Misdiagnosis or Medical Condescension: Has it Happened to You?

Miscellaneous and Personal Stuff I Must Share
41

Those can’t be used without numbing drops! He actually tried to poke you in the eyeball without numbing it?! That’s just stupid. I can’t hold my eyelids still for those puffer things anyway, but my optometrist for the last 5 years doesn’t use that, either. BUT he always uses proparacaine and all I’m aware of is looking at a pretty blue light - which is apparently actually touching my eyeball - but I’m completely unaware. That guy was a total jackass.

I have two misdiagnosed incidents.

First was somewhere around 2003. I got a wicked case of hives. Head to toe, swollen lip, swollen left hand, itchy as hell. I had never had hives like that before (mildly as a kid with penicillin and Mr. Bubble of all things), and didn’t recognize them as being that. But the GP I went to said it was ringworm. Um. Nobody gets ringworm from head to toe like that unless they’re immunocompromised. I had actually had ringworm before, as I worked in animal rescue and everyone gets it at some point. It was not that. When I objected, she referred me to see a derm in the same building, lucky for me able to get me in on an urgent basis so I could just head over there.

The moment I walked in the door, the desk person asked if I was breathing OK. I was. The moment the PE saw me, she asked if I was breathing OK. Still was. The second the doctor got eyes on me, he asked if I was breathing OK. Yep. But the hives were so bad, he was surprised I was breathing with no trouble. This was a Thursday. Immediate Rx for steroids and two antihistamines (desloratidine and hydroxyzine) He put me on work leave and I had to come to the office to see him Friday and Saturday. He gave me his personal cell number with instructions to call him Sunday afternoon to tell him I was still OK. Then another visit Monday before he would release me for work on Tuesday.

I had those hives for 6 months. In the meantime, derm doc referred me to an endocrinologist because bloodwork showed an increase in inflammation that’s not normal with just an allergic reaction. Endocrinologist looks at me with a gaggle of students behind him also all staring at me. He asked a couple questions and shrugged. That was it. Fuckin weirdo.

Once those hives finally went away, haven’t had a hive since.

Second one, about four(?) years ago, I had a throat infection. Started behind my left tonsil after work Friday and got fairly painful by Sunday. Enough that I went to the ER as my GP (a different one from above, that one was one and done) was closed Monday and I didn’t think it could wait. Was probably a 7 on the pain scale. I wanted to rule out/in strep since I had had it a few times in the past and while the pain wasn’t the same as the other times, it was in the same-ish area. But now it was also radiating toward my left ear and I hadn’t eaten anything since Saturday.

I tell as much to the ER doc, and she decides it’s an ear infection (they had taken a throat swab during triage and it wasn’t strep). I was like, no, I really don’t think so, the pain started in my throat and is radiating toward my ear. Yes, the ear is red in there, because it is, indeed, radiating - but the painful ouchy pain is in my throat, and you can palpate the swelling down here (under my jaw)… She kind of dismisses that and starts telling me about not using q-tips to clean my ears. Look. I’ve never had an ear infection in my life. Not as a baby or even as a juvenile when they’re more common. I used to be a swimmer. This is not that. She says the antibiotic should take care of it and sends me on my way.

By Monday evening, I haven’t slept, I still haven’t eaten anything and have only had enough water to swallow Sunday’s pill and Monday’s pill. The swelling has doubled. By 2am my pain is 9, only thinking I should say 10 if my arm has been chopped off. I mean it’s not amputation bad, but it’s pretty bad. Back to the ER. Rocking myself and weeping in the chair for about 10 minutes when they fast tracked this time since I’ve returned within a day. IV fluids, morphine and a steroid finally got me comfortable. Nurse gave me a warm blanket and I basically passed out while waiting for a CT scan, the swelling was solid feeling and new ER doc wanted to rule out an abscess. CT was clear and I was on my way with vicodin and an abo change from azithromycin to clindamycin. Which apparently did the trick. I was miles and miles better by the next day, and totally better the day after that.

Never did find out what the infection was. Still wonder if that infection would have killed me.

42

OK, I’ll play. I actually was thinking about this from the other side but then remembered my story.

To set the scene:
Winter in New England. Thursday evening. I am a college senior and I have literally been to the infirmary maybe twice in my entire college career for upper respiratory things. I’m walking and I slip on some mud and feel my right ankle snap. I try to scramble to my feet but can’t stand. Passersby ask “Are you OK?” and I respond “No-call an ambulance, I think I broke my ankle”. They call campus security who picks me up and drives me to the infirmary where the nice nurse make me sit down and put my foot up. They then insist that I stay there overnight until the doctor arrives the next morning. I protest that I just want to go back to my room with the crutches they have supplied but they insist that I must stay.

The following morning (Friday), the doctor arrives. He takes a quick look at my ankle, turns to me and says “I hope you’re not staying in the infirmary just because you sprained your ankle”. Feeling chastened, I meekly volunteer “Shouldn’t we X-ray it?” He says (voice dripping with sarcasm) “Well if you absolutely insist, I supposed we could call a cab and take you to the hospital in town and get an X-ray, but even if it was a hairline fracture, they wouldn’t do anything until the swelling goes down. The orthopedics come by twice a week on Thursdays and Mondays with a portable X-ray machine and they can see you then.” " OK," I again agree, and hitch a ride back to my dorm with campus security.

Once back at the dorm, I crawl up the three flights to my room and crawl into bed, where I stay for 48 hours, ordering in pizza, since I can’t walk on the crutches. By Sunday, I am stir crazy and it is super bowl Sunday, so I force myself to try to make it downstairs to the TV room. I keep falling to the side, and once downstairs I discover that the crutches are different heights. I readjust them to be equal which helps my balance immensely. i then limp my way back upstairs.

Monday, I hitch another ride from security (the heroes of this tale side there is no way I could have managed the 3/4 mile on ice paths to the infirmary on crutches). There are two orthopedics. One comes in and checks my ankle and I try to make light of my injury, joking that it is school colors (purple and gold). They do an X-ray and I wait in the hall while they see an assortment of other students with various sprains and injuries. They put up the X-ray on the box and even my untrained eye can see a clear spiral fracture of the fibula. Meanwhile, the other orthopedist comes out of an exam room, glances at the lightbox, does a double-take and asks “Has he talked to you about this yet?” I answer “No” and continue to wait. Soon my orthopedist comes out of a room, checks the X-ray, turns to me and says “Wait until everybody else is done and then I’ll talk to you”.

I dutifully wait and the orthopedist then brings me back into a room and says “This needs immediate surgery. You have until 9 Am tomorrow morning to decide whether to have it here or fly home to have it done”. Home was California. School was 90 minutes from the nearest airport. Flying home wasn’t happening. Luckily, I had shadowed a local doctor the previous year and my mother was able to call him and verify that these orthopedists were indeed qualified and knew what they were doing.

They informed me that I would probably be hospitalized for 3 days after the surgery. “Fine,” I said, I’ll just go back to my dorm and pack up some underwear and a toothbrush. “You can’t do that,” they tell me. “You have a bad break. We can’t let you leave the infirmary.” I protest that they had just sent me home for 3 days but they refused to let me leave. The following day, they send me in a cab to the local hospital.

They put me in a bed to wait for my surgery, which is an add-on. I turn on the television, to try to distract myself from the fact that I am 3000 miles from home, in a strange hospital, about to have surgery and in pain. They cut in for a new break. “Dan Rather looks very upset,” I think. They then proceed to show the space shuttle Challenger exploding. This does not improve my mood. Soon, I am rescued by staff who bring me to the OR. The nice anesthesiologist decides to make small talk. “I saw your X-ray,” he says. “That’s a bad break. You’ll probably have arthritis in your thirties.” That is the last thing I remember before waking up in pain. (Also, I have found that the quickest way to bring a Jewish mother flying to your side is when she calls you after surgery to answer the phone and say “I can’t talk to you now Mom, it hurts too much. Call me back tomorrow,” and then hang up on her.

The doctor who sent me away from the infirmary comes to see me every day in the hospital since he is the official school doctor. After being released I actually move into the infirmary for a couple of weeks until I can learn to walk on crutches. After 6 weeks the large external screw is removed, leaving the metal plate and 6 screws that are internal. I have extensive soft tissue damage which I have been told it because I “walked on it” for 3 days and did not have immediate surgery. After all this time I am still much more upset about the condescending manner in which I was dismissed than the fact that the diagnosis was missed.

7 years later, after finishing my residency, I am inundated with the usual multiple letters desperately seeking doctors in underserved areas. On catches my attention, because it is from the town where I went to college. It begins “Have you ever considered a career in Student Health?” It is signed by the student health doctor who sent me home.

43

I apologize for all the typos above; it timed out before I could edit.

Anyway part two of “I haven’t actually learned anything in the past 30 years”

January 2016. I am walking up my driveway after a long day at about 1 AM and I catch my bad foot, trip and slam my face into the concrete. I am able to sit up stunned and notice that there is blood pouring off of my face. A passing car sees me, and the driver stops to call out “Are you OK?” I respond “No. I need to sir here a minute before I can stand up.” She drives off. I manage to make it to my feet and go into the house where I catch a glimpse of myself int he mirror. My nose and forehead are bleeding and there is a deep cut on the bridge of my nose which looks like it may need suturing. I decide to go to the ER, which fortunately is only about 10 minutes down the road.

I slowly drive to the ER, realizing that I can’t wear my glasses because 1) I have a large open wound on the bridge of my nose and 2) they are broken anyway and 3) my splitting headache is affecting my vision. I make it to the ER by holding them in front of me with one hand while driving with the other (kids-do not try this at home). I struggle to find parking, finally park illegally and throw myself on the mercy of the valet parkers (who I did not know were there) to move my car to an appropriate spot.

Surprisingly, having blood dripping off your face gets you seen quickly. They assign me a nice ER doctor along with a 4th year medical student (who is going into anesthesiology but you can’t have everything). They clean up the wound and tell me I will not need stitches. “Don’t you think we should X-ray it?” I ask. “I suppose we could get a CT scan just to make sure there is nothing broken,” the ER doc says. This time, since we are there anyway I say “Let’s get one, just to make sure.”

I get my CT and he informs me that it is normal. The nurse gives me some ibuprofen and they prepare to send me on my way. I feel a bit like I have made this trip for nothing since all they did was give me some ibuprofen and clean my wound but I reassure myself that it was better to get checked out since it was quite a hard fall.

I joke with the ER doc that I am going to have one heck of a black eye. “Oh no,” he says. “You don’t usually get a black eye unless your nose is broken.” I don’t contradict him despite the fact that I can feel the bruising and swelling already. They hand me a pack of discharge papers and send me on my way.

Over the next few days I develop two impressive black eyes. It takes several weeks but the bruising and swelling fades but I am left with a scar on the bridge of my nose. A few weeks later, I am cleaning out my car and come across my discharge paperwork. I scan through it before throwing the papers away and come across one entitled “Care of Nasal Fractures”. Surprised, I scan the rest of them and find the official CT reading which documents a non-displaced nasal fracture. Knowing that there would be no change in management, I do nothing else. I surmise that the ER doctor’s reading of the CT was negative but between the time he left me and the time I was discharged, the official reading came back and they gave me the appropriate discharge paperwork but neglected to tell me of the corrected reading.The ER sends me a survey about the care they gave and I comment that the patient should actually be informed of any final diagnosis.

I do not have nearly as much animosity toward the doctor as I do toward the one above simply because he spoke to me respectfully (and also, his error has much less potential consequences).
In my own practice, I always try to respect the patient’s concerns, and I almost always X-ray sprained ankles, just to make sure.

44

Not serious, but both condescension and mis-diagnosis.

Back story: Four weeks earlier my wife had come down with what seemed to be a cold with fever that wasn’t going away. Eventually, he had missed it and finally got an X-ray that showed pneumonia, but by then it was clearing.

Then, a week before this, I had come down with the same symptoms my wife had had. After a week of fever (not over 100, but my normal was more like 97 than 98) and feeling rotten I went to see him. He examined me and here was the conversation:

Dr: You have an upper respiratory infection commonly known as a cold.
Me: But I don’t run a fever with colds.
Dr: You are running a fever with this cold.
Me: But I have exactly the same symptoms as M had three weeks earlier.
Dr: There is nothing that has a three week incubation period.

I left and went to see a doctor that had recently opened an office in my area. He listened, sent me for an X-ray, diagnosed pneumonia, gave me an antiobiotic that was specific for what he suspected (a mycoplasm, for which erythromycin is specific) and my “cold” cleared immediately. The second one is still my doctor. Meantime, my wife had to get treatment to improve her lung function which had declined thanks to her mis-diagnosis.

Sometimes the hoofbeats you hear really are zebras.

45

Went into the ER with swollen legs once. The next thing I knew I was having an electrocardiogram because the nurses thought I was having a heart attack.

I was in there for about seven hours before the tests came back and they diagnosed me with a protein deficiency.

46

I went to the ER a couple of months ago with an impacted stool. I knew what it was I have been there before. I needed someone to stick their finger up my rear and work it out. I was not constipated as stools were passing regularly but coming out like little ribbons because they were being forced past a stuck stool. They insisted I mush have a growth in my colon and scheduled me for a colonoscopy. After 3 trips to the Er over a 7 day period and horrible pain and sickness I talked my girlfiend into putting on a rubber glove. I was easier than I could have imagined. Problem solved.

47

Seriously, I don’t know why anyone who knows of the existence of another hospital would go to St. Francis; I’ve heard too many horror stories. I remember a friend who was admitted for like a week at 13 years old with terrible abdominal pain, and they kept giving her Paps over and over again and never did diagnose her with anything.

48

Testicular torsion. Misdiagnosed as epididymitis. Result? Much pain, cancer scare after course of antibiotics did not cure non-existent epididymitis, unilateral orchidectomy, offered Teflon prothesis, declined on grounds of “iron ball or nothing.”

49

My mom went through several “you’re just fat” diagnoses. She had been exhausted and had trouble breathing for a few months. Doc said she just needed to lose weight. She was in the hospital a few days later with viral pneumonia. She almost died in the hospital. The same doctor (because it was the Trusted Family Doctor for years) told her to lose weight and put her on an 800 calorie a day diet himself. She couldn’t stick to it and she felt worse and worse, exhausted all the time. She eventually went to the hospital again and it was worse. Congestive heart failure, which of course her doc blamed on her weight instead of considering the damage might have been from the pneumonia.

She was treated for CHF for several years when she started feeling weak and dizzy and again exhausted. In all the exams and hospitalizations nobody thought to check for it, but a friend mentioned it sounded like diabetes, which SHE had. She tested my mom and I think her sugar was so high she should have been in a coma. Friend took her to the ER, where they diagnosed diabetes. After being treated she started losing weight and got some of her strength back but again another misdiagnosis, and I don’t know if this was the same doc but she fell hard on the ice. Wherever she went they x-rayed and said she was fine. She was still in a lot of pain way after she should have healed from a “bruised tailbone”. Several visits later, after being told she was healing slow because she was obese, acting like she was seeking pain pills, and just generally treating her like she must be wrong about the pain if nothing else she finally got a second opinion and found out she’d broken her tailbone.

I remember not long before she died she was having a lot of trouble with her ears and sinuses but she didn’t want to bother going to the doctor. “They’ll just tell me it’s because I’m fat again.”

50

As mentioned in the worst pain thread I had a Staghorn kidney stone. For 10 years I would get treated for an UTI in the spring by my Ob/Gyn and every fall I would get treated for a sinus infection by my PA. I was also going to the chiro about twice a year because my “back” hurt. I finally asked my PA about the amount of ABx I was taking and he scheduled me to see the best urologist around.

The first visit: they put me on ABx. The second visit (2 months later) again they put me on ABx. 3 weeks later when symptoms were back I was back in his office. He had his intern do an ultrasound. It showed “nothing”. at which point he said there wasn’t anything they could do for me and my “back” pain. I ticked off all the symptoms that I had that pointed toward a kidney stone (hadn’t heard of staghorns back then): itchy skin for no reason to the point I would tear skin, my eyes were turning yellow, the pain in my back, the constant UTIs etc.

And then I broke down bawling and said I might as well check myself into the local loony bin because I just couldn’t live with the pain any more (which had never been medicated).

The doctor decided to humor me and sent me for an x-ray. A half hour later he was talking surgery (ESWL Kidney Stone Surgery & Removal Procedures ) now. I looked at him and said “I have 3 kids at home and need a bit more time than that to set up babysitters and for my husband to have time off.” It was scheduled for 2 days later and he sent me home with ABx and pain meds. And a second surgery a month later. And a third a year later.

2 years after that I had laser surgery with a different urologist to remove a tiny bit more but there is still a piece left that grew 1mm from the time I had my last ESWL until the laser surgery. At that point I started asking about ABx to keep it from growing. It took my PA consulting with other doctors for that to happen. It’s actually standard for infectious kidney stones but since they aren’t common…

Oh… and from reading journals I found out that ESWL is contraindicated in large stones and my stone involved my whole kidney (which is why the ultrasound didn’t see it… no edges). It damages the kidney too much.

So I have a kidney that works at maybe 16% and the other has picked up the slack. I get kidney reflux if I don’t pee every 4 hours around the clock (bladder is scarred from passing sand and infection for so many years).
For condescension I will forever remember the nurse who gave me crap for bleeding on the net panties I was given to wear after birthing my last son. I was hemorrhaging and she was worried about a $10 pair of panties. I’m an NA in Iowa so I guess she thought I was Hispanic, Black or just a Poor Person of Color instead of having dual insurance and, if it came to it, I could have bought a pair of net panties. The one chuck they managed to get under me to catch the blood weighed over 2# … not counting the blood that poured out as they walked me to the toilet or the clots I passed in the toilet.

I turned grey from bloodloss.

I think the hemorrhaging was caused by them putting leads on my son’s head while he was still inside me. Halfway through the day they thought he was in distress and started procedures for an emergency c-section. Then they reached inside again and found the leads had fallen off (I was telling them I could still feel him moving). My Ob tried to laugh it off as “too much hair” since my other 2 sons had had thick crops of hair. Nope, number 3 was almost bald.

51

For 25 years I’ve had no ACL in one knee because an Army doctor said it was just a partial tear. When you are a 20 year old private you listen when a captain says something and you don’t ask for a second opinion.

52

I had a . . . disagreement on a diagnosis with a NP at a doc in the box back in January. I came in with a flare up of diverticulitis that I had finally decided needed antibiotics to kill. After waiting the expected 2.75 hours in the waiting room and another 1.25 hours in the exam room, I was told that I did NOT have diverticulitis but rather a UTI. I got a lecture in self-diagnosis and a prescription and was told to start the pills right away.

I was cool, because I knew something the NP did not. I took the prescription and asked why she thought I had a UTI, and she told me the results of the urinalysis pointed directly to a classic UTI. Well, I hadn’t peed in a cup or anywhere else in that building, and I asked her why she thought I had. Confusion and embarrassment ensued as the NP looked at some sample container and looked at my chart and realized there was a mismatch in patient names.

I just gave up and left. Never did get “treated”. I somehow resisted the powerful urge to give a lecture on ‘getting your shit straight’ before treating patients.