The way he approaches the problem so logically with grace, you can almost say that I idolize him ("I never met anyone so perfect....") and then there is this love he has for his wife..that makes him the perfect husband.
(Women are often more attracted to hard-working men!)
Anyways, during the sloppy day it was yesterday, very important lessons were taught to me.
Do I want to be data gatherer, or a problem solver?
Why was the patient 20/400 in one eye and 20/20 in the other?
What was the reason? follow follow follow. Just like Sherlock Holmes would, look for clues that will tell the 'story'.
This was the very important lesson that was taught and I shall remember it.
Mental disease: Morgellon's disease
--why did I write Mental disease? it was described me to as a skin condition and I just typed up mental before I looked up the definition from Wikipedia.
Morgellons (also called Morgellons disease or Morgellons syndrome) is a name that was given in 2002 by Mary Leitao[1] to a proposed condition characterized by a range of cutaneous (skin) symptoms including crawling, biting, and stinging sensations (formication); finding fibers on or under the skin; and persistent skin lesions (e.g., rashes or sores). Doctors,[2] including dermatologists[3] and psychiatrists,[4] regard Morgellons as a form of delusional infestation (also called delusional parasitosis), i.e. the belief that there is a pathogenic infestation despite contrary medical evidence.[5]
Despite the lack of evidence that Morgellons is a novel or distinct condition and the absence of any agreed set of diagnostic symptoms,[6][not in citation given] the Morgellons Research Foundation and self-diagnosed Morgellons patients successfully lobbied members of Congress and the U.S. government's Centers for Disease Control and Prevention (CDC) to investigate the proposed condition.[2][7] The CDC researchers issued the results of their multi-year study in January 2012, indicating that there were no disease organisms present in Morgellons patients, the fibers found were normal clothing fibers, and suggested that patients' sensations were manifestations of "delusional infestation".[8][9]
Lambert-Eaton syndrome: (LEMS often associated with lung cancer... 50-70%)
Lambert–Eaton myasthenic syndrome (LEMS, sometimes Lambert–Eaton syndrome or Eaton–Lambert syndrome) is a rare autoimmunedisorder that is characterised by muscle weakness of the limbs. It is the result of an autoimmune reaction, where antibodies are formed against presynaptic voltage-gated calcium channels in the neuromuscular junction (the connection between nerves and the muscle that they supply).[1]Around 60% of those with LEMS have an underlying malignancy, most commonly small cell lung cancer; it is therefore regarded as a paraneoplastic syndrome (a condition that arises as a result of cancer elsewhere in the body).[2]
People who develop LEMS are usually over 40, although it may occur at any age. The diagnosis is usually confirmed with electromyography and blood tests; these also distinguish it from myasthenia gravis (MG), a related autoimmune neuromuscular disease.[1]
If the disease is associated with cancer, direct treatment of the cancer often relieves the symptoms of LEMS. Other treatments often used aresteroids, azathioprine and intravenous immunoglobulin, which suppress the immune system, and pyridostigmine and 3,4-diaminopyridine, which enhance the neuromuscular transmission. Occasionally, plasma exchange is required to remove the antibodies.[1]
Canaliculitis
One of the most misdiagnosed condition and this family physician wonderfully got it right.
The infection was caused by none other than Actinomyces Israelii and it is half yeast/bacterial like infection that is managed by minor surgery and antibiotic.
Actinomyces israelii is a species of rod-shaped bacteria within the Actinomyces. Known to live commensally on and within humans, A. israelii is an opportunistic pathogen and a cause of actinomycosis. Many physiologically diverse strains of the species are known to exist, though all are facultative anaerobes.[1]
Actinomycosis is most frequently caused by Actinomyces israelii and is sometimes known as the "most misdiagnosed disease,"[who?] as it is frequently confused with neoplasms. A. israelii is a normal colonizer of the vagina, colon, and mouth. Infection is established first by a breach of the mucosal barrier during various procedures (dental, GI), aspiration, or pathologies such as diverticulitis. The chronic phase of this disease is also known the "classic phase" because the acute, early phase is often missed by health care providers. This is characterized by slow contiguous growth that ignores tissue planes and forms a sinus tract that can spontaneously heal and recur, leading to a densely fibrotic lesion. This lesion is often characterized as "wooden." Sulfur granules form in a central purulence surrounded by neutrophils. This conglomeration of organisms is virtually diagnostic of Actinomyces israelii.[citation needed]
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