medicine is becoming more and more specialized, and what you don't do on a regular basis, you do less well.

when I did my residency in internal medicine, I was thinking of cardiology as an option, and I was one of the best in hearing heart murmurs and recognizing subtle changes on the ECG, to the extent that one of the cardiology attendings wrote a note to the chief resident, after I made, what he thought, was a briliant diagnosis.

but, I eventually chose hematology, and although I occasionaly picked up a cardiac problem that was missed by the referring GP, as the cause of the patient's problem (and not the mild anemia, he refered him for), and occasionaly had to look at EKGs (and still do), or adjust heart medications. whenever there is a more complex problem, I consult one of the cardiologists I work with, or even a very good medical resident, who sees EKGs every day on the ward. I still know how to look at an EKG and usually get it right, but as we are dealing with someone's life, I want to make sure that I am not missing something of importance.

even in my own field of practice. due to my illness, I haven't been examining patient's samples under the microscope for quite a while, and as I am gradually going back to being a bit more active, I make sure that I review each slide with one of my colleagues, until I regain my confidence and skills.

the bottom line is that I personally would not want my neurologist to make any decissions regarding my EKG, even if he knows how to look at it, and not even regarding my respiratory muscle tests. ( after I have learned the hard way, what the best neuromuscular specialists know about it).

and I fully agree with Annie, that in modern medicine, the best care for a patient is when there is a physician in charge, working with a team of other specialists that work with each other, each giving his/her input related to his/her specific expertise. they should all have some degree of understanding of each field, but not to the same extent. this team should also include non-physicians if needed, such as nurses, physiotherapist, dieticians etc.

alice

I'm not saying that any Neurologist is making a "life threatening" descision, what I'm saying is they can analyze an EKG, and can make a referral afterwards. This is how the medical world works.
And Neurologists do work with heart patient all the time. Especially after Strokes, and Heart Attacks!
They also have to know the heart for things like POTS! Dysautonomia! And I should take that back about the "life threatening" decisions, as Neurologist have to when dealing with Dysautonomia, or POTS!
If you are a medical person as you claim, you'd know this!

I'm concerned that this young man is getting the impression that he should Not listen to His Doctor. A Doctor who is a specialist with MG. He shouldn't be told not to trust His doctors opinions.

If his Neurologist wants to order an EKG, then he should be trusted to do so, and the referral if something is wrong! Period!

I don't know about your practice, but most doctors, order tests, and then send a referral. Based on the out come of those tests!
Also, many doctors write out an order for an EKG, and they're done in the hospital, and those EKG's are read at the Hospital, and then the results are sent to the doctors office. Again, if you are a medical person as you claim, you'd know this as well!

Tyson, please listen to your doctor! I'm begging you to listen to your doctor, and understand that people on the internet, are just that, people on the internet. They should never , and I do mean Never try to diagnose you, or take the place of your doctor, who knows you, and your results from personally examining you. They should NEVER EVER be the one you go to for your health! Please listen to your doctor, the person you can see, and a degree you can see. People on the internet, are just that People who you don't know. This is way too serious of a situation to Not listen to your doctor.

This whole thing has caused me great concern for this young mans health! He is New to all this!

Lizzie

I just want to say--if it turns out you have Graves', don't automatically assume it's going to be as much trouble as MG. I've had it for 15 years, and I take a thyroid suppressant (PTU). Now and then I have a flare-up (I was in remission for five years without drugs) and that needs to be managed, but in between I have no symptoms. As chronic autoimmune diseases go, this one's not so bad!

I have to admit that I find this quite amusing,

first, I had to convince people that I am ill, and need proper medical help. and this took quite a few years. (and I am not sure all are indeed convinced, but at least I have eventually found those that trust me and are ready to help me find the best management approach, even though my illness "refuses" to fit their book).

and now, I have to "convince" people that I am what I claim- a physician.


well, as I was not sure myself regarding my illness, and wanted to think they were right (you can call it denial), even though I had more and more evidence that they were not, it was very hard for me to say - listen I am ill, even if you think I am not. and I myself wanted to have "objective" evidence.
(which I eventually got).

but, proving to myself that I am a physician and what I "claim" to be, is very easy. and just makes me understand how much I should trust myself and not what other people think or say.

so thanks for that,

alice (from the MG "wonderland").