Doctor shares how patients are often misdiagnosed
Patients Are Not Faking is a new trending social media campaign after
#metto. People from all over the world are sharing their missed
diagnosis experiences.
The campaign is correct as more often we ignore patient’s symptoms and they end up with complication.
Indigestion, persistent cough, shortness of breath, constipation, fever, headache, feeling tired all the time are some common symptoms that many of us experience, but their significance is often undermined in the daily rush of life. We often ignore symptoms or minimize their significance and delay going to the doctor. However, this is how our body tries to tell us that all is not well and that it’s time to see a doctor. These symptoms are important as they may be due to a disease and at times, most of these may signal a serious health condition.
Often people ignore warning signals and do not address them until they fall ill, often with grave consequences. The cardinal rule to be followed in such cases is, “Never ignore a symptom which is unusual (different than usual), unexplained or occurring for the first time in life.”
They may be red flags to consult a doctor as soon as possible. Also, a patient is faking symptoms should be last diagnosis. The commonest example of this could be the fake illness so often cited during a fight between mother-in-law and daughter-in-law. The latter mostly complains of generalized body ache and loss of energy. This is not untrue, and the underlying reason could be a vitamin D and iron deficiency, one of major reasons being an increase in the amount of household chores suddenly.
In general, about 80% of Indians have vitamin D deficiency and the symptoms of this in women include those related to osteomalacia such as body ache. The loss of energy is usually due to anemia and thus, it is important to advise them to take iron and folic acid weekly. In the Vedic Era, menstruating women used to keep a fast for Santoshi Maa. In this period, it was compulsory for them to consume jaggery and chana which are rich sources of iron and protein.
WE all know today iron and protein have to be eaten together for better iron absorption in a fasting state.
I would also like to quote from some personal experiences I have had which indicate that patients do not fake.
Sometime ago, we missed diagnosing a brain tumor in a middle-aged woman who lost her son and was in acute grief and insomnia. She was put on sedatives for six months without looking for the cause. It is important to remember that grief cannot last for more than two weeks and anything beyond should be diagnosed.
Another case in point is that of a patient who was always complaining about his wife having an illicit affair. He himself was diagnosed with brain tumor which presented in the form of acute anxiety and suspicion.
In my own case, my symptoms were ruled out as anxiety for almost 10 days since all the initial tests were normal. However, I was diagnosed with underlying lungs clots.
The takeaway here is that one must listen to the patient since they give the best diagnosis of what they are going through.
The World Medical Association has started a movement wherein it says that doctors should not examine close relatives and close friends. This is because more often than not, they tend to ignore symptoms and cannot imagine them as having or being diagnosed with a rare or a serious disease. Same is true for treating known VIPs.
It is also true that many patients come with a diagnosis of third-year syndrome. Medical students start imaging what they are taught in the third year of MBBS or patients starts imagining diseases when they surface on Google. These types of cases make the doctors feel that most people come with symptoms without an underlying disease.
No symptoms are as fake. Even these patients need to be educated to ensure that they do not end up being anxious over time.
The following are red flags. · Do not ignore first attack of acidity after the age of 40 as it may be a sign of heart attack. · Do not ignore first attack of asthma after the age of 40 as it may be a sign of heart attack. · All wheeze is not asthma and all asthmatics do not wheeze. · You may have been getting headaches for years but if the present episode of headache is unusual, severe and unexplained, you need immediate medical attention. · If you get up exhausted after hours of rest, this needs to be evaluated.
Remember the following,• Signals for emergent attention mean to call the doctor right away.
• Symptoms for urgent attention mean to contact the doctor same day.
• Symptoms for attention mean doctor to be informed in the next visit.
One should be able to differentiate emergent from urgent symptoms and signs. Emergency warrants medical attention within minutes. The window period for cardiac arrest is 10 minutes, for heart attack 3 hours, for stroke 3 hours and for stoppage of bleeding 1 hour. Stay alert to live longer and healthier
By
Dr KK Aggarwal
The campaign is correct as more often we ignore patient’s symptoms and they end up with complication.
Indigestion, persistent cough, shortness of breath, constipation, fever, headache, feeling tired all the time are some common symptoms that many of us experience, but their significance is often undermined in the daily rush of life. We often ignore symptoms or minimize their significance and delay going to the doctor. However, this is how our body tries to tell us that all is not well and that it’s time to see a doctor. These symptoms are important as they may be due to a disease and at times, most of these may signal a serious health condition.
Often people ignore warning signals and do not address them until they fall ill, often with grave consequences. The cardinal rule to be followed in such cases is, “Never ignore a symptom which is unusual (different than usual), unexplained or occurring for the first time in life.”
They may be red flags to consult a doctor as soon as possible. Also, a patient is faking symptoms should be last diagnosis. The commonest example of this could be the fake illness so often cited during a fight between mother-in-law and daughter-in-law. The latter mostly complains of generalized body ache and loss of energy. This is not untrue, and the underlying reason could be a vitamin D and iron deficiency, one of major reasons being an increase in the amount of household chores suddenly.
In general, about 80% of Indians have vitamin D deficiency and the symptoms of this in women include those related to osteomalacia such as body ache. The loss of energy is usually due to anemia and thus, it is important to advise them to take iron and folic acid weekly. In the Vedic Era, menstruating women used to keep a fast for Santoshi Maa. In this period, it was compulsory for them to consume jaggery and chana which are rich sources of iron and protein.
WE all know today iron and protein have to be eaten together for better iron absorption in a fasting state.
I would also like to quote from some personal experiences I have had which indicate that patients do not fake.
Sometime ago, we missed diagnosing a brain tumor in a middle-aged woman who lost her son and was in acute grief and insomnia. She was put on sedatives for six months without looking for the cause. It is important to remember that grief cannot last for more than two weeks and anything beyond should be diagnosed.
Another case in point is that of a patient who was always complaining about his wife having an illicit affair. He himself was diagnosed with brain tumor which presented in the form of acute anxiety and suspicion.
In my own case, my symptoms were ruled out as anxiety for almost 10 days since all the initial tests were normal. However, I was diagnosed with underlying lungs clots.
The takeaway here is that one must listen to the patient since they give the best diagnosis of what they are going through.
The World Medical Association has started a movement wherein it says that doctors should not examine close relatives and close friends. This is because more often than not, they tend to ignore symptoms and cannot imagine them as having or being diagnosed with a rare or a serious disease. Same is true for treating known VIPs.
It is also true that many patients come with a diagnosis of third-year syndrome. Medical students start imaging what they are taught in the third year of MBBS or patients starts imagining diseases when they surface on Google. These types of cases make the doctors feel that most people come with symptoms without an underlying disease.
No symptoms are as fake. Even these patients need to be educated to ensure that they do not end up being anxious over time.
The following are red flags. · Do not ignore first attack of acidity after the age of 40 as it may be a sign of heart attack. · Do not ignore first attack of asthma after the age of 40 as it may be a sign of heart attack. · All wheeze is not asthma and all asthmatics do not wheeze. · You may have been getting headaches for years but if the present episode of headache is unusual, severe and unexplained, you need immediate medical attention. · If you get up exhausted after hours of rest, this needs to be evaluated.
Remember the following,• Signals for emergent attention mean to call the doctor right away.
• Symptoms for urgent attention mean to contact the doctor same day.
• Symptoms for attention mean doctor to be informed in the next visit.
One should be able to differentiate emergent from urgent symptoms and signs. Emergency warrants medical attention within minutes. The window period for cardiac arrest is 10 minutes, for heart attack 3 hours, for stroke 3 hours and for stoppage of bleeding 1 hour. Stay alert to live longer and healthier
By
Dr KK Aggarwal