missed, turtle wins

MISSED
from yahoo.com/motley fool
they had an article recently on the 5  most misdiagnosed diseases
except for no 1 i dont recall misdiagnosing the no 2-5
im sure over a career of 30 years that i may have missed things
but theres not a case that stands out

over the 30 years i never was sued or reprimanded by the medical
board or insurance companies
i did make patients mad at times and i definitely made my nurses
real mad at times
just ask them

hoax-slayer.com
here is the list
5   cardiovascular disease-things like stroke heart attacks aortic
aneurysm angina tia
preventative measures like controlling blood pressure and cholesterol
have been shown to prevent these things
the problem sometimes would be convincing patients to eat correctly
exercise maintain a normal body weight and if needed take medications
for their blood pressure and or their cholesterol

it sometimes was hard to convince a non symptomatic patient to take
a medication with its cost and side effects
those who did though helped themselves a lot
usually the ones that didnt do it were men

but an episode of of a tia or a heart attack scare or a family member
who died or had a heart attack or stroke would usually bring them back
in for treatment

4.   pulmonary embolism-miss this one and the patient usually a young
healthy patient can die
i always kept a high level of suspicion for these and luckily for me and
several young patients they were diagnosed early before things got worse
these usually start with a deep vein thrombosis or blood clot in the leg

3.   myocardial infarction-thats a heart attack
i always had a rule if someone came in with chest pain they had to be
proven to not be having a heart attack
in my career i picked up on a teenager and a young new mother who
were having one
i personally dont recall missing a heart attack

2.   neoplasm-cancer
the most misdiagnosed cancer is melanoma
i remember finding them on patients some that even the dermatologists
didnt think was a melanoma
one patient insisted that a lesion on her leg was not normal
i thought it was ok but went ahead and biopsied it
yep it was melanoma she ended up at md anderson and at the ten year
mark she is cancer free
i also picked up on cancer sometimes just from seeing patients with
vague symptoms but believing as did the patient that something was
wrong
some of these cancers if picked up early are curable if delayed
they are fatal

1.   infections
we all doctors are guilty of this one
misdiagnosing viral infections as bacterial infections
why does this happen
patient demands
drug company pressures and incentives
people want to get well quickly

although i dont recall missing bad infections like meningitis or
or bad pneumonia

eventually testing will be available to tell doctors whether these infections
are viral or bacterial
then if bacterial the proper antibiotic can be given
thats a big problem looming over medicine
the resistance of infections to our antibiotics with no new antibiotics
really looming in the near future

so in summary
i did real good in my career i think because i always had this rule
prove in your mind and your patients that this is not a stroke or heart attack
or blood clot in the lung or cancer or meningitis
i didnt do well with the viral infection thing

so i would give  myself an 80% rating for my career

TURTLE WINS
kr a facebook friend posted this one
it made me smile since just last week as this happened when i
was driving i thought the same thing

i take great pleasure in watching crazy drivers zip in and out of
traffic passing me as they speed by going down the highway
only to find them right beside me at the red light

turtle wins

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the organicgreen doctor