Tuesday, May 27, 2014

The Patient Always Tells You The Diagnosis

Today we are going to talk about some missed diagnoses, or medical disasters.

This is a lesson to go out to all Healers, wherever you are,  no matter what your healing training--to open the heart to another soul, your client or patient.

In Medical School we are taught that if we are quiet, observant, inviting, and ask the right questions to keep the patient talking, at some point eventually they are going to tell you in plain language what their diagnosis it, what is troubling them...

...it can be a classic symptom or complaint. It can be a pain. It can be a change in their energy level...

You just LISTEN with all of your medical knowledge, and your job is to 'interpret' for them what they are experiencing, and to 'diagnose' it into medical terms.

Then you can plan the course of therapy and treatment for them.

Here is an example in the E.R.:

Doctor: what brings you here today? How can I help you?

Patient: I have had this pain in my stomach that has migrated to here (points to right lower quadrant of abdomen). It really hurts. I can't eat.

Doctor: It sounds like you have appendicitis. Let's run some imaging tests and blood work to make sure before we call the surgeon.

I was in computer class and got a little creative...

In the hospital, and in medicine, if you don't laugh you are going to cry. We see so much.

The following stories are true, and easily avoidable. Watch the healer's part, and the patient's, and see 'next time' what could be done to avoid the missed diagnosis.

Rectal Exam Deferred
Patient presents for some condition, a surgical one, that is vascular. The intern comes to the hospital bed and does a history and physical. The part for the rectal examination comes up. The intern doesn't want to do it, the patient really doesn't want to have it, and since it's not related, they both agree to skip it (Rectal Exam Deferred is what is written on the H&P).
The patient presents one year later with an advanced rectal cancer that might have been picked up earlier.  (this was at a local VA)

The 'Fibroadenoma'
A young, vibrant mother of two asks her general practitioner about a lump in her breast. He chooses to monitor it. It is hard, and not fixed. Very rubbery to the examination. It is most likely a benign Fibroadenoma. There is no family history of breast cancer. Fifteen, twenty years come and go with no change. Her sister has breast cancer that was found by mammogram. Wanting peace of mind, the woman requests a surgical biopsy of the mass. It is slow-growing cancer, a Lobular breast cancer, that has advanced to the lymph nodes. Chemotherapy is initiated at the same time as mastectomy with lymph node dissection. The cancer returns as a pathologic shoulder blade fracture (mets to bone) ten years later. The woman succumbs to the cancer, with two long years of misery at the end. (this was at a local big box hospital)

A reader told me of a friend who had just been diagnosed with Stage IV (metastatic) cancer. 

The primary care physician had never run a single test, and dismissed it as 'indigestion'.

The Single Mom
A new acquaintance had her mother die of colon cancer when she was in high school. For about eight years before the diagnosis was made, the mother 'didn't feel right'. Time and again, she went to her doctor, trying to get relief from her condition. They kept telling her 'you are exhausted because you are a working single mother. You need to lose some weight. Then you will feel fine.'
She kept feeling lousy. She kept coming back. Eventually, every test was done, blood work, CT, etc. 

Except the colonoscopy. As a last resort she got it.

They couldn't even pass the endoscope because there was complete blockage of the colon by tumor. She had surgery at six a.m. the next day, and was in the hospital for the next two years, before she died. She had one complication after another, and chemotherapy too.  (this was at a local big box hospital)

The Bladder Infection
The woman of three girls had urinary urgency, frequency, stress incontinence, and hematuria.  Bladder infection was diagnosed, and many rounds of antibiotics were given to the patient, and completed.
There was no follow up with a urologist. Appointments were made, but cancelled by the patient due to babysitting needs of the grandchildren. The primary care did not insist on following through with the evaluation by a qualified specialist.
This woman had a kidney transplant ten years prior to these symptoms.
Kidney transplantation is a very big risk factor for bladder cancer.
The woman experienced complete urinary outflow obstruction the day after Christmas. Tumor had grown over the bladder neck from the inside. She had a radial cystectomy, removal of the native kidneys, and an ileal conduit to a stoma on the abdomen. She is alive today after spending over six months in and out of the hospital and rehab for c.difficile colitis and other iatrogenic conditions.
(this was at a local big box hospital)

The Doctor's Wife
This woman spoke to our freshman class in Medical School in the fall.
She experienced weight gain, hunger, hard to control diabetes, fatigue, and mood changes. She wanted to feel 'normal' again. Her husband dismissed her symptoms. She went from one specialist to the next for about ten YEARS trying to seek relief from her condition that she did not understand and did not want to have. 
Apparently her specialists did not understand her condition either!
She had a pituitary adenoma that was giving her Cushing's syndrome (too much cortisol in her body--adrenals were getting the signal to make too much).
After surgery to remove the tumor, she had complete relief of her symptoms.

These stories are not meant to scare you.

They are examples of how doctors who are not 'in touch' with their intuition, or your situation, for whatever reason, can cause harm through misdiagnosis.

Your intuition, your 'gut instinct', for yourself and those you love, are going to give you the persistence that is needed to navigate today's complex medical system.

Even if it takes longer than you might think, if something 'isn't right', keep searching for something to help diagnose and treat whatever is going on with your health.

Sometimes it takes MANY caregivers, for example, when I had brain surgery, I had a massage therapist, my medical team, and counseling to help me with my anxiety.

If I had known about Reiki back in 1990 when I had the surgery, I would have had that too.

So, in review:

  • be persistent
  • go where your heart 'senses' you are listened to--you matter
  • unfortunately, some primary care has become somewhat like the phone customer service--you have to go through a lot of people until you get to the one who can resolve the situation
  • if something doesn't 'seem right', it probably isn't
  • If you don't improve, you don't always have to 'live with it'. Keep searching until you have a very good idea what your condition is, and what is its natural course.

Aloha and Mahalos,

Reiki Doc

P.S. If your pet is acting funny, they might be on to something earlier than you--take their guidance, okay?   http://www.dogsdetectcancer.org