The lovely and talented Pamibe (she made my blog banners) has been having trouble with a secondary infection from poison ivy. She had been to the ER once - received antibiotics - and went about life. Well, it seemed that the antibiotics weren't working too well - there was no noticeable change in her condition after an entire week. This means she headed on back to the ER...

Never mind that the arm had started to get better a few days after I started antibiotics then turned around and is once again swollen and painful. What that says to me is the infection was almost knocked out but got the upper hand once more.. But I’m not a doctor and must trust those who are.[emphasis mine --ed]

That last sentence really scared me! As I told Pam in the comments - she needs to get a second opinion. There are good doctors and bad doctors, there is also the fact that this is not a doctor she sees on a regular basis - he doesn't know her. And last of all - he's an ER doctor - and while he might be good at figuring out some skin emergencies, he may miss something that a dermatologist would see right off the bat. All of these things make a difference in how you might be treated in the ER.

Let's go back to the beginning shall we? The first thing that bothers me is that the original ER doc - not only gave her an IV antibiotic treatment and an ultrasound AND an oral antibiotic prescription - after all that, why didn't they tell her to make a follow up appointment with a dermatologist to be sure it was all healing well? Even with kids and strep throat - which is very common - the doctor wanted them back in for a throat culture once the antibiotics were done... to be sure the infection was gone.

So, she returns to the ER with what she considers a valid point - it's not getting better! She sees a different doctor who seems to consider this a negligible problem. At which point - like many many people out there - she begins to question herself. Am I being a hypochondriac? Am I too worried about nothing? Maybe I should wait and see if things get worse...

The reason I wanted to blog about this is because it's still a common reaction. The doctor must know what he/she is talking about - I'm not qualified so I should shut up and go home. NO! You know yourself. Unless you are a hypochondriac - in which case you wouldn't stop going to the doctor anyway - so that is not an issue.

If you know something is wrong - and the current doctor is not paying attention to you - go get another opinion. Tell the second doctor - you are there for a second opinion. Chances are good you are right and there is a problem that needs to be taken care of. This is especially true if you are getting an opinion from an ER doctor. They do lots of things well in ER's - they also make mistakes. I'm just saying - give yourself the benefit of the doubt - trust yourself. You are the only person who has a totally vested interest in your health. So, don't just go home and worry - keep checking until you get an answer that sounds reasonable.

Now it may be that Pam will find out from a dermatologist, that this is the normal course for this type of infection - and it's nothing to worry about. Or she may find out she needs different treatment. But, she needs a better answer than the one she got in the ER - and she - like anyone else - needs to be proactive about getting that answer.

Always remember that the doctor won't have to live with the consequences of a misdiagnoses - you will.

Posted by: Teresa in Medical at 10:20 AM | Comments (4) | Add Comment
Post contains 669 words, total size 4 kb.

1 Most important for all to note: ER doctors ARE NOT experienced doctors. They are medical residents that are applying what they learned in the classroom and practicing on their patients.

Normally their care is signed off by the head of ER which is an experienced doctor, unless he/she is is involved in one or more severe cases. Residents do rotations in ER rooms 1 time a year for 12 weeks during a 2 year practicum. You are so right when you right when you say she should trust her judgement.

According to the New England Journal of Medicine, women between 26 and 46 have the highest rate of undiagnosed and misdiagnosed diseases than any age group and overall more than men.

I'm really glad you wrote about this. I've heard such horror stories of women who have died of cancer becuase they didn't seek second opinions and thought that the problem was in their head.

Posted by: Michele at July 06, 2005 01:23 PM (ht2RK)

2 VERY well written post, driving home a rational point. I hope this helps more people than just myself, because I can't be the only one saying "but he/she's the doctor".

Posted by: pam at July 07, 2005 02:19 AM (l6NIn)

3 My Mother was sent home 3 times from ER.....(her symptoms were nasea and vomiting for 4 days, extreme vertigo..almost unable to stand, and a terrible headache..she had history of colon cancer) Drs. sent her home 3 times #1 sinus infection #2 urinary tract infection #3 dehydration. I finally called from 3 states away with my 1 year of LPN schooling, and requested an MRI of her head...she had a brain tumor blocking 3 vessicles......
Go with your gut folks.....
Go with your gut....
It rarely is wrong.

Posted by: ArmyWifeToddlerMom at July 07, 2005 02:46 AM (VMlQI)

4 That's why I wrote it - people are misdiagnosed all the time... men, women, teens, children. The person thinks - well the doctor said there was nothing to worry about and wham! the person ends up gravely ill or dead.

We've given a huge amount of power to physicians. And while they are well trained - they are not infallable. And sometimes the symptoms of something bigger aren't presenting in a manner that would cause concern.

As I said - the person with the problem has the most to lose and therefore the largest self-interest in getting the right diagnoses. We've let the "trust your gut" reaction fade over time - this is not a good thing for our own survival!

Posted by: Teresa at July 07, 2005 04:55 AM (nAfYo)

Hide Comments | Add Comment