?? epilepsy ??

Trudy trudyg at netcom.com
Fri Jun 9 10:07:58 EST 1995


Dear Doctors, I work with families on a daily basis and my primary area 
is to counsel and educate those dealing with epilepsy.  The 'denial' 
process is an expected part of the progress of the patient or family 
member..bearing in mind that there are also different levels of denial.  
It is a time the person needs to mobilize the resources necessary to deal 
with the situation. 

You may be able to locate an organization where you can match the 
patient/family with another who can provide appropriate information.  
The EFA has affiliates and Parent & Family Networks across the US.

There is a definite lack of patient education coming from physicians in
most instances and that would certainly be a first step.

Siupak Lee, M.D. (siupakmd at pc2.hinet.net) wrote:
: rkeysphd at nyc.pipeline.com (Ronald B. Keys J.D. Ph.D) wrote:

: >CAN WE CREATE INFORMATION-SEEKING BEHAVIOR IN A PATIENT AND PATIENT'S
: >FAMILY? This patient who refuses to see a physician or get necessary
: >testing sounds like a very difficult patient. With this type of problem,
: >the first step should be to counsel, educate, fight with and if necessary,
: >try to drag the patient in for an MRI for which in this case, would be a
: >MRFN (magnetic resonance functional neuroimaging). This patient needs it.
: >Patient education is an important part of a clinician's job.  

Sounds like a patient who also may be frightened, in which case, 
education *is* the key.  There is also an element of respecting the 
individuals right to making a decision not to procur treatment.

: >Breaking down a patient's defenses against treatment in order to treat the
: >patient is not an easy matter. I don't have the answers other than to have
: >all of the necessary and potential information on treatment at hand and to
: >be patient with the patient by talking and spending time with them, 
: >perhaps in a client or patient-centered context. Within the context of a
: >BIOBEHAVIORAL MEDICINE MODEL, the idea here is to create
: >information-seeking behavior in the patient and the patient's family. 

Where is your practice?....we could use someone like you in the bay area!
: > 
: I don't know much about the biobehavioral medicine model. Do you think
: you may further elaborate on this? What I do here in difficult cases
: is to try to identify the most susceptible one in the family and work
: on that person; hoping that with some "inside" force from the family
: side, the job of persuading the patient to seek proper treatment may
: be make easier.  If it is the patient himself who is denying the
: problem or who does not belive he needs treatment or further workup, I
: just have to spend more time discussing with him again and
: again....sign!

Again, referring him/her to others with epilepsy may be an alternative.

: >Perhaps we need to take a second look at how we talk to our patients,
: >altogether. 
: > 
: Yes. A lot of doctors don't know how to communicate properly,
: including me. :)

: Siupak Lee, M.D.
: siupakmd at pc2.hinet.net

PHP offers a program to health care professionals on "Better Ways" of 
talking with families.  It is a program that assists physicians in just 
that.  If you are interested, please feel free to drop me a note.

Trudy
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