Doctors are surprisingly bad at reading lab results. It’s putting us all at risk.

[Alvin]

The man was 66 when he came to the hospital with a serious skin infection. He had a fever and low blood pressure, as well as a headache. His doctors gave him a brain scan just to be safe. They found a very small bulge in one of his cranial arteries, which probably had nothing to do with his headache or the infection. Nevertheless, doctors ordered an angiogram to get images of brain blood vessels. This test, in which doctors insert a plastic tube into a patient’s arteries and inject dye, found no evidence of any blood vessel problems. But the dye injection caused multiple strokes, leading to permanent issues with the man’s speech and memory.

https://www.washingtonpost.com/news...utting-us-all-at-risk/?utm_term=.1281be16ce03

 

[alex3619]

Tell me about it. These things do happen, and often because doctors rely on hunches/intuition too much, but I was once told I had haemochromatosis by a whole bunch of doctors, and every one was wrong. I am a carrier, and that led them to misinterpret my blood work.

 

[Inara]

Also I wish doctors would not just look at the normal ranges, but at a tendency, too. It's not difficult and there's a chance the patient can be helped.

Just some days ago, husband felt fatigued after exercise and activity for weeks, and we thought it was an infection (it probably was at the beginning), but it didn't go away. It is so uncommon that he feels exhausted. Also, he had low blood pressure when standing. When looking at his lab results - all in the normal range - the tendencies showed dehydration and low ferritine. More lab tests would have been better, regarding ferritine, but as long as the values are in the normal range the doctor won't do anything. Turned out husband drinks not more than 1l per day and had anaemia as a child. After drinking enough and taking some ferritine, the symptoms disappeared. (It's highly improbable he has haemochromatosis, and I see no risk in taking ferritine on a short term.)

 

[Alvin]

Also I wish doctors would not just look at the normal ranges, but at a tendency, too

Indeed, someone i know has low blood iron and major symptoms coming from it. Just approaching the low end of the range satisfies the doctor who says no more treatment is needed. They still have the major symptoms, just slightly less

 

[Amw66]

Yes, we have had low end of ferritin ( and therefore RBC parameters) , phosphate, other movement edging towards high TSH, glucose rising , but everything is normal so what' s the issue.
There seems to be no thought that not everyone will be within " normal" parameters.

 

[alex3619]

The problem with normal and low ferritin is it presumes everything else is normal. That is only the ferritin is abnormal. For example, its an almost universal presumption of normal blood volume. That is less likely if you have ME, OI or SFPN. Take RBC count. Normal applies to concentration, with the presumption that volume is normal. If your volume is lower, then the impact of a slight drop in count will be magnified. If its a bigger drop in count and even lower blood volume, its massively amplified. Yet still "normal". I think its possible for someone to be anaemic with normal RBC count and other factors normal, if blood volume is low enough. There will still be insufficient oxygen carrying capacity.

 

[Inara]

Exactly. I thought: If you're "dehydrated" (it's not literally that, yet), it would make sense (just from a logic angle) that blood volume is decreased, and so concentrations go up (there were other values at the upper limit), and low blood pressure while standing makes sense (we made a poor-man's-tilt-table-test), so do symptoms like feeling more exhausted than usual and having trouble with concentration - less oxygen where it should be maybe?

Now to be fair, husband didn't tell the doctor he only drinks 1l per day, maximum. He also didn't tell childhood stories. But he didn't tell me neither, only after I said to him "the lab results would fit dehydration - how can that be possible, you drink enough, don't you?"

I feel a bit sad if I imagine that another person with these symptoms (or a comparable story) would have left the doctor's office with "you're absolutely healthy" (in a way: correct), feeling exhausted and the like, probably feeling sicker with time, and these symptoms would have stayed - it's difficult to change habits, especially if you think nothing's wrong with them - and the simple solution would be to drink more.
(Of course, the solution isn't always simple.)