What medical mysteries can educate us about getting higher well being care

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Who doesn’t love a superb thriller?

For 15 years, medical reporter Sandra G. Boodman has chased down probably the most uncommon, quirkiest and weirdest medical circumstances for her month-to-month Medical Mysteries collection. Latest tales have centered on a teen who couldn’t get up, a lady wrongly recognized with ALS, and a complete household and visitor felled by an odd flu-like sickness.

I checked in with Sandra to seek out out extra about how she writes the column and the teachings we will study from it.

Right here’s our edited dialog.

Q. How do you select your concepts?

A: It needs to be one thing I haven’t written about. It needs to be a solved case. I have to know the last word analysis. Regardless that it’s a solved case, there needs to be a thriller. And there needs to be a human story.

Q. When you decide a case, how do you report it?

A: I ask for a chronology of occasions and medical data that affirm the analysis. The medical data and chronology allow me to see whether or not, certainly, it is a thriller, whether or not it unfolded in an fascinating manner. Will this be an fascinating case?

Then, I interview the affected person, generally the dad or mum, generally the partner. The final step is to speak to the physician who made the analysis or the present treating physicians. Any step alongside the best way, the method can fail.

Q. Do you write about unsolved circumstances?

A. No, it needs to be a solved case. Lots of people write to me and say, “I’ve this downside, are you able to assist me?” Sadly, that’s not what I do. I did as soon as write a few lawyer in Detroit who had gone to the undiagnosed-disease program on the Nationwide Institutes of Well being. He’s seen greater than 100 medical doctors and nonetheless doesn’t have a solution. However I assumed his case was so uncommon and fascinating, I did make an exception that point.

Q. What are a few of your most memorable medical mysteries?

A: I wrote a few household that stored getting recurrent strep throat. They couldn’t determine it out. An enterprising veterinarian received concerned. It turned out their cat could have been the vector. Once they lastly handled the cat, no one has had strep.

One of many weirder ones — there was a lady who had severe kidney and coronary heart issues. It turned out she was consuming an excessive amount of licorice. That was actually odd.

And I nonetheless vividly keep in mind a State Division employee who had horrible itching on her head at evening. She had even been labored up for a sort of most cancers. She had seen a number of dermatologists. It turned out she had head lice for a complete yr. How did they miss that? That was actually gorgeous.

Q. What have you ever realized in regards to the medical system from writing about medical mysteries?

A. Medical care has change into more and more specialised. Medical doctors are acquainted with a small slice of what’s occurring, but analysis is an inherently complicated course of. I additionally assume time pressures are worsening. It’s like: “You’ve received 10 minutes. Go.” That’s not going to work with an advanced downside.

I additionally assume generally sufferers aren’t good at describing the issues. The individuals who are likely to do higher are organized and may describe their signs in a manner that’s intelligible for a physician.

Q. What’s your finest recommendation to sufferers for getting higher medical care?

A. Main-care medical doctors can actually assist a affected person. I usually see individuals who go proper to specialists. They might not have a primary-care physician, or they use pressing care once they’re sick. That may be problematic. Folks actually undervalue the function of a superb primary-care physician.

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Feeling full? Don’t fear. Your abdomen in all probability gained’t explode.

This week, a reader requested: I at all times really feel like my abdomen goes to blow up after I eat on Thanksgiving. Can that truly occur?

Whereas theoretically doable, this can be very unlikely on your abdomen to blow up from overeating, stated Sophie Balzora, affiliate professor of drugs at New York College Grossman College of Medication and a gastroenterologist at NYU Langone Well being. She writes:

Your abdomen is a tricky organ, with thick muscle partitions and a wealthy blood provide that may simply face up to even a hearty Thanksgiving meal.

The abdomen additionally has a outstanding capability to stretch from its resting quantity with out a lot change in strain. Even earlier than that first chunk of turkey hits your mouth, the anticipation of it — whether or not by odor or sight — sends a sign to your mind that’s delivered to your abdomen, telling it to organize for meals. As you eat, the abdomen stretches, making increasingly room.

However abdomen rupture has occurred. One case report concerned a 24-year-old feminine affected person who visited an emergency room in Turkey with sudden stomach ache, vomiting and nausea after consuming an extreme quantity of fruit. An stomach surgical procedure revealed her abdomen was perforated and held practically 5 liters of partially digested meals, together with grapes and pomegranate — clearly exceeding a quantity that almost all human stomachs can tolerate.

To study extra, learn the complete reply from Balzora in Ask a Physician: If I eat an excessive amount of, will my abdomen explode?

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Why it looks like your physician doesn’t care about you: Many sufferers outline caring as listening, investigating, following up on outcomes and advocating for them. This sort of caring takes time and sources that many medical doctors aren’t given, says doctor Shirlene Obuobi.

Please tell us how we’re doing. Electronic mail me at wellbeing@washpost.com.



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