# RKS: MEDICAL FRATERNITY'S JARGON - Disease Explainable To Lullaby Patients' Queries
# RKS: MEDICAL FRATERNITY'S JARGON
- DISEASES EXPLAINABLE TO LULLABY PATIENTS' QUERIES
1st September 2022
PATIENT GLEEFUL - HEALTHCARE PROVIDER ELATED
A TRUE WIN - WIN
Dear Reader,
How many of us, our near and dear ones, needed serious medical attention which only a Medical Professional can provide? Statistics reveal that averagely 2.7% of Indians are hospitalised in a year i.e. over 3.5 crore Indians require critical medical attention each year. 430 crore medical consultations are sought by Indians on a yearly basis - roughly 3 medical doctor interface per year by every Indian averagely!
Indians are ranked the highest visitors of medical information sites on internet and if their score is 100, the closest are Pakistanis and UAE nationals at 40! Thus, the medical profession is now, as never before, on a continuous state of high alert since they are expected to convincingly answer all patients' queries emanating out of googled medical condition and its management options.
In the field of medicine there are always reported miracles since no doctor can claim he has truly all the answers. Hence, just as juniors shrewdly manoeuvre their way to the management's good books by smart responses to cover inefficiencies, the current healthcare has also to take cue from the same philosophy.
PERTHES DISEASE
A recent WhatsApp forwarded message was indeed an eye opener. It pertains to how a medical student completely ignorant on a particular topic scored excellent marks in that question in an exam paper.
Question of 20 marks on Perthes Disease. The student was even blissfully unaware of the word 'Perthes' but still managed to score 17/20 marks!
Question:
Write a note on Perthes Disease.
Answers:
Perthes Disease is an unique type of disease & very important from medical perspective.
Incidence -
A good number of people suffer from Perthes disease & the incidence varies from place to place. It is commonly said that the number is gradually increasing but it is probably because of better diagnostic facilities and increasing awareness among people.
Definition -
Different authors have defined Perthes disease in different ways but the most commonly used definition is one which helps in clearly defining this disease.
Classification -
Perthes disease is classified according to the types and degree of the disease. It is important to know the classification because the treatment and prognosis depends on it. Some authors have mentioned different stages also depending on the severity of the disease.
Signs and Symptoms -
The signs and symptoms of Perthes disease depend on the type, degree and duration of the disease. Many people present early and many people present late in OPD. The time lapsed from onset of the disease to presentation in OPD is influenced by educational status of the patient, financial condition of the family, availability of medical facility ,and individual tolerance. Many a times the patient comes after other systems of treatment have been tried and have failed.
Investigation -
Although by examination and history taking majority of the cases can be diagnosed, modern modalities of investigations are helpful in border line cases.
Diagnosis -
Diagnosis depends on a good history taking, thorough examination and investigations.
Treatment -
Treatment depends on the type and degree of the Perthes disease. This varies from conservative treatment to surgical intervention.
Prognosis -
Prognosis depends on the type and degree of the disease, the interval between the onset of disease and instituting the treatment and the skill and experience of the doctor.
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UNDERSTANDING BASICS OF APPROACHING AN ILLNESS
Let's get the basics right.
DISEASES vs DISORDERS
Diseases are those when the body tissue reacts to a particular causative factor.
TREATMENT vs MANAGEMENT
Diseases like infections and those due to nutrient deficiencies can be cured. Diseases due to physiological alterations can also be fairly well-tackled by experienced and relevant specialist albeit knowledgeable doctors. What is challenging are diseases wherein hereditary plays a crucial role like diabetes and hypertension. Such affections have no treatment currently available which can cure them permanently. They can ONLY be MANAGED and hence treatment is to be taken lifelong to prevent complications and its consequences. There are no miracles possible and asking questions enquiring eliminating diabetes or hypertension is inviting jargons to lullaby the inquisitive mind.
On the other hand, disorders trouble for long periods and only those medical professionals with a sharp knowledge on pathophysiology pertaining to anatomical (structural) disruptions can provide the best optimal solutions. A list of such nagging disorders can be long and would include orthopedic disorders (including cartilage disorder - osteoarthritis), refractive eye disorders, hearing disorders, psychiatric disorders, sleep disorders, dyslexia, etc. Disorders can be generally TREATED but cannot be eliminated (CURED) and could keep the sufferer on tenterhook for long periods. Herein lies the challenge for the doctor and the patient / patient's well-wisher. Explaining the scientific basis of the nagging disorder's waxing and waning convincingly is knowledge-driven and a sharp-minded google-learned sufferer can pinpoint if the doctor is well-versed or otherwise on facts regarding his diagnosis and management.
DOUBLE-EDGED SWORD
The patient has to ask himself whether he wants real answers or mere confirmation of his beliefs and impressions based on googling and heresy and personal prejudices?
For diseases such as due to infections or nutrient deficiencies the googled information provided by patient (or his family) could provide a vital insight even to the most sharp-minded treating physician. However, there is no point in probing and irritating the treating doctor in seeking firm and positive encouraging answers to curing the hereditarily passed on maladies like diabetes or hypertension, or genetic diseases. There are just no explanations nor permanent remedial measures available for many of these.
If one yet insists on explanations, the discerning doctor will provide all the responses just as the 'ignorant student' did for the Perthes disease.
By the way - look at most of your previous interactions. There have been dime a dozen times that one has asked 'leading' questions to doctor and recollect the responses given.
A diabetes / hypertension patient or his relative asks:
- Can he / she have sweets in diabetes? He has a very sweet tooth.
- Can he / she consume sweets once-in-while?
- Can he / she consume alcohol?
- Will losing weight reduce or even lead to stopping of diabetes / hypertension pills?
- Is not exercising good to reduce blood glucose / blood pressure?
- Is the salt to be restricted because of hypertension?
What can one expect the doctor to reply to such questions. The answers are obvious.
Now let's look into a different set of questions that a patient or his relative asks:
- Why does he / she have diabetes? He / She does not eat sweets, regularly exercises and even periodically checks up medically.
- What is the reason for high blood pressure?
- Why is there is a nagging skin problem?
Here, the doctor is medically flummoxed as to how to correctly answer. Hence, one of the standard replies given is diseases like diabetes or hypertension or many skin conditions are mainly due to 'stress' and this is an evergreen appealing cause to most patients since everybody enjoys a secret pleasure within in proclaiming he / she has stress. Who will ever admit or say he / she does not have stress? In diabetes and hypertension stress can only aggravate the conditions but cannot be the sole cause. Otherwise instead of anti-diabetics and anti-hypertensives, the doctors would have been prescribing anti-depressants as cure for these ailments!
Herein, comes the medical jargon and a win - win situation - doctors unaware of how diabetes is cause or chronic skin condition accrues are happy to explain it simply on basis of stress and the patient gleefully accepts this explanation as it sounds like music to the ears.
MY MY MY! SOME RELATIVES CAN BE GOD-SENT
I have a patient whose family has been under my advices since nearly three decades now. The son has grown up and when his wife delivered a baby boy he noticed one of the arms was not properly moving. On enquiring, the attending neonatologist told him it was a simple nerve inflammation and will soon resolve. However, this concerned father, an architect by profession, studied the googled data and on matching the manifestations with the diagnosis he opined that the brachial plexus (nerve bundle in the armpit) was torn whilst pulling out the baby with forceps. Even I was taken aback and advised him on consulting yet another senior pediatrician - only to confirm his worst fears. He took it positively and, instead of spending energy on blaming the gynecologist (also my dear friend and who is no more), he concentrated his attention on salvaging the situation. Together we found out who is best for repair of the torn brachial plexus in the world (incidentally the most experienced is a plastic surgeon from India - Mumbai) and approached him for the same. That was not the end of the story. The true father even analysed in which period of the child's life if the surgery is performed the outcome would the best - and he exactly subjected his son to operation during those early couple of months post-birth (even though his parents and in-laws were questioning why permit a procedure at such a tender age). Today the very same child is 6 years old and he has recovered near 90% of the disability. The toil is yet on for achieving the miraculous perfect end-result!
BEWARE!
YouTube provides innumerable solutions pertaining to day-to-day problems like electronic and electrical malfunctioning, fixing leaks in plumbing installations, housing solutions, travel aid, etc. etc. Although there are videos on body physiology, anatomy, and even operative procedures there is no uploaded cinematized solution for treating diseases! WHY? Because the doctor is the only hope one can have and it would be foolish to question his diagnosis generally (a second opinion is fine in complex cases) or juggle with his treatment based on googling.
There are 5 affections for which it is advisable to neglect the googling emergent treatment options and adhere strictly to the doctor's advice:
- Infections
- Diabetes
- Hypertension
- Cancer
- Heart diseases
Just like we have window shopping and body shopping, there is also doctor shopping (synonym: double doctoring). No point in doctor shopping once the diagnosis is confirmed without doubt and the care is as per set protocol and after all options fully evaluated. In the case of the abovementioned 5 ailments any deviation from conventional allopathy is a recipe for disaster and doomed to fail with resultant high possibility of severe crises occurrence in due course.
However, for most OTHER prolonged sufferings there could be alternative options, other than allopathy explored - including changes in way of living.
One anecdotal incidence that could be appropriately mentioned here: I had facilitated a meeting between the directors of an Ayurvedic Healthcare organization and a Drug company. The Ayurveda 'specialist' told the Pharma personnel that he has a good product that can cure asthma. To this the owner of one of the largest vaccine manufacturer, the Drug company in question, retorted: "Mr XXX if you have the cure for asthma that you claim then, not yourself, but even your driver would own a private jet"!
Friends, foes and medical frowners be a balanced googlers when it comes to health and its maintenance and restorative options. One cannot substitute the 5-15 years of laborious medical studies of qualified doctors by mere googled data. Colleagues to remember that adopting medical jargoning to pacify the inquisitive mind will be better than snubbing a Mr Bean!
How true.....such an interesting read!
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