Forgot your password?
typodupeerror
Medicine

'Selfie' Helps Doctors Diagnose Mini-Stroke 47

Posted by timothy
from the socially-redeeming-value dept.
OakDragon (885217) writes A Toronto woman had the presence of mind to record herself, using her smartphone, as she suffered from a bout of semi-paralysis. She had suffered the same symptoms two days earlier, and had gone to the hospital; but by that time the condition had passed, and doctors sent her home. However, using the smartphone video, doctors later diagnosed her with a transient ischemic attack, or mini-stroke. The diagnosis was confirmed with an MRI.
This discussion has been archived. No new comments can be posted.

'Selfie' Helps Doctors Diagnose Mini-Stroke

Comments Filter:
  • by i kan reed (749298) on Thursday June 19, 2014 @10:06AM (#47271637) Homepage Journal

    This is among the consequences of a surveillance society. More information almost always helps people with positive intentions do their jobs.

    On the other hand that's not an endorsement of a surveillance state.

    • Re: (Score:1, Insightful)

      by Anonymous Coward

      This is among the consequences of a surveillance society.

      That's only the case if it is the subjects of the surveillance - we, the people - who have control over the retention and dissemination of the information.

      • I don't disagree, but the two inevitably end up inter-tangled due to the complexity of life. We can make every attempt to prevent abuse, but abuse will happen too.

    • Re: (Score:2, Interesting)

      by drinkypoo (153816)

      Corollary, that's why we need to grow the fuck up and stop trying to make other people live the way we want them to live, only worrying about stuff that actually has a direct impact on us. Meanwhile, we (as a species) ignore most of the people actually doing that kind of stuff while concentrating on our neighbor's habits and proclivities that don't actually affect us if we don't pay them any mind. Then we can enjoy the benefits of a surveillance society without having to worry that we're going to get reamed

    • by hackus (159037)

      On the other hand, when government and fascist corporatist attiudes prevail in society, only the elite qualify for immediate MRI exams.

      "Oh, Mr. Bankster, you said you have a slight pain last week? Lets do a complete work up and MRI."

      The rest of you are having an "its all in your head", take an aspirin, come back when the bill is much cheaper to put you in the ground than give you a MRI.

  • Very smart (Score:5, Informative)

    by TheCarp (96830) <`ten.tenaprac' `ta' `cjs'> on Thursday June 19, 2014 @10:17AM (#47271753) Homepage

    Having worked in PC service, I can relate to what the doctors must feel seeing this. Its so hard diagnosing a problem that isn't happening now. You don't know if the user has any idea what they are talking about, or if they are missing some piece of information or including red herrings.... when someone has the presence of mind to actually properly document the problem they are having so that you can actually see what is happening.... its great; those were always the best.

    • Screenshots...

      but then of course, it would be so much easier if people were able to appropriate describe a problem, and understand a description...

      • ... and next steps will be doctors (or their personal assistants...) asking patients to shoot such selfies, including for conditions which leave no obvious visual sign (pain...)
  • The use of the term 'selfie' was wholly unnecessary to the story. In fact, the only reason it's there is so they can get their drivel on slashdot. Kill this spam with fire.
  • After popping a bunch of benadryl and being satisfied that my condition wasn't worsening, I elected to make a regular appointment with my GP instead of going to Emergency.

    I decided to take a few photos of the skin rash before it went away, which allowed the doctor (three days later, when I was totally fine again) to quickly identify that it was indeed an allergic reaction, and based on where it appeared, the subsequent interview helped diagnose the cause. Worked great!

  • There are stroke commercials on TV pointing out that exact symptom, saying know the symptoms and act fast. What the hell is wrong with that doctor that they missed that? IANAD and I get that that the symptoms weren't apparent when she was actually being examined, but really?
  • by BrendaEM (871664) on Thursday June 19, 2014 @11:31AM (#47272729) Homepage

    Too many women die by the "all in your head" diagnosis.

    My friend's ex-girlfriend went to the hospital for chest pain, was diagnosed with anxiety. She died less than a week later.

    • Re: (Score:1, Insightful)

      by DNS-and-BIND (461968)
      How's this a "woman thing" again? The medical profession is snappy and high-handed with both sexes. They don't care about you any more than a mechanic cares about a car. But I guess to certain people everything is a male oppression dystopia because that's all they think about all day long. It is a poor witch-hunter who cannot find witches.
    • by Stickerboy (61554)

      Too many women die by the "all in your head" diagnosis.

      My friend's ex-girlfriend went to the hospital for chest pain, was diagnosed with anxiety. She died less than a week later.

      There's too many generalities and not enough specifics for this to be useful, in any way. To preface what I'm about to say: yes, medicine, like most professions, historically has had sexism problems. Although with the older generation of doctors retiring and/or dying, and more women studying medicine than men at many schools, that is changing.

      For every woman that dies by the "all in your head" diagnosis, there's a substantial number of women that are harmed through expensive and unnecessary testing and eve

  • by Dcnjoe60 (682885) on Thursday June 19, 2014 @11:54AM (#47273019)

    There is something wrong with this story. Doctor's won't discount a TIA because the symptoms subsided. That is exactly why they are transient! The news this morning also ran this story and indicated that the doctors had originally concluded it was stressed induced (conversion reaction). The problem is if it was a conversion reaction, then the video would not disprove that. Furthermore, after seeing the video, they did an MRI and found an indication. Why was that not done originally? Standard response for a TIA is to do an MRI. Besides, if damage was now detected, it indicates she did not have a TIA but had a stroke.

    Something is not quite right with this story.

      • by l0ungeb0y (442022)
        I fail to see how this wouldn't be likely to happen under private insurance. A lot of Doctors tell people to go home to clear out their waiting rooms. Running tests may indeed be billable, but take time and require documentation.
    • ... because the doctors at the ER had already decided that it was not a TIA.

      ... because so many other possibilities seem more likely.

        "I don't need any more facts because my mind is made up" doesn't just apply to the political world.

    • by Stickerboy (61554)

      Since you're asking a similar question to someone else I replied to, I'll cut and paste my answer from below.

      The doctor didn't think her story, as it was told to them at the time, was a TIA. What happened to cause the misdiagnosis? Most likely, a "failure of doctor-patient communication. With a completely normal physical/neurological exam, all it takes is for a slightly confusing or badly told patient story (which NEVER happens, of course, with a patient freaked out about a possible medical problem) or a do

  • I'd like to know why the doctors didn't ask for an MRI the first time around. Why did the patient need to wait and get "proof" there was a real problem? Intact why don't we get an full body MRI and maybe even a CT scan maybe every 20 years to find possible problems before they happen?
    • by Stickerboy (61554) on Thursday June 19, 2014 @04:14PM (#47275685) Homepage

      I'd like to know why the doctors didn't ask for an MRI the first time around. Why did the patient need to wait and get "proof" there was a real problem? Intact why don't we get an full body MRI and maybe even a CT scan maybe every 20 years to find possible problems before they happen?

      Well, IAAD. I don't have access to the notes/file, but I can give a pretty reasonable guess to your answers.

      Why didn't the doctor ask for an MRI the first time around? Well, she went to the ER. Now, admittedly, I haven't worked in the Canadian system or outside of 2 confluent states here in the US, but standard of practice where I have worked is that ER doctors do not have access to MRI scans. They take way too long for the fast turnaround of ER care. MRIs can take 30 minutes to multiples of hours. CT scans take a few minutes. MRIs are either handled by outpatient scheduling or by admitting the patient for an inpatient stay in the hospital. On top of that, any stroke suspicion automatically gets a CT of the head without contrast to rule out intracranial bleeding, which is by far the most serious and emergent diagnosis from that class of symptoms. Tangentially, a CT of the head likely would not have picked up a small ischemic stroke like her later MRI.

      Why did the patient need to wait and get proof? Well, with the story written down and no workplace rush, hindsight says she probably deserved an inpatient workup for a TIA the first time around. The #1 cause of misdiagnosis is failure of doctor-patient communication. With a completely normal physical/neurological exam, all it takes is for a slightly confusing or badly told patient story (which NEVER happens, of course, with a patient freaked out about a possible medical problem) or a doctor that's not hearing or associating the right phrases to lead them down the TIA/stroke diagnosis pathway to be sent home.

      Now let's turn this around, based on her initial episode on presentation to the ER. You're the patient that just had a five minute spell of weirdness that includes, "had trouble speaking words". In a few minutes, those symptoms were gone like it never happened. A CT scan will likely be negative for anything (but it will dose you with about 20 chest X-rays' worth of radiation to your brain). By definition, a TIA won't show anything on MRI (a small-scale infarct on MRI is a stroke, period). There is no medical "fix", as TIAs are self-limiting and resolve themselves - there is only secondary prevention. If this is a TIA, your best treatment includes going on aspirin daily (ulcer risk), antiplatelet medication like Plavix daily (bleeding risk), and a statin daily (multiple adverse effects well-documented. You can avoid taking if LDL is already low). On the basis of five minutes of symptoms that haven't returned, would you feel like taking this medication for the rest of your life? Does dosing every single person that comes in with a similar story with a combination of multiple medications sound like a good outcome?

      Third, why doesn't everyone get a full body MRI and maybe even a CT scan every 20 years? Well, you can. You'll need a credit/debit card or an appropriately-sized stack of cash, but radiology suites will be glad to scan you. I'd hate to put words in their mouths, but I would venture to say that would be their preferred business model. Especially if they could get away with not having to deal with third-party payers.

      Oh! You want someone else to pay for your scan. First, you need a good reason to order the scan to get someone else to pay for it. So let's think about it. Multiply thousands of dollars of unnecessary scans times 300 million people+ here in the US, rotating every 20 years. Then factor in all the incidental findings which will be inconclusive and need either further scans or maybe invasive surgical procedures to investigate. Factor in complications and harms from procedures and radiation dosing (a single CT of the chest is equivalent to about 70 chest X-rays, which is not insignificant in term

Computers are unreliable, but humans are even more unreliable. Any system which depends on human reliability is unreliable. -- Gilb

Working...