Complex syndromes

Many of you may have had the experience of symptoms, or clusters of symptoms, for which you have not had an explanation. Fortunately, in the vast majority of cases, such occurrences are occasional and do not have a significant impact on the person's quality of life. 

Some of us, however, unfortunately live this experience regularly or constantly. For example: migraines, brain fog (which has come under the spotlight in online conversations about long Covid, yet a reality for some of us since well before, and independently of Covid-19), balance problems, hearing loss with tinnitus, livedo reticularis, temporary episodes of blurred vision (amaurosis fugax), infertility/repeated miscarriages, random joint aches and pains, unpredictable and changing bowel problems, pain that does not respond adequately (or at all!) to treatment, etc...

Sometimes it can even be difficult to figure out what kind of service, or what kind of medical professional to go seek help from. Other times, one has sought help from too many professionals, receiving an array of conflicting diagnoses and recommendations...

The words attributed to William Osler, the famous British Doctor, ring true more than ever today: "Listen to your patient! He is telling you the diagnosis!"

I will start by reconstructing the natural history of your personal, lived experience and issues with you: the timeline of the appearance of your symptoms, their duration and evolution in time, their relation with events (daily or otherwise) and with other symptoms... In short, we will construct a therapeutic conversation so that you -- the individual -- are the centre of our attention, rather than a diagnosis suspected too hastily. At the same time, we will begin discussing what your goals are, what your fears are, and what are the clinical experiences that you would absolutely wish to avoid. 

There are 69823 different diagnosis codes in ICD-10, and 10393 rare diseases/clinical entities according to a comment on Nature Reviews Drug Discovery in 2020... Navigating this wide field of knowledge that is -- at times with some uncertainty -- available to us is a delicate endeavour that requires time, and a pragmatic approach aimed at improving the individual's condition without causing further harm (Primum Non Nocere, or duty of non-maleficience).

This is what I can promise you in our therapeutic relation.

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