Teen Outsmarts Doctors In Science Class  
Self-diagnosis impresses docs who've missed signs of her disease for years

http://www.nbcbayarea.com/news/us_world/Teen-Outsmarts-Doctors-In-Sciene-Class.html?yhp=1
By  EMILY FELDMAN

Updated 10:21 AM PDT, Mon, Jun 15, 2009

When doctors didn't give a Washington state high school student the answers she wanted, she took matters into her own hands.

Eighteen-year-old Jessica Terry, brought slides of her own intestinal tissue into her AP science class and correctly diagnosed herself with Crohn's disease.

"It's weird I had to solve my own medical problem," Terry told CNN affiliate KOMO. "There were just no answers anywhere ... I was always sick."

For years she went from doctor to doctor complaining of vomiting, diarrhea, weight loss and stomach pains. They said she had irritable bowel syndrome. They said she had colitis. They said the slides of her intestinal tissue were fine, but she knew that wasn't right.

"Not knowing much about a disease you're growing up with is not only nerve-wracking, but it's confusing," Terry told the Sammamish Reporter.

So when local pathologists stopped in to teach students in her Biomedical Problems class how to analyze slides, the high school senior decided to give her own intestines a look.

What she found? A large dark area showing inflammation, otherwise known as a granuloma––a sure sign of the intestinal disease.

To confirm her suspicion, she checked in with her teacher.

"'Ms. Welch! Ms. Welch! Come over here. I think I've got something!" she shouted.

Mary Margaret Welch, who has spent 17 years teaching science at Eastside Catholic School, had a feeling Terry was on to something.

"I snapped a picture of it on the microscope and e-mailed it to the pathologist," Welch said. "Within 24 hours, he sent back an e-mail saying yes, this is a granuloma."

The finding impressed doctors.

"Granulomas are oftentimes very hard to find and not always even present at all," said Dr. Corey Siegel, a bowel disease specialist at Dartmouth-Hitchcock Medical Center. "I commend Jessica for her meticulous work."

While Terry's glad to finally have answers, she now knows she'll have a tough road ahead.

Crohn's disease is an incurable, though treatable condition caused by inflammation in the intestines. It can cause malnutrition, ulcers, pain and discomfort.

Still, she looks towards the future with optimism.  She'll begin nursing school in the fall and hopes to have a kid's book on Crohn's disease published.

Good on her!

There's a reason they are called "practicing" physicians.

Based on a few of the Doctors that I met when my father was alive and sick, I'd have to say that outsmarting a Doctor isn't all that difficult.

In another article, they mentioned she received a sample from a biopsy.

ETA- I mean the doctors gave her a sample, not that she biopsied herself.  

Her own tissue sample (you can ask for it).

I've looked at Slides (on a Path rotation).   There may be one or two Granulomas on the whole slide (think of finding one Diet Coke Can in a 1/4 acre lot full of Diet Pepsi Cans, Beer Cans, etc.).  

Any Pathologist will tell you they can miss things....they are MUCH better than an untrained eye, but someone who can look at the slide and take a great deal of time to look at every individual cell (like the young lady they are talking about) can spot things that Path will miss.

AFARR

I wasn't that she outsmarted  the doctors, she out-cared them.

She didn't really outsmart them.  She out-worked them.  I work with doctors for a living, and very few of them like to work or like to interact with patients so of course things like this are usually missed.

As an example, our new CRM (customer relationship management) system sold to three different cardiologist practices shows that it takes them an average of almost four days before emergency calls are returned.  In my opinion, four days turn-around to help with heart problems is unacceptable.  In the software business I manage we try to always have a less than thirty minute turn-around during business hours.  One of the practices is going to stop using the system because those records will be a liability when they have to go to court.z

Wow...but then again, somebody finishes last at med school.

When I was in the Heating & Airconditioning field I wasn't practicing and surely wasn't pulling down the dough that these people do praciticing thier job.....

Why were the doctors unable to diagnose Crohn's correctly ?    I know people who have it, and they were properly diagnosed.

...

in the real world, a 1.000 hit rating is impossible.

A physician is a human, (in this case it was the person reading the slides that let one slip––more a quality control issue), and like any person, when they see the same thing again, and again, and again, you have to make sure they note the DIFFERENCES in one case  vs another. You cannot expect 100% catch on something out of the ordinary unless you insist.
That is why I have always said, "I am in charge of my healthcare, but I consult with my doctor."
He does not have the final word, nor does he simply tell me what to do. I tell him what we will do after he has give me his opinion.

Think that's bad... last night they had a show on about doctors who used to stick ice picks in people's eyes, puncture the skull, and SWIRL the FRONTAL LOBE of the BRAIN until it was destroyed.  They did these labodomies on thousands without patient or guardian consent.  They would pose for pictures while doing them....



Ahhh the altar of Western "Modern" Medicine.

I haven't seen histological samples so I don't know if they can be differentiated that way, but I do know the symptoms of Crohn's colitis and ulcerative colitis are very similar.

the problem is when you do screw up with the hvac diagnosis they don't want to pay you anything at all.

No one expects perfection, but what happened here sounds way below reasonable expectations.

A reasonable person would assume that after multiple doctors over multiple years, all with wrong/different diagnosis's, that someone needs to check everything again, with and with a lot more care.

Western Medicine is better than most.

But they really did that crap not too long ago either.

Here we get back to the 'give a shit' that most doctors don't have. They may at one point, but most have it regulated and worked right out of them.

Nothing focuses the mind like debilitating disease.

+1, Crohns sucks.

My large bowel 'issue' was misdiagnosed for close to ten years.

Well you guys should all stop going to doctors then.

You just going to bitch and moan.

Seriously why dont you guys just stop going?  It would save you money and the doctors a headache.

sadly i have the same exact story.

In other news, spending weeks learning about cars and fixing your own car instead of paying someone who knows what they are doing and can do it it 15 minutes saves money.








How much 'care' can you afford?  Serious question.  At $100-150 per hour, how much time do you want the pathologist spending per slide?  Just wondering.

Her excitement over this self-diagnosis will be short lived once she has a massive flare-up.



I'll be more impressed when she comes up with a cure.

http://upload.wikimedia.org/wikipedia/commons/c/c6/CD_serpiginous_ulcer.jpg

It's amazing how skeptical people here are when it's an article on gun control but swallow anything else the media writes about.

Crohn's disease, like any disease, has a spectrum.  Some patients have very mild disease and others have a textbook presentation with a severe flare-up and extra-intestinal involvement.

The article states that the doctors gave her a diagnosis:



Well, Crohn's disease is a type of colitis, specifically granulomatous colitis.  So it's not like they had no clue but rather that the disease is so mild that were certainly not about to start her on immunosuppressive or anti-inflammatory therapy.

How do we know is was mild?  She had a colonoscopy to look for macroscopic disease and do biopsies, and they found nothing.  OK, so after the fact she finds a *single* granuloma in the entire slide she was looking at.  Wow, call out the National Guard!

So, after her big discovery we find out she's planning on going to medical school.  NOT!  She's going to study nursing.  

And we wonder why we have to import doctors.

You're not going to believe this, but there used to be separate drinking fountains for blacks and whites in this country.  I know it sounds unbelievable but you should look it up.

My cousin has Crohn's disease. Not good.

If doctors were as passionate about doctoring as we are about guns....





We'd be healthier.