
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[@RenaMalikMD]

Thanks for the kind words. It's so unfortunate when our colleagues assume that we have negative intentions or, worse, that we are not credible to give medical education. I'm glad you've paved a path for the rest of us phyaicians on social media. It's certainly not easy, and you're doing a great service!

[@ShropshireFoundation]

agreed 😃

[@robertfalk3767]

I commend you for taking your concerns for Dr Mike to private, and not putting him on blast. Praise in public, criticize in private. Really cool what you did.

[@BPKING.]

What is nuanced?

[@OGimouse1]

And I find it interesting that the assumption is that Doctor Mike doesn't make referrals. And you can tell this guy treats a different class of people because the assumption is that all of the patients can (and therefore will) follow up with a specialist. This guy doesn't have to deal with insurance companies, prior authorization, copays larger than your food budget for the week, deductibles which are 50% of your take home pay, etc. The lanes they should focus on is the class of patient they have and seek to get the best for them within the realistic financial boundaries given their necessary--not idealistic--outcomes.

[@lopsided4831]

What is a phyaicians

[@megclement]

It shouldn’t be controversial to suggest that our mental health is tied to our physical health. It absolutely is and always will be

[@angrymeowngi]

Did you not know that the skeletal system exists outside of the human body? Of course it is not related to mental health! Edit: Wow! Did I make a grammatical error in my statement above that people are missing the sarcasm particularly targeted at the "Orthopedic expert" that commented on Dr. Mike's video? I must not be good at it yet. Or is it that people who respond weirdly have not watched the video? Hmm...

[@nigredoooalgown6245]

Well you heard it here, from an orthopedic surgeon, the brain doesn't control anything! 🤣

[@Wren_BurnsHam]

All I say is, if you don’t take care of your mental health you also might neglect your physical. But idk, I’m not a doctor.

[@UtamagUta]

yeah.. Placebo and nocebo have been recognized as a real thing for years now. The epitome of something created in the brain

[@ezioauditore7636]

@@Imjustright Read what they said again.

[@boat378]

The mentality of "I welcome criticism because it makes us all better at our jobs" is a mindset I wish more people adopted.

[@CycloneRL1345]

Too many people's ego's can't tolerate that sometimes they're not accurate, and block both ears and shout, the world would be much more flawed without criticism

[@chimeragenesis361]

​​@@CycloneRL1345 you sound like the type of bad faith toxic critic this video is actively advising against.

[@lotaryguy12]

@@chimeragenesis361 that doesn't make any sense, he just said cognitive dissonance exists, and it does. Some people can't handle being wrong and choose to be stubborn instead of learning something new.

[@debbylou5729]

Criticism isn’t helpful. A real desire to make things better comes from people that can have ideas to help

[@ExaltedRivr]

​@debbylou5729 constructive criticism in a decent manner is though. By pointing out an objectively wrong statement or action while being polite in your approach with evidence is probably the best way to resolve a mistake.

[@stellabari246]

A family medecine doctor saved my mothers life. She had a brain aneurysm that ruptured. When she went to the ER, they didn’t scan her or anything, and just gave her pain medecin. During the night, she was in so much pain that she couldn’t turn her head, and was vomiting. She called her family doctor, and that doctor recognized the symptoms, and immediately sent her to an other hospital. My mother survived, and a few years later she gave birth to me. Family doctors are important, because they have a broad and general knowledge of symptoms, to understand were to send you and if your life is in danger.

[@luisfernando5998]

Are u sure Uranus ain’t ruptured?

[@Coconut-Monster]

...wut ​@@luisfernando5998

[@FinnOlsen-ij7ve]

Man that must have been terrifying to here ❤❤

[@here_be_dragons9184]

I have similar stories in my family. It's just that ER doctors are jaded. They see so much weirdos and stuff they tend to be dismissive. Now your family doctor is supposed to know you. If she knows you're a person that usually hardly complains she'll know something is going on when you start complaining. Really it's easy as that.

[@maddeninglovecosplay]

My family doctor saved both my husband and my dads life because she was persistant in testing and researching to make sure they got the care the needed.

[@MamaDoctorJones]

Rena is incredible - she’s truly the best! I think a lot of the ego slinging so common in the culture of US medicine becomes much more obvious when some of these doctors engage online.

[@parrotlover8547]

Hi Doctor Jones! You’re such an inspiration in the online medical community! Thank you for spreading your content. 😃

[@emmyhawkins2779]

Love you mama doctor Jones! Thank you for your safe community in all cases :))

[@danarose6043]

You are so sweet and smart and are also hilarious

[@wbae1340]

mama doctor politics!

[@mom2-4kidz]

Mama Dr Jones for president 2024... lol. You're amazing!! You are too, Dr Mike. You can be her VP! 😅

[@iggyman783]

As a clinical psychologist, it’s very frustrating to see the negative reaction from health professionals to Dr. Mike’s attempt to talk about mental health. This physical-mental health divide is a barrier that we are still trying to get over, and continues to negatively affect the care we give to all of our patients. Keep up the good work Dr. Mike!

[@ElijahStroud]

My local university's med school is building a new campus focused on "brain health" which is really cool because they're trying to really increase collaboration between psychology, psychiatry, and neurology. The compartmentalization of mental health and physical health has definitely been a barrier to positive outcomes, but the growing movement to fix that is super exciting to see

[@Shaharalyn1977]

So let me ask you this question how do you approach a colleague whose bedside manner isn't really good? Like years ago there was an incident where I was in the hospital and they told me they wanted to amputate my leg. I told him I was not ready. They were more focused on the physical aspect of it but disregarded the mental part of it and I kept trying to explain to them that well yes something that needs to be done but I'm not ready to do it and it's like they didn't get it except maybe one doctor and the problem was they kept sending in other doctors to try to convince me to do it. I was just not ready because the mental side of it would have been more hard for me to recover from in the physical. So how do you approach a colleague and tell them that even though they're not paying attention to the patient when they're saying they're not mentally ready but from a colleague what can you say to them to make them understand that they shouldn't push it on a patient like that?

[@iggyman783]

@@Shaharalyn1977 that’s where the interdisciplinary aspect of the health professions (in all aspects) comes into play. There are specialties in psychology (such as health psychology) that are specifically designed to help patients prepare for and recover mentally after medical procedures. Of course there’s a lot more to be researched and implemented but at least it’s a start and a step in the right direction.

[@rollihd714]

I kinda get the backlash tho, but it was very unproffessional. Rather as insulting him he should have calrified that you should not always assume it is mental health related. I have experienced myself that some doctors treat a mental health condition without letting the patient being checked out throughly, just some multiple choice papers are not enough! What Dr. Mike could have done better is to clarify that the patient may be checked out in EVERY aspect throughly. In my opinion people could get a wrong idea with DR Mike's video and jump conclusions.

[@nosnah227]

I've had physical pain as a symptom of mental illness, and it's so frustrating when people are willing to go to scammy "doctors" and give all their money to grifters rather be open minded to the idea that physical pain can be a symptom of mental illness. By saying they think it means "it's all in your head," they are the ones perpetuating stigma against mental illness. Dr. Mike even specifically said it's real and not just in your head. So frustrating.

[@itsapersonn]

The Doctor Mike team got balls of steel for doing this. I respect them.

[@akaValeria7]

For one sec i thought u respected their balls💀💀😭

[@lolexguy]

​@@akaValeria7I do.

[@NebulaDark]

No respect from me. This is exactly what trolls want. Just ignore them.

[@SxnnyNevaeh]

@@NebulaDarkthat is true

[@joey.99]

The video says he's responding to a troll, but the entire video is of him responding to a fellow medical professional that had a bad take. That's not trolling

[@jakesmith5200]

I dont know how Doctor Mike feels about this, but i think family physicians are uniquely positioned to be able to comment on a broad range of topics because of their "jack of all trades" nature. My parents are family physicians and note having general knowledge of various systems (and even some psychiatric issues) is vital because the family doctor is usually the first person a patient goes to for help. Just my two cents.

[@sylviaramsay9180]

I agree. I am also not sure why physical and psychological possibilities can't be explored concurrently. Why does a patient need to wait (in Pain) for all the expensive tests and specialist appointments to be concluded before some one asks about their mental wellbeing? Even if the cause is physical there may be some interventions that could help build a patient's psychological resilience and ability to cope with the stress of experiencing pain

[@arringtonash]

@@sylviaramsay9180 Such a great suggestion, absolutely. There are cheaper therapy options out there with mobile apps to start recording things better too.

[@Globodyne]

Jack of all trades is synonymous with master of none. They are too often too busy to keep up with latest research and even more disturbingly don't keep up with modern prescribing guidelines, often completely oblivious to the rules of their own regulatory colleges. Like doctors who throw harmful drugs like Cipro out like candy despite black box warnings and prescribing guidelines to use only as a last resort. I've met many who virtually refuse to learn even 1kb of new information since they graduated medical school.

[@jakesmith5200]

@@Globodyne "...master of none, but oftentimes better than master of one." But I see your point. This is why it's important to keep requiring continued education (and I believe they often do).

[@uglytv3417]

As a pathologist (and thereby another "Jack of all trades" with relatively broad knowledge across a wide swath of medical topics), I have a lot of respect for primary care physicians. Its a tricky job and (just like pathology) benefits enormously from a lack of ego, a willingness to ask for help when needed, and a healthy sense of what constitutes "out of my depth." I have only seen a couple of this guy's videos but he seems to have a reasonable approach and a lack of hubris. I'd go to him for my own care.

[@camcramer22]

What happened here is a prime example of someone who felt confident and tough behind a screen, and then switched up immediately after being called out. Way to stand up for yourself and call them out Dr Mike well done.

[@usernaames]

Meh your attitude is also Internet tough guy and toxic. Dude might just have had a bad day.

[@hattarapilvi]

​@@usernaamesliterally in what way is op acting tough or toxic lmao?

[@Mayllee1]

I can't see how your comment is relevant, or accurate. His comment was on point with the case presented...@@usernaames

[@konradhylton]

YUP. Exactly what happened. He forgot Dr Mike is actually Mikhail Varshavski a real person with real feelings and decided to spew nonsense because he thought there were no consequences. And when confronted on it, he made it WORSE by not just admitting that he was wrong, instead he tried to talk in circles

[@camcramer22]

@@usernaames I was going to respond but it appears others decided to take care of that for me

[@dudeguy1894]

I always find it funny when someone tries to give toxic criticism, but then their tone COMPLETELY changes when they get a polite response.

[@Johnwillson-n7v]

Social media just seems to condition people to assume the worst of others, make you put your guard up, and assume aggression is the only way you'll get your point across and to never ever try to see the other side.

[@JDMimeTHEFIRST]

I didn’t see it as toxic criticism. I think neurotypicals tend to over react to someone giving reasonable criticism. The surgeon was very polite and O actually agree with them. They explains the mselves after Dr Mike misperceived their criticism and it was cleared up. People need to stop assuming the worst and taking everything personally. Neurotypicals especially like to argue and make things gossipy when they’re not. It’s a valid point. Dr Mike missed a step in the process. They communicate differently.

[@everyhandlesalreadytaken]

​@@JDMimeTHEFIRSTyou realize there is no way a public comment calling your content "clickbait" and questioning whether you're competent enough to have an opinion on a subject, while getting your profession wrong as well, is in *no way* classifiable as "constructive/reasonable criticism", right? And I frankly don't get why you make it about neurotypicals, as a neurodivergent individual, it seems rather proposterous.

[@sazonada]

OK. But that's a good thing.

[@fizzybossyt8675]

​@@JDMimeTHEFIRSTsending this message in case you didn't see his reply

[@HeisenbergFam]

"I want colleagues to criticize me" appreciate Dr. Mike for wanting to receive constructive criticism to be better

[@lyn10gaming]

HeinsenbergFam!!!

[@AustinCameron]

If only “scientists” like Peter would do the same….

[@Jayzplayz12]

Wow a breaking bad fan never seen one

[@2yldy]

Oh hey again HeisenbergFam

[@BrokenAsf666]

If I see you again I swear to god

[@Greytheaverage]

As someone with fibromyalgia and a related condition- neuro plasticity and emotional related pain responses are SO REAL. I will have the worst flare ups of my life if I get stressed or upset- even if I sit down and think “oh right, I’m in pain.” The pain will get so much worse. Our brains are so powerful- I know that!!! From experience and other doctors!! Infact the doctor who told me abt it wasn’t a muscular skeletal doctor!!! It’s insane how some doctors get so caught up in the specialist expert mindset and brush off everyone else. I really appreciate you talking about nuanced and less talked about things Dr Mike, don’t ever stop!!!! It educates me and others!

[@amandaggogo]

I'll say this. I spent several weeks going back and forth to my GP, complaining of stomach issues, which have been ongoing for some time. She did a million tests, and at one point said "I think the source is coming from your anxiety, would you like to be set up with a therapist?" Then she went on to say "but I'm not going to rule out other issues just yet either." So she continued to do some more tests, and we decided together that yes, it's stemming from my anxiety, after some sessions with my therapist seemed to alleviate some of the symptoms I was having. That said, each time I go back she still asks me how my stomachs doing, any new issues with it, any ongoing issues, if I want to see a GI, etc. She still checks my stomach when I'm there, but she did great in ruling out things and then suggested that it's linked to my mental health, but tells me not to ignore any new or worsening symptoms.

[@samygafsi6429]

That's a great doctor who understands the importance of the mental physical duality of the body. and props to you for following the doctor advice and trusting their competence.

[@c.d.2313]

The EXACT same happened to me. Noticed that my stomach aches got worse as turmoil entered my life. Eventually I got diagnosed with IBS and that’s known to flair up when you’re anxious or under stress or pressure.

[@ButterNutSqwoosh]

@@c.d.2313 Me too! I was diagnosed with IBS when I was around 16, and I've noticed that when I'm in situations where I am extremely anxious it flares up to extreme levels. And as I have always been an anxious person even as a kid, it may well have been that kind of prolonged anxious state that made me get IBS/made it more severe. Now that I don't put myself in those triggering situations nearly as often, my IBS is a lot more manageable.

[@hedgiebing55]

Oh I am so glad to hear I am not the only one. I also experienced terrible stomach pains many years back. I had so much anxiety back then. My doctor also tested my blood and everything else to rule other things out. She also mentioned stomach pains could be due to anxiety and stress. That's when I started to play the piano and play woodwind instruments to get my mind distracted and calmed. It took a bit for my body to get back into balance but all my symptoms were relieved when my stress was gone. Our minds can do crazy things truthfully speaking.

[@lynnsundrop]

I'm a licensed therapist, and I've definitely had clients who had headaches & stomachaches as anxiety symptoms. Even panic attacks can be mistaken for heart attacks because of how severe the body's response can be. It sounds like your doctor handled your situation so perfectly, and I'm glad they were open to referring you for therapy services. And I'm glad you were open to going :)

[@Diegotheparrot]

"Getting your heart broken by someone will make you feel terrible" Cardiologist: YOU KNOW NOTHING OF THIS MATTER

[@photographicfission7181]

😂

[@rileybirkett3644]

So it's true then, Padme died of a broken heart

[@Diegotheparrot]

@@rileybirkett3644 Are you a cardiologist? If not, you shouldn't speculate about padme's demise.

[@j.luv.08]

LMAOOOO

[@Monkey_1640]

People are allowed to speculate about what they want Stop gatekeeping other Oh and before you say you aren’t You are

[@nicolejclarke]

As a victim of horrific childhood trauma, I SO APPRECIATED your insight! Most doc just shrug me off as lying.

[@sarazigova8650]

Exactly

[@BuzziandBuzzi2]

I’m sorry, I hope a doctor near you can help. :(

[@jayus2033]

What happend 😂😂

[@lapisangstylazuli]

​@@jayus2033 your comment is very insensitive and inappropriate. Learn and grow as a person, do better

[@jayus2033]

@@lapisangstylazuli Go back to Elder Scrolls Online you nerd

[@MikesDadvice]

Dr. Mike During my 13+ year career in the ER, I have seen many patients who could benefit from a mental health approach for their pain. If I were to even mention that I would get eviscerated by hospital management and probably CMS for that matter. Part of the problem is that in the ER we simply don't have the time to approach a conversation like that, many other issues like this have lead me to schedule my departure from hospital work into private practice. I love your channel, keep making great content!

[@kathrynbentley3000]

You respectfully called the other doctor out without putting him down. Good for you.

[@mikeycarbis6536]

You and Jordan Peterson would be an interesting conversation

[@TheMrCC21]

He's made videos before about other doctors raging over stuff he says or does. He wants doctors to be united in medicine for the betterment of society. Being divisive is like taking two steps back (for a lack of a better analogy).

[@spvillano]

@@TheMrCC21 diversity is OK, diverging from evidence based medicine is not. But worse is, demanding a specialist for everything. If one is bleeding to death, do you honestly want to keep on dying while a vascular surgeon is called?

[@bespokepenguin103]

@@mikeycarbis6536Jordan Peterson: The perpetual professional victim

[@Levienna]

yes This! Would be a fantastic collab@@mikeycarbis6536

[@rachelportman4204]

Dr. Mike, as someone who likely deals with chronic pain solely due to stress and anxiety, I appreciate you so much for voicing that your mental health can contribute to pain. So many doctors I’ve been in contact with don’t even acknowledge the connection and don’t have many solutions for us who don’t have a diagnosis or injury. THANK YOU for speaking for everyone who suffers from this and don’t let those misinformed bother you.

[@fluffyphoenix8082]

it's crazy cause I've experienced the exact opposite in my own life! doctors blaming ALL my physical symptoms on my mental health, even though I know something else is going on. well I finally got diagnosed with a type of heart disease... which took years because doctors kept saying "it's depression and anxiety". not at all trying to discount what you're saying, don't get me wrong. I just find it so interesting how so many people have very unique experiences.

[@AstralArbourSystem]

And on the other other side, I've had doctors insist I couldn't possibly have depression because I was "too young" and it must be a solely physical condition causing my feelings. Then when they didn't find anything in my blood tests they finally sent me to a psychiatrist, and would you look at that starting high school as an autistic kid fucked me up.

[@roxannlegg750]

@@fluffyphoenix8082 same here - and ive slammed him for his message....that original video bite was just plain offensive and only re-inforces drs who treat us pain patients as psych cot cases!

[@bsn0730]

I've experienced the opposite of these replies.... what I gathered from what Mike said, doctors should do a proper exam and investigation into the physiological issues going on and once those are ruled out, investigate the mental side of it. I actually have a deformation in my back that basically gave me old man back in my teens but I've noticed my back feeling much better in recent years as I've worked through my mental health issues without even really doing anything specifically for my spine. I get the impression that these doctors you're speaking of are mediocre doctors (sadly common among all professions) not doing a thorough investigation or admitting when the scope of the problem is outside what they're familiar with.

[@heatherburch6760]

This is why when people are given certain antidepressants they don't hurt as much because they're not as tensed up in their muscles

[@troubletrumble]

That is so fucked up that a qualified doctor would go and throw shade on another colleague like that. Good on you, Doctor Mike, for standing up against that.

[@namantherockstar]

Mike inspires me.. My parents said if i get 50K followers They'd buy me a professional camera for recording..begging u guys , literally Begging...

[@MilesJ.]

that's hard to believe, man. A lot of you accounts keep saying stuff like that. We'd like if you stop or just get out of here with that. We only talk about Mike or the topic at hand. @@namantherockstar Thank you for listening to my TedTalk.

[@dumbassdude8372]

Its jealousy, He wants to have the same fame dr mike has

[@dallastexas5653]

@@namantherockstarjust get a job and buy your own camera

[@Star_Scoot]

The hospital I work at is practically a war zone from doctors against nurses to nurses and doctors against cnas and God forbid anyone else. It is BAD in break rooms. I am in the float pool so I see everything. The amount of disrespect is insane and of course they aren't getting fired when it's actually impacting patients.

[@KatBaumgarten]

When i was 14 i had stress-induced gastritis - throwing up blood, couldn't keep solid foods down, etc, but my bloodwork was fine. The first doctor i saw in urgent care said it couldn't possibly be stress because i was 14 and had nothing in my life that could be that serious, then he said i was probably faking it to get out of school, then saying i was probably bulimic. 15 minutes with my family doctor and he correctly identified the cause, gave me medication and directions on how to keep my stress levels down. I had lost 10 pounds in a week, and was a few days away from an ulcer. At 14. He literally saved my life. So much respect for family doctors ❤

[@Cletrac305]

When my parents were getting divorced, I was in the 6th grade. I outwardly handed it very well. However I was also being bullied on at school. I missed 42 days of school that year, most of them I was sent home with severe stomach issues, with uncontrollable vomiting. Mostly on Monday mornings. They couldn't say I was faking it but never drew the line to psychosomatic. Later, much later, I learned that many people that have severe issues they are facing their brains unconsciously create a real physical situation designed to remove you from that situation. This actually happens a lot to "brave" people who have to just keep going through their fears no matter what. It's NOT an indication of cowardice or laziness.

[@FirstnameLastname-jd4uq]

“You’re 14 you have nothing in your life to be that stressed about” that is absolute complete utter garbage. How are they even a doctor?

[@KatBaumgarten]

@@FirstnameLastname-jd4uq that pissed me off so much, i had to learn how to fight to be taken seriously by doctors since i was really young and honestly, it's still hard sometimes nowadays

[@Ndjieisneuowwus]

I’m sorry that happened to you, thankfully doctors like Mike are raising awareness ❤

[@blueberrybecca4148]

I am an ortho nurse and I was talking with my dad about how mental health is a huge contributor to how people feel and manage their pain. I could have two patients who are the same age and had gotten the same surgery and they will experience completely different levels of pain. The patient with a good support system, few mental health complications, and a higher socioeconomic status is most likely going to feel less pain and manage it better than someone who has a poor support system, poor mental health, and a lower socioeconomic status.

[@Babalutu573]

How does socioeconomic status affect the perception of pain?

[@TheSwauzz]

This is quite a statement to make. Are there any studies to support this? Pain tolerance is a personal thing, in my experience. Also the more pain you have dealt with, the better equipped you are at handling it.

[@Westernkoala]

I have chronic back pain and am so sick of *stress* coming up in the DD. Fine bring it up once or twice but when a patient pushes back because it doesn't sound right in their case docs shouldnt brush them off.

[@mikacakes]

@@Babalutu573 It can have many different effects but the basics are that the poorer you are the more bs you have to deal with in life. rich people have house-keepers, poor people have to mop their own floors. Rich people can order in or eat out, poor poeple have to go grocery shopping and cook. Rich people have paid time off, poor people have unpaid sick leave. Rich people have savings to support them when they can't work, poor people have debt and medical bills to bankrupt them. So lets say you have a slipped disk in your back, if you're rich you can take as much time off as you need, you can get help in to do your chores, you can get food delivered to you instead of cooking or starving, you don't have to worry about bills and bailiffs, you can get a taxi or uber to medical appointments, you can afford to see the best physicians, you can focus solely on recovery. You won't be constantly reinjuring yourself or preventing healing, you won't have to engage in tasks that hurt and you won't have the heightened cortisol and adrenaline from worrying about bills hampering your recovery.

[@Babalutu573]

@@mikacakes in terms of recovery yes, but the question still is unanswered, how does socioeconomic status affect the perception of pain is what I want to know. If both have same age, same gender, have same surgery or injury, how does socioeconomic status affect how one perceives pain as oppose to the other?

[@katac8]

As a physiotherapist, I can only say thank you! Mental health is a HUGE factor in rehabilitation. The state of mind can have so many effects on engaging in the process, managing pain, setting goals, etc. Psychosomatic pain is a real thing!

[@TheHrb1234]

It reminds me of my childhood and how my mother would take me to the seaside(beach) for a couple of days before I had to go in for surgery (I had at least 2 a year throughout). I look back now and even though it wasnt prescribed or identified back in the mid 70s, I can look back and see how it made me in a better frame of mind going into hospital both mentally as well as physically. Although I cannot state any empirical evidence per se, I believe it helped my healing post surgery.

[@Kate98755]

I’ve always thought this and wanted to schedule a lecture discussing the mental health issues of being chronically ill.

[@heathieAK]

I work in physical therapy too and also see this all the time. I was very glad when he brought it up in his initial video.

[@kariross8120]

As a person who was told by a doctor that I “should see psychiatrist” for the gi pain and discomfort I was in that turned out to be physical in nature I 100% agreed with your information on mental health and pain. After I had my first child I was experiencing some pain and neurological issues. I was referred to a neurologist and he did a complete work up including scans. He gently brought up postpartum anxiety/depression. He validated me and explained that he thought my pain and discomfort was from untreated anxiety. I was grateful it was treatable and I took medication and saw a therapist. All of those issues were resolved. So I’ve seen both sides. The point is one doctor did a full work up and the other did not. We need less shame surrounding physical pain.

[@NotesNNotes]

@@yeshummingbird - right, it seems to me that Dr Mike implied that every method for identifying the cause of pain (and my initial thought was even from other providers) would be taken before he would suggest mental health treatment, and that the other doctor didn't catch it or ignored it.

[@Venturification]

My mother and sister was kinda distraught that the nurses and the one delivering the baby gave no information of post birth problems. Which in my mind is baffeling as why would people in the medical field NOT actually educate their patients in symptoms etc. And this is in the ''perfect'' country of Norway. The fact that my mother had to explain stuff that she didn't necessarily had any education in, but she had experience in the same stuff that happened to my sister. Just kinda sad really. I am sorry if some of this is unreadable.

[@SurviveOutdoors]

As a Doctorate in Psych and 40 years as a Physician Asst. You are 100 percent on target. Actually to catch a mental health issue we often drive in and out of lanes. Great video. Always will have the reactionary comment . Keep it up Dr Mike.

[@spencercox8571]

Right. Telling another doctor to "stay in their lane" screams insecurity to me. Any doctor with confidence in their skills will want to focus on collaboration in such a scenario, not getting defensive over absolutely nothing (and factually accurate information, too).

[@Snagrit]

Hey Dr Mike, I am a critical care doctor from Australia training to be a pain specialist. This IS your lane. I WISH we had more primary care doctors who understand the biopsychosocial model of pain instead of jumping on biomechanical explanations and leading patients down a path of endless tests and procedures that do more harm than good. Keep doing what you are doing.

[@inner_kundalini]

@Snagrit Sounds like you too are staying in your lane 😉 So glad your patients have you ❤ Bravo!

[@Not_undelicious]

Chronic pain patient in Australia 🙋🏼‍♀️ we need more drs like Dr Mike and yourself who actually believe us and understand what's going on with the body and brain together.

[@monoymono9]

so yes

[@Justanotherconsumer]

The value of generalists is that they are not a hammer that sees everything as a nail.

[@marydotjpeg]

Chronic illness/chronic pain patient here in Australia as well. I've been having a hard time having diagnosis but I'm happy with the medical care here compared to what I experienced in the US but it's so difficult finding doctors to finally be diagnosed. I have been seeking a 2nd opinion on a diagnosis it's been a difficult journey because I keep getting worse we even looked into autoimmune 😭 my numbers were borderline positive so my GP said he can't diagnose me so I'm at a loss... neurologist appointment in April meanwhile I feel like a literal skeleton 😅

[@emilywagner6354]

Jealousy is such an unattractive emotion.

[@yuriiarama9578]

​​@palerider955he is assuming that the trolling from the other doctor comes from a place of jealousy. I don't know about that, but it's possible. Dr Mike is a rather big person online. Maybe the other doctor wanted to throw some shade on Mike to get some clout himself.

[@emilywagner6354]

@palerider955 Of Dr. Mike's success? Of Dr. Mike not contacting them when they offered to help?

[@LillerThatIsMe]

When I saw that he had sent a fan comment to Dr Mike’s dms it made me wonder if the other doc started hating on him cause he didn’t get a dm back 😬🫣😂

[@melodylightsahgasestarlight]

​@@LillerThatIsMeSame thoughts. I feel like he's having a tantrum because Dr. Mike did not ever respond to him or asked him for information despite him offering it.

[@iditrirajan]

​@@melodylightsahgasestarlightI thought the same tbh. The moment I read "I'm also a doctor". I knew it's coming from him because he's salty that his influencer didn't respond to him

[@plainsong76]

As a psychologist, I applaud you for this video.

[@CrystaJoy]

I’m In Neuropsych and I was thinking the same thing. That is why I was petitioning for hybrid PCP/Psych practices as things like Dysthymia can affect the overall physical state of a person. That Ortho doc was way out of line.

[@Tsukiyumi3]

I’m a new PT and was recently taught about pain caused by Psychological factors , the Ortho doc was absolutely ridiculous Dr. Mike clearly said if all anatomical signs were ruled out then it could be from Psychological factors that caused the physical pain and it’s absolutely real

[@spvillano]

@@Tsukiyumi3 pain is always real, regardless of cause. It can be physiological or psychological, it's still processed by the same brain. One of my grandchildren suffered from clinical depression, recalcitrant to treatment. Due to some missteps, what was missed was Hashimoto's. Autoimmune disease of the thyroid, destroying the thyroid and depressing thyroid hormone production, causing the depression. With a history of grandfather having the opposite, Grave's disease, autoimmune thyroid disease stimulating the thyroid.

[@Tsukiyumi3]

@@spvillano 100% agree , pain is complex especially if it was caused by the brain But I wanted to correct myself there, I meant Psychological factors but I didn’t realize I typed physiological sorry English isn’t my first language and typing fast is bad sometimes hahaha 😅 Im sad to hear about your grandchild I hope they’re doing well and I wish them the best treatment, bless you !

[@user-zv7uh6bo2w]

I had excruciating physical pain that was treated as a mental health issue.

[@johnbarnes794]

I happened to see your video yesterday. I have a psychosomatic pain disorder. I suffer from severe anxiety. I’ve had shoulder surgery &spine surgery that did nothing. I was so happy to see that mental health can cause physical pain to be turned up. I’m in therapy with the LA Pain Psychology Center. I say kudos to you!

[@4201productions]

My paediatrician has been in the field for 35+ years and I showed this to him for his opinions as A well experienced doctor, He replied to me “I wish there were more doctors like this that were open about speaking into other fields of medicine that correlate with their field in even the slightest manner and speaking about the general population over just their patients” From the perspective of some random 14 year old boy (Me), I am proud you are willing to provide factual information to keep your viewers informed and healthy, Thank you!!

[@CynthiasTikka]

You are one smart kid! I'm glad you are watching social media for positive and information purposes. Advocating for yourself especially when it comes to your health is something that many, many adults never learn to do. Or even try to learn about their health conditions. Good job 👍!

[@TheresaONeill-ze3jb]

You are very well spoken..I love it! Have a wonderful life

[@singlebadassmomhere328]

Wow!!! 14?!?! You must have wonderful parents/guardians/teachers! You mannerism in speaking is remarkable at your young age. Keep it up and you'll have a very bright future 😊❤

[@hexagonshorts2186]

Dr Mike you have earned my utmost respect. The fact that you hid the name of the troll to not destroy his living is extremely appreciable.

[@beastofthenumber6764]

the fact that made this video instead of treating the matter private is a flavor of hyprocrital.

[@cristinesplinis5815]

Someone close in my life was a victim of sexual trauma. She then a few months later started having pelvic pain. She went to her gynecologist several times trying to find the source. Pelvic exam, x-ray, and MRI found nothing wrong. She broke up with the boyfriend, and a couple months later, the pain decreased and eventually went away. The patient came to the conclusion with her psychiatrist that the pain was largely psychosomatic and she has since come to terms with it. Real pain can definitely come from psychiatric causes.

[@xxxxSOSEXYxxxx]

Possibly, or maybe she has Endometriosis and it’s gone undetected. It commonly ignored. If she works on her mental strength and continues to have pain during sex, she should see another specialist.

[@cristinesplinis5815]

@@xxxxSOSEXYxxxx Absolutely. Thankfully, the pain subsided almost immediately when she got away from the guy. ❤️❤️❤️

[@Silly_35]

So happy to hear she’s no longer with that awful guy, I hope she’s doing well

[@ohnoes7032]

There's no such thing as psychosomatic pain anymore, keep up with the research.

[@cristinesplinis5815]

@@ohnoes7032 strange. She had pain, then dealt with the trauma, and the pain was gone. There was no other potential cause, since an MRI was done as well as other tests. Sounds like you’re the one who needs to do their research.

[@carlchandler9881]

Dr. Mike, so many of us Love you so much it hurts. Keep doing what you're doing. You brighten our days and I've learned so much from you. You never over step your position on things and always advise to do our research and consult specialists in regards to questions on specific conditions. You are always professional and a complete joy. Thank You! The Haters can just get a therapist to deal 😅. Keep a positive outlook and Remember, never let them get to you because you are genuine and a good guy! Keep videos coming!! 😊

[@piros100]

"My colleague treats pro athletes, I treat REAL PEOPLE" 🤣🤣🤣the subtle shade of this sentence made me chuckle.

[@eloisepharmacist]

Oh yes 😂😂😂

[@impracticalnuke]

Servicing high end cars is difficult, but it takes a different breed of medical professional to service normal, average cars on a daily basis by the hundreds, if you catch my drift

[@faithfuljohn]

the funny is as a former competitive runner, I never wanted to see a doc who treated real patients... cause my problems weren't normal problems. Like "yes I can walk fine... but I'm racing against other fast people, so no this isn't good enough and this barometer for health is not useful to me".

[@hulda4ever]

🤣😂🤣😂

[@ChosenOne41]

I think he meant "average" and not "real". Unless he thinks all athletes are fake people, like how the moon landing is fake according to some? 🤔🤔

[@sister-uu7or]

I get migraines when my PTSD is triggered. I PROMISE you that somatic pain can be caused by mental illness. Thanks for what you do, Dr. Mike.

[@salamandra1983]

Yikes, hope it gets better for you some day.

[@coryannemoen7466]

Same!

[@logandanger6163]

can agree. I have chronic pain and when i'm more stressed, anxious or panic. It is worse in pain severity. As well as having a hyperactive nervous system due to PTSD, so the threshold to where the nervous system signals pain is much easier to pass compared to someone with a more normal behaving nervous system.

[@Katie-qg7xz]

Migraines are triggered when brain wave patterns are disrupted. Stress, lack of sleep make this happen. That also happens with PTSD.

[@Emily.R.W]

It’s just such a pointless argument to say it’s not relate, since it’s obvious that the psychological state of a person can affect their physical health, even if it’s as simple as going to the bathroom more often due to stress. Nearly everyone I know who has had IBS was also having a tough time with their mental health. High stress can also cause hyperventilation without knowing it, then also causing headaches and shoulder pain. Someone I know was prescribed tai chi for that and it worked. Additionally, this link between mental and physical health is why placebos work.

[@JustShpigel]

I love how humble Doctor Mike is. He never is TOO proud of himself, although he deserves it

[@bornstar481]

He is so proud of himself that he calls anyone who disagrees with him or dislikes him “trolls” to suggest their words aren’t serious

[@FallenAngel9979]

@@bornstar481He calls them trolls because that’s what they are.🤦🏻‍♀️

[@spoperty4940]

@@bornstar481 did you watch the video bruh? he called him a troll because he was toxic, he didnt approach it well and he was simply putting out misinformation about mike. he literally said multiple times that he is open and wants criticism, if its presented in the correct form(no, commenting on some1's video is not the correct form to do so.) and he showed an example where he exercised this principle.

[@Natso_1]

​​@@FallenAngel9979to play devil's advocate he explains in the video that he believes the orthopedic did not understand what he meant to say, yet he still calls him a troll which he totally did not have to do. However the other people probably were soo, in the end, idk.

[@cameronmachado1774]

He put a completely legitimate criticism in the thumbnail though

[@sarahcarr6729]

I have been a practicing Licensed Massage Therapist for 20 years, focusing on how a negative head space directly impacts actual physical issues and/or creates physical issues. After many additional trainings in craniosacral therapy and somatic respiratory integration the correlation between mental health and physical issues is abundantly clear in many cases. I’ve battled the medical community for years because specialists tend to view the body and human condition from their one specific view and perspective. Fortunately, I have many physicians, PA’s and NP’s who come to me after having an office in a hospital in my area specifically for the staff only. Thankfully I’ve proven myself competent to them and have witnessed the shift in their focus to the recognition of how mental health impacts the work they do and how my practice is an excellent complementary hands on approach to amplify their own results with patients. In my opinion you are absolutely right on with what you’ve said. I regularly recommend patients see their physician and/or specialist when I find irregularities and always say I’m happy to collaborate to improve their care. Well done, Dr. Mike!

[@ashla7567]

I’ve spent a lot of years in neuropsychological research and met one 14-year-old girl with conversion disorder so severe that she was unable to walk for months. No underlying physical causes whatsoever. After inpatient treatment and working through her trauma intensively, she slowly recovered. Even though I’d been studying the brain for years, it was really eye-opening to see. We even wrote up a case study on her with her permission.

[@cecilia-joyadamou2074]

My friends grandma has this when she was a child too!! So interesting.

[@anajuliaarantes3457]

i had this at this exact age but i hadn't no significant trauma just my brain shutting down

[@bmg9136]

Please use the proper term, FND. - Functional Neurological Disorder. Based on current research and use of fMRI, the understanding of the disorder has changed, the cause is not always related to past trauma ("conversion") or mental health. People can have a migraine, an illness, an injury, or a surgery that sets off FND. My episode that landed me in the ER was likely from a migraine and sensitivity to a medication. I had a mild flare up directly after a (non related) surgery months later. The positive side of FND, it's reversible with a team approach that includes education/awareness of FND, PT, OT, vestibular rehab, some medication, mindfulness, lifestyle changes, rest/pacing of activity, and possibly CBT.

[@ashla7567]

@@bmg9136 I was speaking about one specific patient that I encountered a few years ago. This girl’s symptoms appeared following severe psychological trauma and so she specifically was diagnosed with conversion disorder by her psychiatrist and neurologist.

[@brentfarvors192]

The exception does not make the rule!! So MUCH BS!! The problem isn't with an "anxiety" DX, but that it is used for everything!!! Literally means: "We are too lazy to figure out what is wromg with you"; To the point that people dont bother with Dr's anymore...They have no choice but to self medicate...Seriously, get F'd!!!

[@mommakimma]

I'm so happy you mentioned 'the Body Keeps Score'. As a counselor I was so pleased to see you offer patients psycho-somatic help. I feel like not enough doctors recognize that past difficulties can impact how a person heals or feels pain. The brain is part of the body and its still not completely understood, helping an individual recognize that they *might* have a past issue impacting them today can be a huge aid in getting them better.

[@kellyb6198]

My therapist loves that book, when I first started seeing her it never occurred to me that a past trauma was affecting me physically. After working through it I've improved so so much

[@drlaurastirbu]

Gabor Mate MD also has impresive books on the subject, i am sure you know him also.

[@janedoe6704]

Van Der Kolk has been debunked. He still believes in the recovered memory movement and got fired from Harvard. I really wish the mental health field would stop pushing this book as scientific.

[@Allison-fs6bq]

I was misdiagnosed for 12 years with endometriosis. I considered removing my ovaries the pain was so bad. My specialist sent me to the er and after running every test (blood urine mri ct scam and neuro exam) I was properly diagnosed with CPTSD with psychosomatic and executive dysfunction. This message is important and could’ve saved me years of pain so thank you for opening this conversation Dr. Mike ❤

[@seonghwa2465]

If you don’t mind me asking, what were the physical effects that the cptsd had on your body? I know you said you were misdiagnosed with endometriosis so I know where that pain would but has a doctor explained to you how the cptsd was affecting you physically? If so, what was there explanation of it? I was just curious, if you don’t mind explaining it?

[@rachelliz4786]

I'm very chronicly ill and have been gaslight, and told by some doctors (and other people in my life) that its all in my head, because of that am very critical of people who say stuff like that, no matter who they are and if they are a dr or not. Despite that, I can step back and see that you are absolutely not saying that someone's pain isn't real, and I actually really appreciate your take on this. The way you describe that your mental health can influence the "volume" of your pain is a very good way of communicating such a complex topic in a short and simple video so a lot of people can understand. I interpret your original video as you comparing the connection between (chronic) pain and mental health to a radio and a hand that can change the volume. A radio (pain) can be on and the volume (influenced by mental health) can be all the way down so it sounds like the radio is off even though is not, and the volume can be really high at other times making it impossible to ignore, mental health has a big influence on the pain but none of that means the radio is off or doesn't exist. As people work on their mental health the volume can slowly ho down, it may never be all the way down but i count and reduction in pain as a win. I'm really sorry that the first dr. in the comments was so disrespectful, toxic, and really confusing. I think its wonderful that you are not defensive when someone respectfully corrects you and you see it as an opportunity to improve and correct your content to help others. I hope others can learn from your response to criticism, and i hope the first dr. sees this and changes his ways. Your videos are very educational, entertaining, and you show that the health care system can get better, thank you for being amazing and giving me hope 💜

[@Freya025]

As someone with an autoimmune disorder, I can absolutely tell you that the more stressed out I am, the worse I feel. I can even trigger a flare-up of my disorder purely by my stress level and that plays into my mental health and how I am coping with what is happening in my life at that time. Also, as someone who saw specialists trying to get a diagnosis, it was my LPN who actually figured out the problem. Specialists aren't special in the sense that they are the only ones with that particular knowledge, clearly.

[@Amita8505]

As an LPN, I appreciate this comment ❤

[@SweetSallyRadio]

Same here! I also work with an organisation dedicated to help patients with musculoskeletal disorders (rheumatoid patients most of us), and it's even proved that people with those conditions that live in places with moody weather (always rainy, cloudy, etc) PERCEIVE more pain that the ones with sunny weather. So, yes, there's a lot of factors that doctors have to take into consideration when talking about pain....

[@elsaamanda5999]

For real! I have many autoimmune conditions and my alopecia flares when I’ve had a stressful time in my life

[@brunorca]

And this is pretty much why Dr. Mike is the only online doctor I take seriously nowadays, he's open to debate and explain everything and also often corrects himself when he's wrong about something.

[@Benedocta]

I don't think that's fair. There are so many medics on youtube who put out excellent, scientific and educational content. Medlife Crisis comes to mind, for example.

[@lisbetsoda4874]

​@@Benedoctayes, BUT there are also real charlatans here on KZbin who make money off selling us stuff. Sometimes quite insidiously.

[@mrsatan2229]

​@@BenedoctaDr. Siobhan Deshauer, ( violin MD) makes really good videos too. More of a blog than in depth topics, but still really informative, and honest.

[@Lorena_Halo]

@@Benedoctayes but,it’s not like their like doctor mike, their not putting themselves out their to different experiences that even doctor mike has, each is different yes,but doctor mike focuses on what he brings to the table but has a side of joy like attraction to enjoying what he puts out their, compared to regular doctors or few doctors online they don’t potentially portray what everybody wants, for instance I want something that he has that some doctors tend to fail to have what he has, you might like someone else and yes theirs better out there,just in a different way they put themselves out and about, what they say, what advice. Doctor mike does that but he tends to invite other people who know nothing about being a doctor, like callmekris where she jokes around with mike and talk about less doctor things and he does the same, mike also does boxing and he shows that in his videos that he puts out if you find them,where could you see a doctor video like that rarely any doctor in KZbin does that specially show it on KZbin or the whole internet itself , doctor mike nephews who he teaches one of the nephews who wants to be like him some import things. The list goes on, this is how I see it.

[@brunorca]

@@Benedocta wasn't meant to discredit EVERY other doctor, I know there are many good ones, like MamaDoctorJones, but it's not the type of content I usually look for. More like Dr. Mike is the only one among the ones I've been watching recently*

[@leev7152]

As someone diagnosed with conversion disorder, I appreciate you talking about these aspects of pain. My MRI were clean, brain scan too, they did a lot of tests and couldn’t pin point what was going on. I’ve been having motor tics, aphasia, PNES, paralysis etc. I had to stop college, work, my social life was non existent, and because my tests were clear, lots of doctors have been dismissing it under “you’re faking it”. Later on, after being misdiagnosed with Tourette’s, epilepsy, schizophrenia (??), a neurologist told me it’s a functional neurological disorder, coming from unresolved CPTSD.. I was finally seen as valid in my problems and not someone faking a disorder, and realising how hard trauma can alter my body’s function was mind opening. I’ve been through therapy, seen psychiatrist and change my lifestyle to match my body needs and I’ve been doing way better. I still have PNES, but a few times a month, instead of dozens a day. I can walk and talk as before and it’s been a huge improvement. I was so depressed by my physical state and my life being turned upside down that I didn’t see a way out and was considering the worst. I’m so glad I met doctors that are educated about these disorders and wanted to thank you for bringing awareness about them, it means a lot ❤

[@melissapotter6010]

It took almost ten years of MRI’s EEG’s and seizure studies to get diagnosed with conversion disorder. After my first seizure study the doctor told me that since I was a 16 year old girl that it was probably me being dramatic and to go home. I had unresolved PTSD from several things from my childhood and was diagnosed with PNES by my psychologist years later. I totally understand the struggle to get a proper diagnosis when you have been told you are faking it or being dramatic. Hope all is well and stays that way!

[@AutarchKade]

I saw this from the other doctor's perspective for sure. The video starts off as if mental health issues can straight up cause pain and other problems directly, but then it feels like halfway through there's a retcon to where they're only exacerbating underlying issues. It really did come off at first like "There's nothing to find, so the pain is all in their head," which really did come off like pseudoscience. Glad you clarified.

[@Buffbarbie69]

DOCTOR MIKE! You are so right. I am a healthy 23 year old. I have a history in powerlifting and weightlifting and am active duty military so when I randomly lost all feeling in my hands and arms I felt it must be nerve related. I initially go to the doctor and they ran blood tests and referred me to a neurologist. My blood work came back normal and so we did nerve testing, muscle testing, and a brain scan mri. After all of this, the neurologist called me back in and sat me down and said hey everything is physically healthy but I have seen this in people who have suffered severe PTSD would you like to talk about it? This as an absolute shock to me but I received mental health help and now have full feelings back in my arms, hands, and body. To this day i notice the numbness only returns when I am very stressed or anxious and I am able to calm myself down and work on it. So as someone who went through this I absolutely believe you are so right and am grateful for your approach !

[@wadehiggins1919]

That was definitely one symptom I would not have associated with PTSD. Thank you for sharing.

[@thomasthorsen5462]

i'm studying physical therapy and we're literally taught that emotions play a huge role in how bad the pain feels

[@xxxxSOSEXYxxxx]

Makes it easier for you guys to gaslight your patients.

[@bethfinne3260]

💯 🎯

[@kalecccxi333]

No one ever denied that?

[@gemmacorinne9487]

As someone with fibromyalgia - pain all over my body every single day - which was triggered by a period of major mental health problems and stresses - I actually found your OG video perfect! And it’s exactly when my doctors did, we rules out many many physical problems first, before coming to the diagnosis of fibromyalgia

[@EmDaMo]

@@gwennyrjthat is also not what they said..

[@84rt_]

@@gwennyrjit isn’t, however, depression, anxiety, stress, and other brain disorders heavily affect fibro symptoms. There are also studies out there that link brain chemical imbalances to fibro. So while it’s not psychosomatic, it is very linked to the brain and is very hard to diagnose because the symptoms can come and go and because it’s a checklist rather than something that can be definitively diagnosed through blood work, X-ray, MRI, etc. (I have fibro and have been diagnosed for nearly ten years). Everything is connected in the body. If your foot is hurt and you don’t do anything about it, it’s going to affect your knees, hips, and back; treat the foot and the pain up the leg and to the back will go away. Treat the brain, and some of the symptoms from fibro will go away. It’s why people with fibro are often on antidepressants like cymbalta or amitriptlyne. My doctor increased my antidepressant to help with my severe fatigue and guess what, I can actually wake up in the morning and get stuff done. Everything is connected.

[@evanc5656]

@@gwennyrjMan ur a real brainiac huh?

[@gwennyrj]

​@evanc5656 what are you talking about? He is talking about how mental trauma is causing physical symptoms. Fine. But that's not what fibromyalgia is. It is caused by neuro inflammation, latest research shows possibly autoimmune, and has a physical cause. It isn't what he is talking about in this video. I'm guessing the person I responded to was misdiagnosed.

[@crystalw8050]

@@gwennyrj I know two people who worked on their trauma and had dramatic improvements in their fibro symptoms. Chronic stress leads to chronic inflammation in the body. Stay open minded. It improves your chance of healing.

[@kat.nicolette]

I love the way you handled that. Toxic criticism isn’t very productive but to be truly helpful to patients criticism and continual education/improvement is a must.

[@AnnaPleyer]

The worst thing a doctor can do, is to not open up in any directions. Actually I have a doctor, she's not listening and she's just focused on "her lane". But diagnostic can't be "in one lane", you HAVE to inform yourself beyond your comfort zone. The worst nightmare as patient is to feel unwell and your doc says "nah, don't know. It is what it is" and they're not taking your problem seriously. I really appreciate your point of view. You're really a great person and don't let anyone change that ^_^

[@karenjackson4729]

My doctor was much the same. You could almost hear a timer start when she rushed in with her laptop. She did not listen and sometimes gave untruthful advice. Ten minutes or so seemed to be the time allotted per patient.

[@AnnaPleyer]

​@@karenjackson4729 I'm so sorry to hear that :( hope you will find a new doctor soon, so that you will be accepted and valued like you should.

[@karenjackson4729]

I already have an amazing RNNP who solved the issue on the first appointment. She ran a full thyroid panel, made adjustments to my levothyroxin- down from .175 to .125 in three months, and added T3. Still fine tuning, but the results are amazing.

[@annacarlsson1280]

Im ok with "I dont know" becous its human to not have all the answers and also shows a person thats smart and humble.... but if they dont forward me to someone or get a second oppinion then its a bad doctor..... And is not actualy smart and humble, just an idiot xD

[@blakemccabe15]

The fact that you have this goal, are open about making mistakes, and discuss it publicly is one of the many reasons you are so trusted by so many. Thank you for everything you do.

[@KairainM]

You handled that with grace. You're willing to learn from your mistakes and handle criticism better than most people I know.

[@mcrossmelissa96]

I love how professional Dr. Mike is. He handled that situation with such grace. Dr. Mike is such a wholesome person.

[@DoctorDiscover]

You're laying a healthy blueprint for the rest of us doctors on KZbin. I appreciate that.

[@loriw2661]

I’m with you, Mike. When someone brings something I’m wrong about to my attention, I’m grateful because then I don’t have to be wrong any longer.

[@teresadiodato]

It just happened that you didn't call him for a collab or info as he asked. So he needed his moment of "fame" by turning himself against you. Easy and clear! On the other side, it's scary how a doctor can misunderstand what another doctor says. So I can't imagine how they can misunderstand their patients.... keep up the great work, Doctor Mike, and proud of your honesty and how humble you are!

[@solihin9018]

Who's the doctor he's talking about

[@teresadiodato]

​@solihin9018 Actually, I don't know. To be correct as usual Mike covered his name. But I am curious too

[@samanthabroaddrick2529]

I came to that same conclusion... He never reached out to him so he got testy! 🙄

[@JudgeFudge57]

Right ! By the logic of the other doctor I should only refer to specialists for any ailments I might have.

[@footlessgecko]

Anyone figure out who it was?

[@TheLadydevere]

Your channel is one of my favorites. We need more open conversation about mental health in general and your large audience helps to educate and amplify these important issues. Love your open style.

[@jessshreds]

Psychosomatic illnesses are definitely a thing. People can even have pseudo seizures. Which are very real seizures but not caused by electrical activity in the brain ie. Epilepsy. Keep educating Dr Mike! Ignore the haters!

[@louisbaker4362]

Yep, I have NEAD. Mental health is something I have to take seriously because it manifests very real problems.

[@annajosullivan]

They are no longer called pseudo seizures. They’re called non epileptic seizures. They decided pseudo seizures sounded like the person was faking and they can’t actually help them at all. I have both epileptic and non epileptic seizures after having brain cancer twice.

[@MichelleMacAuley]

Yeah. The illness may not be "real", but the pain & symptoms are 100% real.

[@annajosullivan]

@@MichelleMacAuley are you talking about non epileptic seizures? The only way to tell the difference is with an EEG so they feel real and your body hurts just like having an epileptic seizure afterwards.

[@marieb1680]

yep! I have PNES (psychogenic non epileptic seizures) stemming from my C-PTSD. They are real seizures, not pseudo seizures, but the cause is mental/trauma-related in nature, not electrical as in typical epilepsy. I feel so seen by this video!! :) Edited to add: when I say "real seizures", you can identify if someone has had a tonic clonic seizure by doing bloodwork after the episode, and my post-seizure bloodwork looks just like someone with electrical epilepsy!

[@KnightSlasher]

Props to doctor mike for realizing that the other side might have good points and that they should work together for the best outcome

[@SxnnyNevaeh]

Props to doctor Mike indeed 👍

[@2.0o5]

Yes exactly!

[@bostons_departed3631]

As a disabled vet I think I can see this being true. When I have my spells of depression, it’s like the ankles, knees, migraines, and shoulder are way worse than ever. But when I’m having a PTSD moment there is no pain. At all. I feel 19 again. Like invincible. And full of rage. Like a Pitbull on crack. Just ready to get violent.

[@Binstabih]

Not the same but as an SA victim i get the same pattern! Just wanted to validate. Pure rage/indestructible body versus migraines/sore body and fainting spells, it makes me insane lol but Botox for the migraines and neck pain was a huge help!

[@stickybeaker]

Wow. Thanks for the epiphany. I'd never picked up before that when I'm in a rage I feel no pain. My head is spinning right now.

[@finleyrolls401]

I couldn’t agree more!!! My chronic Illness symptoms are ALWAYS worse when I’m depressed or anxious.

[@danielle7729]

Thank you for your service

[@mashhud3290]

Props to Doctor Mike to respond politely, and props to the other doctor for apologizing and using a more polite tone afterwards.

[@andreasofia564]

Hey! Nursing student here from Canada. I actually really appreciate you bringing up the conversation of pain and psychological stress that may be contributing to pain and/or causing pain. I know someone who has generalized anxiety disorder, and sometimes, his anxiety is manifested by stomach pain. The health care provider that messaged you is a perfect example of what is wrong with health care, in the sense that they don't approach care in a holistic way. This can sometimes make things worse as something important might've been missed, and I think it is not talked about enough, so I'm glad you brought this up :)

[@Crushnaut]

Let's not discount reductive approaches to problem solving though. Neither holistic nor a reductive approach is always right and both points of view have value. That is both inside and outside of medicine.

[@TheBlizzzard29]

Orthopedic Surgeon seemed to misconstrue what Dr. Mike was saying and tried to piggy back on Dr. Mike's popularity to troll and make a name for himself. He tried to flex and it didn't work. I applaud Dr. Mike for clarifying and bringing this troll up in this video.

[@clarissagafoor5222]

that`s a very good thought -

[@tightropewalkergirl6485]

Didn’t work as Dr Mike didn’t name him! Hahahah Good for him!

[@duuude907]

​@@tightropewalkergirl6485yep and then he highlighted Dr. Rita who went about things in a professional manner

[@praisyrampogu3966]

Dr. Mike dealt with thus perfectly. Ask questions, provide evidence, discourage the behaviour yet apreciate the intentions, finding middle groud and taking action!! ❤

[@geared2cre8]

Doc, you're doing a service and giving out free information that could cause people to question their primary care physician. I could see how this can be annoying for doctors and their patients but patients have the right to educate themselves and I'm grateful they it's you giving out that information. Yet i would still research things myself. Just like a second opinion is always recommended for anything you do in life, doctor mike is just a step in the process to help people get healthy and we should all be praising that ❤

[@johnhootsell5882]

I think you’re both right. I was blown up in Afghanistan. My family was flown out to say goodbye, but I survived because of amazing surgeons. But…I spent years on high dose pain meds for chronic pain, I fell into depression and the pain always seemed to be getting worse. When some family members suddenly needed my help I gained motivation. I started to ignore my pain to help them and eventually asked my pain management doctor to take me off of my pain meds. I think I had found purpose and happiness. It doesn’t mean I don’t have chronic pain, but I have solved something that makes me feel I can’t control it. I’m thankful for all my surgeons and all my doctors who helped me distinguish my pain from my depression. They are easy to confuse.

[@readingwithfrenchy]

And thats his point. Sometimes its physical, sometimes its mental creating physical and both are ok and should be discussed. The other doctor trying to say that its only physical and not mental is a joke. I have had mental become phtsical before but thats where we need better health providers who can ask the same questions that Dr. Mike has and rule out everything you can physically and then go into, well maybe its coming from here and lets do that and rule it out. Ive had this done for me for my arm and for my skin. While physical is there first, the mental exaccerbated it to an extreme and i wasnt healing properly and wasnt getting any better.

[@jourdyngroman]

i respect you for not calling out the first doctor when you very well could have. tact and professionalism

[@Itsme_youmnahh2]

You're the reason why I wanna be a nurse while I'm older. Thank you for teaching us so much Doctor Mike!

[@bdarci]

Why not be a doctor?

[@HejwjWjek]

​@@bdarcibecause of the insane study and money requirements

[@adaa3144]

@@bdarci it's such a weird question. Why not a pilot if you are flight attendant?... 😅Doctor and nurse have different level of responsibility and they take care of different things and maybe thats the thing that she is seeing herself in.

[@ingridn0g]

​@@bdarciwhy not be a nurse, though? Both are invaluable professions! I get that maybe you are just curious, but if that's the case, you could just ask their reasons for wanting to be a nurse.

[@Itsme_youmnahh2]

@@bdarci being a nurse holds a diffrent responsibility than being a doctor. One skill that you need to have as a nurse is to be able to take good care of the patient and I am really god at that and feeling empathy is also another one which I'm really good at. That's why I would rather be a doctor than a nurse.

[@editaatteck9587]

Your videos are what the world and everyone needs: educational, honest, transparent, respectful, allowing for introspection and astute judgment as a medical consumer. Thank you! PS. To “stay in your lane”attitude in one of the major things that are wrong in our medical system. Collaboration gets us ahead. Our body (+ our environment) is ONE interconnected system.

[@ashleycnossen3157]

Dr. Mike, you are doing the OPPOSITE of gaslighting! Your channel has made me feel empowered and informed, and I wish every doctor took the same approach that you do to patient care!

[@valmacclinchy]

Exactly 💯

[@kaaffibneashraf9245]

Just because there are trolls on the internent made to bring you down never let them. We are with you doctor mike ❤

[@Dr.Era.MentalhealthNinja]

As a Psychiatrist from India, I find your explanation accurate, nuanced and surely a leaf to borrow for many leading doctors in India who refrain from referring to psychiatrists for the fear of "losing" the patient or "offending them". I have had folks from India get a Fibromyalgia diagnosis only when they went overseas to USA, instead of standard practice as it should be the way you mentioned. Keep doing the great work!

[@invaderg3332]

I'm in India and I believe it's among the better professions. But only if you are commted to listening to your patients, empathizing and giving solutions. I had one such psychiatrist. And she was the bomb. Was also a pretty awesome psychotherapist as well. Sadly we live in different cities.

[@QueenofPutrescence]

@@invaderg3332 YES! Keyword many health professions seem to overlook when trying to diagnose patients-listen to them. We patients know ourselves better than Doctors do, please listen to us!

[@AikenLewis-Merner]

I've suffered with pretty severe seasonal depression and general anxiety for years, and had no idea my mental health could contribute to my physical health in these ways. I always knew that it could affect my health, but this genuinely answers so many questions I've had about my physical pain that I've been trying to find for years, so knowing this is practically life changing for me

[@Tannlore]

As someone who suffers from PNES, that is seizures that are a direct result from PTSD and trauma, you were right on the button. It wasn’t until it was discovered where my seizures were coming from that I was able to begin treating my condition. I used to have several seizures a day, now I have three or so a year.

[@candyswirlzpop]

That's definitely one that is practically impossible to get figured out unless you truly listens to you and didn't just blow you off thinking you're making it all up.

[@abarrazarios]

Yea but the seizures are not coming from your trauma or any mental issues

[@Tannlore]

to the contrary, the trauma/mental issues cause my flight/fight system to be perpetually engaged practically without rest. When the rest DOES come, it triggers the episodes. Any time a heavily stressful/mentally draining event happens, it will always be accompanied by debilitating seizures if I'm not on my medication. The medication is anti-depressants, nothing at all seizure related either. It keeps my systems going "down" low enough to set off all the problems. @@abarrazarios

[@Tannlore]

I spent 25 years being told I made it up or was just having "odd cold symptoms". I went through seizure trials and medicines taking all sorts of different drugs that have left lasting issues because of side-effects that I did not need to take at all. Doctors were shooting in the dark. It wasn't until I happened to be at the same hospital in New Jersey that was researching PNES that I LUCKED out. Part of our therapy was talking with other sufferers. There are horror stories of people collapsing, having the ambulance called, and EMT tormenting them because they thought they were "making it up" and that PNES wasn't a real thing. It's honestly been horrible. To this day, I just tell people, "I have non-epileptic seizures" and leave it at that. I don't bother explaining because I get the, "Oh, it's just your feelings and all in your head? just stop having them" yeah.. no thanks. @@candyswirlzpop

[@theheartbreaknurse]

What I love about your channel is not only that it’s evidence based but you emphasize the importance of INDIVIDUALIZED care. Every human being is different. Dr. Mike does his due diligence and is incredibly self-aware. Grateful for people like him who bring these important conversations to the masses.

[@iamlegion3093]

As someone who’s struggled with mental health, I can’t believe that’s controversial

[@julia3354]

It's really depressing that mental health, after all the proof, the years, the literature, is still pushed to the side by so much of society that even doctors warn not to think of mental health.

[@gastonborda5607]

I've never struggled with mental health, as such, I can't relate to you, how you feel, how you think, or the struggles you've had to deal with. BECAUSE I understand all of this, I try to keep an open mind to try and understand your position on a given topic. And a lot of people who are like me do this. The problem is we have an ever increasing number of people who don't understand because they can't relate, so their stance on the subject is screw you. And that's why it's controversial. A lot of people don't care to understand.

[@artemis754]

​@@gastonborda5607a lot of my mental health problems caused physical pain. I slept worse, I started to feel sick, stomachaches and such. so it's a wild thing to say that mental health and physical health can't be related (not aimed as an attack as you, just generally baffled that people, especially doctors, say these kind of things)

[@gastonborda5607]

@@artemis754 Yeah, I've learned that now a days, you can't blindly trust even experts XD everyone's got an agenda or simply refuses to update their views as new information comes out. It's sad really, and it's that same close mindedness that propagates these problems and leads to the average man claiming that mental health is a myth. You and I may not see a world where mental health awareness is universal, but I'm hopeful that we'll get there as a country some day

[@artemis754]

@@gastonborda5607 i do hope mental health will be seen as more important globally. it is actually very important

[@jazzygirl2080]

As a person with a mental illness, I appreciate the fact that you treat both the body and the mind, and when you do suggest that it's a mental illness, you acknowledge that. Yes, the symptoms are real butt, it may be a mental cause and not a physical calls. A lot of us with mental illness feel like we are either brushed off like everything's in our mind. Or the mind is completely ignored and I appreciate what you do and you make people like us feel very validated. Thank you, keep up the good work.

[@Sunflowersarepretty]

I respect how dr Mike didn't reveal who that doctor was. Also its wonderful that you're looking for constructive criticism to grow. That's the mature thing to do. There's a fine line between constructive criticism and negative criticism or trolling.

[@KelsieHeath]

Occupational therapist here with diagnosed anxiety and PTSD from a car accident. I have chronic ankle pain from an ankle fracture s/p ORIF. It’s so refreshing to see a physician acknowledging that mental health can impact physical pain. I have physical pain from a previous injury but it is 100% exacerbated when my anxiety or PTSD are flaring up. Thank you for your holistic approach to medicine that sees the whole person rather than just labs and imaging.

[@PvtRipley]

It's good to know that there are doctors out there like Doctor Mike who are not only dedicated to their job and their patients, but also willing to learn and correct the information they give in order to avoid spreading misinformation, as he provided an example of towards the end. I think it's also stellar that he considers their patients' opinions and inputs on what they believe is going on, and makes sure they're comfortable with any testing/treatment options before proceeding with them.

[@bobbie9066]

I love that you said that, for physical symptoms, to check as many possible physical causes first, then always validate the experience before/when bringing up the possibility of mental health impacting it. It's great you managed to fit all that in a short, too!

[@Strangelyfey]

For me as a person with both mental health issues and physical disability, I can see both sides of this. I have fibromyalgia, and cptsd. My cptsd symptoms aggravate by fibro symptoms. I think the most frustrating thing in my case is due to how difficult it is to diagnose fibromyalgia, I definitely experienced a lot of doctors dismissing my symptoms as being solely mental health related. Test after test showed up as clear. I can’t count how many times I went to urgent care for symptoms that didn’t make sense, just to be told there was nothing wrong with me. I definitely think that you, Dr. Mike, approached this very empathetically, and in no way maliciously. I love that you opened conversation on health struggles that this can be either physical or mental health issues, or quite possibly both. Very much appreciate the work you do.

[@queerskiesahead847]

Yes, I just commented a very similar post!! Getting medical doctors to diagnose Fibromyalgia is enough to give you more mental health issues than you start out with. From anxiety, to depression, to wondering if you're a hypochondriac, it's horrible!

[@TheLilja9]

fibro is a central sensitization syndrome. Def treable, even curable with brain rewiring programs

[@Strangelyfey]

@@TheLilja9 hey friend, If you were to read on this disorder through the National Institute of Arthritis and Musculoskeletal disease, there is no cure, but there is symptom management. therapy definitely does help with part of that, because mental health symptoms can aggravate the fibromyalgia symptoms. Some of my worst flair ups are when I am stressed. There are a lot of complicated symptoms with fibromyalgia and I have a medical team on my case working with me regularly now to help manage those symptoms, but none of them have the ability to cure me. Trust me if I could be cured I’d be putting all my attention into that, just to stop struggling daily.

[@Strangelyfey]

@@queerskiesahead847 it’s really defeating when you have no idea what’s going on and neither to do the doctors. I’m really lucky that when I changed doctors my new doctor at the time looked over my file and realized what might be the problem. I genuinely believe she saved my life.

[@readtheroom831]

I was diagnosed with both after years of struggling and I couldn’t agree with your comment more 👌🏼

[@swisskingoverwatch3341]

I've had neurodermatitis, vomiting and diarrhea from stress and going to a psychiatrist and working on my mental health helped me with all of it, no not everything is perfect but it went back by 98%

[@SxnnyNevaeh]

I hope you’re doing good or okay now 🤍

[@swisskingoverwatch3341]

@@SxnnyNevaeh yeah im doing great not perfect but so much better than before

[@achyshaff5653]

My daughter suffered from cyclical vomiting syndrome . It was heartbreaking to see her go through this. Stress and anxiety did make flares much worse, but her physical reactions were , like you, very very real and unsettling. I’m glad you are getting treatment .💜

[@smooth_like_butter6649]

We are with you Dr Mike,you have always been sincere and kind ❤

[@bornstar481]

It’s all an act. Many celebrities have been exposed for being the most nastiest people when the cameras get turned off.

[@arinontop143]

​@palerider955he is a great person and doctor he can make mistakes at times he is a human being

[@arinontop143]

​@polyratte3350no

[@dnalfaro]

I'm arriving kind of late to this video, but I really liked it. I'm not a doctor or healthcare specialist of any kind and I really appreciate the content made for people like me to understand. It's interesting how mentioning these kind of things, just to have them in consideration, to actual doctors or med students can go really wrong. The times I've gotten the same answer: "tell me about it when you become a doctor" are uncountable. This content, coming from a doctor, serves to people to set at least some background that other doctors at least are going to hear and consider. Then the rewarding experience of exchanging knowledge finally can start. Thanks Doctor Mike!

[@nirmalsidhu8467]

as someone suffering with anxiety and panic attacks,I was relieved and felt validated when he said mental health does affect physical health!

[@kremapeneva9732]

My son is 13 and he watches your videos every single day. I am very happy he has got someone like you to look up to. Thank you!

[@CavalierConfessional]

I’m sorry this happened to you. It’s frustrating when it feels as though you are almost deliberately misunderstood. Thank you for the work you are doing.

[@kristinastarnes305]

I really love that you own up to any mistakes and correct yourself and actually get the facts! I also love that you genuinely care for the well being of your patients and others.. I’ve been blessed to find a family physician who is like you. He’s the best! I wish everyone could have a doctor like y’all.

[@a.j.9797]

As a mental health clinician, I approve of this message! Dr. Mike, you are spot on! I love your content, and you're amazing! ❤ I wish I could have said more but you said it all!

[@roxannlegg750]

of course you would...it feeds into your confirmation bias.

[@cathyu.1487]

I'm speaking in defense of this mental health clinician from my own personal experience. Experienced a severe trauma situation - domestic violence with death threats. I had no prior health issues, other than treated hypothyroidism. No history of physical pain or physical discomfort. As that situation wore on - I couldn't leave the county due to a court order related to divorce and child welfare for 18 months - I experienced some of the strangest physical issues, just from prolonged stress of the situation. Worst gingivitis I've ever had in my life (stress gingivitis is a thing!). Mouth was bleeding with open sores. Never experienced that before and haven't since. Severe pain that would radiate from my back, across my shoulders, down my arms. Extreme difficulty sleeping. Feeling terrified all the time. Fortunately: successful conclusion - I got full custody and was given permission by the court after 18 months to leave the state for other employment. Once we left that situation, those symptoms slowly but surely resolved. Also got great counseling during and after the situation for myself and my kids. Really helped me to put the situation in perspective, which reduced the stress over time, improving my mental and physical health. Been pain-free and in good health in the years following that situation.

[@bowdennthani732]

​@@roxannlegg750 how do you know that it is Confirmation Bias?

[@roxannlegg750]

@@bowdennthani732 He started off saying it was well recieved because it got loads of likes and thumbs up. And altho he had a few bad comments and shade thrown at him, when ppl correlate "likes" with the message being a good one, its not factoring into account the number of people who disliked it and moved on, without clicking the thumbs down. I made a comment that he needed to be more careful about what he says - and it was deleted. They just dont tolerate opposing opinions or criticism. His belief he had a good message was re-inforced by the number of likes, which only confirms his belief in his message. That is confirmation bias.

[@arvin9425]

@@roxannlegg750 yes but... his belief and information was correct? You may be misunderstanding dr mike in that he did not use the likes to justify what he was saying as objective fact, he just mentioned that the video was doing well so its clear that the information reached a high number of people.

[@Shreyg996]

As a fifth-year medical student, eagerly working toward my dream of becoming a doctor in the near future, I genuinely appreciate and deeply respect the invaluable insights you share in your videos! The medical community truly needs more dedicated professionals like you!

[@Lindsey_L]

The maturity and humility demonstrated here is very admirable. Dr. Mike continues to inspire me- so grateful I found his channel. Keep doing what you’re doing!!

[@Mary-xt9jg]

Thank you dr mike for your lesson on emotional maturity and showing us what that and communication and cooperation looks like💯❣️ please never sell out 🤑 please, continue to learn and grow and share with us your good heart. Thank you.

[@hlwatkins83]

As a mental health therapist trained in trauma, I loved your clip & was so thankful for a medical doctor saying mental health & trauma is important!

[@xandra_5099]

General anxiety disorder comes with ALL kinds of physical problems in your body alone 😒

[@readtheroom831]

Couldn’t agree more 👌🏼

[@xandra_5099]

@readtheroom831 my first panic attack was at 12 years old. I thought I was dying and it was terrifying. Stomach aches, diarrhea, vomiting, shaking, cold sweats, passing out....and this is just what anxiety will do. To say none of it is connected is totally inaccurate and a slap in the face to those who have to live with this pain daily 💔

[@readtheroom831]

@@xandra_5099 I absolutely agree. I suffer from anxiety but most of my attacks are related to my C-PTSD. I will smell something or hear a sound and immediately go into a panic attack. It’s horrible and is definitely a physical reaction to past experiences I’m subconsciously aware of. And having doctors or people act like the mind and body aren’t connected and don’t affect each other is wild to me.

[@HouseMDaddict]

I work with kids/teens that often come from traumatic backgrounds and many of them have anxiety and/or depression resulting from their home lives or previous living situations. They're the ones that constantly have GI issues, headaches, and medical issues that usually pop up on a test day especially or before they have to go to a class they don't like, etc. Is it avoidance? Yes. Are the symptoms real? Also yes

[@delladegroff]

As someone whose medical condition that almost killed me was disregarded for mental health related for years, it’s a hard topic. But, I agree that there are times where that’s the case. Thank you Doctor Mike for speaking up for both situations!

[@eustacedeslauriers5202]

I do appreciate receiving the information that mental health issues could be aggravating levels of musculoskeletal pain. I have bipolar, musculoskeletal pain and lumbar disc herniation, all diagnosed for years, almost 8 years now. And no one has ever told me that these separate health issues of mine that I’ve always been dealing with separately could be related. Like I never thought to maybe mention to my physiotherapist that I also have pretty severe mental health issues, and ask them if that could be worsening my chronic pain, because that thought has never even crossed my mind as a possibility.

[@deejayk5939]

Some doctors are arrogant and incapable of listening, others are the opposite. Absolutely you are right, mental health does affect your physical health. Thanks, Dr. Mike!

[@magenbrown9306]

THANK YOU!! It is so refreshing, as a counselor/therapist, to see an MD actually be willing to reference an individual's mental health as an influence or contributor to their physical health issues! Many times mental health is bypassed or completely ignored as a possible factor! I also appreciate that you are willing to discuss the appropriate way to have a discussion and disagreement with a colleague! You've made my heart happy and you are SOOOO appreciated!! ❤

[@sunnyplace729]

This happened to me. Over a decade of headaches and neck pain. It was a massage therapist that suggested it though. I had an illness as a baby, and the way my family talked about my recovery left me with fears that it could recur. I took my medical records to my doc and he went over them and explained things doctors didn't really understand at the time. He assured me it was over, and over time my headaches and neck pain just went away.

[@Grammichal]

I’m a licensed massage therapist as well so I really appreciate your observations. Stay healthy, be happy. 😊

[@karasnow5916]

Mental health professional here of 17 years who continues to see patients daily...love to see doctors admit that mental health concerns and trauma physically hurt. And LOVE that you've read The Body Keeps the Score...a book Ive read, use and recommend.