On Inside Health on Radio 4 this week: some people are being misdiagnosed as having exercise-induced asthma

On Inside Health this week: some people are being misdiagnosed as having exercise-induced asthma. So if you or someone you know has had this diagnosis, and especially if you are an athlete, more especially if medication has been prescribed, and even more especially if that is steroid medication, then I suggest you visit this BBC webpage. Rather than exercise-induced asthma, the problem may be vocal cord dysfunction, and this problem does not respond to inhalers. I suggest you also have a look at my recent blogpost about asthma.

A medical theory that has led to dozens of women being jailed for shaking their babies has been called into question by new scientific research.

Doubt over 'shaken baby' theory that has sent dozens of parents to prison
article in the Telegraph

Extract:

"Two British pathologists have found that a combination of injuries used to diagnose abuse, known as the "triad", can happen naturally.

Dr Irene Scheimberg, from London's Bart's Hospital, and Dr Marta Cohen, from Sheffield Children's Hospital, warn that bleeding on the brain and retinas, swelling of the brain and oxygen deficiency do not only occur through vigorous shaking.

Their discoveries could have a dramatic effect on future child abuse trials and child protection hearings.

Dr Scheimberg said: "When there is no evidence of physical abuse, apart from the haemorrhaging, we may be sending to jail parents who lost their children through no fault of their own.

"As scientists it is our duty to be cautious when we see the triad and to take each case on its merits. We owe it to children and their families."

The study, published in the journal of Paediatric Developmental Pathology, found that the symptoms of shaken baby syndrome can happen in babies before they are taken home from hospital."

A woman who smells of rotting fish has been diagnosed with a rare genetic condition after 30 years of being dismissed as a hypochondriac.

Rotting fish woman diagnosed with genetic condition
Article in the Telegraph

Extract:

"The 41-year-old suffered decades of bullying and low self-esteem because of her pungent odour, but doctors refused to take her complaints seriously, believing she was a hygiene neurotic.

She has now been diagnosed with trimethylaminuria, a genetic condition that affects the smell of sweat, breath and urine.

The condition – also known as fish malodour syndrome – is incurable, but the patient from Perth, Australia has been able to seek counselling and support from fellow sufferers.

Professor John Burnett, head of pharmacology at the University of Western Australia, said that the case was a warning to doctors not to dismiss conditions that appear minor but have a great impact on the psychological health of patients."

Kylie Minogue's cancer was 'misdiagnosed' initially

Kylie Minogue's cancer was 'misdiagnosed'
Telegraph article.

Her spokesman said that Kylie wanted "“to let people know she believes one should trust one’s instincts and not be afraid to seek a second opinion”."

Here's Dorothy Rowe's take on the Depression debate. - Dorothy Rowe is a psychologist who has written several books about depression.

The true nature of depression - Dorothy Rowe's article in The Guardian

Extract:

"Gordon Parker makes the important point that depression is over-diagnosed because doctors do not discriminate between depression and unhappiness, but he fails to understand that the list of symptoms that psychiatrists use to diagnose the condition does not include the one distinguishing feature of depression which any person who has been depressed knows only too well. When we are unhappy, we can be close to and comforted by other people and we comfort ourselves, but when we are depressed, we are alone in a prison which seems as real as it is invisible. It is this terrible aloneness that makes depression far worse than any physical illness."

Too many people are being diagnosed with depression when they are merely unhappy, a senior psychiatrist said today.

Depression is over-diagnosed, psychiatrist claims - Guardian

Extract:

"Too many people are being diagnosed with depression when they are merely unhappy, a senior psychiatrist said today.

Normal emotions are sometimes being treated as mental illness because the threshold for clinical depression is too low, according to Professor Gordon Parker.

Prof Parker said depression had become a "catch-all" diagnosis, driven by clever marketing from pharmaceutical companies and leading to the burgeoning prescription of antidepressant drugs.

Writing in the British Medical Journal (BMJ), he said the drugs were being marketed beyond their "true utility" in cases in which people were unhappy rather than clinically depressed.

The psychiatrist, of the University of New South Wales, Australia, said the "over-diagnosis" of depression began in the early 80s, when the diagnostic threshold for minor mood disorders was lowered."

Thank goodness Professor Gordon Parker is injecting a bit of sense into this matter! - The mental health charity, MIND, found that a walk in the country works well as an antidepressant - http://www.guardian.co.uk/health/story/0,,2079804,00.html - and it's certainly safer than psychotropic drugs. These pharmaceutical 'therapies' benefit no-one but the drug companies who manufacture and market them with extravagant claims for their efficacy and dubious claims for their safety.

One of the frequent adverse side-effects of antidepressants, especially tricyclics like amitriptyline, is massive weight gain, which is particularly ironic since overweight is associated with depression, and sensible doctors should be aware of this and hold back on their habitual recourse to prescribing tablets instead of trying to help with the problem.

Instead of the nonsensical and clearly unprovable claim made by most doctors that antidepressants save lives, read any of the sensible contributions on the subject by Dr David Healy, one of which is here: http://news.bbc.co.uk/1/hi/health/3675878.stm . And read http://www.socialaudit.org.uk/ for more information about the great harm that the reckless over-prescribing of these drugs is causing.


Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
How to Lose weight!

See my website http://www.wildeaboutsteroids.co.uk/.html
(The site does not sell anything and has no banners or sponsors or adverts - just helpful information.)

Read my Mensa article on Obesity and the Salt Connection

See Sodium in foods and

Associated health conditions and

http://www.wildeaboutsteroids.co.uk/story.html - my 'political' page

http://www.wildeaboutsteroids.co.uk/socio.html - social and economic considerations

I can be contacted via my website if you need my further help. My help is free.

UK Army doctors in Baha Mousa case 'colluded in cover-up'

UK Army doctors in Baha Mousa case 'colluded in cover-up' - Independent on Sunday

Extract:

"Doctors who examined Baha Mousa, a 24-year-old Basra hotel worker who was kicked and beaten to death in British custody in 2003, have been reported to the General Medical Council.

The move follows allegations that army doctors who treated the detainees colluded in a cover-up by misdiagnosing and failing to properly document the extent of prisoners' injuries. Doctors who examined Baha Mousa said in legal evidence that they saw no injuries on his body, except "a little dried blood" around his nostril.

However, a post-mortem found that Mr Mousa had 93 injuries. Photographs of his corpse show clearly his face, chest and upper body covered with contusions and bruising.

The details of Mr Mousa's injuries and his medical inspections are outlined in a 383-point dossier submitted to the Ministry of Defence by Phil Shiner of Public Interest Lawyers, who is acting on behalf of the former detainees.

The dossier will increase the pressure for the Ministry of Defence to hold a full public inquiry into the abuse and torture of Iraqi civilian prisoners in Basra by UK troops. Mr Shiner has listed every example of inconsistency in evidence or allegation of abuse to come out of the courts martial – which jailed one soldier and acquitted six others – into the 2003 beatings.

The former detainees, all civilians with no links to insurgency groups, are now launching a civil action against the MoD, claiming they were hooded, beaten, subjected to sleep deprivation and noise, and held in stress positions during their detention.

Further developments last week saw one of England's most senior judges order the release of evidence used during the courts martial, which the MoD had been withholding from Mr Shiner."

Doctors with iffy diagnostic skills and poor knowledge of nutrition + anonymity of family courts = appalling injustice in Britain.

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=465421&in_page_id=1770

http://news.bbc.co.uk/1/low/england/norfolk/6129724.stm

http://news.bbc.co.uk/1/hi/programmes/panorama/6265782.stm

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/07/15/nadopt115.xml

Poor diagnoses. Mismanaged legal procedures. Insensitivity. Terrible injustice. Catastrophic damage to innocent families. What's to be done?

I think the children should be returned to their parents ASAP.

What do you think?

1.5m people were wrongly told they risk heart disease

1.5m wrongly told they risk heart disease - Guardian

Extract:

"Thousands of people have been wrongly told they are in danger of developing life-threatening heart diseases because of flaws in the way doctors routinely calculate the risk, according to a study of more than a million people published today.

Current estimates of the number at risk of cardiovascular diseases are 1.5 million too high, the report says, suggesting the anti-cholesterol drugs statins are massively and needlessly over-prescribed, inflating the £2bn annual bill to the NHS.

The study in the British Medical Journal made a series of other significant discoveries. It found that white middle-aged men have a lower risk of heart disease than previously thought and women from poorer backgrounds have a significantly higher risk. It also found one in three women in their 60s are at risk of heart disease, a figure previously thought to be one in four.

Concern over the misdiagnosis of heart disease will be compounded by a separate study due today from the Healthcare Commission. It will raise concern over the way the 300 healthcare trusts in England and Wales are monitoring the problem. A third of them were unable to provide details of the treatment being given to patients.

The HC said the number reported as having heart failure was 140,000 fewer than expected. While it is unsure whether the shortfall is a statistical blip, the study from the BMJ highlights how many thousands of people will probably be given the wrong treatment anyway."

I have written before about the overprescribing of statins...)o: - Click on the statins tab at the end of this blog entry to see those entries.

The safest, most reliable, way to reduce your risk of heart disease is to reduce your intake of salt and salty food. This will also reduce excess weight, lower high blood pressure/hypertension and lower high cholesterol levels and improve health in a multitude of other ways too. - See http://www.wildeaboutsteroids.co.uk/conditions.html

Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
How to Lose weight!

See my website http://www.wildeaboutsteroids.co.uk/.html

and http://www.wildeaboutsteroids.co.uk/ami.html
(The site does not sell anything and has no banners or sponsors or adverts - just helpful information.)

Read my Mensa article on Obesity and the Salt Connection

See Sodium in foods

I can be contacted via my website if you need my further help. My help is free...(o:

Here's a rare thing: an honest doctor who admits to mistakes! - Atul Gawande

You can't get it right every time - Guardian

Extract:

""Most of the time, they are patients whom I think I've done all I possibly could for, so I can accept it. But there are always the others. Six months ago, I was performing a thyroid operation on a teacher my age and damaged a nerve that led to her vocal cords. This woman can no longer talk and has had to give up work. The only way I can live with myself is to try to do all I can for her and understand what I did wrong and do better next time. Being sorry is not enough."

Gawande is a general surgeon at the Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. And he still makes mistakes. It's this uncomfortable wound that he has opened up, first in Complications - his bestselling book that was shortlisted for the National Book prize in the US and became the inspiration for the TV series Grey's Anatomy - and now in his follow-up, Better.

"What I'm interested in is failure," he says, "as it's the one area of medicine with which the professionals are often reluctant to engage because the stakes we are playing for are so high. We can fail by putting a decimal point in the wrong place and by not asking the right questions. If you ask any doctor when he or she last made a misdiagnosis, the truthful answer would always be in the last month. We get things wrong and we try to put them right. And, of course, we can fail with a slip of the hand. I once performed an emergency trachaeotomy in which I did everything wrong. I had the wrong knife, the wrong lights and I made the wrong incision. There was blood everywhere and the patient would have died if a colleague hadn't stepped in to help. It was horrific."

If his call for willingness to ruthlessly examine what goes wrong and why is not always shared by other doctors, then neither will be the second part of his prescription for demystifying failure. Mention league tables to most doctors and they start spitting blood, but Gawande is adamant that there is a value in open accountability. "You have to be careful you are comparing like with like," he says, by way of a caveat, "because otherwise the data can be meaningless. For instance, death rates for cardiac surgeons can vary hugely, depending on the age of their patients and the difficulty of the procedures they are undertaking. But we shouldn't allow this to disguise the fact that some surgeons and some hospitals get better results than others. And unless we are prepared to admit this, we'll never improve the overall success rates."

As an example, Gawande cites both the case of the paediatric team at a hospital in Cleveland, Ohio, who virtually single-handedly raised the average life expectancy of cystic fibrosis patients from three years old in 1957 to 33 in 2003, simply by providing aggressive preventive treatment before sufferers became visibly sick from it. You could argue that such successes are largely a matter of money, but Gawande disagrees. "We spend huge amounts of cash on healthcare in the US," he says, "and not all of it is very effective. Infection rates in hospitals are proof of this. Some hospitals have spent a small fortune on portable $5,000 hand-washing machines [superbugs are as rife in America as they are in Britain], but their infection rates have remained as high as before.

"The one hospital in the US that has managed to reduce infection to almost zero did so not by spending money but by analysing procedures. They asked doctors and nurses how they used the system and found that the alcohol gel dispensers were in the wrong place, the gowns they needed for the 3pm ward rounds were in the wrong place and that it was better to have a single stethoscope designated for each patient's sole use than for a doctor to carry his own from patient to patient.""

It's heart-warming to read, "This woman can no longer talk and has had to give up work. The only way I can live with myself is to try to do all I can for her and understand what I did wrong and do better next time. Being sorry is not enough." - Sadly Atul Gawande is rare among doctors in having this moral attitude. - Victims of medical error are mostly abandoned by the health professionals who have harmed them. That is certainly the norm in Britain. - See http://aboutsalt.blogspot.com/search/label/Andrea%20Carey and http://aboutsalt.blogspot.com/search/label/NHS%20Complaints
http://www.sin-medicalmistakes.org/
http://www.patientprotect.org/

I regard the failure of doctors to tell the truth about the causes of obesity as probably the most colossal group negligence in the history of medicine.

Obesity is not caused by overeating. It is caused by fluid retention in people who are vulnerable to salt. - See Mensa article about Obesity and the Salt Connection

Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
(The site does not sell anything and has no banners or sponsors or adverts - just helpful information.)