Really weird medical exam

eth0_

I had a medical exam today for work, it was BIZARRE.

I thought the doctor was a little eccentric but I found his examination really odd.

He got me to lie down and took my blood pressure and listened to my heart, fine enough. Then...he asked me to puff out my cheeks a few times. Then he asked me to squeeze his two fingers as hard as I could. Then he barely covered my ear and asked me to repeat what he was saying. As he was about half a foot away from my ear, this doesnt seem the most scientific of tests, I mean if I was profoundly deaf I think I would have noticed. Then he got me to close my eyes, and he pressed lightly on my eyebrows.

He then told me that depression and anxiety are 'mostly physical diseases, I think really if you go out for a run or join a class, you'll feel much better'. What a load of patronising, ill-informed sh1t.

I told him I just take serotonin tablets now that I buy in a healthfood store in the North because they're banned here, and he asked 'which serotonin? is it prozac?'.

He also said he was going to inform my employer that I had suffered from depression and anxiety in the past, and that I was taking herbal pills for it now.

I'm really angry that he can say this to my employer, surely this is against the confidentiality agreement doctors have with their patients?

Has anyone got ANY IDEA why I had to puff my cheeks out? I've had medicals twice before but this was just utterly bizarre.

Winning Hand

Sounds like a half arsed neuro exam.
Puffing cheeks- facial nerve

Traumadoc

Was this testing part of a physical examination for employment?
Puffing out cheeks tests the muscles about the mouth or the nerve that supplies them, the same with the eyebrow test. To test the ear the doctor will cover one ear while testing the other and then repeat the test for the other ear- these tests are fairly standard when examining the nerves that supply the head and face.

Murtinho

Did he think Serotonin was a herbal medicine? :eek:

eth0_

Murtinho wrote:

Did he think Serotonin was a herbal medicine? :eek:

Yes. I told him I self medicate now with "serotonin tablets that I buy from a health food shop in the North as they are banned here" and he said "What serotonin? Is it prozac?"

Either he wasn't listening to what I was saying, or he hasn't a rashers.

It's scary to think people like that are allowed to practice medicine.

the_syco

Goto another doc. Used to goto one doc, but she never spoke to me, rather to my parents. Got rid of her. The new doc isn't much better, but at least he bullsh|ts less, and says he doesn't know if he doesn't.

county

eth0_ wrote:

Yes. I told him I self medicate now with "serotonin tablets that I buy from a health food shop in the North as they are banned here" and he said "What serotonin? Is it prozac?"

Either he wasn't listening to what I was saying, or he hasn't a rashers.

It's scary to think people like that are allowed to practice medicine.

please tell me there was no leaches involed

Zillah

eth0_ wrote:

He then told me that depression and anxiety are 'mostly physical diseases, I think really if you go out for a run or join a class, you'll feel much better'. What a load of patronising, ill-informed sh1t.

Uh no, thats actually quite accurate. People can get hard-core depression that takes medication to kick. Most depression can easily be cured by a more active life style. Exercise is brilliant for improving emotional condition.

I told him I just take serotonin tablets now that I buy in a healthfood store in the North because they're banned here, and he asked 'which serotonin? is it prozac?'.

Prozac is technically a selective serotonin reuptake inhibitor. It alters serotonin functions in the brain.

He also said he was going to inform my employer that I had suffered from depression and anxiety in the past, and that I was taking herbal pills for it now.

This part is quite bizarre. Clearly its illegal for him to disclose your medical condition to anyone without your permission. Its probably a case of one of two things:

1 - You essentially gave your permission. He says "And so I'll tell your employers..." meaning it as a kind of question. If you say nothing then you imply consent.
2 - Its in your contract. "You will undergo a medical exam for the company and the results will be given to the company on a confidential basis. Sign below".

Has anyone got ANY IDEA why I had to puff my cheeks out? I've had medicals twice before but this was just utterly bizarre.

As said, the other stuff is for nerve tests.

mloc

indeed, prozac being an SSRI is a serotonin related drug. although I don't know how he'd think you were getting them up north because they were banned here.

Out of interest what product is it you are using?

Traumadoc

Serotonin itself does not cross the blood brain barrier - the drugs that work in depression act by increasing the serotonin produced by the brains concentration, these drugs include the serotonin reuptake inhibitors (prozac) this is also the way MDMA (ecstacy) is thought to work.
Perhaps you are taking a serotonin precursor?

tallaght01

totally agree with zillah. Your doc was right, but I'd be prety slow to give a patient's details to their employer. But I guess if that's in your contract then fair enough, although it would make me very uneasy personally.

John

Zillah wrote:

Uh no, thats actually quite accurate. People can get hard-core depression that takes medication to kick. Most depression can easily be cured by a more active life style. Exercise is brilliant for improving emotional condition.

Yes, as well as temporary bursts of endorphins, regular aerobic excercise also increases neurotrophin levels in the CNS. Treatment with SSRIs also increase neurotrophin levels after a few weeks of treatment. Interestingly, the increase in neurotrophins seen during SSRI use occurs around the same time the anti-depressant effect kicks in. In my opinion, exercise should always be the first course of treatment for mild depression and SSRI/CBT treatment should always be done in conjunction with exercise.

tallaght01

Also emerging evidence that SSRIs are having their effect within a week of starting treatment. This contradicts previous claims, and we always told patients that they take a few weeks to kick in. Having said that, I've a lot of patients that told me they felt the effect very quickly, back in the dark ages when i did adult medicine. Also, without trying to be pedantic, I wouldn't agree that exercise "should always" be the first line of treatment for even mild depression. Many depressed patients have zero energy, and very little motivation. Many feel tired all the time. I agree that exercise can help with these symptoms, but seeing as we find it hard enough to get people who've just had a heart attack/stroke to start exercising, I would say it can be extremely difficult to get a depressed patient to stick to even a mild exercise programme.
I've often found that prescribing a month's supply of SSRI's my patients would come off them and they would have the ability to fight the illness themselves. I'm sure that's not in any best practise guideline, but I've seen it work :P

John

Fair enough, I'm not a doctor so I don't actually get to try my hair brained schemes out on people. I stick firmly to the research side of things

tallaght01

not hair-brained at all, mate. You're right that the punters who exercise are nearly always going to fight depression better than those who go into the stage of just staying in bed all day. Mebbe it's because their depression was worse int he first place. Who knows, but the point about exercise being beneficial for depressives is totally spot on.

eth0_

Exercise does improve symptoms of depression in *some* cases, but it was the way the doctor said it, and the tone he took about it, that I found quite offensive.

John

eth0_ wrote:

Exercise does improve symptoms of depression in *some* cases, but it was the way the doctor said it, and the tone he took about it, that I found quite offensive.

That's fair enough, being a doctor isn't just knowing what's good for a patient but their conduct too (which despite our blithering about treatments for depression is the real problem with this doctor). However, you did call his comment about exercise ill-informed **** which is not the case at all. Exercise isn't helpful in *some* cases of depression, in many forms of depression it works across most cases of depression. With things like major depression it obviously doesn't work with everyone all the time, as pointed out above some cases of depression are too severe for the person to get motivated but later in the treatment it would obviously help. Physiologically the downstream effects of exercise in the CNS are remarkably similar to downstream effects of anti-depressants in the CNS.

Tagger

The doctor was testing your cranial nerves by asking you to squeeze fingers, puff cheeks etc. It may seem strange but this is how your neurological function is assessed. The puffed cheeks for instance is actually testing Cranial nerve # VII (facial), the whispering is for cranial nerve # VIII (Vestibulocochlear), etc. All those tests you mentioned correlate with one or more of the 12 cranial nerves. Completely relevant to your exam.

The comment about informing your employer seems inappropriate: Doctor Patient confidentiality.

lorraine2540

Was just reading your post...what was the medication called was it 5htp.....

anotherlostie

The chemical name for Serotonin is 5-Hydroxytryptamine, usually abbreviated as 5-HT.

5-HTP is 5-Hydroxy-L-Tryptophan, an amino acid.

They are not the same thing but 5-HTP is metabolised to 5-HT in the body, and I would suspect that these are the tablets being talked about. Why not send a Private Message to the Original Poster to confirm?

RobFowl

IF it was a works or occupational medical organized and paid for by your company the company do get all the results and reports.
TO be honest while maybe not put to you in the ideal way, I would pretty much agree with most of what he told you.
On another level WTF were you at telling a works medical that you were taking supplements/tablets/drugs which were illegal in this country and not expecting a problem!!!

Nothingcompares

eth0_ wrote: »

Yes. I told him I self medicate now with "serotonin tablets that I buy from a health food shop in the North as they are banned here" and he said "What serotonin? Is it prozac?"

Either he wasn't listening to what I was saying, or he hasn't a rashers.

It's scary to think people like that are allowed to practice medicine.

Do you regret telling him this? Were you just trying to be frank and honest.

Fionnanc

I have got a feeling these "seretonin tablets" from up north may be a placebo. Does anybody know can seretonin be absorbed across the gut? Even so I doubt it can cross the blood-brain barrier.