Ah, yes; I watched this one too, I think you said that you recorded it in New Zealand. Could you visit Mata Mata where they filmed part of the Lord of the rings?
@DGlaucomflecken Dr. Violin spent a non-insignificant period of time talking about journals with a non-insignificant Duchenne smile most consistent with your diagnosis of possible stage 3 J. Addict SUD. But I'm an IT guy, so this counts as data observation, not consultation. :-)
No joke, I literally had that exact ANA scenario years ago. The doctor ordered tests for everything because I had kept getting hives and he referred me to rheumatology because of my ANA. The rheumatologist barely even looked at me, she asked like 3 questions and said I didn’t need to be there and sent me a bill. And it turns out the hives were from anxiety anyway. Lol
I had a lot of mystery medical issues as a teen and my doctor and I had this running joke where I’d say “Maybe it’s lupus” and he’d say “It’s never lupus” and then I’d say “Except for that one time that it was”. For anyone wondering, no, I do not have lupus.
I have rheumatoid arthritis and you explained my disease better than any Dr. I've had to deal with. Thank you. Your enthusiasm is infectious and comforting. Wish you practiced in the US
2:24 i love being in australia. We have whats called the pharmaceutical benefits scheme. And it essentially creates a price cap on most medications that patients need out of hospital. The cap used to be 42.50, and with the last government change it is now 30 AUD. Its an amazing thing. Makes me realise how good australia can be
This is definitely true, but for rheumatology which deals with a lot of complex medical issues, a lot of medicines aren’t covered by PBS because our disorders are rare. For example, my meds have to be imported and cost at least $130 a box 😢
That’s still so much better than what Americans have to deal with. Try paying thousands per month for meds while paying a monthly premium for the privilege of having the insurance company deny meds or tests you need.
@@bobsaget3841 American here you missed the fun part of the extra stuff it doesn't cover EVEN IF YOU MEET THE DEDUCTABLE. Such as the fees for even imagining to step into any sort of healthcare facility which can be hundreds of dollars , the fees for the doctor, or entering a weewoo wagon. THEN paying hundreds for the meds.
I saw 2 rhemtologists in my life the first one at 15 did two blood tests and then told me I was faking my pain because I didn't have arthritis. The second one spent and hour with me, diagnosed my hypermobility the next visit and was shocked no one ever had me do the hypermobility tests. The second one did so much for me and I might have cried when he left the state.
I also have hypermobility. It's 20+ years delayed hypermobility diagnosis (specifically Hypermobile Spectrum Disorder, like Ehlers-Danlos Syndrome). Rheumatology didn't know about it. The electrophysiologist/cardiology who diagnosed dysautonomia also knew what to look for on physical exam for generalized hypermobility and correctly diagnosed me. Also autistic adhd undignosed, and I had sensory sensitivities to symptoms, but because of relational trauma, and not being believed or followed up with, physicians left all symptoms into "anxiety" diagnosis, so I was coping with sensory sensitivities and masking during appointments where there were differences in interoception (difficulty reporting how frequent, and how severe symptoms were on a scale 1-10). and communication differences. See "double empathy" problem. That bias is why I couldn't access appropriate healthcare until recently, and therefore, didn't have the correct accommodations in school or work, and therefore, economic loss and political effects. This is a common story, and had serious political ramifications.
Thank goodness my rheumatologist didn’t only look at my blood tests as I am sero-negative and my levels have always been normal! And yet I still have RA.
I was in the hospital for a TIA and an ANA was ordered. My result was 1:160 nucleolar. My family doc said lots of people have positive ANA and no need to worry but the hospitalist called me at home and encouraged me to follow up with a Rheumatologist. I haven’t seen one yet. I watch your videos religiously and have learned so much. Can you do a video to explain the ANA test and which results warrant a follow up with a Rheumatologist. Thx for your awesome videos and energetic and positive presentations. You are an excellent example of a doctor that really loves to help. I’m sure I can speak for all of your RU-vid Family that you are very much loved. Thx again
Omg you said your interview was a few years ago and I flashed back to crying with you when you matched 😭 crazy to see how far you've come 💕 thanks for bringing amazing, realistic, and genuine content 🤗
I'm a huge fan of Dr G and yours is one of the best reaction video I've seen. I must confess I was often distracted when you smile because your killer cheek bones stood out. They are so well defined. I'm just surprised no one has mentioned them.... Your face is the fantasy of every make-up artist to work on. I've just subscribed to your channel!
Damn, I'm so happy to live in Finland where it's not age specific if you need expensive medicine, you pay pennies compared to the actual medicine and sometimes even the price you pay is compensated. The only issue these days is to get to meet a doctor and get diagnosed for anything. Looking forward to future Glaucomflecken sketches about rheumatology being about them being really exited about new trials rather than journal clubs.
I’m glad you are aware of Rare Diseases, My Neurologist is, too. He is the one who diagnosed me with EDS, Classical type. He is also the one who takes care of my Epilepsy, which is why he’s also wanting to get me tested for Dysautonomia.
I loved this one. I was a Rheumatology researcher working with PBC isolations before going to medical school, so even if Rheum isn't my intended speciality now, it still holds a very special place in my heart.
I really like how you explain the science behind the videos and the culture of medicine. I'm taking science courses for the first time and it's cool to hear how it transfers IRL
Greetings from the UK 🇬🇧 👋 I'm a professional musician & an Arts person, but I'm finding your 'days in the life of a doctor' & all the science to be truly fascinating. I don't know how you keep up your energy & wonderful positivity though - I'm exhausted just watching you! 😁 Bravo! 👏👏👏👏👏
As a nurse who has had to hang an IV eculizumab infusion, I get it- my hands shook because you DO NOT want to have an accidental spill with something so costly 😅. However, here in Australia, ALL medications given in the public hospital system are free to the patient with a very few exceptions (like some breast cancer patients needing to self fund pertuzumab), and even trial drugs if the patient is not in the study can be accessed after trial with compassionate access. But still. Eep.
Not the same drug, but my dad was given some Very Pricy cancer drugs (some of which were still being tested or were newly approved) after his initial tumor metastisised. I've never been quite so glad to live in Finland, which also heavily subsidises the cost of medications.
I love how your reactions were SO informative! I also live in Canada and it was really interesting to hear about the rheumatology drugs and our system! I’d love to hear more about how insurance and drug billing works in our system because while I love our universal healthcare I find that sooo confusing
I really love your videos and the joy and enthusiasm you feel for your calling. The world needs doctors like you. Thru you i also discovered Dr. Glaucomflecken, and I thank you for that. Your patients can be very fortunate to have you.
omg my fav Dr. RU-vidr is reacting to my fav Dr. Tiktoker!!! love you both so much 🥺 you're both my inspiration to continue loving the medical fieeeld 💜
The fact that a person can also have a negative ANA and still have an autoimmune disorder is another reason it isn't always the best test. I had a rheumatologist completely dismiss me simply because my ANA was negative.
Just love your videos. Have no clue what was funny about these clips but it sure was entertaining watching you get a kick out of them. Hope you are well.
Could you make a video that talk about your undergrad/med school experience? I’m curious to see what are some differences between Canadian and US education systems. Also, LOVE your content. I’m a chemical engineer so I have NO idea what most of the stuff you are talking about is, but your explanations are so detailed and it’s always easy to follow 😅
This showed up as recommended video for me, and well being a person with Ankylosing Spondylitis this was a lot of fun! I feel like I've found a cozy little corner with "my people" on the RU-vid. :)
i love your content so much siobhan! ive been a fan for a few years now, and just yesterday your videos kept me alive through a 12 hour drive for my spring break 😂 keep being you ❤️❤️
I just love your enthusiasm! Your explanations, your wonderful personality was made for this! Please keep making videos! I do wish you were my physician, dreams huh ❤❤
Hi Dr. Siobhan! I would love to hear you talk about Ankylosing Spondylitis! I’m from Niagara and my Rheumatologist diagnosed me with this a few weeks ago. I’m 22 and i’m interested in learning more about it and what’s going on in my body!
Its so nice to see you going into rheumatology. My mum has it for 20 years now, shes in constant pain and no medicine helps. She went through every medicine available (also those expensive ones). I wish somebody could help her, and I hope in the future people with rheuma will suffer less. And the more doctors do with patients, the more they learn. Wish you all the best.
I loved this. 😂 I have high ANA BUT it doesn’t seem to be an active Lupus. 🤔 I lagged at the RA in the lungs part. There’s no joints there, “that we know of.” 😅
Just a comment on the ANA from the patient perspective, sorry it ended up being long and winding... My GP specifically ran an ANA when I was going thru a particularly difficult time with pain when I was 25 ( I had already been diagnosed with fibro), and he suspected I had been undiagnosed with ehlers danlos, marfan, or something of that nature and was referring me to Rheumatology even without knowing how the test would come back. It came back as a barely positive - which I did understand didn't necessarily mean anything but I thought it would be an indicator that maybe my body wasn't 100% jiving and things should be looked into since I also felt poorly enough to be actively searching for answers (like maybe running the more specific ANA tests to see if either have a big pop). I have to say that appointment was the most dismissive of my life (and I went through 15 years of doctors telling me I couldn't have endo before ending up in a 4 hour surgery at Mayo having it all cut out). She came in (no chart, no laptop to access my chart if I told her anything new), said "you don't have lupus" pressed on the fibro pain points, confirmed the diagnosis of that, didn't touch the connective tissue issue that irregardless of the test I was there to investigate, and walked out. I found out from reading the notes afterwards that she had ALSO diagnosed me the Reynaud's based on my symptomology testimony to her med student and never mentioned it to me, so I had to do a deep dive on the internet to learn about it. So, I now have a Reynaud's diagnosis, my grandmother already had a rheumatoid arthritis diagnosis, and 2 months afterwards my 3 months younger than me cousin got her lupus diagnosis. Shortly after that I had an eye appointment where my eyes were so dry my optometrist was able to bill it as a medical visit and talked to me about the tear duct plug surgery. And my dentist is at a loss as to why we seemingly can't get my gingivitis under control. So then I had to go huh, no I don't meet the symptoms of lupus, I'm not concerned about that. But I DO meet the early symptoms of Sjogren's, especially since my family seems to enjoy this particular rheumatology class. The lockdown happened before I could pursue everything further with a different doctor, so now I need to get back on that as my symptoms are again getting worse. So, while a barely positive doesn't necessarily mean anything, as the patient I'm also trusting my gut and my body in knowing that SOMTHING ISN'T RIGHT. No, I don't pretend to know what that will be in the end (heck it'll likely be something I've never heard of), I'll leave that to the doctor, but I will keep advocating for myself until I feel like a functional human or get told to forget functionality.
Ain't that a mood. Went to my doctor with pain (turns out I definitely have fibro) but I still have things that don't completely line up with fibro namely that I do have joints that hyperextend and pain/stiffness in my joints that's been getting noticeably worse since my fibro diagnosis as well as some really bad dizziness that has made me feint twice and cramps that leave me bed bound regularly in my cycle and the ONLY thing I've gotten an answer for is fibro that I have functionally been treating on my own for the last 3 years with zero help from my doctor
I love your journal club story. As a postdoc, I'm all too familiar with politics in the research world. As long as the resident was keeping professional, that might be the most honest feedback the senior researcher had gotten in a while! And as an SLE patient, it's funny thinking back to the same-day clinic doc who casually diagnosed me with lupus after a single (albeit very positive) anti dsDNA screen. That is one long, comprehensive diagnostic process!
Very grateful to live in Australia with universal health care- I take olamizumab for chronic spontaneous urticaria aka I'm allergic to every freaking thing and I break out in hives constantly. It costs about $1500 per month but I only pay $7 per dose! Grateful to my immunologist for being willing to do all the paperwork!
I must have heard wrong, because she said 25-65 it's private insurance or government funding that's different from wonderful free healthcare. And they're to encourage the expensive treatment. While in the U.S. a doctor might prescribe the genetic name. Plenty of people talk how Canadian healthcare is not great.
Wait .. did I hear that right only people age 0 too 25 only and 65 and over for universal health care?? So what do the people do for health care between the ages of 26 and 64 years? Do they have to purchase health insurance like we do in US?
@@AutobotSimmer that’s not what she said. She didn’t say push the expensive treatment. The reality is that the effective treatments for many of these relatively rare diseases ARE expensive- they’re relatively new, and have had a lot of clinical trial and production costs. Here in Australia, I give my (public/socialised healthcare, for everyone) patients IV infusions like eculizumab (among many others) and they’re free, but we know it costs our system 10s of thousands of dollars for each dose. The patient often doesn’t even know that, and as a nurse, the doctors and I don’t deal with finances- just the consultant (equivalent to an Attending in North America) sometimes needs to send of a quick online form to say they have approved that treatment. There ARE sometimes instants where because the evidence is so new, some drugs are not widely available and in those rare cases, patients have the option to self fund the usually extra treatment (because they’ll still receive the approved proven drugs). Even then, I see most of them approved for government funding or join funding with the drug company & government- under compassionate access programs. It’s an extra step but it’s there. An example would be a breast cancer patient wanting pertuzumab along with herceptin and chemo even when it’s not clear if the pertuzumab will work with their cancer testing results. Most of my patients are fully funded, and I work in oncology/haematology. For rheumatology: most medications don’t require a hospital visit, so the patient buys the medication at the pharmacy. This is where Australian funding differs. For all low income people and families, for pensioners, and those who have spent a certain amount already that calendar year on prescriptions, all approved treatments are either free or around $6 (AUD). For others, costs are highly subsidised, but newer drugs can still be expensive. Like when I started montelukast years ago, it was around $90 a month! That’s expensive! It came down in price very quickly. I now pay $21. Generics are always approved unless the specific doctor makes a case for why only the branded one will do. My mum is on an expensive immunotherapy medication for her Crohn’s disease, and that costs her $50-100 but is coming down in price too.
That’s funny, we do pay an arm and a leg, but American healthcare is phenomenal, other than the horrible bang for the buck. The US produces some of the best doctors and has medical schools like few others.
I love watching your videos, fun, informative, and you have such a good vibe! I see a beautiful violin behind you, will you maybe post a video with you playing the violin? Would love to hear
I am working as a resident in hematology and we treat patients with thrombotic microangiopathy with eculizumab. I remember that one day a bag of eculizumab got lost in our transportation system.. I think I've spent half a day phoning a dozen different people to find out where that bag got lost because the pharmacy was a bit "frightened" that we wouldn't be able to find it. :D
The Journal Club thing gives me flashbacks! When I was still in undergrad I worked summers in an agricultural Molecular Genetics lab. They had monthly JC for the whole firm, so you could be reviewing an article in Organic Chem, Cellular Bio, Mol Gen, etc. The summer between my Junior and Senior years my boss casually mentions my first week back, "Oh, by the way, I signed you up to present at Journal Club in August..." I started panicking and he laughed, reassuring me he'd help me prepare, and that everyone knew I was an intern (it was a really small firm and everyone knew everyone else) and would have "appropriate expectations" for an undergrad. I did a reasonably decent job and he was right about people being understanding. They only tortured me a little bit 😅. It did help me grow a lot as a fledgling scientist, so I was glad he pushed me out of my comfort zone.
We get so many requests for ANA, ENA and ANCA in the lab because our junior doctors in Aus just test for everything. Lupus tends to be a bit more restricted and they wait for the butterfly rash.
Also to every r a patient, my uncle had r a and was complaining with a pain in his upper back his legs were molting his gp came and gave him An injection for pain and left ,, 2 hours later my uncle died from a massive heart attack cause by a small round pocket of inflammation from his lung to his heart , if that doctor had of taken his blood pressure he would have known his blood pressure was dropping and called an ambulance, so my advice every time you see any doctor always get your blood pressure checked especially if you have pain in your upper back ,, sorry siobhan for texting so much ❤ ❤❤❤
I needed to laugh and you Delivered The Goods Siobhan! Learned a bunch too! Whenever I see your New Video in my RU-vid Mailbox, I hear those "Clapping hands" from your past excitable videos and I Jump and Pull The Rip Cord....YEEEEE HAW ! Cheers From Columbus, Ohio
I'm in Belgium. Ads for meds (not food supplements) are prohibited here as well. Also, all pain killers, even the lightest are only obtainable through a pharmacy, not in the regular drugstore. In The Netherlands this is different and you can find paracetamol and ibuprofen on the shelves.
Very interesting. In Australia lightest painkillers are in supermarkets but this will change with paracetamol soon due to overdosing on paracetamol in suicide attempts. Prescription ads are illegal in Australia
Yeah, I have RA and complications from it or the treatment have required me to see: Pain management Orthopaedics (neck inflammation) PT/OT (various) Proctology (opioid induced constipation hemorrhoids) OBGYN (pelvic muslce inflammation) Nephrology (low back pain that felt slightly different than normal joint pain) GI (NSAID irritation, nausea) Urology (pelvic inflammation again) Podiatry (ingrown nail can't heal on its own) Cardiology (pericarditis/plaquinil screening) Pulmonology (Sleep apnea screening cause of intense fatigue) Opthalmology (Plaquinil testing and opportunistic infections) Psychiatry (anxiety and depression abt illness) Just off the top of my head
Journal clubs on my fellowship program are actually sponsored by big pharma. They give us food, we talk about medications we are going to prescribe at some point, it's a win-win
Could you do a video on types of Lupus like NPSLE? My diagnosis was delayed for nearly 10 years. Turns out sometimes it IS lupus AND sometimes it’s a weird form of lupus too.
“$10-$30k per year” 😭 Just my Benlysta shot is $4k a month, not including all my other meds. That’s down from the $10k a month when it was a monthly infusion. Hurray USA 😩
Not entirely illegal: the ad can mention the drug or its effect, but not both. American channels broadcasted in Canada can run whatever advertising they want, and even side-streamed channels have to carry American drug advertising even when all other ads are replaced.
I love this, it is so funny because it is so true. ! I wish I could have you as my Lupus doctor. And yes , I was tested - blood/urine, every three months for 2 years before the Rheumatologist confirmed that I indeed had Lupus SLE. He wanted to be absolutely sure with no doubt. Unfortunately, I can not take any of medicine that you would normally get for Lupus. My "FLares" are painful.
People are always shocked when I tell them I have rheumatoid related lung disease. Yes, I know there are no joints in the lungs, ha ha. Lol I love my rheumatologist and pulmonologist, and I'm lucky that they work in offices next to one another.
I volunteer in EMS. Are there any conditions which might require an emergent rheumatologic consult? Part of our job is to figure out which hospital a pt. needs to be seen at. Generally, community hospitals closer to where the pt. lives are preferred, but we'll take anybody we suspect to have a specialty condition to a specialty hospital directly so that any care they need isn't delayed.
This happened to me! Right up to the rheumatology consult! No, I didn’t hava RA…..but my health record listed me with RA…. It lead to an order for a c-spine before surgery…. I actually had to tell them that No! I don’t have RA!
You might wanna talk about the Lupus of Selena Gomez..it was featured on her documentary including her kidney transplant😊 Thank you for your valuable content Doc.❤
Been here since year ONE. The violin brought me here years ago and stayed for the interesting subject of medicine and what goes into it. But anywho I have a request if you could bring attention to and do something on Hidradenitis Suppurativa because it sucks and no one knows what it is. Thanks .
