Dear Dr. Roach: My married daughter, now 52 years of age, has for the past two years become psychotic and is on antipsychotic medication.
She makes a humming sound, which seems to be involuntary and over which she has no control. She will begin speaking, and then this sound comes from her. Did you ever hear of such a thing? Could it be her medication creating this sound? J.T.
The medical term “psychosis” has a specific meaning: “a grossly distorted sense of reality.” It’s a symptom, not a diagnosis, and severe psychosis most commonly comes from schizophrenia, although bipolar disease and, to a much lesser extent, depression both can cause psychosis. Given the time course and her age, schizophrenia is the most likely diagnosis.
Schizophrenia is a common condition (affecting almost one per cent of the world’s population) and is highly variable, with different subtypes and degrees of impairment. Repetitive speaking, singing and humming all are behaviours associated with schizophrenia. Recent studies have shown that humming can reduce the unpleasant auditory hallucinations that frequently occur with schizophrenia. It’s possible that your daughter is using the humming as a way of dealing with this symptom.
Medications for schizophrenia have many side effects, and it’s always wise to consider medications for new symptoms. In this case, I think it’s more likely to be her disease causing the symptom, or her way of dealing with the disease. I would certainly not stop her antipsychotic medication without careful discussion with her psychiatrist.
Dear Dr. Roach: My question is regarding time. I don’t mind waiting an excessive amount of time on an average followup visit with my primary care provider, providing that some of that time is spent listening to me and we are discussing more than one issue.
But I do mind waiting, to the point of considering dumping my primary for another doctor, when I’m told “I’m pressed for time, you have three minutes” after waiting an hour or more past my appointment time. My last visit in and out took 21Ú2 hours, and I wasn’t the least upset because I felt she listened to me, gave me my referral and told me her future plan of action regarding my issues.
I would like your opinion on what is a fair amount of time in and out for a visit. To wait to see your doctor and after you talk she goes to her office to process your information (enter it into her computer, write a referral and/or prescription), and she’s on her way to her next patient. M.S.
You are absolutely right to be upset about the way you were treated. Your doctor was disrespectful. You could consider discussing why you are thinking about changing doctors, but I wouldn’t blame you for just switching.
In the United States and Canada, the average time a doctor spends with a patient is about 15 to 18 minutes, depending on what study you read.
The average wait time to see the doctor is about 20 minutes. So your waiting longer than an hour and having three minutes with the doctor is inexcusable.
I have practised primary care for more than 20 years, and I know that sometimes emergencies occur. Some patients require longer appointments and that means longer waits or shorter visits for others. However, the way your doctor handles it is critical, and should include an apology, an explanation and a plan to get you the care you need and deserve.