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re: [infoguys-list] Digest Number 1012

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  • Brian Taylor
    From your description, it does not seem that anyone was very proactive in making this diagnosis, but I doubt you re giving us the whole picture because there
    Message 1 of 2 , Jan 11, 2004
      From your description, it does not seem that anyone was very proactive in making this diagnosis, but I doubt you're giving us the whole picture because there are many things I look at in such cases which are omitted.

      I'd be interested in seeing the ER's headache protocol, for one thing and comparing that with what was actually done. Headache can be a very difficult diagnosis and associated with a million other disease processes. On the other hand, because of the potential that headache is indicative of a serious process, it deserves a fairly high triage and diagnostic level of attention.

      Was a lumbar puncture done at any time during her visits? What were her lab values (SMA-21, etc.)? Was a sedimentation rate done? Was a CT scan ever offered and refused? What, if any, neurological symptoms did she have?

      Second, I'd be interested in how she responded to the medications given. I'd be interested in whether hospitalization was ever offered and refused as often happens after the patient has had pain mitigated with medications.

      Third, I'd be interested in knowing how the patient's current symptoms correlated with the previous diagnosis of migraine which WAS made in conjunction with CT scan a year earlier.

      Fourth, vasculitis would not likely have been diagnosed simply by brain CT scan. A biopsy is almost always required to make the diagnosis.

      Fifth, how early could the diagnosis realistically have been made and what treatment modalities would have been available AT THAT TIME? For instance, there is a very narrow "window" when certain therapies can be undertaken with any reasonable hope of success and the question is whether the delay in diagnosis delayed treatment in a proximally causative way relative to the patient's eventual deficits.

      There's just too much left out here to "guess" what the facility's defense might be.

      Brian Taylor
      Community Safety Services






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    • jameswhitccc@aol.com
      There is evidence of migraines caused by spinal punctures. The more the worse the pain. It becomes chronic and disabling.. Adhesive Arachnoidiits is one of the
      Message 2 of 2 , Jan 12, 2004
        There is evidence of migraines caused by spinal punctures. The more the worse
        the pain. It becomes chronic and disabling.. Adhesive Arachnoidiits is one of
        the main causes. It is a terminal spinal disease that is medically caused by
        spinal surgery and punctures of the dura membrane. The dura is the outer
        shield that is wrapped around the spinal cord and the brain. There are two others.
        The arachnoid and the pia.

        It is too risky to allow any type of spinal injection. Due to being medically
        caused, no medical person or facility will diagnose it honstly. I know for I
        am a victim of AA caused by unsupervised residents at a VAMC. That was twelve
        years ago and I still tying to get an honest diagnose. Jim


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