Just been to GP - saw "hypochondriasis" on notes...

[TolpuddleFarter]

Been to see GP about some side effects I have had from a medication I was on.

Looked at the computer to see "hypochondriasis (3)" on my notes, which obviously is three times where it has been flagged that I am a hypochondriac.

Does this mean from now on I will struggle to get taken seriously?

That.

Any GP you see needs to know that you have this. As a pp said, it shouldn't mean that you get poorer treatment, but it will lead them to sensitively tease out what's happening when you report new symptoms. They're probably less likely to fob you off, if anything, as they're likely to dig a bit deeper and ask more questions.

It just shows how different we all are: I absolutely abhor the euphemistic ‘passed away’. My beloved dad died and he is now dead. He didn’t ‘pass’ into the Elysian Fields. Personally, I would appreciate any professional who didn’t flannel me with wishy-washy language about the finality of the end of life.

@TolpuddleFarter when did you stop the fluoxetine, what dosage were you on and did you taper coming off it? Hypnic jerking and ‘the brain shivers’ are withdrawal effects that can be minimised by tapering much more gradually than GPs recommend.

How much and how often do you drink? No judgement, but if you are unknowingly dependent on alcohol and over-consuming it (maybe as a way of self medicating) then it very easily could be causing the twitches on the nights you don’t drink.

I started typing “alcohol and” into Google and one of the predicted results was “leg twitching”.

Ok well let’s just say 90% of doctors I’ve come across are shit.

Is one of your medication side effects excessive sweating? I think you might have read the wrong word...and jumped to conclusions due to.., good old anxiety

I actually wasn't drinking alcohol until this started. I was on day 4 with no sleep, and Google told me that alcohol was shown to stop myoclonic jerks, so I gave it a go. It was shit sleep, but it was still sleep. I am very wary around alcohol, and feel quite ashamed that I have resorted to drinking when I have felt desperate for sleep.

I was only on fluoxetine for 12 days, and I stopped 7 days ago. This is why I wanted reassurance off the doctor because I thought the jerking would have stopped by now. (But, like I said, I think there is a vicious circle going on here now with lack of sleep and anxiety thrown into the mix.)

OP, I had the same issue of jerking awake every time I was about to fall asleep (though probably not to the same extent), which compounded my insomnia - I used to lie wide awake for hours because I knew that even if I started falling asleep I would jerk awake again. I do think that in my case it was made worse by anxiety and tiredness, so it became a really vicious circle that was difficult to get out from. Some things that I think helped me:

• I had read that fish oil pills help with twitching so I started taking one just before bed. I don't know if it genuinely helped, but the act of taking something that was meant to help made me less anxious about the jerks, and in turn it probably lessened their frequency/severity (the placebo effect works!). Also the benefit is you don't have to get them prescribed and they're not medication so no risk of side effects.
• This is easier said than done, but just reframing the jerks in your mind - when they happened I just tried to see them as something neutral or positive, like "okay this means I'm falling asleep now" rather than something threatening or a symptom of an illness. Again, if your brain sees it as something alarming, your nervous system will fire up at a time when you're trying to relax and sleep, and the jerks are more likely to continue

Eventually my jerks lessened and went away completely, and now I only get them very occasionally (touch wood!!) when I'm overly anxious or tired. I really empathise with you because I know how awful it feels, and hope you find some relief soon.

I was on high dose fluoxetine (60mg) and it caused me a lot of stiffness and like writers cramp feelings all over my body. I say caused, I already had them from largactical , an old antipsychotics I was given a long time ago. But fluoxetine made them way worse .So I think fluoxetine can do weird things to muscles and movement

I’ve never been able to read the screen when at the docs - it is facing the doc not turned towards me.

Try magnesium like others have suggested. It makes you calm and sleepy. Take it a few hours before you want to sleep then don't fight it when you start to feel it happen.

sorry to hear you’re suffering. I have ptsd that’s triggered in medical environments so I do understand.

I find it difficult to still my mind and find common eastern practices useless for me.

what really helps is gentle movement, body awareness exercises and what’s called discursive meditation best.

Yin yoga is great at releasing any trauma, it’s gentle and nurturing. Body awareness exercises (there’s loads on you tube).

Discursive meditation is really helpful. You think of a simple object to start eg a triangle then think of everything to do with that shape, are the corners sharp, what does the number 3 mean to you, does it look strong? Any thoughts that come to mind about the triangle. If your mind wanders, just slowly trace your steps backwards until you get back to the triangle.

Try breathing exercises, simple box breathing, again look on you tube, practice slowing your breath down, breathe from the belly, breathe in for 4 out for 6 in for 4 out for 8.

hard exercise can be difficult if you have anxiety as it increases your heart and breathing rate and sometimes your brain will trick itself into thinking it’s a panic attack, you can’t breathe or you’re having a heart attack. But for others it helps.

the jerking when you fall asleep is probably linked to not feeling safe and therefore trying to keep you awake. If you don’t mind me asking, do you dissociate much, not feel connected to your body fully?

Singing Vowels in an elongated way is a good way to stimulate your vagus nerve and therefore quieten the flight or flight mode.

Treat yourself well. Love and niture yourself

I've had these jerks and they are very much a symptom of severe anxiety. CBT was pretty life changing for me, if you can afford it, I'd definitely try and speak to a therapist privately.

If you do seek CBT privately make sure the CBT Therapist is BABCP accredited as this will ensure that the therapist has a post grad level CBT specific training and ongoing CBT oriented training and clinical supervision in order to reaccredit each year.

There's been a whole conversation over the last decades around how health professionals /society refers to people with different conditions.
...

We don't want to return to 'the appendix in bed 4.'...

But saying - this person with anx for example... Rather than just writing anxiety on notes..
Is pointlessly long winded... And can then block swift review kf notes by others reading the notes..

But from what the OP said the GPs notes didn't say... This patient is a hypochondriac...

They used the correct (although out of date term) hypochondriasis... (as others have said - current term is Health Anxiety.)

Often health notes will include lists of conditions they've tested for /suspect is the diagnosis.

Notes are there for communication and clarity.!

Your medical record is created for the eyes of other professionals, not yours. They need to be clear and concise so that they can be read quickly and accurately.

They're not written with the patient in mind, nor should they be. Since you agree that you DO have hypochondria, I can't quite get my head around why you're annoyed by this. Surely you need your doctors to be aware of it, in order for you to be helped accordingly?

Of course the OP is allowed to be annoyed by something written on her notes and it's been many years since people were entitled by right to request a copy of their personal data (medical records) so of course medical professionals are aware whatever they write could potentially be disclosed to the patient.

Yes we can have access to our notes now. But their primary purpose is to communicate very clearly to medical professionals. I have access to my own notes, and yes terminology can be disconcerting. But it's made very clear when you apply for access, that you may read something that is uncomfortable, and you have to tick to agree that you accept that.

Hiding information that another health professional needs to know, or couching it in woolly terms, is potentially dangerous to the patient. The priority has to be their safety.

If you're prone to anxiety, it's best not to apply for access to your notes (or to peer at the doctor's screen)

I totally disagree with this. I think it’s important to check your notes. They are often inaccurate - hospital notes are often phrased to cover the hospitals ass.

The thing is, the key purpose of these notes is for medical professionals to record information, so that other medical professionals can pick up the thread in future. This is the primary purpose. Notes have to be concise and will use medical terminology that patients are unlikely to be familiar with.

These days, doctors know patients can access their notes. This marks a change and means Doctors need to be careful to only record factual information and to avoid terminology or the past which is now not considered acceptable, and to avoid the kind of statements they once might have used when only other medical professionals would see the notes.

Some things are factual and relevant - if a patient is aggressive, inappropriate, violent, angry, rude, unco-operative. People might not like to see these things written down about themself, but they are important information to record.

Quite often people are sensitive about what is in their medical records. Sometimes they don’t understand what the terms mean or take comments as a criticism of themselves….but they are purely factual information.

It’s always a danger and a difficult balance when records of any kind can then be accessed by customers/clients etc. Misunderstandings will happen. Such records are not designed to be phrased to be understood by the lay-person. The lay-person needs to appreciate that. This is why you have to tick to acknowledge you’ve been told this. I’m sure many hours of NHS time are spent dealing with patients who have misunderstood what they’ve read. That said, it is right that people have access to these records and those keeping records are held to account to record accurately and professionally. But it is also right that they are not required to either write more lengthily in order to explain so lay-people understand, or to focus on pleasing and soothing patients in these notes, in a way which may prevent accurate and sometimes difficult information being recorded.

So we can see the notes. But we have to accept we might not always understand them.

And I do think that some people do t benefit from access to their notes. Most people are fine….they aren’t constantly reading them, or aren’t reading them with a focus on criticising medics, but just looking for relevant updates or historic info.

However, some people find the information really upsetting and difficult to manage. For some it creates worry. Others get offended. Lots choose not to access their records for these kind of reasons, and others Perhaos should consider if accessing their notes is of benefit to them personally.

[T]he key purpose of these notes is for medical professionals to record information, so that other medical professionals can pick up the thread in future. This is the primary purpose. Notes have to be concise and will use medical terminology that patients are unlikely to be familiar with.

May use. It's not actually compulsory to use terms that obfuscate the meaning for an ordinary person.

"Health anxiety" is two short, easy-to-recognise common-ish English words, 14 characters, five syllables, difficult to confuse with anything else, and an established medical term.

"Hypochondriasis" is one long, complex word, 15 characters, six syllables, could at a quick glance be confused with some other medical words, and is also an established medical term.

The benefits of the former are that the meaning is clear to a layperson, the meaning of the name actually reflects the nature of the condition, and it's a term which hasn't become stigmatised and stigmatising through years of use as an insult (which may mean patients given the diagnosis will be more likely to accept it and accept appropriate help).

The benefits of the latter are… it sounds fancy? It's got a bit more mystique and gravitas? And, I suppose, interoperability and compatability with outdated systems and clinicians, which might explain why it's showing up on OP's notes.

"Health anxiety" is concise, factual, accurate, widely-recognised medical terminology — nothing is lost by using it in place of "hypochondriasis".

Requesting a copy of your notes (Subjest access request) will often ( in cases like this ) provide you with a redacted copy of said notes - with sensitive parts covered / removed.
So you wont see the blunt, to the point language used and have your feelings hurt.

Technically that level of redaction could be challenged to the ICO unless there are very clear grounds to believe releasing the info would cause serious harm to the recipient because even if it is blunt language, it is still the requester's personal data. The ICO have advise on their website that opinions are personal data where they identify / can be used to identify a person and surely could in those circumstances.