Slashdot Mirror

← Back to Stories (view on slashdot.org)

'Selfie' Helps Doctors Diagnose Mini-Stroke

Posted by timothy on 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.

47 comments

  1. Among the consequences by i+kan+reed · · Score: 4, Informative

    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.

    1. Re:Among the consequences by Anonymous Coward · · Score: 1, Insightful

      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.

    2. Re:Among the consequences by drinkypoo · · Score: 1, Interesting

      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 it.

      --
      "You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
    3. Re:Among the consequences by i+kan+reed · · Score: 2

      *reposts the same idea rephrased*
      *talks down to me as if I didn't grasp the concept*

      Gee, thanks.

    4. Re:Among the consequences by Anonymous Coward · · Score: 0

      OMG, WTF it's not a selfie damn old folk got no idea.

    5. Re:Among the consequences by fredrated · · Score: 1, Insightful

      Taking a picture of yourself is one of the consequences of a surveillance society? Afraid I don't follow you.

    6. Re:Among the consequences by Anonymous Coward · · Score: 0

      The voice of sanity. Watch out for torches and pitchforks.

    7. Re:Among the consequences by i+kan+reed · · Score: 2

      It is. I'm sorry, omnipresent surveillance tools is a relatively simple consequence.

    8. Re:Among the consequences by i+kan+reed · · Score: 1

      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.

    9. Re:Among the consequences by hackus · · Score: 1

      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.

      --
      Got Geometrodynamics? Awe, too hard to figure out? Too bad.
    10. Re: Among the consequences by Anonymous Coward · · Score: 0

      So you would let men around the globe marry little girls because it does not affect you? You would allow them to follow the Old Testament or the Vedic religions or Islam all which allow men to marry and have sex with female children? The western world almost has that practice eradicated around the world. The pedophiles who defy women's rights get imprisoned or drone bombed. And you want to change that?

    11. Re: Among the consequences by drinkypoo · · Score: 0

      So you would let men around the globe marry little girls because it does not affect you?

      That's what we do now. How would that be any different?

      The pedophiles who defy women's rights get imprisoned or drone bombed. And you want to change that?

      There's lots of collateral damage. You don't want to change that?

      --
      "You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
    12. Re: Among the consequences by Anonymous Coward · · Score: 0

      Whoosh!

  2. Very smart by TheCarp · · Score: 4, Informative

    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.

    --
    "I opened my eyes, and everything went dark again"
    1. Re:Very smart by ArsenneLupin · · Score: 1
      Screenshots...

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

    2. Re:Very smart by ArsenneLupin · · Score: 1

      ... 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...)

    3. RE: Very smart by Anonymous Coward · · Score: 0

      Working in PC service now, I can relate to the difficulty of diagnosing a problem that isn't currently happening. However, on a computer, I can read log files (not always helpful) and make backups; a doctor can run tests (not always helpful) but they can't have you just download a copy of your mind into a donor body on the off chance that the one you are in dies. "Sorry, it isn't happening now. You can go home." just doesn't cut it.

  3. Idiot bait by rebelwarlock · · Score: 1, Troll

    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.

    1. Re:Idiot bait by Anonymous Coward · · Score: 0

      flame broiled spamburgers...mmmmmmm

    2. Re:Idiot bait by Anonymous Coward · · Score: 0

      It's like nails on a chalkboard for me any time someone says the word. It's wholly unnecessary at all times and under all circumstances, unless you're talking to a 2 year old. Isn't that normally the convention? Adding -ie or -y to a word when talking to really small children?

    3. Re:Idiot bait by Anonymous Coward · · Score: 0

      I always thought people take those 'selfies' as a result of a minor stroke.

  4. Selfie is short for... by tepples · · Score: 1
    Anonymous Coward wrote that the word "selfie" is

    wholly unnecessary at all times and under all circumstances

    What better abbreviation of "self-portrait" would you suggest to fit in an 80-character story headline or 50-character comment subject?

    1. Re:Selfie is short for... by Nidi62 · · Score: 1

      What better abbreviation of "self-portrait" would you suggest to fit in an 80-character story headline or 50-character comment subject?

      Well, the words "picture" or "photo" or, in this case, "video" sufficed just fine for decades before some idiots started to use the word "selfie".

      --
      The only thing necessary for evil to triumph is for it to be pitted against a slightly greater evil
    2. Re:Selfie is short for... by fredrated · · Score: 1

      Except that picture and photo do not convey the property of the picture that it is of the photographer, selfie does this.
      This is important in a narcissistic society.

    3. Re:Selfie is short for... by Daetrin · · Score: 1

      What better abbreviation of "self-portrait" would you suggest to fit in an 80-character story headline or 50-character comment subject?

      If one has to have a short and specific word (instead of just "photo" or "video" as has already been suggested) then i would go with "SelfPic" or "SelfVid" as appropriate. It may not roll off the tongue quite so easily, but it's only one character longer than "selfie" and, most importantly, it doesn't sound like you're performing some kind of sex act on yourself.

      --
      This Space Intentionally Left Blank
  5. Helped diagnose an allergic reaction, too! by Myself · · Score: 1

    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!

  6. The original doctor missed that? by RelaxedTension · · Score: 1

    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?

  7. Too Many Women Die from "All in your head." by BrendaEM · · Score: 4, Informative

    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.

    --
    https://www.youtube.com/c/BrendaEM
    1. Re:Too Many Women Die from "All in your head." by Anonymous Coward · · Score: 0

      I wouldn't limit this to just woman, many woman, men, boys, girls are misdiagnosed and pay the ultimate price. BTW did they figure out what happened to your friend?

    2. Re:Too Many Women Die from "All in your head." by DNS-and-BIND · · Score: 1, Insightful

      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.

      --
      Shutting down free speech with violence isn't fighting fascism. It IS fascism!
    3. Re:Too Many Women Die from "All in your head." by Anonymous Coward · · Score: 0

      Could just be a case of not being in the best mindset because of a loss of a loved one. So, he didn't write his post with the proper gender neutral pronouns in mind. Not everything is about those misguided white knights.

    4. Re:Too Many Women Die from "All in your head." by NoSalt · · Score: 0

      It is a woman thing because it is incredibly difficult to diagnose any heart conditions in women from symptoms alone. Many women get told it is only anxiety or indigestion when it is actually a serious heart condition. They are told to go home and take it easy, then they die. This is not so with men. When we have heart issues, it is fairly easy to detect it from symptoms alone.

    5. Re:Too Many Women Die from "All in your head." by Stickerboy · · Score: 1

      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 even surgery or procedures because everyone involved is sure there's an actual physical problem related to a symptom that isn't going away and everyone involved is willing to dive down the rabbit hole to figure out what it is. Case in point: one of my hospital's most frequent patients is a nice woman who came in originally due to unexplained long standing abdominal pain and nausea and vomiting. Even though all the relevant testing was coming back negative, eventually after enough visits, a consulting surgeon felt her symptoms resembled dysfunctional gallbladder pain enough for her to have it surgically removed. Fast forward, the patient is still coming in for the same symptoms, but develops a small bowel obstruction from scar tissue from her previous surgery. Fast forward again after multiple bowel resections for multiple obstructions, and she has developed short gut syndrome on top of her previous symptoms with chronic diarrhea and malabsorption of basic nutrients. She's doing better now on daily IV nutrition. I'll let you imagine what her quality of life is with a permanent IV that has to be changed every so often for serious line infections, and being tethered every day to a bag of nutrients to drip in. And she is by no means a unicorn in the medical world.

      And now, back to your friend's ex-girlfriend. What tests were run? What were the results? What description of pain was she having? What did she die of? Have you contemplated the possibility that the hospital ran appropriate tests for a chest pain evaluation, everything came back negative, your friend's ex-girlfriend was dealing with concurrent anxiety disorder, and died with something unrelated a week later?

      --
      Light a fire for a man and he'll be warm for a day. Light a man on fire and he'll be warm for the rest of his life.
    6. Re:Too Many Women Die from "All in your head." by Anonymous Coward · · Score: 0

      Did she watch a weird creepy video tape then get a sinister phone call just before the chest pain?

  8. Something wrong with this story by Dcnjoe60 · · Score: 4, Insightful

    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.

    1. Re:Something wrong with this story by Stickerboy · · Score: 1

      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 doctor that's not hearing or associating the right phrases to lead them down the TIA/stroke diagnosis pathway to be sent home." Sometimes it's a fine balance to walk between putting words in a patient's mouth that they can enthusiastically nod their heads to versus listening to them stumble around trying to find a way to describe what happened.

      "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."

      --
      Light a fire for a man and he'll be warm for a day. Light a man on fire and he'll be warm for the rest of his life.
    2. Re:Something wrong with this story by Anonymous Coward · · Score: 0

      She went to a different hospital the second time.

      I totally agree with your point about TIAs; the thing about transient ischemic attacks is that they are, you know, transient. How are we supposed to educate the general public about strokes if an ER doctor can't get the message? But no way could a doctor look at that video and think conversion reaction; the symptoms are perfectly consistent with stroke, whereas the indicator for conversion reaction is a nonsensical bundle of symptoms.

  9. As a Canadian... by Anonymous Coward · · Score: 0

    It shouldn't have come to this. They should have given her a MRI or a CT scan the day she went to the hospital. She should have not been turned away for something as serious as a stroke. I would be suing the hospital.

    1. Re:As a Canadian... by IcyWolfy · · Score: 1

      Because MRIs and CT Scans are expensive, and aren't done for every crazy walk-in.
      Most of the time, given an hour or two, everything resolves itself as transient.

      As opposed to the US where everyone gets every damned test, and procedure because otherwise the patient may sue, it's how the rest of the world keeps medical costs in check. Don't perform unnecessary tests (as determined by the doctor, NOT an insurance company)

      It probably didn't help that she was unable to convey her symptoms to the original doctor; as that probably would have caused them to suspect TIA; or it could be that the doctor she saw wasn't versed in it. Doctor's don't know everything, and tend to come to diagnosis related to their experience. Dietician: diet problem; Urologist: Sex-Hormone issue; Endocrinologist: General Hormone Issue GP: stress/lifestyle issue; Oncologist: possibly cancer.

      This is why people need to always get second opinions if they are brushed off. If you get two "it's nothing" opinions, you either have something very rare that will cost lots of money to determine what it is, for minimal benefit -- or, it's actually nothing.

    2. Re:As a Canadian... by Anonymous Coward · · Score: 0

      Too expensive? National Health Care, remember. And no US Insurance Company to bill the shit out of.

  10. Why no MRI the first time? by zerosomething · · Score: 1

    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?

    --
    It all starts at 0
    1. Re:Why no MRI the first time? by Stickerboy · · Score: 4, Insightful

      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

      --
      Light a fire for a man and he'll be warm for a day. Light a man on fire and he'll be warm for the rest of his life.
  11. Very smart by Anonymous Coward · · Score: 0, Insightful

    I say this with respect to your comment. But how is it the women didn't receive a MRI the first damn time she went to the hospital? The doctors had to "witness or watch the video" then decided it was a good idea to give the women an MRI?

    It isn't cheap (for laughable reasons) for an MRI, but we should be seeing cheap and accurate scanning tech by now! It great to know you have health insurance, but you better pray the doctors are going to catch whatever is wrong with you before they rack up thousands of dollars in tests, or they just blow it off as someone overreacting to something minor or non-life threatening.

    Doctors are like public defenders they simply don't give a shit, on to the next sucker. Not all doctors are like that, few still actually care and remember the reasons for why they do what they do. And I really blame how defunct our medical industry is that things are ran like your placing an order at a fast food drive-thru.

  12. Universal Healthcare by hackus · · Score: 1

    Winning!

    --
    Got Geometrodynamics? Awe, too hard to figure out? Too bad.
    1. Re:Universal Healthcare by l0ungeb0y · · Score: 1

      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.

  13. Standard response for TIA does not apply by sabt-pestnu · · Score: 1

    ... 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.