[headmelted]

You're right to be cautious and fact check everything you're told. I apologise if my response becomes overly ranty. This isn't to scare you, just to encourage you that you're doing the right thing by taking such an active role in your child's care.

I have views on this that would seem to most people to be seriously conflicted.

I'm militantly pro-science, and I argue constantly in the face of anti-science and pseudo-scientific bullshit anywhere I hear it. It makes me no fun at all at parties, and even some family members groan whenever someone brings up "alternative views" to the scientific consensus on much of anything as they know I'm about to start lecturing, whether it's climate change, vaccination, flat earth (<- seriously) or most of anything else.

On the other hand, my personal experiences of how medical science is applied locally by doctors and surgeons has made me entirely disillusioned with their whole industry, and I never trust anything I'm told without confirming it for myself.

To explain, I'm based in Northern Ireland, and a debate has gone on for a long time as to whether our National Health Service (NHS) is struggling or in trouble. In reality, it has already imploded.

This isn't hyperbole. Here's an exact quote from the BBC:

"Northern Ireland has some of the worst performance figures in the UK.

During the Christmas period, the number of patients seen in four hours in A&E departments dropped to 63%.

Exactly the same proportion started their cancer treatment within 62 days, according to the latest statistics, while the numbers waiting longer than they should for a routine operation have almost doubled in the past four years."

This hits home for me really hard. In the last six years my extended family has experienced:

- Two missed cancer diagnoses. - A potentially serious (and time-sensitive) diagnosis requiring specialist follow up that was missed on two seperate occasions. - Delayed treatments for potentially life-threatening cancer of over 100% of the recommended waiting period.

Our local hospital has become known as a place more likely to kill you than help you, due to how abysmal the standard of care is. Here's a link from a couple of months ago:

https://www.irishnews.com/news/2018/03/15/news/pensioner-die...

Life threatening emergencies that arrive by ambulance are often left unattended for over four hours (this is recorded in the public record thanks to open data laws).

I sincerely hope the circumstances in the Czech Republic are better and that the doctors are much less overworked and much more capable of helping you, my intention here is just to give you encouragement that you're right in not just assuming that your child's in safe hands without you being involved.

[graycrow]

> I sincerely hope the circumstances in the Czech Republic are better and that the doctors are much less overworked and much more capable of helping you

I'm not an author of the parent comment, but i also live in the Czech Republic and can say that no, It's not any better. And based on a stories which my friends living in other countries telling me, I starting to suspect that the whole world health care system "made a wrong turn" some time ago. Looks like it's screwed everywhere, or at least for majority of the population.

[kome]

I am very happy about the professionalism and the humanity of Italian doctors and the Italian national healthcare service.

Of course there are problems, waiting lists, lack of funding. But damn, it's good and (mostly) free. I feel lucky.

Perhaps there are regional differences, but in my city, it's really good.

[ItsMe000001]

What do you base your judgment on? I think it heavily depends on what you needed services for thus far. I know people who thought just like you - until they themselves or a relative really needed them. Then they changed their opinion. But even then it depends on what exactly the issue is, I know at least one serious cancer case who got everything they could and then some for free - and they had money and shopped around, incl. specialists in the US checking out if it was worth going there for private consultations paid out of their own pocket, who told them they had top specialists right in front of them near where they lived (in Germany, a university clinic).

I think variance is big and individual examples are useless unless you have the exact same problem in the exact same locality as someone else. But I think it's safe to say that anything falling outside standardized diagnosis may not work out so great. I had to do my own research myself and beat a professor's (of medicine) prediction and amazed a few other doctors with "miracles", but I did not actually do anything special, just what I thought was kind of obvious after some research. When you fall into one of the many blind spots your experience will be bad, if you fall into one of the categories which are "standard" you'll probably be one of those people who are very satisfied by what the system provides.

One has to understand how doctors are trained and what the system they work in forces them to do (and what not to do). Once you understand that you may get more satisfaction. For example, doctors prefer treating immediate problems. If you come with a long and varied history, they don't have a time for that, and often they would not know what conclusions to draw anyway - the body is complex and even if they had a hunch, the more possibilities there are the harder it is to diagnose. Also, expectations of expectations: Doctors know (sometimes learned the hard way) that people expect miracles or at least solutions from them when in reality they themselves often don't know.

Finding the cause of a problem may take months or even years of commitment (in retrospect, after a diagnosis, it's always clear of course, "why didn't we think of that sooner"). Few patients have the resources, the patience(!) and will to slowly and iteratively work on a problem, especially when success is highly uncertain. I only solved the one I myself had because I took some very radical steps that set me back income-wise for a decade at least and cost me a few social connections. The majority of people would have gone with "placebos", symptom-covering "solutions" for immediate problems, instead of choosing the great uncertainty (and when I started it was very uncertain indeed and everybody advised me to be "reasonable" and not throw my life away to chase ghosts but listen to the doctors). If I was a doctor I would never treat someone like me - because it would be highly unlikely that the person would be as extreme as I was and give up so much of their current life for very uncertain future benefit. So what doctors offer also is a mirror of what patients expect and are willing to invest (and I don 't mean money, the time and effort under uncertainty is much harder to bear).

.

By the way, my tonsils disappeared by themselves! I went to nose and throat specialists a few times during the last decade because during my long recovery I had plenty of throat issues. At some point they wondered why my tonsils where so tiny, and during the last appointment last year or so I was asked when they had been removed - they weer gone. I never had surgery, and I'm sure I still had them a decade ago. No use asking, nobody knows what happened. They were definitely never removed (or the doctor three years ago would not still have found them to be unusually small, and the next one three years later that they were not there at all).

[kome]

> What do you base your judgment on?

The experience of various family members at different stage of their life (we had to deal with childbirth, cancers, complex surgeries, broken bones, and simply old age, etc) and my experience in living in different countries. I am happy of my city hospital.

[ItsMe000001]

> childbirth, cancers, complex surgeries, broken bones

That's all pretty standard, all of those I'd trust most modern hospitals with. Yes there can be big differences, but at least all of those are part of the standard things modern medicine excels at. Anything ER, surgery, child birth. Cancer treatment is more variable but there's standards, they know what the problem is, they know what to do for diagnosis, and treatment is pretty standardized and most variance is how much they are willing to experiment with the latest (and most expensive) treatments.

Try having anything that is systemic and not easy to see (or invisible to any biomedical imaging). Each time you have a clear diagnosis for which doctors can go to their catalog of appropriate treatments you are lucky. Anything obviously and visibly broken (incl. by using imaging tech) is "the easy stuff".

Your satisfaction also depends on how willing you are to accept whatever the doctors tell you!

If I had accepted the verdict some ten years ago I would never have found that there actually was a relatively easy to identify and treatable cause for my issues. If I had accepted the endocrinologist's recommendation for surgery to remove the nodule in my thyroid, and part of the enlarged thyroid too, I would have had a happy surgery experience, because they are good at hat. But I didn't - and the nodule disappeared and the thyroid shrank back to normal to the great amazement of the endocrinologist. I don't mean to criticize your assessment, I'm happy myself too - but I had to do all the heavy lifting myself, it's just that I know how to use "the system" and how to get what I want from it and not asking for things they are bad at delivering. If you always accept what they tell you psychologically you will be a satisfied customer and life is easy (even if the problems persist, but if you accept them as inevitable your mind learns to ignore them pretty well). If you don't know and never assume that things could be better you'll always give top-rates.

I was extremely satisfied (no exaggeration) and full of unshaken trust in all doctors for almost 40 years, and I had things like jaw surgery to correct an under-bite. I went into this surgery as if it was an appointment for a hair cut, they did not even give me anything to lower anxiety even though they had planned to - my trust was complete, and for things like surgery it still is. Only when I had a problem where there were symptoms but no known cause did I hit a wall and had a very rude awakening.

[magicalbeans]

What was the issue in the end? And how did you solve it?

[dvtv75]

> By the way, my tonsils disappeared by themselves!

You're not alone there: my partner's tonsils "dissolved" when she was younger. I've never heard of this anywhere else until now.

[isolli]

I believe you find this article interesting: https://www.nytimes.com/2015/08/11/upshot/labels-like-altern...

"My friends who believe in homeopathy don’t really care. Those who favor conventional medicine, though, can be just as blinded. Too often, when confronted with evidence that advanced technology might not be providing benefits, the medical community refuses to change its behavior."

He goes on to argue that the distinction between conventional and alternative medicine is misleading. The only distinction should be between what is proven and what is disproven.

[chrisbennet]

"By definition, Alternative Medicine has either not been proved to work, or been proved not to work. Do you know what they call Alternative medicine that's been proved to work? Medicine." --Tim Minchin

http://www.youtube.com/watch?v=ujUQn0HhGEk

[isolli]

And how would you call medicine that has been proven not to work? This is what the original discussion is about: the medical system can be too slow to recognize and stop harmful practices.

There are many examples: Thalidomide, operating on babies without anesthesia [0], intensive glucose control [1], adenoid removal (the topic here) etc.

[0] http://www.nocirc.org/symposia/second/chamberlain.html [1] https://www.nejm.org/doi/full/10.1056/NEJMoa0810625

[gowld]

"Alternative" means "unproven or disproven", doesn't it?

[Chris_Jay]

To pro-alternative folks like myself it just means "not in the medical textbooks yet". Most 'alternative' approaches do have rigorous studies backing them up, just recent and ignored by a lot of people.

[frostburg]

Homeopathy doesn't work. Acupunture doesn't work. Traditional Chinese Medicine doesn't work. Faith healing doesn't work. These rigorous studies you're mentioning do not exist.

[isolli]

This meta-study supports the use of acupuncture to treat chronic pain: https://jamanetwork.com/journals/jamainternalmedicine/fullar...

[frostburg]

The practice seems to have a (very small) effect compared to placebo or "fake" acupuncture, but the "traditonal" theory of it has no explanatory value whatsoever.

[mushtar]

What about getting allergy shots? Do you know that it was considered 'quack science' just as recently as a few decades ago? Now it's been adopted by mainstream medicine as one of the most effective ways to help deal with allergies.

Believe it or not, western medicine doesn't have all the answers, especially when it comes to chronic conditions. Thinking that steroids and antibiotics will cure IBS is quack science, and that's what's being practiced in western medicine.

[frostburg]

You have a distorted view of the methods and procedures of "western" (evidence based) medicine. It is obviously not perfect (and I'm pretty sure that you don't actually know the worst of it - the current obsession with having universal prescriptive protocols for everything is a rather clear local minimum that medical practice is stuck into), but everything else generally doesn't rise above the "not even wrong" bar.

"Western" medicine dramatically improved in the last few decades. "Alternative" medicines do not have the intellectual framework or the ability to improve.

[isolli]

I don't know, it's a matter of definition. What I know is that the article makes a good point.