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Eyes

Old 31st Mar 2018, 06:01
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Eyes

I was searching so I could update the thread about my son's eye problem but I can not find it so . . . new thread.

About a year ago No 5 son woke up one morning and one eye would not focus, it was completely blurred. After many visits to opticians and opthalmologists the problem went unresolved. It took about four months for his eye to return to almost normal.

Finally, this week, he got an appointment with a neuro opthalmologist. Nice lady told him in ten minutes that he did not have a neuro problem and said he should get an ultrasound and scan. Rapid appointment made, results back in two hours. Problem solved.

Ultrasound showed a cyst in the ciliary muscles of the eye. Something triggered it and caused the distorted vision. Over time it resolved and his vision is now twenty twenty. The cyst is still there but removing it is invasive surgery and not recommended since it may not affect him again.

Three things occur to me.
1. Why did not the previous specialists find it? Why did they not order an ultrsound?
2. Even in today's hi-tech world doctors vary between competent and totally and utterly useless.
3. According to the Neuro lady it is rare but not unheard of. Something to add to our personal knowledge, just in case.
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Old 31st Mar 2018, 07:19
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In my experience, ophthalmologists have layers of specialisation beneath the umbrella term. I was referred to one who carried out a minor operation. While I was in the UK, a complication (a growth of scar tissue) developed, which he, by email, advised would be OK until he returned from his holidays in a month's time. However, on my return, my GP referred me straight away to another ophthalmologist in the same practice, who referred me to another in a different practice. He, finally, snipped it off. Wife had an eye problem and saw, in turn, one ophthalmologist who diagnosed it, one who operated on it and one who did follow-up examinations.
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Old 31st Mar 2018, 08:10
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In my experience, ophthalmologists have layers of specialisation beneath the umbrella term
Doctors too can have issues with diagnosis if it's not something within their normal practice. Lass from country town near Melbourne, Oz, visited father working in Nigeria for a holiday, became very sick on return, admitted to hospital where the diagnosis of malaria was never made. Doubt any Oz doctor has had much to do with malaria.
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Old 31st Mar 2018, 08:52
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megan: Some years ago, I was visiting my parents in Wales and became horribly ill. It got worse and my Mum persuaded the local GP to come and have a look at me. He couldn't figure it out so had my Dad take me to a clinic a couple of miles away. Got there, a doctor looked at me and declared 'tonsilitis' and prescribed a family size injection of antibiotics. When I came out, Dad asked me what was the verdict and I said 'waste of time'. The last thing the Army did for me before I left was to take away my tonsils. Dad said 'So, he couldn't recognise malaria then?'
Dad had contracted malaria in Africa during WW2 and I had contracted it in Botswana in the 1960s. And both of us used to get the odd re-visit from the malaria monster.
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Old 31st Mar 2018, 08:57
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I was treated for years for IBS until seeing a different doctor from the previous 2 or 3, one doctor said that it looked like Helicobacter Pylory(?). Blood test, week of antibiotics and cured. Bugger - for years I had been paying a 50% uplift on health insurance because of the non-existant IBS.

However same doc diagnosed a "nasty rash" and issued some cream to rub on it. When it didn't clear up another doctor referred me to the hospital and I ended up having an operation!
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Old 31st Mar 2018, 09:38
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Originally Posted by megan View Post
Doctors too can have issues with diagnosis if it's not something within their normal practice. Lass from country town near Melbourne, Oz, visited father working in Nigeria for a holiday, became very sick on return, admitted to hospital where the diagnosis of malaria was never made. Doubt any Oz doctor has had much to do with malaria.

Something similar happened to me. I'd been in Egypt and Sudan, and had been taking the right malaria prophylaxis for lower Egypt, which turned out to be the wrong prophylaxis for upper Egypt and Sudan. On the flight home one of the other passengers collapsed, so, as a precaution, after we'd landed every passenger was given a printed sheet warning us that if we fell ill over the next couple of weeks to see a GP immediately (I've no idea what was wrong with the passenger that collapsed, other than she was taken off the aircraft straight into an ambulance).

The first night back I developed a high fever and had some really weird dreams, but 24 hours later I felt OK. Then the fever came back with a vengeance and I struggled up to see my GP, and remembered to hand him the chit from port health. He immediately isolated me, sprayed disinfectant everywhere, called an ambulance and had me admitted to an isolation unit at Treliske Hospital (where my wife worked as a nurse at the time). I felt like a fraud the first day there, as I felt OK, but had people coming in to treat me wearing full isolation suits - even my wife. The fever came back, and when I recovered from that in a day or so, I remember being greeted by a doctor wearing no protective clothing at all, and who had a big smile on his face.

He was from the Indian sub-continent, and I clearly remember his words. He said "Mr ****, I am so pleased, so very, very pleased, I know EXACTLY what is wrong with you, you have malaria!".

Apparently they had been looking for tropical disease indicators in my blood and found none, but he had gone down to the path lab and asked to look at the slides and spotted malarial parasites. He was familiar with them, whereas the path lab staff had never dealt with a case of malaria in the UK before. Pure luck really, that his background from his own country gave him the knowledge to make a quick and positive diagnosis.

The result was I was given malarial treatment immediately (not recommended - it's worse than the disease in some respects) and sent home. I had to keep taking the tablets for six weeks, coming back every week for another blood test, but thankfully the disease was cured and has never come back. The only legacy it's left is that it stopped me donating blood, even though I've been clear of the disease for over 25 years. I also have to declare it to people like insurance companies etc from time to time, which can be a nuisance.
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Old 31st Mar 2018, 09:48
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Good news about finding the issue ChrisVJ.

Unfortunately for us, there are many, many causes of illness which present very similar or identical symptoms. The symptoms may also vary widely depending upon the individual affected, and may also be complicated by any medication. Add into the mix the experience and competence and fatigue of your diagnosing doctor....
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Old 31st Mar 2018, 11:57
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It wasn't uncommon among people I worked with in PNG to stop taking the suppressant (Chloroquin) as soon as they were back in Australia, and then come down with malaria. This would then go undiagnosed, despite the doctor being told that the patient had just returned from PNG.
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Old 31st Mar 2018, 12:01
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I may have mentioned it, but I recall a young man decades ago getting a snooker cue in his eye. No real harm done but for weeks the pain didn't let up. Long story short, he was sitting in the hospital, for the umpteenth time, with a hanky held over his eye when suddenly the tip of the cue was in the hanky.

You'd have thought they'd have found that.
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Old 2nd Apr 2018, 14:26
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I've always felt vocabulary plays a huge part in the diagnosis conversation. It makes me think that health professionals have trigger words they listen for.

When I told my doctor I'd lost 5kg in less than a year but not dieted, I had an appointment with a Colorectal surgeon in short order. 6 months later they can definitely tell what is not wrong with me.

The problem is that for certain conditions and patients without the language to describe them, the chances of triggering the best response is reduced.

It's partly why I'll see any of the doctors at our practice to broaden my exposure to different experience.
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Old 2nd Apr 2018, 14:42
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My Mum had been losing weight for some months..heartbeat was fluttery, her blood pressure very high and she had no appetite. She had been going to her Doctor and he had been prescribing various things with no effect...then she went to the Docs again and he wasn't there, so she saw another Doctor, a lady who had been in the Army Medical Corps. She took one look and said "It's your thyroid!!" and sent her off to Charing Cross Hospital to see a specialist, who gave her some pills. The evening she came back, she was in the kitchen and I could hear things going on...."Would you like a pancake, dear?" she called out... "Yes...thanks Mum..." I replied...and a pancake duly arrived. One for me and six for her...then I realised the pills had worked, she'd been dragged back from death's door, and went on for another 20 years or so.
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Old 2nd Apr 2018, 15:58
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GP friend who looked after GP refresher training in fairly large area spoke of one patient who came to see them.

Did the process of elimination questions and ended up in a quandry as there were a couple of potential things it could be.

Called a colleague in another practice whom knew had a love of a particular subject matter which susepected it could be and asked for advice.

Sent patient around to see other GP and patient pissed off that own Doctor couldn't tell what was wrong.

Turned out GP specialism was bang on the button and knew the symptoms and had patient admitted to hospital and in isolation very quickly.

Patient wanted to make a complaint and it was own family who reminded him that he had refused to see GP for 10 years, had kept quiet about symptons within family and had GP acted quickly, they had ensured he was admitted with hours and he fully recovered.

No complaint was forthcoming as he did realise that anotehr GP may have just given him antibiotics and told to come back if cleared up, which it would have cleared up but symtoms were still there.

It was a tropical disease that had lain dormant in him for 15 years and only GP had known a colleague was interested in the weird diseaese he would likely have kicked the bucket.
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Old 2nd Apr 2018, 16:56
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Some 20 years ago, I was in the position of being a patient for whom no positive diagnosis for my condition could be obtained despite CT and MRI scans and various biopsies.
At one stage I was in a teaching hospital under the care of a senior consultant.
We had many discussions, and, as a vehicle engineer, I told him that any mechanic can diagnose a blowing exhaust, whereas a malfunctioning automatic transmission might be stripped and rebuilt after no fault was found.
He proposed bringing his students and asked me to answer their questions honestly - what he and I knew was that he didn't know what was the cause. AFAIK, none of them identified the cause of my complaint, and I was subsequently discharged an transferred to my 'local' hospital that specialised in complaints of my sort.
At length I was discharged from there with a golden ticket to return immediately (without passing GO) should my condition deteriorate - which it soon did.
As I waited to be wheeled into theatre for an exploratory operation, surgeon and the anaesthetist were placing bets on the outcome - which turned out to be a physical abnormality usually detected in early childhood - something that I have yet to find any physician who has heard of it.
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