Thursday, October 4, 2007

More on Misdiagnoses

Not to belabor this subject, but CNN had another article about misdiagnoses that I thought I would share with you. This article was about several of the most common illnesses or conditions that tend to be misdiagnosed. Here, briefly, are the five they list:

1. Aortic dissection: This is when the aorta, the main artery leading from the heart to the rest of the body, actually tears. This is obviously catastrophic, since a complete tear results in massive blood loss. But sometimes this condition is hard to diagnose, as the pain or sensation the person feels can mimic other illnesses, or even something as simple as heartburn.

I had a friend whose father died of this; the pain he felt was in his back, and he thought he had injured his spine or had a slipped disk. He went to a chiropracter for treatment. The chiropracter immediately realized something much more serious was going on, and called an ambulance, but by the time my friend's father was on the operating table, sadly it was too late.

2. Cancer: In a Harvard study of malpractice claims in the U.S., cancer was the most misdiagnosed illness.

In my previous post on oral cancer, the young chef with tongue cancer was initially misdiagnosed by his dentist. And I had a friend whose doctor kept treating her for bladder infections when all along what she had was bladder cancer. Sadly, her initial surgery did not keep the cancer at bay and she died of the disease 2-1/2 years after her diagnosis.

3. Clogged arteries: Sometimes doctors tell patients they're short of breath because they're out of shape, when it's actually coronary artery disease. Chest pain can masquerade as heartburn or a pulled muscle.

4. Heart attack: Heart attacks don't always have the "classic" symptom of severe chest pain. Sometimes the only signs of a heart attack are a feeling of pressure or fullness in the chest, nausea, tiredness or malaise. Pain can also occur in the jaw or left arm. In women, in particular, heart attacks are often misdiagnosed as women tend to have less typical symptoms of heart attack than men do.

5. Infection: In the Harvard study, infection followed cancer as the most misdiagnosed condition.

An example of this is, a friend's mother, who is a lung cancer survivor, had problems breathing after a trip to Eastern Europe. The doctor she was going to at the time thought she was having symptoms of a recurrence of cancer. As it turned out, she had an infection with Mycobacterium avium, which is an unusual type of infection.

So how can you keep yourself from becoming a victim of misdiagnosis?

1. Ask for more tests (Do your research and find out what tests are commonly prescribed for symptoms such as yours).

2. Ask, "What else could my illness be?" (And of course, do your research so that you are aware of what other illnesses it could be, and can suggest them if your doctor does not).

3. Don't assume no news is good news. This is very important; my friend with the bladder cancer had been receiving CT scans regularly as follow-ups to her cancer surgery. Apparently, she did not hear any results from the last one she had had, and somehow did not find out until 3 months later that the scan had showed enlarged lymph nodes in her abdomen. Who knows whether her outcome might have been different had she found this out sooner?

This goes for all kinds of tests, including your yearly Pap test. If you had one and don't hear from your doctor, call him or her and ask if everything was OK. And ask for copies of your lab tests, and read them carefully. If something doesn't look right, call your doctor and ask about it.

4. Assume your doctors don't talk to one another. Always tell each doctor you go to about anything going on with the other doctor: Any tests, any blood results, any scans, any symptoms. If you feel your doctors should be working together as a team, schedule a conference call.

5. Be wary when your doctors work in shifts - be sure each one passes on information to the other. And whenever possible, try to always see the same doctor even in a practice that has a number of physicians.

Sometimes you only get one chance to get your diagnosis right. Make sure you do everything that is in your own power to accomplish that.


RUTH said...

An important series of posts. For 6 months prior to Mick's bowel actually bursting he was given Gaviscon (he actually had bowel cancer) and as you probably know for 3 months he we given ear drops until he was diagnosed with brain cancer.

Mauigirl said...

Thanks, Ruth. I know, these mistakes happen all too often.