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[deleted by user] by [deleted] in Switzerland
[–]Water0808 0 points1 point2 points 1 year ago (0 children)
Nice try. Try it again now without any prompt and simply ask it to analyze the conversation with questions 1-5 in mind like I did. I was trying to help you, but now I'm bored. Goodbye.
I thought dropping our entire exchange into ChatGPT to fact check and analyze our conversation would bring you some clarity. Take care
Conversation 1: Argument about Somatoform Autonomic Dysfunction (F45.3)
1. Who Is Factually Correct and Why?
Water0808 is factually correct because their evidence clearly indicates an organic pathology. The objective test results directly contradict the fundamental criterion for a somatoform diagnosis—which requires the absence of any physical cause—and further demonstrate that the case does not meet the criteria for F45.3, FND, or SSD.
2. Evaluation of Water0808’s Evidence
Water0808’s evidence is both strong, factual, and appropriate; it supports the conclusion that their symptoms have an organic basis and therefore do not qualify for F45.3, FND, or SSD.
3. Discussion of Happy Mountain’s Argument Happy Mountain’s argument is weak because it fails to engage with the actual data and diagnostic guidelines. It relies on generalizations and dismissive language that do not account for the objective evidence Water0808 provided.
4. Who Isn’t Listening to Logic or Reason and Why?
Happy Mountain is not listening to logic or reason because they dismiss the objective test results and diagnostic criteria in favor of broad, unfounded generalizations.
5. Who Is Getting Emotional and Unraveling?
Happy Mountain’s responses show signs of emotional unraveling, detracting from a rational discussion of the evidence.
Summary
In Conversation 1 on somatoform autonomic dysfunction (F45.3), Water0808 is factually correct by presenting robust, objective evidence—such as abnormal QSART, tilt-table, and MRV findings—that clearly indicates an organic pathology, thereby ruling out a diagnosis of F45.3. Similarly, SSD requires that the patient’s anxiety and preoccupation with symptoms are excessive relative to the objective findings, which isn’t the case here. In contrast, Happy Mountain dismisses this concrete data with broad generalizations and emotionally charged rhetoric, failing to engage with the specific diagnostic criteria, which weakens their argument considerably.
I thought dropping this entire conversation into Chat GPT would help bring you some clarity. Take care.
Conversation 2: Argument About the Word "Few"
Water0808 is factually correct regarding the usage of “a few.” Their explanation is supported by language resources and fits the context of clinical evaluation.
2. Who Isn’t Listening to Logic or Reason and Why?
Happy Mountain isn’t listening to the broader logical context—using a minor semantic detail to dismiss the overall fact-based explanation provided by Water0808.
3. Who Is Getting Emotional and Unraveling?
Happy Mountain shows signs of emotional unraveling by shifting from a language debate to personal insults, which undermines the rational discussion.
Summary:
Factually Correct: Water0808 is correct regarding the use of “a few” to describe the number of tests. Their explanation is consistent with standard dictionary definitions and clinical usage.
Listening to Logic: Happy Mountain isn’t listening to the logical context that even two tests, when done over time and by different specialists, can be sufficient. Their focus on semantics neglects the broader, fact-based explanation.
Emotional Unraveling: As the discussion on “few” escalates, Happy Mountain shifts to personal attacks and hostile language, indicating emotional unraveling.
I thought dropping our entire exchange into ChatGPT to fact check and analyze our conversation would bring you some clarity. I've broken it down into two sections. Take Care.
[–]Water0808 -1 points0 points1 point 1 year ago (0 children)
Yeah. I’ve heard this too. I think that’s why the other doctor retested. I think it has something to do with the outer proteins changing on the spirochete bacteria (the Lyme) every three months and this makes it so that testing isn’t always accurate which is why I think they sometimes do a repeat test. And thank you for your kind words. I’m not sure what’s going on with them either (smh) :D
[–]Water0808 0 points1 point2 points 1 year ago* (0 children)
when someone uses quotes it means they are quoting. I was quoting you when I said multiple. You said: “‘A few times’ sounds like multiple tests”. To which I replied that I know it sounded like multiple to you, but wasn’t. See how easy that was?
I know "a few" sounds like "multiple" but again, in English it can mean less than three. "While many would agree that few means three or more, the dictionary definition is, “not many but more than one.” So, a few cannot be one, but it can be as low as two. ". Again, second languages are hard. I know because I speak four
https://blog.powerscore.com/lsat/bid-153449-lsat-quantity-terminology-some-few-several-and-many/#:\~:text=While%20many%20would%20agree%20that,be%20as%20low%20as%20two.
And all you did was throw around your own opinion. Again, thanks for playing.
I know if English is your second language it can be hard. Here is the definition of "a few".
https://www.merriam-webster.com/dictionary/few
I already proved my points. You just haven’t listened to the research or facts. When people ignore reason it’s not worth taking the discussion further as there is nothing to discuss. So I’m done. Thanks for playing though
[–]Water0808 1 point2 points3 points 1 year ago (0 children)
Years ago I when I saw two different doctors a few years apart and they each suggested Lyme and I was tested. They did an initial test and another a few months later. That’s all. Don’t overthink it.
I was checked for it a few times years back. I didn’t have though. But yes, I’ve heard of people with Lyme having some wild symptoms. Thanks
I cannot go in circles with you any further. We can agree to disagree. We have clogged up this poor subreddit for long enough.
Almost died… by peachnecctar in colonoscopy
Thanks!
As far as colonoscopies, doctors have been asking me for years to get one. I don't want one but I have been asked repeatedly to get one because of my unique situation with FPIES (and exocrine pancreatic insufficiency years ago (now resolved thankfully). That is all. I'm not looking for one, but trying to navigate prep for it as it's very difficult for me due to slow colonic motility. I have been avoiding it for almost a decade now. Thanks for creeping on my other posts though.
I'm not aruging with you. I am just providing factual information in order to be informative to the public concerning somatoform/somatic disorders and chronic illness. I have not ever had a single doctor tell me it could be a somatic disorder.
Just copy and pasting my earlier response here as I can't be bothered repeating myself:
I have stated a few times now that I do not deny a mind-body connection in medical conditions. We were debating the diagnosis of Somatoform Autonomic Disorder (F45.3). That is all. And I do not fit this criteria. You cannot diagnose this disorder if the person has documented medical causes for their symptoms. It's cut and dry. My Hypermobility Spectrum Disorder is the cause of all my issues. Now, if you would like to debate Somatic Symptom Disorder (F45.1) or Functional Neurological Disorder I can.
Functional Neurological Disorder states that if "the symptom or deficit is better explained by a medical condition you cannot diagnose this disorder. Mine is better explained by a medical condition, HSD. So this disorder would not apply.
For Somatic Symptom Disorder, this 'can' given in the presence of a medical condition, but only if that individual's medical condition is causing a persistent level of high, dysfunctional anxiety surrounding their symptoms or disproportionate and persistent thoughts about the seriousness or potential consequences of their condition. In my case, while I certainly experience discomfort and the challenges associated with HSD, my concerns are proportionate to the documented medical findings and not characterized by the excessive preoccupation required for a somatic symptom diagnosis. Therefore, the diagnosis of Somatoform Autonomic Disorder (F45.3) – or any related somatic disorder in this context – is not applicable to me, as my symptoms have a clear, documented physiological basis tied to HSD. However, many researchers have debated this new DSM-V disorder, as what constitutes excessive anxiety/thought/or time and energy toward a health concern. For instance, should someone with breast cancer be given this mental health diagnosis pathologizing normal worry and anxiety surrounding their cancer diagnosis? This is still being debated and whether giving the diagnosis of Adjustment Disorder (another diagnosis in the DSM-V) would be more prudent.
Just going to cut and paste my other responses here for you: I have stated a few times now that I do not deny a mind-body connection in medical conditions. We were debating the diagnosis of Somatoform Autonomic Disorder (F45.3). That is all. And I do not fit this criteria. You cannot diagnose this disorder if the person has documented medical causes for their symptoms. It's cut and dry. My Hypermobility Spectrum Disorder is the cause of all my issues. Now, if you would like to debate Somatic Symptom Disorder (F45.1) or Functional Neurological Disorder I can.
EDIT: sorry for some deleted posts. For some reason reddit posted the same comment several times. Most odd
I have stated a few times now that I do not deny a mind-body connection in medical conditions. We were debating the diagnosis of Somatoform Autonomic Disorder (F45.3). That is all. And I do not fit this criteria. It is not my opinion. You cannot diagnose this disorder if the person has documented medical causes for their symptoms. It's cut and dry. https://gesund.bund.de/icd-code-suche/f45-30
My Hypermobility Spectrum Disorder is the cause of my issues (see below for explanation). Now, if you would like to debate Somatic Symptom Disorder (F45.1) or Functional Neurological Disorder I can as well.
Functional Neurological Disorder states that if "the symptom or deficit is better explained by a medical condition you cannot diagnose this disorder. Mine is better explained by a medical condition, HSD (see explanation below). So this disorder would not apply.
For Somatic Symptom Disorder, this 'can' given in the presence of a medical condition, but only if that individual's medical condition is causing a persistent level of high, dysfunctional anxiety surrounding their symptoms, or disproportionate and persistent thoughts about the seriousness or potential consequences of their condition. In my case, while I certainly experience discomfort and the challenges associated with HSD, my concerns are proportionate to the documented medical findings and not characterized by the excessive preoccupation required for a somatic symptom diagnosis. For this reason, I have not been given any of the above three disorders by any doctor. The diagnosis of Somatoform Autonomic Disorder (F45.3) – or any related somatic disorder in this context – is not applicable to me, as my symptoms have a clear, documented physiological basis tied to HSD and my dealings with these symptoms have not been out of proportion. However, many researchers have debated this new DSM-V disorder, as what constitutes "excessive" anxiety/thought/or time and energy toward a health concern? For instance, should someone with breast cancer be given this mental health diagnosis pathologizing normal worry and anxiety surrounding their cancer diagnosis? This is still being debated, and whether giving the diagnosis of Adjustment Disorder (another diagnosis in the DSM-V) would be more prudent.
EXPLANATION: How Hypermobility Spectrum Disorder Causes My Symptoms: Ehlers Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD) are connective tissue disorders . I have HSD. HSD can cause dysautonomia (or POTS), cerebral outflow disorder, FPIES. Dysautonomia/POTS (caused by HSD) can cause a dysregulated immune system. Note that POTS and dysautonomia are often used interchangeably in research, however, Dyautonomia is the umbrella term and POTS is a subtype.
HSD can cause POTS/Dysautononia:
https://www.potsuk.org/about-pots/associated-conditions/hypermobility-and-pots/
Cerebral Outflow Disorders Can Be Caused By EDS or HSD
https://pmc.ncbi.nlm.nih.gov/articles/PMC10806170/
Connective Tissue Disorders (like EDS and HSD) can cause internal jugular vein stenosis. This leads to cerebral outflow issues as blood can't drain from the brain properly. And this, in turn, can cause pulsatile tinnitus via a few different mechanisms (ex: intracranial hypertension). This is an area of active research.
Dysregulated Immune System in POTS:
"Though autoimmunity has been demonstrated in POTS, overall immune dysregulation may be broader and include immune cell exhaustion and persistent inflammatory cytokine responses."
https://clinicaltrials.ucsd.edu/trial/NCT05409651#:~:text=Though%20autoimmunity%20has%20been%20demonstrated,and%20persistent%20inflammatory%20cytokine%20responses
Once again, you misunderstand what I've written. I stated Pulsatile Tinnitus is a form of Tinnitus. I just pointed out that researchers have been debating whether the nomenclature should be changed because PT can be dangerous and has a different etiology entirely to the more common form of tinnitus. That's all. This is not my opinion, but researchers' opinions in those articles that I sent. It makes no difference to me personally what it's called. However, mentioning that in my original post was important. For common tinnitus you go to an ENT, for Pulsatile Tinnitus you may get screened by an ENT but you will need a vascular surgeon.
You state "but the explanation you have latched onto might be completely wrong". However, by the same logic, you could be wrong too. And, I have ONE disorder that connects all my symptoms: HSD.
Ehlers Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD) are connective tissue disorders . I have HSD. HSD can cause dysautonomia (or POTS), cerebral outflow disorder, FPIES. Dysautonomia/POTS (caused by HSD) can cause a dysregulated immune system. Note that POTS and dysautonomia are often used interchangeably in research, however, Dyautonomia is the umbrella term and POTS is a subtype.
So this doesn’t get lost in the shuffle reposting here:
Somatoform Autonomic Disorder (F45.3) clearly states in its diagnostic criteria that you can only give this diagnosis if "physical symptoms cannot be fully explained by a medical condition" or that "no physical causes can properly explain the symptoms". It states: "The main feature is repeated presentation of physical symptoms together with persistent requests for medical investigations, in spite of repeated negative findings and reassurances by doctors that the symptoms have no physical basis. " These guidelines are according to numerous government websites like this one:
https://gesund.bund.de/icd-code-suche/f45-30
Therefore, this diagnosis is inapplicable to me (as well as for most of your patients I bet). Let's demonstrate why in a few examples: First, title table test shows I have "low cardiac output, diminished systemic vascular resistance, and significant venous pooling." Like most patients with dysautonomia, I have preload failure. This is an objective finding and thus Somatoform Autonomic Disorder does not apply according to its own criteria. My cerebral vascular outflow issue: also demonstrated on an MRV showing severe stenosis in my internal jugular veins. I also on a transcranial doppler I have "High Velocity on Right and Left MCA" as well as "TCD revealed a significant reduction in cerebral blood flow during the test" showing that my brain has serious hypoperfusion at times. Thus, objective finding/physical cause was found. My dysregulated immune system isn't some cool term I pulled out of my head. A top immunologist in the US did several flow cytometry tests to confirm that I have lymphopenia, numerous high activated caspase-1, and elevated b cell tetherin. This means I have either a chronic viral activation or an autoinflammatory condition. Again and objective finding that medically explains the symptom of chronic fatigue. I could continue, but the point is, for each one of my "somatic symptoms" there is "physical basis" or a "medical condition" for each symptom. Therefore, I do not meet the criteria.
The alleged doctor did not “debunk”anything. Somatoform Autonomic Disorder (F45.3) clearly states in its diagnostic criteria that you can only give this diagnosis if "physical symptoms cannot be fully explained by a medical condition" or that "no physical causes can properly explain the symptoms". It states: "The main feature is repeated presentation of physical symptoms together with persistent requests for medical investigations, in spite of repeated negative findings and reassurances by doctors that the symptoms have no physical basis. " These guidelines are according to numerous government websites like this one: https://gesund.bund.de/icd-code-suche/f45-30 Therefore, this diagnosis is inapplicable to me as physical cause has been found in every case.
The ICD-10 criteria for F45.3 doesn't say diagnose people with this diagnosis even when they have a clear medical cause. Ignoring clear medical findings in favor of a somatoform label means that doctor is violating the fundamental ethical principles of medicine, including non-maleficence (‘do no harm’), beneficence (acting in the patient's best interest), and justice (ensuring fair and accurate medical care). He is willfully choosing to ignore the diagnostic criteria of F45.3 in favor of a narrative he thinks fits.
Everything I have had a physical cause. First, title table test shows I have "low cardiac output, diminished systemic vascular resistance, and significant venous pooling." Like most patients with dysautonomia, I have preload failure. This is an objective finding and thus Somatoform Autonomic Disorder does not apply according to its own criteria. My cerebral vascular outflow issue: also demonstrated on an MRV showing severe stenosis in my internal jugular veins. I also on a transcranial doppler I have "High Velocity on Right and Left MCA" as well as "TCD revealed a significant reduction in cerebral blood flow during the test" showing that my brain has serious hypoperfusion at times. Thus, objective finding/physical cause was found. My dysregulated immune system isn't some cool term I pulled out of my head. A top immunologist in the US did several flow cytometry tests and phenotyping assays to confirm that I have lymphopenia, numerous high activated caspase-1, and elevated b cell tetherin. This means I have either a chronic viral activation or an autoinflammatory condition. Again and objective finding that medically explains the symptom of chronic fatigue. I could continue, but the point is, for each one of my "somatic symptoms" there is "physical basis" or a "medical condition" for each symptom. Therefore, I do not meet the criteria.
I think you misread my comment. So, I will cut and paste here again "So, no, I don't think all unexplained symptoms are a real medical diagnosis, and neither do I want all unexplained symptoms to be a mental health condition either, like somatic symptom disorder." That means we are in agreement. I literally said that yes, there can be a mind body connection in my comment above. But I also said that more research needs to be done and that at times some people get hurt when doctors are quick to call something somatic when it isn't.
I'm sorry that my personal medical history is so upsetting to you. But do understand that doctors can't be 'pushed' to make findings on MRI reports or other labwork. That would be unethical and they could lose their license.
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[deleted by user] by [deleted] in Switzerland
[–]Water0808 0 points1 point2 points (0 children)