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A Boston group’s study offers data on cancer misdiagnosis, and how to stop the problem. According to a statement issued yesterday by Boston-based Best Doctors, Inc., cancer is commonly misdiagnosed. Though 28 percent seems disturbingly high, the release also polled doctors on why they believe misdiagnosis occurs. One thing the study made clear is that doctors and researchers, as we would hope, are not taking this problem lightly. It happened to Suzanne Summers, All the doctors in an unnamed med complex diagnosed her with stage 4 cancer 5 doctors, she got a second and third opinion from another institute it turned out negative. A few weeks ago I posted this excellent image about medical symptoms shared on my Facebook Page which proved to be very popular with my followers. It was created by a fellow teacher and blogger, Jenny on her excellent website, The English Student. What I thought I’d do with this post is to expand a little more on some of these symptoms and share the possible associated medical problems. Luckily, you haven’t broken or fractured your arm because that would cause excruciating pain or be excruciatingly painful. Sometimes, if you haven’t drunk water for a while, your throat can feel dry and worse still, parched. If I run too fast on my weekly runs I can feel my chest tighten and it takes me a while to get my breath back. If, however, your legs are weak because you’ve drunk a bit too much alcohol, you will probably have to lie down and sleep off the effects of alcohol! The expressions in blue relate to medical vocabulary and symptoms while the words in pink are adjectives we use linked to medical terms and symptoms. As a licensed Internal Medicine physician working in a community hospital in Nebraska, I love the close and personal nature of doctor-patient communication that happens during our hospital rounds.This close and trustful relationship inspired me to teach my patients everything I knew about their symptoms and medical diagnosis. As a hospitalist working in the ICU, I have had several real life experiences to convince me that accurate and timely medical diagnosis literally makes the difference between life and death. As the patient arrived in the ICU, I was immediately alarmed by the appearance of the patient. In most patients with medical diagnosis of seizures, I had to rely on someone other than the patient to get the exact sequence of events.
As soon as that thought came to my mind, I immediately ordered the nurses to stop everything they were doing and rush the patient to the CAT Scanner.
Finally, everything made sense: the sudden collapse, the low blood pressure and even the seizure.
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DisclaimerThe information I give out here should not, in any way, be considered medical advice. The above images show original Certificate issued for Mrs Urszula Renska, which states that she finished special course for diagnosis with Oberon device. Oberon is a nonlinear computer diagnostics device invented by Russian researchers from the Hospital of Senior Department of Public Health Services of Administration of Omsk Region, led by Vladimir Igorevich Nesterov. Oberon is a descendant of the original EAV (electroacupuncture) device invented in 1958 by German physician Reinhold Voll, combining Chinese acupuncture with the measurement of galvanic skin response. Oberon allows diagnosing not only pronounced pathological processes, but also the earliest forms of the diseases or predisposition to them, however it does not belong to the class of medical equipment and consequently does not have to be registered with the committees for certification and licensing of medical-purpose equipment. Oberon works with software called Metapathia - which enables visualization of human body systems and organs.
Nesse urges his colleagues and concerned members of the public to have realistic expectations at this time that the DSM is, once more, revise. Crude exogenous organic damage of the most varying kind can produce acute psychotic clinical pictures of a basically uniform kind.
The number of medical diseases that can present with psychotic symptoms (ie, delusions, hallucinations) is legion. In this article, I focus on secondary psychosis due to a medical illness or substances and not on the cognitive disorders of delirium and dementia.
A primary psychotic disorder, such as schizophrenia, is a diagnosis of exclusion, and all patients with new-onset psychosis need a medical workup that excludes medical-toxic causes of psychosis. A thorough history and physical examination with emphasis on the neurological and cognitive parts are the cornerstones for the initial approach to psychosis. Among the tests selected for screening, the most sensitive test needs to be ordered because a negative test result removes the disease from the clinician’s differential diagnosis list. If there is a strong clinical suspicion for a disease, its diagnosis must be actively pursued with repeated tests (eg, serial electroencephalograms [EEGs] for epilepsy). Of note, there is no consensus regarding the need for routine brain imaging in first-episode psychosis.
The appropriate role of routine genetic screening in patients with psychosis is an area in flux. Tay-Sachs disease (GM2 gangliosidosis type 1) and Niemann-Pick disease type C are rare storage disorders that have adult-onset variants. Other autoimmune disorders to be considered include Hashimoto encephalopathy and paraneoplastic syndromes.
Although PLE is most commonly associated with small-cell lung cancer, many other tumors have been implicated.
In a joint study between Best Doctors and the National Coalition on Health Care (NCHC), researchers found that 60.5 percent of doctors surveyed believed cancer misdiagnosis rates to be between zero and 10 percent, a number far lower than the 28 percent estimated by the BMJ Quality and Safety journal. In the study, doctors were asked for possible ways to avoid misdiagnosis, or changes that need to be made the diagnostic system. We reserve the right to remove impersonators or personal attacks, threats, profanity, or flat-out offensive comments.
I think doctors just size up if a person can take chemo and then tells them they have cancer.


I also want to offer some additional vocabulary that you can use with some of these symptoms.
Perhaps you did some strenuous exercise or overused your arm at work.The soreness normally passes. In either case, you may find that you cannot stop sneezing and have to keep blowing your nose. As we approach winter, I’m afraid more and more people will come down with heavy colds that could feel debilitating. However, I do hope that the vocabulary shared in this post is helpful for next time you have to talk about such a topic. If you did please share it and don’t forget to subscribe to my blog if you don’t want to miss out on my posts.
To my surprise, I realized people without any medical background can understand very complex medical concepts if you tell it to them in a language they understand. When patients describe their symptoms clearly and accurately to the doctor, they greatly increase the chances of getting the right medical diagnosis.
Although it is usual to have some confusion following a seizure, it is very unusual to get lightheaded. The seizure, the lightheadedness and the low blood pressure together seemed like some kind of an unusual combination of symptoms for the medical diagnosis of seizure. Sometimes, science can not completely explain how doctors make decisions based on their gut feeling. The patients themselves were mostly confused after the event or had at least some lapses in memory during the event.
I immediately called the cardiovascular surgeon and then went to the patient’s bedside to tell him what we had just discovered. Normally, aortic dissection causes pain in the chest and you only think about this medical diagnosis when someone is presenting with a symptom of chest pain. If you think about it, how easy it is to overlook a minor detail and how that can result in something catastrophic. In my opinion, this concept is fundamentally wrong and is the main reason why people get wrong medical diagnosis. The image on the right hand side states that the Oberon device, this one used by Mrs Urszula Renska, can be used on European Union territory - this is the declaration of conformity.
A thorough differential diagnosis of possible medical and toxic causes of psychosis is necessary to avoid the mistaken attribution of psychosis to a psychiatric disorder.
The overall clinical and epidemiological situation is of utmost importance in narrowing the initially rather broad differential diagnosis of psychosis to keep the workup manageable and to determine the degree of urgency. Clinicians may be unfamiliar with a disease that is rare per se (many genetic disorders fall into this category) or rare in the clinician’s practice (eg, cerebral malaria in the United States). To detect fluctuations in mental status typical for a toxic psychosis, repeated visits with bedside testing of cognition may be necessary. Finally, a positive finding on an examination or a positive laboratory test result alone (eg, a urine drug test positive for cannabis) does not establish causality. The suggested laboratory battery is a compromise between broad-based screening (eg, erythrocyte sedimentation rate for inflammatory conditions) and exclusion of some specific conditions that are treatable if diagnosed (eg, HIV infection, syphilis, thyroid disease, vitamin B12 deficiency). A normal baseline CT or MRI scan, however, is reassuring and can help patients and families accept that medical and neurological causes of illness have been excluded. Endocrine diseases are the prototype for systemic illnesses that affect the brain and lead to a wide variety of neuropsychiatric symptoms. Among the metabolic disorders, only acute intermittent porphyria (AIP) is sufficiently common to be routinely considered in patients with psychosis, particularly if abdominal complaints (colicky pain, severe constipation) and peripheral motor neuropathy are present.25,26 AIP is an autosomal dominant disease of heme synthesis that results from defects in the enzyme porphobilinogen deaminase (PBGD). A young woman who presents with psychosis that progresses to seizures, autonomic instability, and unresponsiveness should have a workup for ovarian tumors because she might have encephalitis associated with N-methyl d-aspartate (NMDA) receptor antibodies.37,38 Considering PLE in progressive or poorly responsive neuropsychiatric syndromes is critical so that a tumor search is initiated. Immigrant populations or travelers can present with diseases associated with psychosis that would be considered uncommon in the United States (eg, cerebral malaria, toxoplasmosis, neurocysticercosis, sleeping sickness).
Narcolepsy is characterized by the tetrad of excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucinations (ie, vivid auditory or visual illusions that occur when falling asleep).44 However, the full tetrad is present in only 10% of patients.
What should not be considered a reason, Best Doctors’ David Seligman says in the release, is doctor apathy or ineptitude.
On the other hand, I have watery eyes when I cut onions and they really sting or when I have a cold. When the complex medical issue at hand relates to the the real person in the patient’s room, it becomes personal.
I will describe the story of a real patient that I admitted to the ICU on my on-call day to illustrate how a timely medical diagnosis can save a life. The doctor, therefore, decided that the patient deserved a second opinion from a specialist. Most doctors get this kind of gut feeling about the seriousness of the illness by just looking at the patient. When I examined the patient, I , too, was concerned about the slightly lower blood pressure. The patient was on the operating table getting his blood vessel repaired within the next 30 minutes. Symptoms belong to the patients, not to the diseases.  You need to look at the symptoms of an individual patient who is in a unique situation and try to think what changes in the body of that patient could produce those symptoms. One organizing principle separates etiology into primary psychiatric and secondary categories, the latter includes delirium (toxic psychosis), dementia, medical illnesses, and substances (Figure) This terminology avoids the term “organic,” which implies a mind-body dichotomy that is no longer tenable.2 Psychosis can be attributable to a combination of factors, and all possible causes must be systematically examined, hence the lack of a hierarchical organization in this nosology. Psychosis is a frequent ancillary symptom of delirium that can overshadow its cardinal cognitive features.3,4 It is therefore critical to routinely consider the possibility of a delirium in any patient with psychosis.
Clinicians might also not recognize a common disease if it presents in an atypical manner (eg, HIV infection presenting with psychosis).
This point is perhaps most relevant with regard to incidental findings on a sensitive neuroimaging modality, such as a brain MRI.


If there is clinical concern for a delirium, EEGs, arterial blood gases, or lumbar punctures become more important.
These defects could result in an accumulation of the porphyrin precursors, porphobilinogen (PBG) and aminolevulinic acid (ALA).27 A diagnosis of AIP is therefore suggested by an excess of ALA and PBG in urine and a concomitant decrease in PBGD enzyme activity in erythrocytes. In addition to the patient’s geographic locale and travel history, immune status can help identify likely infectious agents. From a research standpoint, 29 percent of surveyed doctors also felt that lawmakers should offer incentives to hospitals that are gathering data and presenting research about misdiagnosis. A seizure is an abnormal brain activity that results in involuntary and sudden movement of certain parts of the body or even the whole body.
The doctor was somewhat alarmed by this combination of his symptoms and had some doubts about the medical diagnosis. He wanted to consult a Neurologist– a specialist of diseases of the brain and the nervous system. I then went ahead and asked the patient, his son and his wife about the details of the incident. Then I asked the patient if he had any confusion or loss of memory or even just a slight clouding of his thought during the event. The patient felt something, some catastrophic event in his body that happened within fractions of a second that caused him to collapse into the ground.
Luckily, he arrived at our hospital about 4 hours after the event and was operated on within 5 hours of the event.
Normally, patients and their family do not understand how much weight we put on the story they provide us. By contrast, psychosis as a result of corticosteroid treatment was diagnosed in only 5% of patients, and psychosis was thought to be from a primary psychiatric disorder in fewer than 1% of cases.
I beat cancer by a severe change to my diet, it is much easier to starve a cancer into submission then to chemo it..
This is the main goal of my book project: to teach patients the details of how medical diagnosis is made by telling them the real stories of patients they can relate to. Although it can be any type of spontaneous involuntary activity, it mostly presents as shaking or flailing with sudden fall and some degree of confusion or change in mood or behavior. This was not surprising as many patients that have seizures do not have anything  visible on a head scan that can explain the seizures. Everything checked out fine except for the fact that he had a slightly lower than normal blood pressure. But we are not able to explain it in any specific scientific terms except for saying “the patient appeared stressed” or “patient looked very sick”. Something that sudden with such an impact on the whole body had to be related to blood supply. As the tear extended all the way to his brain arteries, he collapsed and had some seizure like activity.
I will be sharing numerous real patient stories with you  on this website to tell you how we arrive at the right or the wrong medical diagnosis based on what the patients and their family tell us.
Traditionally, what people do is try to match the symptoms of the patient with known symptoms of a disease from textbooks. The doctor then reassured him and was planning to send him home but he had a hunch that the medical diagnosis did not make complete sense.
I was the on-call doctor in the nearest regional hospital that day accepting outside transfers. As I said,the rural family doctor also had a similar hunch that influenced his decision to send this patient out for further investigation to explore the medical diagnosis. In a last bid to put some sense to the thing, they looked at me and said, “But, doctor, his medical diagnosis is seizure which happens in the brain, not in the chest.” I said, “Thanks for reminding me, I will explain my reasons later, can you please move him as fast as you can to the scanner and get a CAT scan of his chest?” They reluctantly followed my order. If his blood pressure had been normal, the family doctor might not have been alarmed in the first place and he would have ended up dead. You can all help your doctor save more lives my sharing these stories with your loved ones so that they understand how doctors make medical diagnosis. This can lead to wrong medical diagnosis as symptoms are very subjective and depends on the unique features of the individual patient. If the patient did not have any symptom, that blood pressure could have been considered a low normal,” the good doctor tried to reassure himself. I am not a Neurologist but we did have Neurologist available in the hospital to consult on the case.
As it turns out, we need to listen to our inner voice when making critical decisions about medical diagnosis. The few words that he told me next gave me the second clue in making the right medical diagnosis. If the wife and the son had not individually shared their story with me, I would not have asked the right questions and he would have ended up dead too.
He had a dissection of his aorta extending into his brain arteries.” What that meant in plain English was, “This patient has a tearing of the largest blood vessel that carries blood out from the heart to the rest of the body. I felt like I was too weak to even control my own hands.” So far everyone had been focused on “what happened”.
I suddenly changed my thought process and asked what exactly did the patient feel like when it happened.
It had to be something in his chest, either his heart or his lungs or one of the major artery coming out of his heart.



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