Monday, December 29, 2014

Dr Google is NOT your friend


Last night, I tossed and turned, thinking about something I saw on my friend's FB feed. After being sick for a couple of weeks, She posted that she still wasn't feeling well. She talked about needing another round of antibiotics. A few of us posted the usual "feel better soon" and gave her lots of sympathy. I mean, who likes to be sick?

And as I scanned the other replies then I saw this one:

"Sounds like adrenal insufficiency to me"

WHAT?

My NP radar went haywire. Does this person even know what adrenal insufficiency is? Do you? You can chase the link to learn more. But I can tell you that my friend's symptoms do not even closely resemble adrenal insufficiency. As a matter of fact, as an armchair quarterback, I'd say that her symptoms are most likely left over from her bout with influenza. The residual cough and nasal stuffiness can be just as rough as the illness itself.  Luckily, my friend is a nurse, and smart enough to know that she doesn't have adrenal insufficiency. And she did the really smart thing, and saw her personal physician for evaluation and management of her illness.

But what about the general public? Can you imagine a less educated person reading this? And thinking that they have some horrible illness? And who would post this? But judging by what I see in my feed, everyone has an opinion on medical questions.

Parents show up in my clinic all the time with their children, having Googled their symptoms. According to the Pew Research Center, 1/3 of Americans have turned to the internet to learn more about their medical condition and/or symptoms. The parents of the children I see report to me what they have learned from Google. And it's up to me to undo the damage done by what they have read.

A swollen lymph node (gland) in the neck? Leukemia, according to the presenting mom. The mom is tearful and worried, so I order a CBC to reassure them. I can't tell you how many times I've seen a child in the office with this.  With a concurrent fever, I'll swab for strep and treat with antibiotics.

I've experienced this in my own family as well. My mom, who just loves being a junior doctor, gave up her Mayo Clinic Health Manual for Google. She searches stuff she and my dad are experiencing all the time. I will never forget the day she called me to tell me she thought my dad was having a stroke. When I asked why she thought that, she told me she Googled his symptoms of headache and visual changes. And where was my dad? Sitting next to her....Ayyyyy! (BTW, turns out it was a migraine...after she DROVE him to the ER...didn't want to bother the paramedics...but that's a whole other issue...).

But back to runners. I see a lot of advice seeking in my FB feed with runners posting questions about injuries or pains they're having. As a medical person, I'm often stunned and amazed at what I read for responses. Even my favorite mother runners, Dimity and Sarah, used to post reader questions about injuries. I used to read these posts but I started to get frustrated and upset about the responses. So many times, I typed a snarky response but hit delete. I haven't noticed these kind of posts lately, so I wonder if they've gotten away from that. I hope so. Smart move, in my opinion.

Enemas. The cure for all that ails you.
The problem with obtaining medical advice from a blog, from a friend, from Facebook, from the internet, is that you have no way of knowing how reliable the information is. A lot of what you read is word of mouth. The other issue is that the person you are asking isn't getting the big picture. There is no substitute for a good medical history and exam. Friends and family curbside me all the time with medical questions. I rarely give an answer because when I have, inevitably, there is some piece of the puzzle missing from the story--and I've gotten burned. I've become cautious, and no, I don't give out medical advice anymore. Sorry.

Who do you trust?



Know your sources. Anecdotes--"what worked for me"--can be useful and reassuring, but I like science to back what I do and say--in the office and on the road. Go to reliable sites--the ones that use evidence based medical information: the CDC, WebMD, and MedlinePlus are a few examples. This website has a list of 100 reliable websites for medical advice. While not comprehensive, it's a good place to start. Dr Oz? Not so much. Good resources for running injuries include Runners Connect, Runners World magazine, National Institute of Arthritis, Musculoskeletal, and Skin Diseases,  and the American Academy of Orthopedic Surgeons.

You should rely on your personal medical provider, sports medicine physician, orthopedic surgeon, physical therapist, and certified trainer. And do rely on your gut. If it doesn't sound right, doesn't feel right...it isn't right. If you don't like what you're hearing, get a second opinion. But don't count on the general public or your next door neighbor who used to be a nurse or Dr Google to steer you in the right direction. I'm not saying you shouldn't do your own research. But be careful what you read.

I didn't get my diploma from Google University. And neither should you.









21 comments :

  1. A.Freakin.MEN! My daughter LOVES to google symptoms, telling me she MUST have conditions I have NEVER heard of. I've warned her to NOT do this, and if she truly IS sick let me know so we can get her an appt. with a NP/Doc.

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    1. I've been wanting to write this one for a while but after I saw that post...well, the door was open and I went in...

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  2. Great post Wendy! It's so true that we often try to diagnose ourselves through Google...I've scared myself MANY times doing this! It's so important to see/consult a doctor when you can. If I go online I usually go with WebMD. I think one time I even paid online to get a medical opinion...not doing that again!

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  3. I am guilty as charged with Google. I need a doc that doesn't tell me "everybody's tired" and "stop running". With insurance that won't cover so much as a mammogram, sadly seeking medical help is a last resort for many.

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    1. I get it, I do! But googlers need to be careful what they read...it isn't a one size fits all. And I worry more about non-medical people offering their opinions, no matter how well intentioned they are!

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  4. Wendy, I think that runners are definitely some of the worst (myself included) about Googling symptoms of injuries, etc.; I think, for the most part, we're pretty safe because these are not usually life-threatening issues. I am disturbed to think that people, like your parents, are using the internet as a means to figure out more serious health problems. I have great insurance so I tend to go to the doctor if I have something out of the ordinary or something that doesn't improve quickly; I know that not everyone has this resource and, unfortunately, I think the internet is taking up the slack. Hopefully the rise of more affordable, easily accessible, small clinics will help people with this, but it's definitely a scary thought. Thanks for sharing this!

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    1. As I said, I think it's ok to google reputable websites to get info but the problem is those people who post problems and solutions on Facebook and the like.

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  5. My husband does this and it drives me insane. You truly can't believe anything you read on the internet! I'm sure some of it is very good advice, but you can't be too careful.

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  6. YES YES YES.
    You and my husband need to have a serious ranting session about this. He gets so pissed about how much "truth" some blogs try to offer--flinging diagnoses around like Mardi Gras beads. And what he hears about in the hospital.... between paranoid runners and good ole WebMD (which no doctor trusts)... it is indeed exhausting!

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  7. People think they can find anything on Google and diagnose the problem. The internet is a wonderful thing, however I think many of us rely on it too much. -L

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  8. HA!! yes I have said before that I only look for things like PT ideas now because otherwise even a hangnail is a sign that I'm going to die!

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  9. Love this post! I google to get a general idea as to what I 'might' think it would be (like hamstring issue) but when I knew there was a serious problem and something was actually wrong I went ahead and went to PT.

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    1. Googling in general is probably ok...if you are smart about it! Sounds like you got the info you needed and did the right thing. Now I hope you get better. Fast!

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  10. Haha, I'm pretty sure you are talking about me :) When I saw that comment I just laughed and was like'WHAT?!!" Funny thing is she is a close friend of mine! I hate the fact that people do this...Dr Google is NOT your friend, we could all probably have a symptom of every disease out there. I wanted to reply to that comment but couldn't find "polite" words :) We also have a HUGE problem with this in my MRTT chapter. People are always posting their running injury symptoms and people chime in with what they THINK it is and that could lead the person down a bad road! I try to remind everyone on a constant basis that we are NOT doctors and that everyone's symptoms are not always necessarily the same and they need to be careful giving recommendations!! Great post ;)

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    1. Yep! I couldn't let that comment go. I wondered what you thought about it! Anyways, it's a post I've been wanting to write for a while, and that was the comment that finally pushed me over the edge!

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