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Misdiagnosed Diseases

Five commonly misdiagnosed diseases

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 information


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.

Elizabeth Cohen is a correspondent with CNN Medical News.
Find this article at:
Five commonly misdiagnosed diseases - CNN.com
 

David Baxter

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Has your illness been misdiagnosed?
By Elizabeth Cohen, CNN

In June 2004, Trisha Torrey found a golf ball-size lump in her torso. A surgeon removed it and gave her the grim news: cancer.

And it wasn't just any cancer but an extremely rare type of lymphoma.

"The oncologist told me that if I didn't begin chemo immediately," says Torrey, "I would be dead by Christmas."

The 52-year-old marketing consultant says she was petrified. But something in her gut told her the diagnosis was wrong.

Her doctor assured her it was right: two labs had confirmed the subcutaneous panniculitis-like T-cell lymphoma.

Against her doctor's orders, Torrey delayed chemo and went to another oncologist, who sent a tissue sample to the National Institutes of Health. The result: Torrey never had cancer.

The lump was a harmless fatty growth.

"On the one hand, I was overjoyed; on the other hand, I was just furious," Torrey says.

She couldn't believe she had been on the verge of having chemotherapy for nothing. What was it in Torrey's gut that told her the diagnosis might be wrong?

It's a lesson worth learning because misdiagnoses are more common than you might think: A 2005 study in the Journal of the American Medical Association says autopsy studies show doctors are wrong 10 percent to 15 percent of the time.

Here, from Torrey and from medical experts, are some red flags -- five reasons for suspecting your doctor might have made the wrong diagnosis.

1. You don't get better with treatment
Sometimes doctors stick to a diagnosis even when multiple treatments aren't working.

As vice president for loss prevention and patient safety at Harvard's Risk Management Foundation, Bob Hanscom remembers one particular lawsuit against Harvard doctors.

A young woman complained of stomach and chest pain. Her doctor prescribed a medicine for gastric reflux. When it didn't work, a second doctor prescribed another drug for gastric reflux. It also didn't work. The woman ended up in the emergency room with acute pancreatitis, which eventually caused kidney failure.

She survived but will be on dialysis the rest of her life.

"In her deposition, she said nobody was listening to her, so she kind of gave up," Hanscom says. "When I read that, I thought, 'Oh God, I wish you hadn't given up.' "

2. Your symptoms don't match your diagnosis
This is where the Internet comes in. You don't have to be a medical professional to Google your diagnosis.

For example, let's say a doctor diagnoses you with tendinitis. Looking it up, you can find out it usually lasts about six to 12 weeks, according to Dr. Saul Weingart, an internist and vice president for patient safety at Dana-Farber Cancer Institute in Boston, Massachusetts.

If you're still in pain beyond that time, the doctor may have made the wrong diagnosis.

3. Your diagnosis is based purely on a lab test
The reality is that labs make mistakes. In Torrey's case, she says two labs made mistakes. When lab results are the sole criteria for a diagnosis, that can be a red flag, says Torrey, who works as a patient advocate. Another red flag is when a diagnosis of a rare disease comes from a lab that doesn't specialize in that disease, Weingart says.

4. Your doctor attributes common complaints to an uncommon ailment
Torrey says her doctor said her night sweats and hot flashes were caused by the extremely rare lymphoma. Actually, they were signs of menopause.

5. Your diagnosis usually involves a test you never received
This is where the Internet comes in handy again. If you find out a specific test can determine the diagnosis you've been given, but you were never given that test, that's a reason to head back to the doctor's office armed with questions, says Torrey.

If you suspect you've been misdiagnosed, you have two choices: You can go back to the doctor who made the original diagnosis, or you can seek out a second opinion (or do both).
 

David Baxter

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Is Your Diagnosis Wrong?
October 2, 2007

One of the greatest benefits of the internet is its empowerment of patients by providing them with health information. We all know that doctors are human and make mistakes. Furthermore, the office practice of medicine is often as much an art as a science, so a doctor's diagnosis is often an educated opinion, one that might very well be wrong. When you bring a problem to the physician, especially if it is not straightforward or common, the history, physical, and laboratory evaluation often produces a "most likely" diagnosis, rather than a rock solid answer.

Physicians need patients' help to practice optimal health care. Patients who keep track of their own lab tests and medications, and who review their medical problems using information on the internet are more likely to discover errors, and are also more likely to suspect that a diagnosis that has been made is incorrect. These five rules can help you figure out whether the diagnosis the physician has made is correct. Take a look and, if your illness fits one or more of these criteria, consider going back and questioning your doctor further. Or, consider getting a second opinion from another doctor.

Having a trusting relationship with your doctor is one of the most critical aspects of working through a difficult, potentially erroneous diagnosis. If you trust him/her, it does not need to be a contentious or confrontational interaction. In fact, your doctor will likely appreciate your concern about your own health and appreciate the assistance in arriving at the correct diagnosis. If not, then its time for a new doctor anyway!
 

ladylore

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I had a scare like that once. Doctors mistook gall bladder attacks for ongoing urinary tract infections. When I went back for about the 5th time within a couple months, the doctor gave me an ultra sound and I was immediately admitted to hospital and surgery the next day.
 

iam*who*iam

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this is what terrifies me the most.

because i have mental health issues, any time i feel like something is really wrong, it doesn't get taken seriously by dr.'s.

even trying to just ask to get allergy testing, is a big hassle.

the ER 4-5 yrs. ago, sent me home after telling me there was nothing wrong..after i went in with horrible pain on my right side.

that night my appendix burst, and when i finally got back to the ER in the morning, i had 20 mins. to live..and THEN that is when they looked at the blood work results from the day before, and saw there was something wrong.

i do not trust dr.'s with my life anymore.

too many times, they've told me things are in my head.
 
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i think all you can do is stick to your guns when you believe something is wrong and insist that they listen to you. maybe even use the appendix story to tell them that you have not been taken seriously before and it nearly killed you. that you need for them to take you seriously.
 

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