••• The Big Brother's, oops, i mean Apple's Gazette ••• A Sophisticated Periodical with Panache and a Sense of Humor
Misdiagnosis (NOT funny)
The sixties, 1960’s, was the decade of appendectomies – more appendectomies were performed in the west during the sixties, than in the last 40 years combined.
All it took was for a kid to complain of stomach ache of the lower abdomen to be diagnosed with appendicitis, then hospitalized to have the appendix removed. In most cases there was no inflammation, thus no reason to have the appendix removed, instead, lots of gas = bloating.
It was almost fashionable in the 60’s to have one’s appendix removed; the diagonal scar on the right lower abdomen was a common sight in the summer, along with string-bikinies and platform shoes.
The 1970’s was the decade of Tonsillectomies; just as with the removal of the appendix, all it took was for a child to complain of a throat-ache, before, during or after a common cold, to have its tonsils removed.
Only years later we were told that neither appendix nor tonsils were useless organs God just put into the human body because he had some left-over organs – rather part of the immune system, ergo ” endocrine glands” that have a purpose.
In the 1980’s it was in vogue – mostly in the U.S. – to be diagnosed with Epstein Bar virus. Though to this very day there has not been found any positive evidence as to the existence of such a virus, all it took was for patients to complain of tiredness to be diagnosed with Epstein Bar virus.
It seemed as though many felt left out if they didn’t have that virus, thus friends diagnosed friends, assuring their friends they have EBV, and suggested they see “their” Doctor who then diagnosed them, as well.
Treatment ? No one really knows if there was a cure for it, but the virus disappeared, cuz….. something better came along to diagnose patients with = MVP.
The 1990’s was the era of over-diagnosis of MVP ( Mitral valve prolapse) in the United States. Women and men, though mostly women, were diagnosed with MVP at an alarming rate – not by Cardiologists, though, rather internists who felt so sure their patients suffered from MVP, they didn’t even order an echo-cardiogram or sent them to a Cardiologist, even though an echo-cardiogram is pivotal for the diagnosis of MVP.
The symptoms, of those diagnosed with MVP, varied – some patients complained of tiredness, dizziness, feeling-faint, or weakness. When the blood tests came back normal and the Physician puzzled as to what the cause may be, he’d ask the patient to slightly bend over, then listened the patient’s heart with his/her stethoscope and ……hear a murmur, diagnosing the patient with MVP.
Mind you, the Physician would not order an echo-cardiogram, instead immediately prescribe
1. Beta Blockers
2. Antibiotics – to be taken prior to every dentist appointment, be it teeth cleaning or other dental procedures, to assure no bacteria would enter the blood stream, ending up at the heart valves, worsening the symptoms of mitral valve prolapse.
More than 92% of those diagnosed with MVP in the 1990’s were misdiagnosed and only a very small percentage ( less than 7% ) were eventually diagnosed correctly and recovered after receiving the appropriate treatment. Those not seeking a second opinion from a Cardiologist/(Radiologist) developed other ailments, and by the time it was found out they did not suffer from MVP, they’d already been diagnosed with new disorders, due to side effects they experienced from the medications prescribed to them ” for MVP”, which they did not have.
*Note the “common” side-affects of “Inderal”, a beta-blocker most often having been prescribed to patients diagnosed with MVP :
“Fast, slow, or uneven heartbeats – feeling light-headed, fainting- feeling short of breath, even with mild exertion – swelling of your ankles or feet – nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes) – cold feeling in your hands and feet – and ….. depression, confusion, hallucinations
The aforementioned are the “common” side effects, not the rare ones, thus patients misdiagnosed with MVP, after complaining of dizziness, weakness, feeling faint, etc. ,were prescribed medications whose “common” side-effect not only worsened their initial symptoms, but resulted in making them VERY sick, with many even questioning their “sanity”, after Physicians suggested ( since the medication didn’t work) they’re complaints may be “Psychosomatic”.
Here one of the “many” documented cases of the misdiagnosis of MVP during the 1990’s.
Patient X : Gender female, Age :mid-twenties – Symptoms : weakness, tiredness, fainting, feeling faint. Diagnosis: ( “without” echo-cardiogram) Mitral Valve Prolapse ( MVP)
Treatment: Prescription of beta-blocker, “Inderal” and antibiotics prior to teeth cleaning or any other dental procedure.
Patient X had no previous illnesses, in overall good health, outside of the complaint, see above, thus follows Doctor’s orders and takes the medications prescribed.
After a month the Symptoms begin to worsen, feeling more weak and faint than before, experiences “confusion”/ forgetfulness, can’t even remember own phone number – is beginning to start increasingly depressed due to not feeling well.
After 6 month into the treatment ( medications) Patient X gains weight, developes a yeast infection from the antibiotics taken before and after teeth cleaning, feels faint, weak, confused and instead of seeing a “Psychologist” as suggested by the patient’s Physician who feels her “new” symptoms and weight gain may be psychosomatic, Patient X goes to see a “Cardiologist” who “immediately” orders an echo-cardiogram to see if the patient really suffers from MVP.
Radiologist findings, as well the Cardiologist’s and Technician’s observation? No signs of Mitral Valve Prolapse ( MVP) with which Patient X was diagnosed and medications ( beta blockers) prescribed as treatment.
The Cardiologist takes her instantly of the medications, including the antibiotics and Patient X is feeling somewhat better, no longer confused, but still feeling increasingly faint, weak and dizzy.
This goes on for a few more “years” with the feeling of faint increasing when Patient X suddenly observes a “spider vein” underneath her left collar bone and consults with her new personal Doctor, the Cardiologist.
The Cardiologist looks at the “spider vein”, and assures her it’s “superficial” – just cosmetic.
Months pass, Patient X gets up one morning and her left arm ( upper and lower ) is three times the size of its normal size (swelled up) – is driven to the emergency room.
Emergency physicians call for a Vascular surgeon, Patient X appearing to have an acute Thrombosis. Vascular Surgeon immediately points out the very apparent “spider vein” asking Patient X how long she’s had it, to which she tells the Vascular Surgeon she’s had it for a few months and that her Doctor told her it’s just “cosmetic”.
The Vascular surgeon tells Patient X it’s not at all cosmetic” rather the symptom and sign that there is a clot.
Long story short, the Patient is placed into the ICU because a clot is found in her Subclavian vein,
causing a full blown thrombosis to her left arm, which can result in an embolism if not instantly treated. The treatment ( a solvent to resolve the clot) however, CAN cause her to have a stroke, thus has to be monitored in the ICU – and stay in the hospital for 8 days.
The problem initially diagnosed as ” MVP” turns out to be “TOC” =
Thoracic Outlet-syndrome – most probably caused by a car-accident she was in years prior, with the first rib ( upper rip underneath the left clavical bone ) having dislocated and pressing on her subclavical vein and artery.
Whenever Patient X turned her head to the right, or backwards, it caused an obstruction to the subclavian artery, with blood not flowing to the brain, thus resulting feeling faint, dizzy, etc.
Treatment: Patient X’s first rib was removed by a Thoracic Surgeon. All symptoms disappeared and Patient X has been enjoying good health since.
The latter is one of uncountable documented cases involving misdiagnosis in the United States, which brought about one of the biggest medical investigations into medical malpractice ( negligence\error) to have been conducted in the United States.
What’s alarming is that many of the Physicians having misdiagnosed Patients with MVP are still practicing medicine and continue misdiagnosing patients, most often causing patients to become even sicker then they initially were, due to the Medical Boards not acting fast enough.
A reference as to the inefficiency of many Medical Boards, here a recent article from the Los Angeles times, regarding investigations into deaths resulting from overpresciptions of pain medication, with non-actions of the Medical Board to protect people from mal-practicing Physicians.
See > http://articles.latimes.com/2013/apr/26/local/la-me-0427-rx-medical-board-20130427
The best one can do for oneself is to go to a specialist with complaints, for example: Stomach, Digestive problems ( heart burn, gas, cramps, etc) see a Gastroenterologist. Intestinal or rectal complains, see a Proctologist, and so on, and if you don’t “feel” right about a diagnosis, or not starting to feel better after treatment, know that it’s perfectly okay and encouraged by every “good” Physician to question a diagnosis and treatment, since Physicians, too, are ONLY human beings ( not all knowing Gods) who can make mistakes, thus its best for you to see a specialist or other Doctor, to get a second and even third opinion
Should a Physician respond “intimidating” to you when you ask a lot of questions, trying to make you feel inferior, as in ” I know what I’m doing, I’m the Doctor you’re ONLY a (clueless) patient” , then it’s the first sign for you to leave that Doctor and find one who treats you with “respect” = good bedside manners.
Good Physicians are patient Doctors. 😉