Health and Psychology

I will frequently ask new patients to get copies of their laboratory results and a copy of the note from their complete physical. I’m often met with the response that “The doctor said everything was fine.” Or “The doctor said everything was normal.”

In the last several cases in the past year where I have requested laboratory studies and a complete physical note, and have been told “everything was normal” what’s been present has ranged from chronic infection, signs of advanced alcoholism, endocrine and autoimmune problems to end stage lung disease. It’s been more heart breaking in past years where it was usually malignancy and end stage illness.

When I was initially trained in health and medical psychology, it was a new field. The idea was that psychologists would be used as physician extenders. We were taught how to read laboratory data and taught to understand clinical presentations of medical issues. I have a 10-page handout on hands alone and what they look like in various disease states. We went through the entire body like that. We were taught how to evaluate blood pressure, pulse and temperature. From there some of us went on to specialize in health psychology-how to maintain health, lower stress, lose weight, stop smoking, improve diet and exercise. Others specialized in chronic, serious and terminal illness and undiagnosed medical conditions.

For the first couple of years of my practice I worked in a family practice physician’s office. He had a handful of patients that weren’t getting better from what he thought was wrong with them. So I went through his charts on them. Pointing out the laboratory abnormalities he thought were minimal. I advised follow-up studies. ALL of the “minor” laboratory abnormalities resulted in diagnosis of disease states. Of these, about 80% were complaining of either anxiety or depression and had been prescribed medication to cope with “stress.” Once the underlying medical conditions were diagnosed and correctly treated, the “anxiety” and “depression” resolved. In addition the physician improved. He started seeing the same things I was seeing, the darkening of the skin around the neck that’s the hallmark of polycystic ovary syndrome, the paleness of the conjunctiva and gums that marks anemia, the subtle skin coloring changes of cardiovascular and pulmonary disease, the headaches referred to as migraines without the hands being cold that may signify malignancy. (That one caught my husband’s cancer; he’d been misdiagnosed with migraines for 20 years when we met.)

In the 1990’s the field moved away from the idea of psychologists as physician extenders. Psychologists in medical psychology moved into hospital units to manage psychological effects of intensive care, asthma and chronic obstructive pulmonary disease, behavioral cardiology and diabetes. I’ve led groups for people with COPD and AIDS.

If you’ve been sick for awhile and your labs are reported to be “normal” get a copy. I offer a free consultation on laboratory findings. From there you can either collect data to take back to your physician or understand what the findings mean.