The challenges of medical diagnosis | Family
Medical diagnosis is recognized as both an art and a science.
Now, with access to medical information on the internet, patients have joined in the investigation process. But that can be a problem, especially if a medical study or report is misunderstood.
For example, the antiparasitic drug ivermectin has been approved by the United States Food and Drug Administration for use in animals and humans.
An article published in late 2020, which was picked up by the media, said the broad-spectrum antiparasitic had demonstrated success in a trial with antiviral activity against a number of DNA and RNA viruses, including the coronavirus. The article goes on to explain that despite this promise, the drug has yet to be proven effective in fighting a virus on a living organism.
Calls to poison control centers about exposures to ivermectin have risen dramatically in recent months, increasing fivefold since July, as people used it to fight COVID-19, according to researchers at the Centers for Disease Control and Prevention.
The FDA posted warnings on its website alerting the public not to take the drug to prevent or cure COVID-19.
Media coverage of public health issues is significant, especially during a crisis, such as the coronavirus pandemic.
But the reports are brief and cannot provide all the details of the research.
Johns Hopkins Medicine, like many hospitals, has information about health conditions and treatments online with the warning “Do not self-diagnose.”
My family doctor has listened patiently to me for the past few months as I talked about illnesses I had heard of that included symptoms similar to my nighttime itching issues.
The other day I asked my doctor, “What about lupus?”
“No,” he said, laughing. “It’s never lupus.”
He was referring to MD of the house, a TV show I hadn’t seen.
Later I found the YouTube video, Whenever it’s not lupus! — youtube.com/watch?v=QmP4DJO6IzE – with excerpts from the TV show about the many misdiagnoses of lupus.
In 2017, a study showed that 21% of patients who sought a second opinion from the Mayo Clinic came away with a completely new diagnosis.
According to a 2003 study published in the Journal of Biomedical Informatics.
To determine a diagnosis and treatment for a disease, a medical professional will order lab tests and analyze the results, review a patient’s family history, and perform a physical examination of the patient.
Early diagnosis and treatment of the disease can save lives and reduce treatment costs.
But many diseases have similar symptoms, and as more information is learned about a condition, a diagnosis may change.
A friend who was diagnosed with lupus a few years later learned, after a new doctor ordered additional tests, that she actually had Lyme disease.
And sometimes the disease is detected by chance.
My nephew David, a neurologist, recommended that I get further tests after my doctors agreed that my shingles diagnosis earlier this summer might be wrong.
After a brain MRI, a radiologist suggested further evaluation with a full-body bone scan.
After that, a senior medical oncologist ordered a CT scan and additional blood work.
He was diagnosed with chronic lymphocytic leukemia.
The process of diagnosing CLL usually begins with a routine blood test called a complete blood count.
The average age of someone diagnosed with CLL is 71.5, my age.
Although my 96-year-old father was undiagnosed, he has suffered from severe anemia, shortness of breath, and fatigue for over five years, all of which are symptoms of CLL.
About 10% of people with CLL have a family history of the disease or a related lymphoproliferative disorder.
There are two different types of LLC; one grows very slowly and the other grows faster and is a more serious disease. Between these two types of CLL, there are several subtypes that differ at the genetic level.
Tests and time will tell which type is mine.
Andy Winnegar has spent his career in rehabilitation and is based in Santa Fe as a training associate for the Southwest ADA Center.