Doing It for Attention

In response to my previous post, I received a number of comments and feedback which included assertions that individuals who engage in repetitive self-injury in correctional settings are “doing it for attention.”  That got me thinking.  And the more thinking I did, the more I realized that these statements are likely true.  But, not necessarily in the way one would think.  Let me explain.

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Diuretics for Swollen Legs? Not!

Originally printed September 2012

I recently had several women inmates at one of my jails complain that their legs were swollen and request a “water pill” to get rid of the swelling. This happens now and again at the jails and seems to occur in waves; I will see a bunch of requests for water pills to help leg swelling, then nothing for a while, then it recurs. Having the suspicious mind that I do, I often suspect that the real reason for the water pill request is weight loss.Once, in fact, an inmate admitted that the women in her dorm were having a weight loss contest and that was why we were seeing so many complaints of constipation and water retention.

However, some patients have simply been taught by other medical providers, either in corrections or out, that the reason that their legs swell at the end of the day is “fluid retention” and the solution is “water pills.” Both notions are wrong for the vast majority of the patients I see.  The cause of their ankle swelling is NOT fluid retention and diuretic “water pills” will not help them. Continue reading