Munchausen
 

Does anyone have any information regarding RSD and Munchausen? A friend just asked me who was accused by IME after several Dr's agreed with RSD. Any information, studies, documentation, etc would be appreciated. She and her family knows she does not have this everything in her medical history is explainable, yet this ding-a-ling has accused her of this after one visit. The ole "It's all in your head" with a formal name......*sigh* just another victim of a nasty Dr..........ggggggggrrrrrrrrrrrrrrr!!!

Oh my God I am so appalled by this Doc. Have they no compassion.

Hi Hubby with RSD--Well, Munchausen is DELIBERATELY and INTENTIONALLY FAKING of "feigning" illness for SECONDARY GAIN (in the context of the Insurance Companies), for MONEY.

Now, I am by no means an expert, but for an IME doc to "label" someone with the Pshychiatric Term of "Munchhausen"...FIRST, they need to be a QUALIFIED Psychiatrist or Psychologist; secondly, this Psych would have to administer the MMPI test... a MEDICAL MD CANNOT DIAGNOSIS PSCYCHIATRIC CONDITIONS--they may have a "suspicion", BUT, a COMPETENT MD would REFER the patient to a Psych for PROPER psychiatric diagnosis...(which includes conducting the appropriate TESTS)....

Who on EARTH is this IME???? Does your friend have an atty?? This IME needs to be DE_BUNKED PRONTO...

Certainly, with severe RSD and intractable PAIN, SOME patients may END UP having serious psych issues (SUICIDE comes to mind...) but psych conditions are NOT the CAUSE of RSD...I am not sure what studies are out there re Munchausen's and RSD--maybe some of the more experienced and knowledgeable contributors to this forum can steer you in the right direction.

OMG--my blood is boiling for what your friend is being subjected to.:mad:

Brokenwings

Ok - Not sure how much I can put here as far as legalities....BUT I can tell you that this Dr saw her for approx 30 minutes - was hired by insurance company - this dr has a 6 month internship in psych - whatever that means??? Otherwise in his "credits" has done PLENTY of w/c seminars, insurance company work, etc.... Asked her about past medical issues for about 25 minutes, examined her for current condition area of injury for less then 5 - was PAID approx $2000.00 for this visit from what I can figure....There were NO tests like the MMPI that you mentioned, nor any other "psych tests", but has written in a report that can and will be used in court and has diagnosed her with Munchausen.........

Oh and I should also mentioned - looked a little into this Docs history and apparently his main accusation towards people is them "faking" their conditions/injuries..........:mad:

Hi Again Hubby w RSD--well, ALL Medical Doctors are required to do a rotation in various disciplines...however, a 6 month "stint" does NOT qualify a MEDICAL Doctor to be a Psychiatrist...let alone DIAGNOSE a psychiatric disorder...

If your friend's attorney is SHARP, he will do the homework re this particular IME to EXPOSE HIS BIAS. First, the atty should DEPOSE the IME, and GRILL him re his "qualifications", other cases is which he testified, what PERCENTAGE of his Medical practice is DEVOTED to DEFENSE exams, etc...the particular IMEs experience and QUALIFICATIONS in TREATING PATIENTS wtih RSD, not to mention how he arrived at a PSYCHIATRIC diagnosis...a good attorney could make MINCE-MEAT of this guy.... and IMPEACH HIM---and jurors do NOT LIKE "shady" paid for by the IC docs....it blows uo in the Defenses' face, and potentially results in an outcome VERY MUCH in favor of the plaintiff..if this is CIVIL litigation (as opposed to Workers Comp) the monetary damages could be staggering...

Well, I might just have to do a little research re Munchausen's/RSD...frankly, I do not believe there really is much out there, but I am not sure. It is more of a "legal myth" that the Insurance Companies would like to perpetuate...

Brokenwings

Just to clarify
 

Just to clairfy....This IME is saying she has Munchausen regarding herself - NOT her children - IME has said that she has made up in her head the burning pain, muscle spasms, sores, deep pain, cramping, temperature changes, etc........in herself.

There is so much out there on Munchausen By Proxy involving one and their children I just didnt want the two to get mixed up.

from here- http://www.clevelandclinic.org/healt...asp?index=9833

[What are the symptoms of Munchausen syndrome?

People with this syndrome deliberately produce or exaggerate symptoms in several ways. They might lie about or fake symptoms, hurt themselves to bring on symptoms, or alter diagnostic tests (such as contaminating a urine sample). Possible warning signs of Munchausen syndrome include the following:

* Dramatic but inconsistent medical history
* Unclear symptoms that are not controllable and that become more severe or change once treatment has begun
* Predictable relapses following improvement in the condition
* Extensive knowledge of hospitals and/or medical terminology, as well the textbook descriptions of illnesses
* Presence of multiple surgical scars
* Appearance of new or additional symptoms following negative test results
* Presence of symptoms only when the patient is alone or not being observed
* Willingness or eagerness to have medical tests, operations, or other procedures
* History of seeking treatment at numerous hospitals, clinics, and doctors offices, possibly even in different cities
* Reluctance by the patient to allow health care professionals to meet with or talk to family, friends, or prior health care providers
* Problems with identity and self-esteem]

The IME is doing what he is paid for-- and it stinks - but the best proof against it is also with consistent symptoms, regular appt reports and charting by her own doctor- and a good atty that will prove the bias of the IME.


this link is for Oregon - but much of the IME info and other info with how best to deal with the system is good for many areas.
http://www.injuredworker.org/
http://www.injuredworker.org/ime.htm

W/C
 

I found after 14 years going through various w/c cases, that when an IME doctor comes up with a far out syndrome, and spent 30 minutes with the patient, that is favorable to your friend.
Judges do not like so improbale unlikely diagx by IME doc's. The doctors credicility of whom is more likely the better credibility is weighed by the judge. If their doctors hav long history with symptoms consistant with RSD, and put it next to doc that spent 30 minutes and came up with something even the judge is not going to buy...lol, he will say your friends doctors are more credible then the IME doc.

The judges know these doc's get paid for their opinion, and since they are not the treating doctor can get away with saying such unreal stuff...but that makes them look nutty to judge, and your friend is really great shape.

If he came up with auto immune, or lyme disease not realted to accident or injury then that is more challangable. I mean at least soemthing believable. But this is so far off the charts even the judge will chuckle under his breath when eh reads the report.

I would not be surprized if the w/c ask for another IME in six months, and receive another diagx more believable....It always comes down to whose doctor is more credible!
Dianne

Hey there - This is what we thought too as she is working closely with several doctors and has been for the duration of her condition. She has had all the tests to rule out anything else, has had the same dr's regarding her condition, and is still with the same hospital/clinic group, has made almost all of her appointments, etc. (Not even close to the symptoms that someone with Munchausen has) So we thought that with it being so far out of the park that it just might help her, instead of hinder.

She is just frustrated and angry and we are as well, she asked that if there is any research out there or write ups against the association she could forward them onto her attorney. I told her we would see what we could do...thanks for your help and your thoughts, we will forward them onto her.

What ticks me off about this definition - and it's no surprise for it to come out of a big institution like the Cleveland Clinic - is the alacrity with which it could be applied to patients with chronic conditions, whose "subjective" symptoms worsen over time. And to the extent the patient educates him or herself and sees multiple specialists in an attempt to find a new treatment angle, the patient is just tightening the noose around his/her neck. It's almost like they have a diagnostic code: patient is a pain in the butt.

If you'll forgive my Yiddish: Shtup es in toches!

Mike

Hi Everyone,
From what I have heard we should hold the MAYO. as well.:wink:

We all need to hang in their. Love, Roz

I was wondering how many of those Munchie symptoms really fit for any of you?? probably not very many of them.

* Dramatic but inconsistent medical history

* Unclear symptoms that are not controllable and that become more severe or change once treatment has begun

* Predictable relapses following improvement in the condition

* Extensive knowledge of hospitals and/or medical terminology, as well the textbook descriptions of illnesses

* Presence of multiple surgical scars

* Appearance of new or additional symptoms following negative test results

* Presence of symptoms only when the patient is alone or not being observed

* Willingness or eagerness to have medical tests, operations, or other procedures

* History of seeking treatment at numerous hospitals, clinics, and doctors offices, possibly even in different cities

* Reluctance by the patient to allow health care professionals to meet with or talk to family, friends, or prior health care providers

* Problems with identity and self-esteem

Let's see:

* Dramatic but inconsistent medical history NO

* Unclear symptoms that are not controllable and that become more severe or change once treatment has begun AT TIMES

* Predictable relapses following improvement in the condition VERY POSSIBLY

* Extensive knowledge of hospitals and/or medical terminology, as well the textbook descriptions of illnesses OH FOR SURE

* Presence of multiple surgical scars NOPE

* Appearance of new or additional symptoms following negative test results SOMETIMES

* Presence of symptoms only when the patient is alone or not being observed OF COURSE

* Willingness or eagerness to have medical tests, operations, or other procedures YOU BET!

* History of seeking treatment at numerous hospitals, clinics, and doctors offices, possibly even in different cities THAT'S WHY I'M HERE

* Reluctance by the patient to allow health care professionals to meet with or talk to family, friends, or prior health care providers NO

* Problems with identity and self-esteem NOT REALLY

So that could give me a score of 7/11 if administered by unsympathetic hands. (And I totally agree with Roz, you have to be very careful in going for the Mayo. That said, I think there is a lot of interdepartmental variation.)

Mike

Jo Here I Go,

* Dramatic but inconsistent medical history. I am a prior Cancer patient so the Docs are more Drama than I could ever be.

* Unclear symptoms that are not controllable and that become more severe or change once treatment has begun. My Sx are very unpredictable.

* Predictable relapses following improvement in the condition. Some days are better than others.

* Extensive knowledge of hospitals and/or medical terminology, as well the textbook descriptions of illnesses. NO. I was told by the Docs to educate myself.

* Presence of multiple surgical scars. NO

* Appearance of new or additional symptoms following negative test results. NO, the Docs at one time even tought I had Lymphoma because of their CT scan they ordered.

* Presence of symptoms only when the patient is alone or not being observed. No

* Willingness or eagerness to have medical tests, operations, or other procedures No. My husband makes my Doc appointments.

* History of seeking treatment at numerous hospitals, clinics, and doctors offices, possibly even in different cities. History of canceling appointments, that loved ones have made for me.

* Reluctance by the patient to allow health care professionals to meet with or talk to family, friends, or prior health care providers. No, just would want the Docs to be hopeful.

* Problems with identity and self-esteem. No way.

I have a report from a Neruo Doc who worked at the Cleveland Clinic, I will type word for word out if I have to. I just have no clue where my scanner is. Hugs, Roz

Hello Everyone,

Here is a bit of my report from a Neurosurgeon who worked with Hicks MD. Who most of you know is a top RSD DOC at Cleveland Clinic.

NOV. 3, 2005

This is an unfortunate 47 year old female who sounds like she developed radiclular arm pain and then neuropathic pain. She was DX as having RSD or complex pain disorder type 2.

ETC.. ETC.. ETC..

He again states:

I would recoomend that she see a pain MGT. specialists for this. If possiable, she could be referred to a neurosurgeon who specializew in pain mgt. who could consider doing something like a dorsal column stimulator or a trial for
this. I will try to send her to one of the pain mgt. specialists locally to see if they have anything else to off her.

To complete her work-up I recommend she get flexion extension cervical spine x rays.



My point being before I would have SCS I consulted with some top DOCS. They said no way, I was a bad canditate for that procedure. I believe we need to get several opinions at times. I am not MD shopping I am fed up with tablets. I want a MD who knows how to help me. So I can at least drive my Jaguar out of the driveway. Hugs, Roz

Heavens, Roz, what an amazingly amateur report. There isn't one definite thing in it.
And as for "see if they have anything else to off her." :eek: - I just hope that's a typo, but in case it's not, don't go back there, we like having you around :D
all the best!

I second that. I hope you find one. So you can drive you jag out of the driveway. Soft hugs.:hug:

As someone who has had the label as "possible Munchausen's" I can truly empathise with this person.
Unfortunately when one has ulcers caused by the poor circulation of CRPS that refuse to heal despite intensive medical care, there are often egotistical and arrogant doctors who can't believe "all their wonderful knowledge" has not been able to heal so therefore "the patient must be self-harming"
It is an incredibly demoralising and devastating thing to happen.
A psychiatrist is the ONLY one who can make this diagnosis, NOT some semi trained upstart who gets payoffs from insurance companies for getting people off their books!
For me, I had a wonderful Psychiatrist who laughed at the suggestion. Yes, I felt better but I will NEVER recover from the indignity caused by the pindick doctor who knew it all!
There is a far more common diagnosis being handed out these days amongst CRPS patients and that is Somatisation Disorder. This is a very complicated psychiatric disorder where the patient actually feels the pain and often has some signs of the disease but they don't really have it.:confused:
All in all, a horrible situation for anyone to find themselves in!:(

Hi Tayala and All! Yes--somatisation is a frequent "diagnosis" bandied about, PARTICULARLY for those patients in either work comp or civil litigation. The mtoive behind this can be rather "effective" in trying to reduce the COSTS associated with RSD/CRPS: The patient is "demoralised", so slinks away lest they CONTINUE to be labelled in this matter. The REAL harm comes when their OWN treating Docs start to "question" if their patient might indeed either be "faking" or "somatising" after getting hit with denial after denial for treatment and "reports" from these so-called "experts". A pretty effective "wedge" that can be placed between the patient and their own treating physician. Unfortunately, some Doctors fall for it....or, they get so tired and frustrated with continually "defending" their diagnosis of RSD, that they just throw their hands up in desperation and are reluctant to continue to treat the patient....or "pass them off" to someone else (like a shrink)....and the cycle continues.

It is quite the same for many with TOS also - because so few docs really have a good base of knowledge of it. Only a few make use of special MRI/MRA or Neurography tests. So the majority of TOS patients go the many rounds of MDs, PTs, meds, and go thru the WC ringer too.
Just because there is lack of knowledge and lack of a basic test that can prove it.
They call it malingering also.:mad:

Oh yes - this was one of the words they used in the report (I've been able to actually read over it all now...) :mad:

There are a few things that this "Doc" didn't look into well enough tho before he wrote his report - That this gal has had an MMPI (psych test) before she had another surgery a couple years ago - it was required before the surgery. Came out "well adjusted" and "sound, stable" and just plain ducky! Cant wait till the attorney slams that down this what was the word I saw earlier??....LOL...pindicks throat!!!

Hi Hubby-- I think that IME will soon be "choking"!!! How fortunate that your friend has had a prior MMPI! Not ONLY is that IME NOT qualified to render the opinion of "Munchausen's", he is NOT qualified to make ANY psychiatric diagnoses, should the matter go to trial. ALL psych matters are OUT OF HIS AREA OF EXPERTISE, and a Judge will NOT let him testify after the "voir dire" process which determines the extent of this IME's (bogus) "qualifications"...the IME can only testify in MEDICAL areas for which the Judge has found him to qualify as an "expert". Your friend's attorney will be able to question this IME EXTENSIVELY on cross-examination on his "qualifications", so that the Judge can determine to what EXTENT this IME is qualified to testify, not just psych issues, but
MEDICAL issues (perhaps it will be found by the Judge that this IME is not an "expert" in RSD, thus not alllowed to testify re those issues, either)....

Sounds like your friend is in pretty good shape....her Attorney is probably "licking his chops" at the prospect of de-bunking this "IME"!

Nevertheless, it really is reprehensible that your friend has to be dragged through this ordeal. Best wishes to her....

Brokenwings

My Size 15 Shoe Would Like To Meet This Doctor
 

Yuppers I would surely like to kick this ***** in the **** and I'll show him who has Munchausen. Give me a break. Lets line up all these Quacks and have us a nice game of Bowling for Idiots. Thats all I have to say. I'm too dang mad now. Just hang in there. Mark xoxo :D :D :grouphug:

Hi Mark,

Love the bowling alley idea for the duck MD's, we could even use the kiddie racks in the alley. STRIKE:) Love, Roz

You know Wicked, you bring up a REALY GOOD point about Munchausen's.
Isn't it FASCINATING that some IME, or ANY Doc, for that matter, keeps automatically and continually labelling ALL RSD patients as being "fakers" and "Malingerers"?? Kind of makes me wonder if THEY don't suffer from "identification projection" Issues???!!!!

Hmmmmm "Physician, heal THYSELF"....otherwise, get ready for the bowling ball!!

Brokenwings

Hi Everyone,

I really believe this Munchausen Syndrome is really just crap.

A dear friend of my husband's last year went to the MD because he was so weak. They told him he just had the flu. So of course he thought he just had the flu. He was not getting better, just worse.

Then he got DX with Acute Lymphoma. He died a few months later.:(

A person goes to the MD because they aren't well. Then to hear that this is in someone's head or the flu is really wrong.

This poor baby died because they accused this child's mother of having Munchausen's Syndrome.

http://www.msbp.com/review_vindicates_mother.htm

If the MSBP diagnosis is eventually proven to be erroneous and negligent, causing real harm or even death to the child, both the physician and CPS workers hide behind a guise of Good Faith Immunity Laws. The physician will proclaim that he had a legal responsibility to report even the slightest suspicion of abuse, even if he hadn't followed standard medical guidelines for researching all possible conditions which would produce the same symptoms. CPS, in turn, will cry that they were only responding to the expert opinion

http://www.msbp.com/

Hugs, Roz

It's funny that you mentioned the MSBP - I knew that there was THAT condition out there - about making their kids sick - I never knew that they had just the "M" part for people accused of doing this to themselves....Someone told me that the AMA or some medical board (cant remember exactly) does not even recognize this as a real condition - Think it should stay that way....