An easy way to avoid misdiagnosing your patient!

I hate to repeat myself but I feel that too many young adult, middle-aged, and elderly minds are at stake!

Why not take one minute to check “control of breathing” mechanisms to make sure they are intact and avoid misdiagnosing the patient with an incorrect psychiatric diagnosis.

Apparently, acid base syndromes are very common. Doctors are discovering more hypoventilation syndromes as they begin to remember about the respiratory pump system, in addition to the lung.

The signs and symptoms of respiratory acidosis are non specific, just like the signs of mood and psychotic disorders. So why not investigate the birth and paediatric physical history and the physical history right before the acute attack? Why not check all the vital signs? Why not get minute ventilation measurements? And if abnormal, then why not arterial blood gas tests – the only test that can tell for sure if PC02 is abnormal?

Sure, then one would have to look at this health problem differently and look at the current treatments from a different perspective.

For example, did you know that SSRI’s [like Paxil] are shown to improve memory? The same serotonin agonists also help the ventilatory system [and every other system of the body including bone metabolism] although it is not yet understood how it does this.

And electroshock therapy might just improve tidal volume for all we know.

If counting respiratory rate in the mentally ill and depressed helps to treat them and to cure them of their mental illness, then why not try and see if this hypothesis is relevant to major depression and/or bipolar depression?

Paula counts her respiratory rate every day. It is the same every day. Paula suspects that when she gets short-lived attacks of autobiographical memory loss, she may need to increase her Paxil slightly or she might need to lower her lithium slightly or she might need short term periods of home ventilation or whatever else will be invented to deal with acute on chronic hypercapnia and hypercapnic encephalopathy.

This hypothesis is very easy to test in unmedicated dysphoric depressed-looking confused patients.

I know I am repeating myself but I do not understand why doctors [all subspecialties] are so sloppy in checking for normal or abnormal physiological signs.

Why not take one minute to check “control of breathing” mechanisms to make sure they are intact and avoid misdiagnosing the patient with an incorrect psychiatric diagnosis.

To be continued………….

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