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Просмотр полной версии : Rules of Consultations (or *quot; How to set oO?U*quot;)



AlexK
01.09.2004, 19:30
I have written some the rules on a site, but have met a variant better - it was pleasant as have written our colleague Maljarskaja M.M. on the site (http: // mariamm.ru)



INCORRECT QUESTIONS



Questions which should not be set virtually. On them there is no answer. prochtite once why - and any more do not set:)



1. *quot; NOT iAao*quot;

Unfortunately, at the moment I cannot (there is no time, money, opportunities) to go to doctor, therefore respond, please, to my question.



Unfortunately, the objective opportunity of the virtual answer does not depend on your time, money, etc. If it is possible to respond to a question virtually, I mean shall respond. And it is valid, can be there is no necessity for the sake of such simple questions to go on internal reception. And if it is impossible to respond to a question virtually, means it is impossible. Means for the answer to it or him it is necessary to go on internal reception. And you of entreaty will be useless, therefore do not waste time and my. And in general always, when something disturbs you, it is necessary to go certainly to the attending physician on internal reception if you really wish to understand. Virtual consultations are abstract, the list of questions which can be resolved with their help, is limited, and all is resulted or brought in the Directory and ViO. No detailed description exists the basis that the doctor has incured the responsibility to advise and treat on the Internet. Read closely following rhetorical questions and never them set - spare time. Moreover, if someone to you will answer such questions virtually, mine to you advice or council - do not take such answers seriously. For they - the proof of irresponsibility of the adviser.



2. *quot; IS NOT PRESENT eECuC*quot;

Unfortunately, in our city the medical care leaves much to be desired..



It is not very a pity to me, but help or assist in this case I can. There are paid establishments, there are larger cities and the qualified experts. It is very difficult to find the Attending physician, but it needs to be made, for this purpose it is necessary to try and waste time, forces, money. The attending physician can treat only. The Internet-adviser does not know you and does not see a clinical picture, cannot look or see the eyes and spend the necessary analyses in that laboratory to which he trusts. Do not force an Internet-adviser to base or found;establish the consultations on a guessing. Do not set to him rhetorical questions. Search for the attending physician. Let for this purpose it is necessary to go to other city.



3. *quot; GIVE ?oaio*quot;

At me a clamidiosis (a ureaplasmosis, a mycoplasmosis, a bacterial vaginosis, a thrush, and other, other, other). Write please what you recommend the scheme or plan of treatment.



I do not recommend also can recommend nobody schemes or plans of treatment of infections on the Internet. Antibiotics, just as hormones (see a question 4) and other strong agents possess a lot or plenty of by-effects. To appoint or nominate them it is possible only under strict indications. To solve the problem on indications and contraindications the internal attending physician can only, he selects the concrete scheme or plan of treatment in view of specific features of the patient. The virtual doctor can explain only the general or common principles. A reality, in particular, purpose or appointment of medical schemes or plans, he to be engaged has no right. Besides where guarantees of what at you that diagnosis which you have written? The doctor is not the prescription directory offering or suggesting medicines *quot; from u?oU*quot;, etc. the Attending physician is the person who is responsible for the purposes or appointments. To be assured or confident in the correctness, he should diagnose itself, proceeding from that that sees the eyes, instead of to rely on someone diagnosed. The analyses made in the most reliable laboratories, cannot replace an alive view of the internal attending physician. You suggest to incur the responsibility for treatment of a cat in a bag. Any sane person of such responsibility on itself will not take. And it is correct.



4. *quot; PICK UP eAi?ECuaAue?*quot;

My age...., weight...., I do not smoke, it is predisposed to completeness..., abortions... - advise a hormonal contraceptive...



See a question 3. With hormones there are more complexities, than with antibiotics, before their purpose or appointment it is necessary to pass or take place inspection to be convinced of absence of contraindications to their reception. And only if they are not present, to address to the attending physician for individual selection of a contraceptive. Criteria of a choice are, including, both your appearance, and - all this probably to estimate or appreciate details of your life only internally.



6. *quot; YOURS eAiiai?CEee*quot;

To me have appointed or nominated the scheme or plan of treatment.... What can you tell or say about her? Whether she is effective? Perhaps, something to replace \add?



To make comments on purposes or appointments of other doctors unethically. To appoint or nominate schemes or plans of treatment it is virtually impossible - see a question 3. The attending physician appointed or nominated the scheme or plan had any bases for purpose or appointment. He saw you, and to him is more visible, why such scheme or plan. If to you something is not clear or you with something are not consent, you should ask the question to him. The virtual adviser can answer a question, than basically treat such illness or disease, but he has no right to answer a question, than particularly to treat such diagnosis at you personally, and he has no the slightest concept why to you have appointed or nominated such scheme or plan, and whether it is possible for something to change in her without damage to you, or it and is the highlight of the scheme or plan in view of an individual approach of your attending physician.



7. IT WILL HELP or ASSIST?

To me have appointed or nominated treatment. Whether it will be effective?



I do not know. It or this is not known even by the appointed or nominated attending physician. Nobody knows the future. In medicine there are no guarantees. There are effective agents for treatment of abstract diagnoses. There are no obviously effective schemes or plans for treatment of the concrete person. To estimate or appreciate efficiency of treatment it is possible only after its or his termination or ending. It is in advance possible to tell or say, whether purpose or appointment is competent. But words about efficiency. If guessings are necessary to you - for this purpose there are professionals.



8. *quot; ALL HAS checked up, NOTHING HELPS or ASSISTS WHAT TO DO or MAKE? *quot;

At me... Has checked up all - norm or rate. It was treated by all - nothing helps or assists. What to do or make?



You have not given gram of the information. You know all - and that have checked up EVERYTHING that is necessary in this case, and that all results - are normal, and that were treated by EVERYTHING, than it is necessary, and it all has not helped or assisted. All of you know, to share the knowledge - that you checked and than what results were treated also - you do not want. Than I can help or assist you? The doctor bears the responsibility for the purposes or appointments. He should do or make the conclusions, being based on the objective information. The result of the analysis is objective. Write result and norms or rates of laboratory in brackets. Let the doctor, having correlated it with your complaints, will solve - norm or rate it in your situation or not. The attending physician should do or make conclusions. You should him deliver only the facts. If you conceal the facts, and conclusions do or make, the attending physician means you to itself. This your right but then bear completely the responsibility for the health and do not throw off it or her on others. To throw off the responsibility, it is necessary to come on internal reception and to give all the facts, having given to the attending physician most to do or make conclusions and to them to base or found;establish the purposes or appointments.



9. *quot; WHAT IS IT CAN be? *quot;

At me allocation. Tell or say, what is it can be?



I do not know. It is necessary to be surveyed - to hand over for the beginning a smear. All gynecologic troubles are accompanied vydelenijami. And in norm or rate too allocation is. This guessing from section absolutely impossible.



12. *quot; NOT iaue???*quot;

I am flied or treated without effect. On me nothing operates or works. Low immunity. Heard, that \... - vooobshche it is impossible to cure.



- Are treated not for that. It is not precisely diagnosed. The originator is not revealed.

- Are treated not by that. Sensitivity to antibiotics is not certain, for example, or unreliable laboratory, it is impossible to believe results of analyses.

- Are treated one. It is not simply useless, and it is harmful - sm.vopros 10.

- The third person in the pair or steam, not treated.

- Any disease in an organism, not noticed, not allowing to spend high-grade treatment.



The infection can be cured always! Simply yet it was not possible. Something do or make not so.



13. *quot; TELL or SAY AEeciCee*quot;

Tell or Say attributes of an extrauterine pregnancy or a salpingocuesis....



No, it YOU tell or say, that you disturbs, and I or your attending physician we shall solve what to suspect, on what to be checked up and what to do or make. If I to you shall tell or say attributes, All of you them at myself will find. Well and if it would be necessary - open the directory and esteem - time so it would be desirable to assimilate Dzh. K.Dzheromu.



14. *quot; TELL.. *quot;

What is the endometriosis..... Clinic, diagnostics, treatment... More in detail.



The answer to this question is some or a little bit dissertations and monographies. And to waste time on trifles and miss important it would not be desirable. Therefore we leave similar questions without the answer in general. There are directories and encyclopedias.



17. *quot; IT IS NOT TERRIBLE? *quot;

I have drunk postinor. If pregnancy will be saved, how he will affect or influence the child? Whether it is possible to reduce harmful consequences?



If there was all so simply, it would be possible to be mistaken every day and to correct the mistakes or errors without consequences. No, it is impossible to reduce consequences. Nobody knows, will affect or influence or not. Can affect or influence. It is a lottery. It is not necessary to excruciate doctors questions - *quot; tell or say, it is not so terrible??!! *quot; I do not know. A lottery. You will not manage to get the happy ticket the question. From that that I to you shall tell or say - there are no, that you, it completely not terribly and does not influence in any way - so will not be. And you know it. Therefore do not set such questions.

ARCHI
01.09.2004, 19:30
As the person who has addressed consultation, and whose appeal ignorjat, I approve or confirm - .9 and .13 contradict each other.

And in general it is not clear, to what then section *quot; Consultations for a?N?Oo*quot;, if softly ask questions to not set?

Elentre
01.09.2004, 19:30
Who it you, madam, *quot; ?u?O?O*quot;??

The Internet-consultation by virtue of the certain reasons, I hope quite clear, cannot replace internal consultation.

There are questions to which it is possible to respond not seeing the patient, there are questions on which to respond it is impossible.



To sozheleniju, the Internet-consultation not always can solve a problem relative (I emphasize, relative) inaccessibility of a medical care.

Eventually from nezalezhnoj Latvia for one night it is possible to reach to Moscow or up to Peter for normal inspection.

Konstantin P
01.09.2004, 19:30
It is possible to delete item or point 6. *quot; YOURS eAiiai?CEee*quot;

*quot; To make comments on purposes or appointments of other doctors ?NYO???*quot; - it agree, but also in fact it is dishonourable to take many money from patients for each consultation without a positive take from the appointed or nominated treatment, and such pretty often and, the truth, very much often happens so, that only on this site it is possible to receive good consultation and the help, and also to listen to opinion of several experts.

Therefore, do not deprive, please, with such simply necessary pleasure.:o

V.
01.09.2004, 19:30
Who it you, madam, *quot; ?u?O?O*quot;??

The Internet-consultation by virtue of the certain reasons, I hope quite clear, cannot replace internal consultation.

There are questions to which it is possible to respond not seeing the patient, there are questions on which to respond it is impossible.



To sozheleniju, the Internet-consultation not always can solve a problem relative (I emphasize, relative) inaccessibility of a medical care.

Eventually from nezalezhnoj Latvia for one night it is possible to reach to Moscow or up to Peter for normal inspection.

Personally to you:) - it is grateful, it would be desirable from oncologists though a word to hear:rolleyes:

And in occasion of internal consultation, in that continually, sense of my posts in understanding, in what direction to address, to itself? I repeat, we a month address! And all uselessly. What probability of the most terrible diagnosis? Can, *quot; ?ai?Oy*quot; on all other inspections and to run straight in Onkotsentr?

Here yesterday, for example, have addressed to the paid doctor from private or individual clinic so has directed not where nibud, and on gastroenteroskopiju. At family yesterday too were, so have beaten out a direction in the Infectious diseases hospital, it in a month wanderings!

Not, I understand, children and old men to treat is useless, will survive the strongest!

But my father not the old man! He on doctors did not go to lives! And forces at it or him, give the God young! And from it or this that occurs or happens to it or him is even more terrible!

lena
01.09.2004, 19:30
To my father of 60 years. Here a month knocks about on any inspections, find nothing. Complaints: all has begun with a fever, a sweating at night, temperatures for 38, absence of appetite, delicacy. The analysis of a blood has shown an ESR-114, other parameters I do not know, but they have not caused or called trouble in the therapist, like lowered a hemoglobin and erythrocytes. Has spent on drink a course of antibiotics, it became better not. A photofluorogram in norm or rate. The US shows insignificant augmentation of a liver. The doctor in tubdispansere like would grope lymphonoduses.

Now the temperature skips - that 38,5 36,2, fevers are not present. The repeated analysis of a blood: eritrotsity - 3,29; a hemoglobin 95; a hematocrit 28; thrombocytes 437; leucocytes 8,75; lymphocytes of 16,4 %, an ESR 120. A bilirubin in norm or rate. Here also it is thought where now to move So to find out it is necessary, that for sites. That means *quot; like ?aUOa?*quot;?



http: // forums./showthread.php? t=14579

It is possible to spend a biopsy of lymphonoduses still.

KT = a computer tomography.

For diagnostics of a multiple myeloma - primarily fiber of plasma, an electrophoresis of fibers plasmas (m-gradient), further an immunoelectrophoresis, kons. A hematologist and doobsledovanie under indications.

From the illnesses or diseases proceeding from a high ESR (114-120 doubtfully, certainly, it it is exotic) - rheumatic polimialgija (well and Horton).

As it is a lot of complaints, but their specificity low also my assumptions will remain only assumptions.

Night sweats, causeless hyperthermia (there is no obvious reason), loss of mass of the body, the increased lymphonoduses (where?) - it is possible to suspect a lymphogranulomatosis. But only to suspect.

In general, at the elderly person a hyperthermia for no apparent reason, delicacy, a set of nonspecific complaints - an occasion to look for oncologic process. The tumour of a thick intestine which is not causing an intestinal obstruction is possible or probable. Make KT an abdominal cavity with contrast (contrast - inside). To a hematologist the sense to address is.

P.S. For a tumour of an intestine search first of all by means of a colonoscopy, instead of KT.