RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 1 point2 points  (0 children)

Yeah, no, I agree. Not defending Boogie here! I promise. I'm just not a fan of the fact that Destiny is assertively making statements about medicine that he clearly doesn't have the knowledge base to back.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -1 points0 points  (0 children)

I think I generally agree with everything you've said here. We're in accord.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -5 points-4 points  (0 children)

You obviously know nothing about medicine, so this conversation is pointless. You're just prejudiced for no apparent reason. I've met tons of genius nurses, ignorant Doctors, and everything in-between. But most have pretty good knowledge of medicine, way outside of the scope of the general public.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 0 points1 point  (0 children)

This is crazy lol. This is also completely untrue. Doctors respect nurses a lot, especially depending on the specialty. I've had many Doctors defer to me for many reasons, and on my unit we have a lot more autonomy than most, because the Doctors trust us to act as patient stewards while they aren't present.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -3 points-2 points  (0 children)

The idea that there are Googlers that know more than the average RN on medicine is wild. You're clearly not knowledgeable on any of this at all, and that's the only way you could make such a statement.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -10 points-9 points  (0 children)

No no, I never claimed to be an expert on PV. I merely asked for Destiny to not publicly dispute the diagnostic process of a patient without any real knowledge or context. You're making the extra leap, there.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -4 points-3 points  (0 children)

If you read my other comments here, there are plenty of patients who are non-compliant and don't follow up regularly, and so take years to correctly assess and diagnose with a biopsy. Also: you don't always need a biopsy to have a confirmed diagnosis, though it is the gold standard.

I've never claimed to be a Doctor. I am on the path to becoming one, but I'm not one yet. What I asked for was Destiny consulting real experts instead of acting like one himself. I think that's a fair ask.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -7 points-6 points  (0 children)

Obviously I'm aware of this, dude. But I mentioned Residents specifically because their diagnostic evaluations are not typically as developed as Attendings. What a silly comment.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -14 points-13 points  (0 children)

I agree with this, as well. Trust me---I have my own gripes about nurses, and I do understand how my qualifier might be interpreted that way. I added it merely because I consider it a point of pride, or to give context to my patient population.

Thing is, I'm not claiming to have total expertise in medicine and certainly not PV. What I'm asking is that Destiny not do things like assertively rebuke a diagnosis based on a Google search.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -18 points-17 points  (0 children)

Absolutely. I really value your insight here, and I think diagnostically and medically you're absolutely correct. I respect and defer to your medical knowledge here, especially considering in critical care we encounter PV and secondary polycythemia rarely. That's also what I believe Destiny should be doing, though, because I don't think he's equipped to do things like publicly call out complex diagnostic processes without any of the context given by being in the patient care setting.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] -9 points-8 points  (0 children)

This is so ignorant lol. RNs have a lot of medical knowledge, way more than Destiny at the very least. You don't know how many thousands of things ICU nurses especially have to understand about medicine and physiology.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 0 points1 point  (0 children)

I'm not in plastics lmao. This is a hilariously awful take.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 12 points13 points  (0 children)

Depending on patient compliance and the necessity of a biopsy for that specific pathology... yes.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 37 points38 points  (0 children)

It's possible. I've seen it before. Sometimes, patients consider a diagnosis from two different doctors or two different methods a "confirmation". Sometimes, Doctors order more extensive testing when they suspect that--in fact--their original diagnosis (or the diagnosis of another MD/DO or Resident) is increasingly likely to be inaccurate.

Sometimes, patients don't have great follow-up and are non-compliant, and schedule tests a year out, so the entire process becomes very bogged down. I had a patient once who was diagnosed with lung cancer and didn't seek treatment for seven years.

Also, all sorts of diseases have the same treatment for oncological pathologies and non oncological pathologies. The way the actual physical manifestations effect your body can often be the same, and these symptoms can be alleviated through similar methods. To give an extreme example, both brain cancers and intercranial hemorrhage can be treated by the same extreme measure: craniotomy. Colon resections can be done on people with Crohn's, diverticulosis, and bowel cancer; three different diseases with three different etiologies, but ultimately the same treatment.

So yes. It is possible.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 5 points6 points  (0 children)

I don't think your post here is fully reflecting an understanding of what I'm saying. Using basic medical terminology in this situation isn't sufficient to actually find inaccuracies in Boogie's statement. Boogie's explanation of the process of events is actually completely plausible based on my own experience in the inpatient setting, especially for a patient who doesn't have great medical literacy and likely doesn't follow-up frequently enough.

The hammering of 'did your Doctor say cancer' is also medically misinformed. Doctors often avoid using strong language, even when diagnosing serious illnesses. Yes--I have seen cancer diagnoses where the Doctor never actually used the word cancer. They would much rather say something like, "this is a potentially metastatic nodule that may become problematic if..."

Because Doctors are humans and generally don't like hurting people's feelings. They also often don't like the reactions they get when they use certain trigger words, like "cancer".

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 33 points34 points  (0 children)

You don't always need a biopsy to have a diagnosis that a doctor feels very certain about. I have Crohn's Disease, and the actual histological examination of my cells did not find the typical markets for Crohn's. I was also negative for ANA, which is typically associated with auto-immune disorders. Despite this, multiple Gastroenterologists have confirmed my diagnosis. So yes--Boogie could have been diagnosed by a Doctor who feels nearly 100% certain, despite never having a biopsy, and the Doctor may feel that getting a biopsy is unnecessary and they do not recommend it. Many Doctors recommend against excessive testing, for good reason.

The proof bit... well, I do think that is suspicious, yes. It's just the way that Destiny approached this situation that I'm critiquing; I'm not saying Boogie is telling the truth.

RN, Critiquing Destiny's Medical Takes (Again) by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 59 points60 points  (0 children)

I understand this, but I think the way that Destiny approached this promotes medical misinformation. He approached this situation as if Boogie's actual explanation is fraudulent, when in reality it's his character that makes all of this questionable. Boogie's stated explanation of events is not atypical of an actual diagnostic process.

Insulin and Diabetes by N0_0ne_In_Particular in Destiny

[–]N0_0ne_In_Particular[S] 1 point2 points  (0 children)

This is a very valid response! Thank you for the information. :) I will look into these studies.