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Experts: Certain diseases are misdiagnosed often
To help guard against misdiagnosis, don't be afraid to push for more tests
Make sure all your doctors talk to one another, share informationBy Elizabeth Cohen
Empowered Patient is a regular feature from CNN Medical News correspondent Elizabeth Cohen that helps put you in the driver's seat when it comes to health care.
ATLANTA, Georgia -- The celebrity was John Ritter.
The actor died in 2003 of an aortic dissection -- a tearing of the major artery that comes out of the heart. His widow later settled a wrongful death lawsuit against a California hospital, alleging his condition had been misdiagnosed "at least twice."
Experts who study malpractice cases and autopsy reports say certain diseases are misdiagnosed over and over again. It's worth knowing what they are so you won't be a victim.
1. Aortic dissection: Sometimes aortic dissections are easy to diagnose -- a patient feels a distinct tearing sensation in his or her chest. But other times they're pretty easy to miss because the symptoms could point to other diseases, says Dr. Robert Bonow, past president of the American Heart Association. "Sometimes it feels like heartburn," he says.
2. Cancer: In a Harvard study of malpractice claims in the U.S., cancer was far and away the most misdiagnosed illness, primarily breast and colorectal. Study authors attributed this to doctors failing to stick to cancer screening guidelines.
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, says Bonow, who's also the chief of cardiology at Northwestern Medical School.
4. Heart attack: Sound strange? How could a doctor miss a heart attack? Bonow says the big and obvious attack -- the one where someone clutches his or her chest and falls to the floor, the one Bonow calls "the Hollywood heart attack" -- isn't always so clear. Sometimes the only signs of a heart attack are a sense of fullness in the chest, nausea and a general sense of not feeling well.
5. Infection: In the Harvard study, infection followed cancer as the most misdiagnosed condition.
So how can you keep yourself from becoming a victim of misdiagnosis?
1. Ask for more tests
Actually, Nancy Keelan says, demand more tests. For more than three years, Keelan says, she complained to her gynecologist about irregular, heavy bleeding, and for three years he told her she was entering menopause and not to worry. Keelan says it turned out she had both advanced endometrial and ovarian cancer. "I believe he missed my diagnosis five times," says Keelan, who was 46 when she got her correct diagnosis.
Keelan, a registered nurse, now speaks to women's groups, telling them not to let more than three weeks go by if they're having new, strange symptoms. She says if the doctor tells you it's no big deal, you can frame your request this way: Tell your doctor you know it might be nothing, but would it do any harm to have a simple test? She says a simple ultrasound, would have caught her cancer much earlier.
2. Ask, "What else could my illness be?"
Let's say you've been experiencing shortness of breath when you exercise, and your doctor tells you you're just out of shape. You can ask your doctor if it could possibly be something more dangerous. Dr. Mark Graber, chief of medicine at the Veteran's Administration in Northpoint, New York, says the single most common cause of misdiagnosis is a doctor's failure to consider other possibilities after an initial diagnosis is reached. "It's called premature closing -- the minute they come up with a diagnosis, they don't think about a better solution," he says.
3. Don't assume no news is good news
Another source of misdiagnosis: Lab results get lost or forgotten. A study by Dr. Tejal Gandhi at Harvard Medical School found that up to 33 percent of physicians did not always notify patients about abnormal test results. "No news is not good news," says Dr. Saul Weingart, vice president for patient safety at Dana Farber Cancer Institute. "It might be that the report fell down behind someone's desk."
4. Assume your doctors don't talk to one another
Our experts said doctors often don't share information about test results. One piece of advice: Use that conference call function on your cell phone. Make phone appointments with your doctors at the same time, and then conference them all together.
5. Be wary when your doctors work in shifts
The title of Gandhi's 2005 study in the Annals of Internal Medicine says it all: "Fumbled Handoffs: One Dropped Ball after Another." In it, she describes how a hospital patient's tuberculosis was misdiagnosed partly because test results weren't passed on when doctors changed shifts.
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Here's a paragraph from http://en.wikipedia.org/wiki/IatrogenicIn the United State alone, recorded deaths per year (2000):
- 12,000 -- unnecessary surgery7,000 -- medication errors in hospitals20,000 -- other errors in hospitals80,000 -- infections in hospitals106,000 -- non-error, negative effects of drugsBased on these figures, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Also, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).
This totals 225,000 deaths per year from iatrogenic causes. In interpreting these numbers, note the following:
- most data were derived from studies in hospitalized patients.the estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.the estimates of death due to error are lower than those in the IOM report. If higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.(Dr. Barbara Starfield of Johns Hopkins School of Hygiene and Public Health, Journal of the American Medical Association, July 2000)
Who has a spare two minutes to play in this month's FG Trivia game!
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He had lung cancer and underwent all the treatments and beat it. He was cancer free for 9 years then one day he started to loose control of his facial muscles, mostly his mouth and started to feel out of sorts and have unusual feelings in his hands. (he was in the USA on vacation at the time). He went to the Dr. and he said they did not know what was wrong but his lack of control in his hands meant he could not drive home to Canada and had to fly. They diagnosed him with myasthenia gravis. This was in May, he never felt better he went into the hospital when he got back home, and never came out, in July they found a spot on his lungs said they would cut him open for further investigation, and when they did he was loaded with cancer. It was too late, in September he passed away.
Cancer is a sneaky killer.
â€• Mae West
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I often wonder if cancer treatments even work. My mom had breast cancer in I think 1987-88. They removed one breast and said she didn't need any chemo or radiation, that they got it all. Then in the 90s she got lung cancer. They removed half a lung, she caught a hospital virus and almost died. They said again, no chemo or radiation necessary, we think we got it all.
Then last year she found a lump on her neck. They radiated it and it disappeared, but more lumps cropped up. Doctor gave her chemo. Lumps resisted and he went on to radiation. He acted like it was working. Our hopes were up. Then Mom was rushed to hospital after an incident and a brain scan revealed a mass. (I hate th "T" word) They wanted to operate and Mom said hell no and we supported her. We saw what brain surgery did to my aunt and we wanted no part of it. So the did a "Gamma Knife" procedure on her which is basically a laser knife. No cutting or surgery involved. Shortly after treatment, Mom could walk again and talk again and was starting to regain use of her hand. But the lumps kept appearing everywhere and when she last went to hospital, she had malignant fluid around her heart that was causing her pain. They drained it. They said nothing to us about her dying. And I was so naive I didn't think she was. Then an ICU nurse, when I asked why Mom was having such stomach pain, told me "cancer sometimes does that when it's in the stomach area." I said "She has cancer in her stomach?!" The nurse said "Oh I thought you knew. I'm so sorry." She could have been fired for telling me but I will always be grateful to her for doing so. But I still wonder if that doctor knew the chemo wasn't working and the radiation wasn't working and if he was just doing **** to pacify us. Out of five doctors, not a one leveled with us.