Readers Diagnose Conditions Online Right?

Recently,a Doctor Lisa Sanders posed a question to Readers ,

“Can you solve the mystery of a middle-aged man recovering from a serious illness who suddenly becomes frightened and confused?””

New York Times added,

Every month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult case and solve a diagnostic riddle. Below you will find a summary of a case involving a 55-year-old man well on his way to recovering from a series of illnesses when he suddenly becomes confused and paranoid. I will provide you with the main medical notes, labs and imaging results available to the doctor who made the diagnosis.

The first reader to figure out this case will get a signed copy of my book, “Every Patient Tells a Story,” along with the satisfaction of knowing you solved a case of Sherlockian complexity. Good luck.”

Self Medication

Self Medication

The Diagnosis.

On Thursday, we challenged Well readers to figure out the diagnosis for a 55-year-old man who was recovering from a terrible injury and suddenly became confused and paranoid. More than 250 readers wrote in with some very thoughtful assessments of this patient’s problem. Remarkably, 70 readers were able to make the diagnosis.

The correct diagnosis is…

Serotonin syndrome

The winning answer came in just 40 minutes after the case was posted. It came from Thea Grendahl Christou of Chicago. A writer and musician, she read through the case, and got a timely consult with her husband, a physician. After hearing the symptoms, he asked her to read the patient’s medication list and, based on that, made the diagnosis.

She tells me that she loves these medical mysteries and, when she can, sits in when her husband presents difficult cases to his residents. She says she is often as good as the interns — at least early in their year.”

The habit of referring to internet and self diagnosis ans self medication is on the rise.

This is a dangerous practice.

Some time back a patient’s relative . suspecting that the Diagnosis to be incorrect, checked th Internet and gave a correct Diagnosis and the Doctor followed it up and the patient was cured.

On the other hand , not all the information on the Internet, that is featured in the first search results are correct.

People have a tendency to follow the top results.

The fact is the search engines deliver results , based on key words, tagging and a host of other factors.

Even Wikipedia, which is normally accurate need not always be correct; it is constantly corrected, updated.

In the absence of a detailed Study of the subject, for which people spend time money to become a Doctor,it is not safe to check the internet and go in for medical solutions.

My friend’s daughter referred to a site on ‘ weight loss and fruits’ and went on a diet of only fruits.

She followed it for a day.

The next morning when she was at her office she felt giddy , tired and had called on her Father, who was at my residence to pick her up.

A 66-year-old had to rush to her travelling 30 Kms , take her home.

As suggested by me, he gave her lot of Water, tender Coconut water , fed her with Idlis, which contains protein and Starch(a Staple diet of South India).

She slept off 12 hours before returning to normalcy.

May be the questions by New York Times might be with a view to educate the readers, while simultaneously help increase its circulation and readership.

For the author of the Book, A doctor,  a chance to promote her and her Book!

But entering into a subject which is a matter of Life and Death, it is inadvisable and dangerous.

As things stand to-day the concept of family Doctor, who knows your Family History(not merely Health) who knows the patient well, who examines you physically, allows you to talk freely of your symptoms and order you to follow his advice is gone.

We have assembly line Medicare, where the Doctors have to refer to files even for Names and at tames the Hospital where they had seen the a patient!

Personal care is gone.

It is alright for the Doctor to discuss the case with you.

Because you have access to Internet, you do not become a Doctor.

Don’t do this, for health’s sake.

‘The Diagnosis:

Serotonin syndrome is an unusual but potentially life-threatening condition caused by excess levels of the body chemical serotonin in the central nervous system. It is usually seen in those who accidentally take too many medications that increase serotonin levels in the brain.

The well-described triad of symptoms seen in serotonin syndrome consists of changes in mental status, like confusion or agitation; changes in heart rate, blood pressure or body temperature; and changes in muscle function, usually tremors or exaggerated reflexes. This patient had all three. He was confused and agitated, his heart rate, body temperature and blood pressure were elevated, and he was trembling and had clonus, a sign of muscle hyper-reflexiveness.’

Meanings of Neurological terms- in Simple English

One gets confused and at times frightened by the terminology used by Neuro Specialists.

Neurological disorders are frightening by themselves.

To help people understand the medical lingo  of some common terms used by Neurologists, I am furnishing simple meanings of these terms.

ab-		away from
acou-		hear
act-		do, act
ad-, aff-	to
aden-		gland
aer-            air, gas
alg-		pain
alve-		tough
ambi-           both sides
andr-		man
angi-           blood vessel, duct
ante-		before
anti-		against, counter
arachn-		spider
arch-		beginning, origin
arthr-          joint
articul-        joint
audi-           hearing
aur-            ear
ax-, axon-	axis
bar-		weight
bi-             two, double
blast-		bud
brachi-		arm
brady-		slow
capit-          head
cata-           down
caud-		tail
cell-		cell, room
centr-		center
cephal-		head
cerv-           neck
chord-		string, cord
chro-		color
chron-          time
contra-		against, counter
corpus-		body
crani-		skull
cry-            cold
cut-		skin
dendr-		tree
dent-           tooth
derm-           skin
dors-		back
dys-		bad, improper

ect-		outside
electr-		amber
encephal-       brain
end-		inside
epi-		upon, after
esthe-		feel, perceive
eu-		good, normal
exo-		outside
extra-          outside of, beyond
fibr-           fibrous, fibers
glom-           little ball
gloss-          tongue
graph-		write, scratch
hemi-		half
hyper-		above, beyond, extreme
hypno-		sleep
hypo-		below, under
inflamm-        setting on fire
infra-		beneath
inter-		among, between
intra-		inside
lingu-          tongue
medi-		middle
mega-           large
meningo-	membrane
mes-		middle
meta-		beyond
micro-		small
multi-          many
ophthalm-       eye
para-		beside, beyond
peri-		around
phag-           eat
phon-           sound
phot-           light
poly-		many
proprio-        self, one's own
resti-          rope
retro-		backwards
somat-		body
spondyl -       vertebra
sub-		under, below
supra-		above
syringo-        pipe, tube
tel-		end

Please send additions to this list to me

[Etymology of Neuroscience Terms] | [Return to Top of E.H. Chudler’s Page]!MBn/

Interactive Sites on Medical Information.Click On The Ailment.

The tutorials listed below are interactive health education resources from the Patient Education Institute. Using animated graphics, each tutorial explains the procedure or condition in easy-to-read and understand language. You can also listen to the tutorial. 

These tutorials require a special Flash plug-in, version 6 or above… If you do not have this in your PC, you will be prompted to obtain a free download of the software before you start the tutorial.

  Diseases and Conditions

A Headache That Didn’t Go Away

I have relative of mine,about 50, who had difficulty in vision. Ophthalmologist advised him to wear glasses.By chance he happened to see a GP who informed him his case was not one of vision ,but of eye balls about to pop out and he immediately rushed to Specialty hospital where he was diagnosed with a disorder that has resulted in his eyeballs being held only by 40%.He was immediately operated upon and he is recovering.
Moral-better seek second opinion .Sometimes, though cynical it may sound , it may again be not 100% correct.Sometimes there are as many opinions as there are doctors.What are we to do?

Valerie Novak fervently wished doctors would stop telling her the intense headache she’d endured for several weeks was a migraine. For one thing, neither the Georgetown University senior nor her close relatives had headaches, and migraines are frequently familial. None of the increasingly potent drugs doctors prescribed was doing much good. And the 22-year-old had lost 15 pounds in three weeks from bouts of severe vomiting.

“I was so frustrated and upset,” recalled Novak of her ordeal last summer, which involved consultations with half a dozen doctors, several trips to area emergency rooms and two hospitalizations. Novak, who had always been healthy, said she feared the unrelenting pain in her left temple and associated symptoms were something “I’d have to live with for the rest of my life.”

Her mother, Kathy Novak, a nurse practitioner in Bowie, was similarly skeptical of the diagnosis but grateful that doctors had ruled out more ominous possibilities, such as a brain tumor. When her middle daughter began complaining about double vision, Kathy took her to an ophthalmologist. His judgment led to an accurate diagnosis that had nothing to do with migraines but was instead a rare complication of a common item listed on Novak’s medical records. Left untreated, it might have killed her……………….

Back home with her parents, unable to go to class, Novak recalled that her “eyesight was getting wonky, with really, really weird double vision.” Alarmed, her mother made an appointment with an ophthalmologist, hoping he might have an explanation that didn’t involve migraines.

After dilating Novak’s eyes, the eye specialist immediately spotted something alarming: Her optic nerves were dangerously swollen. “This is not a migraine,” he told Novak. “You have increased intracranial pressure.”

The unrelenting headache as well as the numbness, tingling and vomiting were caused by a rise in pressure in the brain. The condition, which can result from a head injury or meningitis, is considered a medical emergency; increased pressure caused by a buildup of fluid can permanently damage the central nervous system by restricting blood flow to vessels that supply the brain. In Novak’s case, the double vision was caused by pressure on her cranial nerve.

The ophthalmologist’s first thought, given Novak’s age and history, was pseudotumor cerebri, a rare condition sometimes called a false brain tumor, that affects women between ages 20 and 45. Valerie’s illness had nearly all the hallmarks but lacked one critical variable: She was not overweight or obese, as are most of those with the condition.

The ophthalmologist immediately sent Novak to Greenbelt neurologist Roger Whicker. She immediately began taking a drug to reduce the pressure and underwent another MRI and other testing, which revealed the actual cause of the illness and changed the diagnosis to sagittal sinus thrombosis, or SST, caused by a blood clot in her brain.

Misdiagnosed With Coma, Belgian Man Communicates After 23 Years

Very sad.Some doctors, despite fancy degrees,make a cursory examination and arrive at a prognosis.
In this case brain activity should have been mapped or at least pupil dilation examination should have been more thorough.
It is very hard to digest that that this should happen because of inefficiency of the doctors.
Many of us regard doctors next to God, forgetting that medicine is an evolving science ; most of the treatments are exploratory in Nature and these procedures have contra indications as well;some of the medications are effective with out anybody knowing why and how it cures.Classic example is grand mal seizure .We know that this seizure is triggered by sudden increase in electrical discharges in the brain and Eption is prescribed to treat this.But none knows how it works or whether it has side effects.
Because of commercialization of medicine , neither the doctor nor the patient has the time to discuss family history of the patient;nor are the patients interested in slow and steady cure or allowing body to take care with minimal supportive treatment.
It is imperative for patients to inform and discuss with the doctor,your family history,your known allergies and your symptoms.
It is also mandatory on the part of the patients to check the medicines prescribed for contra indications.If yes, inform the doctor and have the medicine changed.Even then you should also chek up on internet about the medicine’s efficacy.This may sound tedious, but will save not only money, but your life as well.
When going for surgery check before hand the anesthesia that is about to me administered and see if it it is compatible with your system for some anesthetics are incompatible.
If you had any disease prior to surgery that has resulted in Edema(especially pulmonary), Nitrous oxide is to be shunned.
While getting tests being carried out make sure at the lab, it is done for the part for which you have problem i.e.what the doctor has prescribed and see that the report is yours when you collect it.Never depute somebody else to collect it.
Also popping pills based on advertisement or based on what your doctor has prescribed earlier ailments is dangerous.
All these jobs are to be carried out by Doctors.Unfortunately,Doctors have no time for patients for they are too busy.


Conscious but unable to communicate for 23 years after a car accident that was thought to have put him into a deep coma, a quadriplegic Belgian man has described how medical science finally put an end to his agonizing years of silence.

Now able to make himself understood via a computer and specially built keyboard, the man, Rom Houben, said in the Monday issue of the German magazine Der Spiegel that when doctors made the correct diagnosis, it was like starting a second life.

“I shall never forget the day when they discovered what was truly wrong with me — it was my second birth,” Mr. Houben, now 46, was quoted as saying.

Mr. Houben, who was an engineering student at the time of the accident, lives in a care home near Brussels. He was assumed to be in a persistent vegetative state until three years ago, when the breakthrough was made.

In the interview he recalled the aftermath of the car accident that paralyzed him and the realization that no one understood that he was fully conscious.

“I screamed, but there was nothing to hear,” he said. He added that he then became a witness to his own suffering as doctors and nurses tried to speak with him until they gave up all hope.

Using brain scanning techniques, Dr. Steven Laureys, a neurological researcher at the Liège University Hospital, discovered that Mr. Houben’s cerebral cortex was still active.

On Monday, Dr. Laureys, who recently published a paper on comas, said that as many as 4 out of 10 similar patients may have been misdiagnosed.

He also described the moment he realized, for the first time that Mr. Houben was fully conscious. “It was one of those rare moments where you really see that what you are doing is useful,” he said in a telephone interview.

“It was a very big moment not just for me but for the whole team, one of those few much-needed moments” for medical professionals.