Re: Please - I need a contact near Anchorage AK...

August 22, 2012

Bill, this is the best I can come up with, and I'm sure you've already found

this link, which may or may not be current.

http://therapists.psychologytoday.com/rms/prof_results.php?city=Anchorage & county\

=Anchorage & state=AK & spec=251 I don't know if any of them are qualified to make a

medical dx though. Hopefully Meyer has better ideas. I hope you find what

you are looking for.

Does this mean, perchance, that someone near and dear to you is ready to

acknowledge they have AS?

- Helen

>

> ... that is, with a Clinical Psychologist - *AS savvy* - within a hour

> or so drive of Anchorage. Anybody, please?

>

> - Bill ...AS, retired geneticist

>

> --

> WD " Bill " Loughman - Berkeley, California USA

> http://home.earthlink.net/~wdloughman/wdl.htm

>

August 22, 2012

helen_foisy wrote:

> Bill, this is the best I can come up with, and I'm sure you've

> already found this link, which may or may not be current.

>

http://therapists.psychologytoday.com/rms/prof_results.php?city=Anchorage & county\

=Anchorage & state=AK & spec=251

Thanks Helen. I hadn't come up with that particular list, and it does

provide another useful, and different, perspective on the local resources.

> I don't know if any of them are qualified to make a medical dx

> though. Hopefully Meyer has better ideas. I hope you find what

> you are looking for.

>

> Does this mean, perchance, that someone near and dear to you is ready

> to acknowledge they have AS? - Helen

It would *seem* so; the tone is getting pretty urgent. But this is a

really, really tricky-dicey situation.

>

>> ... that is, with a Clinical Psychologist - *AS savvy* - within a

>> hour or so drive of Anchorage. Anybody, please?

[ snip ]

- Bill ...AS; retired geneticist

--

WD " Bill " Loughman - Berkeley, California USA

http://home.earthlink.net/~wdloughman/wdl.htm

August 22, 2012

helen_foisy wrote:

> Bill, this is the best I can come up with, and I'm sure you've

> already found this link, which may or may not be current.

>

http://therapists.psychologytoday.com/rms/prof_results.php?city=Anchorage & county\

=Anchorage & state=AK & spec=251

Thanks Helen. I hadn't come up with that particular list, and it does

provide another useful, and different, perspective on the local resources.

> I don't know if any of them are qualified to make a medical dx

> though. Hopefully Meyer has better ideas. I hope you find what

> you are looking for.

>

> Does this mean, perchance, that someone near and dear to you is ready

> to acknowledge they have AS? - Helen

It would *seem* so; the tone is getting pretty urgent. But this is a

really, really tricky-dicey situation.

>

>> ... that is, with a Clinical Psychologist - *AS savvy* - within a

>> hour or so drive of Anchorage. Anybody, please?

[ snip ]

- Bill ...AS; retired geneticist

--

WD " Bill " Loughman - Berkeley, California USA

http://home.earthlink.net/~wdloughman/wdl.htm

August 22, 2012

> My own experience with trying to address my mild AS in therapy is that topic

went nowhere, although otherwise the therapy was helpful. Psychologists in

general tend only to recognize AS as a factor when someone is *obviously*

impacted to the point of being socially and vocationally debilitated by it. They

don't " get " nuanced differences, or the exhausting uphill battle a mildly ASD

person faces every day as they try to " blend in " like a left-handed person in a

right-handed person's world.

Exactly.

We went through 4 marriage therapists, and though #3 was quite good, she didn't

get how AS affected so much of the marriage dynamic. My inability to express

myself and my sensitivities, plus my ex' poor communication, rigidity and weak

theory of mind were dismissed as minor things.

It wasn't until the last therapist, who specialized in AS marriages (one or both

partners) that the AS traits we both had impacted so much of our dynamic.

Minor example: I hate being tickled, X loves it to fetish level. He couldn't

understand I hated being tickled, because he found it so wonderful. Therefore, I

must have reasons for denying this part of myself, and that I must be repressed.

The therapist did a lot of work trying to make him see my brain and body didn't

work the way his does ... I think she was about to break through when he went

psycho.

--Liz

August 22, 2012

> My own experience with trying to address my mild AS in therapy is that topic

went nowhere, although otherwise the therapy was helpful. Psychologists in

general tend only to recognize AS as a factor when someone is *obviously*

impacted to the point of being socially and vocationally debilitated by it. They

don't " get " nuanced differences, or the exhausting uphill battle a mildly ASD

person faces every day as they try to " blend in " like a left-handed person in a

right-handed person's world.

Exactly.

We went through 4 marriage therapists, and though #3 was quite good, she didn't

get how AS affected so much of the marriage dynamic. My inability to express

myself and my sensitivities, plus my ex' poor communication, rigidity and weak

theory of mind were dismissed as minor things.

It wasn't until the last therapist, who specialized in AS marriages (one or both

partners) that the AS traits we both had impacted so much of our dynamic.

Minor example: I hate being tickled, X loves it to fetish level. He couldn't

understand I hated being tickled, because he found it so wonderful. Therefore, I

must have reasons for denying this part of myself, and that I must be repressed.

The therapist did a lot of work trying to make him see my brain and body didn't

work the way his does ... I think she was about to break through when he went

psycho.

--Liz

August 22, 2012

> My own experience with trying to address my mild AS in therapy is that topic

went nowhere, although otherwise the therapy was helpful. Psychologists in

general tend only to recognize AS as a factor when someone is *obviously*

impacted to the point of being socially and vocationally debilitated by it. They

don't " get " nuanced differences, or the exhausting uphill battle a mildly ASD

person faces every day as they try to " blend in " like a left-handed person in a

right-handed person's world.

Exactly.

We went through 4 marriage therapists, and though #3 was quite good, she didn't

get how AS affected so much of the marriage dynamic. My inability to express

myself and my sensitivities, plus my ex' poor communication, rigidity and weak

theory of mind were dismissed as minor things.

It wasn't until the last therapist, who specialized in AS marriages (one or both

partners) that the AS traits we both had impacted so much of our dynamic.

Minor example: I hate being tickled, X loves it to fetish level. He couldn't

understand I hated being tickled, because he found it so wonderful. Therefore, I

must have reasons for denying this part of myself, and that I must be repressed.

The therapist did a lot of work trying to make him see my brain and body didn't

work the way his does ... I think she was about to break through when he went

psycho.

--Liz

August 23, 2012

here... Bill... Please consider contacting me by phone about your relative's situation. So far, you haven't disclosed enough information on this list to provide parameters about what the problem or problems are, or what is being asked for. I have no interest in getting into the nitty-gritty of what's happening, but so far, what you've disclosed is about as helpful in finding a specialized, competent resource as it would be if someone needing a specific car repair to go out to a soapbox in a public square and start out with a speech saying only that they have a transportation issue. Even if the need's urgent, saying that alone isn't really much help. Especially since "dicey" really doesn't tell us much.

From what I was able to see on the linked Psychology Today listing, most of the individuals listed would be categorically unqualified to diagnose. That's helpful to know if there's any issue regarding the person's "label." Most of the persons listed are general counselors, as clearly indicated by their masters' level (or less) degrees and certifications. I'm pretty sure there wasn't a licensed clinical social worker in the bunch -- and LCSW's usually have a "broader perspective" than most mental health counselors with master's degrees. Also, there were just a tiny nbumber of persons with Ph.D. degrees, and they didn't have descriptions of their practice specific enough to be of help, especially if the person is possibly a mature individual seeking diagnosis or very specific problem-solving help.

Please consider calling. Depending on the issue(s), it may be necessary for your relative to seek professional help in the lower 48. Alaska is not known for being a hotbed for leading-edge clinical work.

N. Meyer Same time zone as you: Portland, Oregon Re: Please - I need a contact near Anchorage AK... > > >> > Bill, this is the best I can come up with, and I'm sure you've >> > already found this link, which may or may not be current. >> > http://therapists.psychologytoday.com/rms/prof_results.php?city=Anchorage & county=Anchorage & state=AK & spec=251>> >> Thanks Helen. I hadn't come up with that particular list, and it does provide another useful, and different, perspective on the local resources. > >I hope that those individuals listed are still there and can really help. My experience from living in the north is they come and go. > >My own experience with trying to address my mild AS in therapy is that topic went nowhere, although otherwise the therapy was helpful. Psychologists in general tend only to recognize AS as a factor when someone is *obviously* impacted to the point of being socially and vocationally debilitated by it. They don't "get" nuanced differences, or the exhausting uphill battle a mildly ASD person faces every day as they try to "blend in" like a left-handed person in a right-handed person's world. >> >> > Does this mean, perchance, that someone near and dear to you is ready to acknowledge they have AS? - Helen >> >> It would *seem* so; the tone is getting pretty urgent. But this is a really, really tricky-dicey situation. > >Bill I am sending out prayers and best wishes for a good outcome. I hope has some suggestions for you too. >- Helen

August 23, 2012

On 8/22/2012 6:50 PM,

rogernmeyer@... wrote:

Â

From what I was able to see on the

linked Psychology Today listing, most of the individuals

listed would be categorically unqualified to diagnose.

That's helpful to know if there's any issue regarding the

person's "label." Most of the persons listed are general

counselors, as clearly indicated by their masters' level

(or less) degrees and certifications. I'm pretty sure

there wasn't a licensed clinical social worker

in the bunch -- and LCSW's usually have a "broader

perspective" than most mental health counselors with

master's degrees. Also, there were just a tiny nbumber of

persons with Ph.D. degrees, and theyÂ didn't have

descriptions of their practice specific enough to be of

help, especially if the person is possibly a mature

individual seeking diagnosis or very specific

problem-solving help.

I don't put much stock in these listings -- they are advertising,

little more.Â Any mental health professional can add their name in

order to get visibility for their practice.Â If they know how to

spell a particular condition, they can add their name to the list of

'qualified' therapists.Â It doesn't mean that they are informed

enough about a disorder to actually treat a patient/client.

In my experience, the best referrals are usually from those who

actually have some sort of direct experience with the therapist in

that context.

Best,

~CJ

August 23, 2012

On 8/22/2012 6:50 PM,

rogernmeyer@... wrote:

Â

From what I was able to see on the

linked Psychology Today listing, most of the individuals

listed would be categorically unqualified to diagnose.

That's helpful to know if there's any issue regarding the

person's "label." Most of the persons listed are general

counselors, as clearly indicated by their masters' level

(or less) degrees and certifications. I'm pretty sure

there wasn't a licensed clinical social worker

in the bunch -- and LCSW's usually have a "broader

perspective" than most mental health counselors with

master's degrees. Also, there were just a tiny nbumber of

persons with Ph.D. degrees, and theyÂ didn't have

descriptions of their practice specific enough to be of

help, especially if the person is possibly a mature

individual seeking diagnosis or very specific

problem-solving help.

I don't put much stock in these listings -- they are advertising,

little more.Â Any mental health professional can add their name in

order to get visibility for their practice.Â If they know how to

spell a particular condition, they can add their name to the list of

'qualified' therapists.Â It doesn't mean that they are informed

enough about a disorder to actually treat a patient/client.

In my experience, the best referrals are usually from those who

actually have some sort of direct experience with the therapist in

that context.

Best,

~CJ

August 23, 2012

I'm sure Bill, with his field of expertise, is quite aware of all that, as I was

when I posted the link. Sometimes though it does lead to finding someone who

really can help, if you find a caring professional on the other end of the line

who, though they can't help, is willing to take the extra five minutes with you

since you are calling from a long ways away, and recommends someone who *can*

help who is new to that area, as did happen for me (on an unrelated issue) many

years ago. " Leave no stone unturned " as they say

- Helen

>

> > From what I was able to see on the linked Psychology Today listing,

> > most of the individuals listed would be categorically unqualified to

> > diagnose. That's helpful to know if there's any issue regarding the

> > person's " label. " Most of the persons listed are general counselors,

> > as clearly indicated by their masters' level (or less) degrees and

> > certifications. I'm pretty sure there wasn't a licensed /clinical/

> > social worker in the bunch -- and LCSW's usually have a " broader

> > perspective " than most mental health counselors with master's degrees.

> > Also, there were just a tiny nbumber of persons with Ph.D. degrees,

> > and they didn't have descriptions of their practice specific enough to

> > be of help, especially if the person is possibly a mature individual

> > seeking diagnosis or very specific problem-solving help.

> >

>

> I don't put much stock in these listings -- they are advertising, little

> more. Any mental health professional can add their name in order to get

> visibility for their practice. If they know how to spell a particular

> condition, they can add their name to the list of 'qualified'

> therapists. It doesn't mean that they are informed enough about a

> disorder to actually treat a patient/client.

>

> In my experience, the best referrals are usually from those who actually

> have some sort of direct experience with the therapist in that context.

>

> Best,

> ~CJ

>

August 23, 2012

CJ...

I'm glad YOU said it. My thoughts exactly.

It may be easiest for WD's relative to make inquiry of a person or persons they trust. If no names or referrals come up, this may indicate that there just isn't a professional in Anchorage qualified to "do the work," whatever that is.

N. Meyer

Re: Re: Please - I need a contact near Anchorage AK...

From what I was able to see on the linked Psychology Today listing, most of the individuals listed would be categorically unqualified to diagnose. That's helpful to know if there's any issue regarding the person's "label." Most of the persons listed are general counselors, as clearly indicated by their masters' level (or less) degrees and certifications. I'm pretty sure there wasn't a licensed clinical social worker in the bunch -- and LCSW's usually have a "broader perspective" than most mental health counselors with master's degrees. Also, there were just a tiny nbumber of persons with Ph.D. degrees, and they didn't have descriptions of their practice specific enough to be of help, especially if the person is possibly a mature individual seeking diagnosis or very specific problem-solving help. I don't put much stock in these listings -- they are advertising, little more. Any mental health professional can add their name in order to get visibility for their practice. If they know how to spell a particular condition, they can add their name to the list of 'qualified' therapists. It doesn't mean that they are informed enough about a disorder to actually treat a patient/client.In my experience, the best referrals are usually from those who actually have some sort of direct experience with the therapist in that context.Best,~CJ

August 23, 2012

CJ...

I'm glad YOU said it. My thoughts exactly.

It may be easiest for WD's relative to make inquiry of a person or persons they trust. If no names or referrals come up, this may indicate that there just isn't a professional in Anchorage qualified to "do the work," whatever that is.

N. Meyer

Re: Re: Please - I need a contact near Anchorage AK...

From what I was able to see on the linked Psychology Today listing, most of the individuals listed would be categorically unqualified to diagnose. That's helpful to know if there's any issue regarding the person's "label." Most of the persons listed are general counselors, as clearly indicated by their masters' level (or less) degrees and certifications. I'm pretty sure there wasn't a licensed clinical social worker in the bunch -- and LCSW's usually have a "broader perspective" than most mental health counselors with master's degrees. Also, there were just a tiny nbumber of persons with Ph.D. degrees, and they didn't have descriptions of their practice specific enough to be of help, especially if the person is possibly a mature individual seeking diagnosis or very specific problem-solving help. I don't put much stock in these listings -- they are advertising, little more. Any mental health professional can add their name in order to get visibility for their practice. If they know how to spell a particular condition, they can add their name to the list of 'qualified' therapists. It doesn't mean that they are informed enough about a disorder to actually treat a patient/client.In my experience, the best referrals are usually from those who actually have some sort of direct experience with the therapist in that context.Best,~CJ

August 23, 2012

CJ...

I'm glad YOU said it. My thoughts exactly.

It may be easiest for WD's relative to make inquiry of a person or persons they trust. If no names or referrals come up, this may indicate that there just isn't a professional in Anchorage qualified to "do the work," whatever that is.

N. Meyer

Re: Re: Please - I need a contact near Anchorage AK...

From what I was able to see on the linked Psychology Today listing, most of the individuals listed would be categorically unqualified to diagnose. That's helpful to know if there's any issue regarding the person's "label." Most of the persons listed are general counselors, as clearly indicated by their masters' level (or less) degrees and certifications. I'm pretty sure there wasn't a licensed clinical social worker in the bunch -- and LCSW's usually have a "broader perspective" than most mental health counselors with master's degrees. Also, there were just a tiny nbumber of persons with Ph.D. degrees, and they didn't have descriptions of their practice specific enough to be of help, especially if the person is possibly a mature individual seeking diagnosis or very specific problem-solving help. I don't put much stock in these listings -- they are advertising, little more. Any mental health professional can add their name in order to get visibility for their practice. If they know how to spell a particular condition, they can add their name to the list of 'qualified' therapists. It doesn't mean that they are informed enough about a disorder to actually treat a patient/client.In my experience, the best referrals are usually from those who actually have some sort of direct experience with the therapist in that context.Best,~CJ

August 23, 2012

Bill and all... [My last post on this subject..] If there's interest or need for a definitive diagnosis, the closest one can is available from a Seattle, Washington clinician. There are several clinicians in Seattle qualified to conduct a differential DX.. Most folks don't seek a differential DX. To the best of my knowledge, there isn't such a medical or Psy.D/Ph.D. capacity to do the same in Alaska. Just for info...Portland has at least a half dozen highly qualified diagnosticians for adults, two of whom are forensic [court-level] experts. If counseling is sought, it simply may not be available in Anchorage, no matter what. For that matter, good counselors anywhere are hard to find. If the individual is committed to seeking counseling, a move away from Alaska is most likely the only way to increase one's chances for finding a good match. Dat's "my take." N. Meyer Re: Re: Please - I need a contact near Anchorage AK... > >rogernmeyer@... wrote: >> here... >> >> Bill... Please consider contacting me by phone about your relative's >> situation. So far, you haven't disclosed enough information on this list >> to provide parameters about what the problem or problems are, or what is >> being asked for. I have no interest in getting into the nitty-gritty of >> what's happening, but so far, what you've disclosed is about as helpful >> in finding a specialized, competent resource as it would be if someone >> needing a specific car repair to go out to a soapbox in a public square >> and start out with a speech saying only that they have a transportation >> issue. Even if the need's urgent, saying that alone isn't really much >> help. Especially since "dicey" really doesn't tell us much. > >Oops! I jerked your chain. Abject apologies. > >But *thank you* for the response, and the offer of talking with you by >phone. I might have done that - still might at a future time, if that's >OK. But for now I have the best I can get. > >> >> From what I was able to see on the linked Psychology Today listing, >> most of the individuals listed would be categorically unqualified to >> diagnose. > [ snip ] > >Yes, I agree - categorically. I expected that (in advance) and/but like >Helen (later) I like to be comprehensive and "...leave no stone >unturned." It really was kinda "urgent"; still is. > >'Counta 'cause of the circumstances, I was vague -- deliberately. > >My own usual resources (Board-certified and State-licensed Genetic >Counselors in my previous employment) weren't readily available. So... > >But finally I have made contact with a few, and learned fershur what I >expected and you implied: There really *isn't* any good "AS-savvy" >talent around Anchorage. > >- Bill ...AS; retired geneticist > >-- >WD "Bill" Loughman - Berkeley, California USA >http://home.earthlink.net/~wdloughman/wdl.htm > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree; but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >

August 23, 2012

Bill and all... [My last post on this subject..] If there's interest or need for a definitive diagnosis, the closest one can is available from a Seattle, Washington clinician. There are several clinicians in Seattle qualified to conduct a differential DX.. Most folks don't seek a differential DX. To the best of my knowledge, there isn't such a medical or Psy.D/Ph.D. capacity to do the same in Alaska. Just for info...Portland has at least a half dozen highly qualified diagnosticians for adults, two of whom are forensic [court-level] experts. If counseling is sought, it simply may not be available in Anchorage, no matter what. For that matter, good counselors anywhere are hard to find. If the individual is committed to seeking counseling, a move away from Alaska is most likely the only way to increase one's chances for finding a good match. Dat's "my take." N. Meyer Re: Re: Please - I need a contact near Anchorage AK... > >rogernmeyer@... wrote: >> here... >> >> Bill... Please consider contacting me by phone about your relative's >> situation. So far, you haven't disclosed enough information on this list >> to provide parameters about what the problem or problems are, or what is >> being asked for. I have no interest in getting into the nitty-gritty of >> what's happening, but so far, what you've disclosed is about as helpful >> in finding a specialized, competent resource as it would be if someone >> needing a specific car repair to go out to a soapbox in a public square >> and start out with a speech saying only that they have a transportation >> issue. Even if the need's urgent, saying that alone isn't really much >> help. Especially since "dicey" really doesn't tell us much. > >Oops! I jerked your chain. Abject apologies. > >But *thank you* for the response, and the offer of talking with you by >phone. I might have done that - still might at a future time, if that's >OK. But for now I have the best I can get. > >> >> From what I was able to see on the linked Psychology Today listing, >> most of the individuals listed would be categorically unqualified to >> diagnose. > [ snip ] > >Yes, I agree - categorically. I expected that (in advance) and/but like >Helen (later) I like to be comprehensive and "...leave no stone >unturned." It really was kinda "urgent"; still is. > >'Counta 'cause of the circumstances, I was vague -- deliberately. > >My own usual resources (Board-certified and State-licensed Genetic >Counselors in my previous employment) weren't readily available. So... > >But finally I have made contact with a few, and learned fershur what I >expected and you implied: There really *isn't* any good "AS-savvy" >talent around Anchorage. > >- Bill ...AS; retired geneticist > >-- >WD "Bill" Loughman - Berkeley, California USA >http://home.earthlink.net/~wdloughman/wdl.htm > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree; but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >

August 23, 2012

Bill and all... [My last post on this subject..] If there's interest or need for a definitive diagnosis, the closest one can is available from a Seattle, Washington clinician. There are several clinicians in Seattle qualified to conduct a differential DX.. Most folks don't seek a differential DX. To the best of my knowledge, there isn't such a medical or Psy.D/Ph.D. capacity to do the same in Alaska. Just for info...Portland has at least a half dozen highly qualified diagnosticians for adults, two of whom are forensic [court-level] experts. If counseling is sought, it simply may not be available in Anchorage, no matter what. For that matter, good counselors anywhere are hard to find. If the individual is committed to seeking counseling, a move away from Alaska is most likely the only way to increase one's chances for finding a good match. Dat's "my take." N. Meyer Re: Re: Please - I need a contact near Anchorage AK... > >rogernmeyer@... wrote: >> here... >> >> Bill... Please consider contacting me by phone about your relative's >> situation. So far, you haven't disclosed enough information on this list >> to provide parameters about what the problem or problems are, or what is >> being asked for. I have no interest in getting into the nitty-gritty of >> what's happening, but so far, what you've disclosed is about as helpful >> in finding a specialized, competent resource as it would be if someone >> needing a specific car repair to go out to a soapbox in a public square >> and start out with a speech saying only that they have a transportation >> issue. Even if the need's urgent, saying that alone isn't really much >> help. Especially since "dicey" really doesn't tell us much. > >Oops! I jerked your chain. Abject apologies. > >But *thank you* for the response, and the offer of talking with you by >phone. I might have done that - still might at a future time, if that's >OK. But for now I have the best I can get. > >> >> From what I was able to see on the linked Psychology Today listing, >> most of the individuals listed would be categorically unqualified to >> diagnose. > [ snip ] > >Yes, I agree - categorically. I expected that (in advance) and/but like >Helen (later) I like to be comprehensive and "...leave no stone >unturned." It really was kinda "urgent"; still is. > >'Counta 'cause of the circumstances, I was vague -- deliberately. > >My own usual resources (Board-certified and State-licensed Genetic >Counselors in my previous employment) weren't readily available. So... > >But finally I have made contact with a few, and learned fershur what I >expected and you implied: There really *isn't* any good "AS-savvy" >talent around Anchorage. > >- Bill ...AS; retired geneticist > >-- >WD "Bill" Loughman - Berkeley, California USA >http://home.earthlink.net/~wdloughman/wdl.htm > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree; but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >

August 24, 2012

What is the difference between a definitive dx and a differential dx? Simple English please. ~ "Nobody realizes that some people expend tremendous energy merely to be normal."--Albert Camus Sent from my VZW BlackBerryFrom: rogernmeyer@...Sender: aspires-relationships Date: Thu, 23 Aug 2012 14:34:02 -0700 (GMT-07:00)To: <aspires-relationships >ReplyTo: aspires-relationships Subject: Re: Re: Please - I need a contact nearAnchorage AK... Bill and all... [My last post on this subject..] If there's interest or need for a definitive diagnosis, the closest one can is available from a Seattle, Washington clinician. There are several clinicians in Seattle qualified to conduct a differential DX.. Most folks don't seek a differential DX. To the best of my knowledge, there isn't such a medical or Psy.D/Ph.D. capacity to do the same in Alaska. Just for info...Portland has at least a half dozen highly qualified diagnosticians for adults, two of whom are forensic [court-level] experts. If counseling is sought, it simply may not be available in Anchorage, no matter what. For that matter, good counselors anywhere are hard to find. If the individual is committed to seeking counseling, a move away from Alaska is most likely the only way to increase one's chances for finding a good match. Dat's "my take." N. Meyer Re: Re: Please - I need a contact near Anchorage AK... > >rogernmeyer@... wrote: >> here... >> >> Bill... Please consider contacting me by phone about your relative's >> situation. So far, you haven't disclosed enough information on this list >> to provide parameters about what the problem or problems are, or what is >> being asked for. I have no interest in getting into the nitty-gritty of >> what's happening, but so far, what you've disclosed is about as helpful >> in finding a specialized, competent resource as it would be if someone >> needing a specific car repair to go out to a soapbox in a public square >> and start out with aspeech saying only that they have a transportation >> issue. Even if the need's urgent, saying that alone isn't really much >> help. Especially since "dicey" really doesn't tell us much. > >Oops! I jerked your chain. Abject apologies. > >But *thank you* for the response, and the offer of talking with you by >phone. I might have done that - still might at a future time, if that's >OK. But for now I have the best I can get. > >> >> From what I was able to see on the linked Psychology Today listing, >> most of the individuals listed would be categorically unqualified to >> diagnose. > [ snip ] > >Yes, I agree - categorically. I expected that (in advance) and/but like >Helen (later) I like to be comprehensive and "...leave no stone >unturned." It really was kinda "urgent"; still is. > >'Counta 'cause of the circumstances, I wasvague -- deliberately. > >My own usual resources (Board-certified and State-licensed Genetic >Counselors in my previous employment) weren't readily available. So... > >But finally I have made contact with a few, and learned fershur what I >expected and you implied: There really *isn't* any good "AS-savvy" >talent around Anchorage. > >- Bill ...AS; retired geneticist > >-- >WD "Bill" Loughman - Berkeley, California USA >http://home.earthlink.net/~wdloughman/wdl.htm > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree;but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >

August 24, 2012

What is the difference between a definitive dx and a differential dx? Simple English please. ~ "Nobody realizes that some people expend tremendous energy merely to be normal."--Albert Camus Sent from my VZW BlackBerryFrom: rogernmeyer@...Sender: aspires-relationships Date: Thu, 23 Aug 2012 14:34:02 -0700 (GMT-07:00)To: <aspires-relationships >ReplyTo: aspires-relationships Subject: Re: Re: Please - I need a contact nearAnchorage AK... Bill and all... [My last post on this subject..] If there's interest or need for a definitive diagnosis, the closest one can is available from a Seattle, Washington clinician. There are several clinicians in Seattle qualified to conduct a differential DX.. Most folks don't seek a differential DX. To the best of my knowledge, there isn't such a medical or Psy.D/Ph.D. capacity to do the same in Alaska. Just for info...Portland has at least a half dozen highly qualified diagnosticians for adults, two of whom are forensic [court-level] experts. If counseling is sought, it simply may not be available in Anchorage, no matter what. For that matter, good counselors anywhere are hard to find. If the individual is committed to seeking counseling, a move away from Alaska is most likely the only way to increase one's chances for finding a good match. Dat's "my take." N. Meyer Re: Re: Please - I need a contact near Anchorage AK... > >rogernmeyer@... wrote: >> here... >> >> Bill... Please consider contacting me by phone about your relative's >> situation. So far, you haven't disclosed enough information on this list >> to provide parameters about what the problem or problems are, or what is >> being asked for. I have no interest in getting into the nitty-gritty of >> what's happening, but so far, what you've disclosed is about as helpful >> in finding a specialized, competent resource as it would be if someone >> needing a specific car repair to go out to a soapbox in a public square >> and start out with aspeech saying only that they have a transportation >> issue. Even if the need's urgent, saying that alone isn't really much >> help. Especially since "dicey" really doesn't tell us much. > >Oops! I jerked your chain. Abject apologies. > >But *thank you* for the response, and the offer of talking with you by >phone. I might have done that - still might at a future time, if that's >OK. But for now I have the best I can get. > >> >> From what I was able to see on the linked Psychology Today listing, >> most of the individuals listed would be categorically unqualified to >> diagnose. > [ snip ] > >Yes, I agree - categorically. I expected that (in advance) and/but like >Helen (later) I like to be comprehensive and "...leave no stone >unturned." It really was kinda "urgent"; still is. > >'Counta 'cause of the circumstances, I wasvague -- deliberately. > >My own usual resources (Board-certified and State-licensed Genetic >Counselors in my previous employment) weren't readily available. So... > >But finally I have made contact with a few, and learned fershur what I >expected and you implied: There really *isn't* any good "AS-savvy" >talent around Anchorage. > >- Bill ...AS; retired geneticist > >-- >WD "Bill" Loughman - Berkeley, California USA >http://home.earthlink.net/~wdloughman/wdl.htm > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree;but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >

August 24, 2012

What is the difference between a definitive dx and a differential dx? Simple English please. ~ "Nobody realizes that some people expend tremendous energy merely to be normal."--Albert Camus Sent from my VZW BlackBerryFrom: rogernmeyer@...Sender: aspires-relationships Date: Thu, 23 Aug 2012 14:34:02 -0700 (GMT-07:00)To: <aspires-relationships >ReplyTo: aspires-relationships Subject: Re: Re: Please - I need a contact nearAnchorage AK... Bill and all... [My last post on this subject..] If there's interest or need for a definitive diagnosis, the closest one can is available from a Seattle, Washington clinician. There are several clinicians in Seattle qualified to conduct a differential DX.. Most folks don't seek a differential DX. To the best of my knowledge, there isn't such a medical or Psy.D/Ph.D. capacity to do the same in Alaska. Just for info...Portland has at least a half dozen highly qualified diagnosticians for adults, two of whom are forensic [court-level] experts. If counseling is sought, it simply may not be available in Anchorage, no matter what. For that matter, good counselors anywhere are hard to find. If the individual is committed to seeking counseling, a move away from Alaska is most likely the only way to increase one's chances for finding a good match. Dat's "my take." N. Meyer Re: Re: Please - I need a contact near Anchorage AK... > >rogernmeyer@... wrote: >> here... >> >> Bill... Please consider contacting me by phone about your relative's >> situation. So far, you haven't disclosed enough information on this list >> to provide parameters about what the problem or problems are, or what is >> being asked for. I have no interest in getting into the nitty-gritty of >> what's happening, but so far, what you've disclosed is about as helpful >> in finding a specialized, competent resource as it would be if someone >> needing a specific car repair to go out to a soapbox in a public square >> and start out with aspeech saying only that they have a transportation >> issue. Even if the need's urgent, saying that alone isn't really much >> help. Especially since "dicey" really doesn't tell us much. > >Oops! I jerked your chain. Abject apologies. > >But *thank you* for the response, and the offer of talking with you by >phone. I might have done that - still might at a future time, if that's >OK. But for now I have the best I can get. > >> >> From what I was able to see on the linked Psychology Today listing, >> most of the individuals listed would be categorically unqualified to >> diagnose. > [ snip ] > >Yes, I agree - categorically. I expected that (in advance) and/but like >Helen (later) I like to be comprehensive and "...leave no stone >unturned." It really was kinda "urgent"; still is. > >'Counta 'cause of the circumstances, I wasvague -- deliberately. > >My own usual resources (Board-certified and State-licensed Genetic >Counselors in my previous employment) weren't readily available. So... > >But finally I have made contact with a few, and learned fershur what I >expected and you implied: There really *isn't* any good "AS-savvy" >talent around Anchorage. > >- Bill ...AS; retired geneticist > >-- >WD "Bill" Loughman - Berkeley, California USA >http://home.earthlink.net/~wdloughman/wdl.htm > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree;but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >

August 24, 2012

There is confusion stems stemming from what we mean by a diagnosis. We can have

a clear diagnosis of a disease, a symptom, or a lab result. Medical

professionals very often pop out a Latin or Greek word that sounds like a

definitive diagnosis, when really it is the fancy name for a symptom. Some of

this is push from patients and families, who need a name of an enemy--something

they can blame. Some of this push comes from insurers and statisticians.

Medicine used to be able to send you for tests or consults with a differential

diagnosis.

Now, the push is for a definitive diagnosis we can code, label, track and

quantifiy, which has caused symptoms to be elevated to diagnosis status. For

instance, you used to be able to send a patient for a blood test because they

had excessive thirst, rule out diabetes. Now, because we need to send the

patient with a diagnosis before they can even get the test that makes the

diagnosis, we need to call it something so insurance will pay. We should not

call them diabetic until we have evidence they are, because diagnoses have

consequences, so we call it " polydipsia " so we can have a " diagnosis " to satisfy

the bean counters. So now the patient has a " diagnosis " --they are thirsty

because they have polydipsia (in other words, they are thirsty because they are

thirsty). Patients latch onto these as the " diagnosis " when really they have

been told nothing.

A patient usually presents with a symptom, and the name for this symptom is

usually the first " diagnosis " they get, with a list (differential diagnosis) of

possible diseases or disorders which might cause that symptom. One is usually

the most likely, and this can be called the presumptive diagnosis.

Medical examples: all of the following are definitive diagnoses, only one is a

disease--

1. excessive thirst (a symptom which could be due to diabetes, due to a side

effect from a medicine, due to another metabolic problem, fever, psychiatric

disorder, anemia, or due to a hot day--the differential list, or part of it) but

it's a 50 year old overweight guy with a family history of diabetes. We know he

has polydipsia for sure, now we have to find out why. Our initial diagnosis is

polydipsia, presumptive diagnosis is diabetes, differential is all the causes

of polydipsia above and then some. So we check the tests for causes of thirst

and the blood test finds:

2. hyperglycemia (high blood sugar, a lab finding, now a definitive diagnosis

too) which could be due to diabetes, alcohol, liver disease, steroid usage,

having just eaten or asthma attack, among other things (another differential

list) So now we know where the thirst is coming from, we have a definitive

diagnosis for that (the thirst is caused by high blood sugar). We have ruled

out other causes of thirst, such as anemia, and generated another differential

list for the lab result. We test further for other reasons for high blood sugar

and find none, so the ultimate definitive diagnosis is...

3. diabetes (a disease).

The " which could be due to... " is the differential diagnosis (what different

things are on the list of possible causes?)

So if someone has anger management problems, for instance, the differential

includes seizures, a brain tumor, an adrenal tumor, a stroke, depression,

bipolar disorder, an explosive disorder, an autistic meltdown, or a

hypersensitive spouse (not a complete list). The first " diagnosis " will be

anger management problems, the differential is what might have caused it, and

the definitive diagnosis (usually something from the differential list, unless

you are House) requires observational time and testing (and sometimes,

you never get a definitive diagnosis).

Hope this helps.

> What is the difference between a definitive dx and a differential dx? Simple

English please.

> ~

>

> " Nobody realizes that some people expend tremendous energy merely to be

normal. "

> --Albert Camus

>

> Sent from my VZW BlackBerry

> From: rogernmeyer@...

> Sender: aspires-relationships

> Date: Thu, 23 Aug 2012 14:34:02 -0700 (GMT-07:00)

> To: <aspires-relationships >

> ReplyTo: aspires-relationships

> Subject: Re: Re: Please - I need a contact near

Anchorage AK...

>

> Bill and all...

> [My last post on this subject..]

>

> If there's interest or need for a definitive diagnosis, the closest one can is

available from a Seattle, Washington clinician. There are several clinicians in

Seattle qualified to conduct a differential DX.. Most folks don't seek a

differential DX. To the best of my knowledge, there isn't such a medical or

Psy.D/Ph.D. capacity to do the same in Alaska.

>

> Just for info...Portland has at least a half dozen highly qualified

diagnosticians for adults, two of whom are forensic [court-level] experts.

>

> If counseling is sought, it simply may not be available in Anchorage, no

matter what. For that matter, good counselors anywhere are hard to find. If the

individual is committed to seeking counseling, a move away from Alaska is most

likely the only way to increase one's chances for finding a good match.

>

> Dat's " my take. "

>

> N. Meyer

>

> Re: Re: Please - I need a contact near

Anchorage AK...

> >

> >rogernmeyer@... wrote:

> >> here...

> >>

> >> Bill... Please consider contacting me by phone about your relative's

> >> situation. So far, you haven't disclosed enough information on this list

> >> to provide parameters about what the problem or problems are, or what is

> >> being asked for. I have no interest in getting into the nitty-gritty of

> >> what's happening, but so far, what you've disclosed is about as helpful

> >> in finding a specialized, competent resource as it would be if someone

> >> needing a specific car repair to go out to a soapbox in a public square

> >> and start out with a speech saying only that they have a transportation

> >> issue. Even if the need's urgent, saying that alone isn't really much

> >> help. Especially since " dicey " really doesn't tell us much.

> >

> >Oops! I jerked your chain. Abject apologies.

> >

> >But *thank you* for the response, and the offer of talking with you by

> >phone. I might have done that - still might at a future time, if that's

> >OK. But for now I have the best I can get.

> >

> >>

> >> From what I was able to see on the linked Psychology Today listing,

> >> most of the individuals listed would be categorically unqualified to

> >> diagnose.

> > [ snip ]

> >

> >Yes, I agree - categorically. I expected that (in advance) and/but like

> >Helen (later) I like to be comprehensive and " ...leave no stone

> >unturned. " It really was kinda " urgent " ; still is.

> >

> >'Counta 'cause of the circumstances, I was vague -- deliberately.

> >

> >My own usual resources (Board-certified and State-licensed Genetic

> >Counselors in my previous employment) weren't readily available. So...

> >

> >But finally I have made contact with a few, and learned fershur what I

> >expected and you implied: There really *isn't* any good " AS-savvy "

> >talent around Anchorage.

> >

> >- Bill ...AS; retired geneticist

> >

> >--

> >WD " Bill " Loughman - Berkeley, California USA

> >http://home.earthlink.net/~wdloughman/wdl.htm

> >

> >------------------------------------

> >

> > " We each have our own way of living in the world, together we are like a

symphony.

> >Some are the melody, some are the rhythm, some are the harmony

> >It all blends together, we are like a symphony, and each part is crucial.

> >We all contribute to the song of life. "

> > ...Sondra

> >

> > We might not always agree; but TOGETHER we will make a difference.

> >

> > ASPIRES is a closed, confidential, moderated list.

> >Responsibility for posts to ASPIRES lies entirely with the original author.

> > Do NOT post mail off-list without the author's permission.

> > When in doubt, please refer to our list rules at:

> > http://www.aspires-relationships.com/info_rules.htm

> > ASPIRES ~ Climbing the mountain TOGETHER

> > http://www.aspires-relationships.com

> >

August 24, 2012