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For Book: Symptom A Doc Might Notice
Old 06-19-2016, 11:56 AM   #1
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For Book: Symptom A Doc Might Notice

Here's a subplot for a book I'm writing.

The main character and his wife have a famous doctor over for dinner. She notices a subtle symptom in the main character's wife that leads to a diagnosis of a serious disease. I want it to be a subtle symptom that the wife or the hubbie (who has a Ph.D in neuroscience) might not even notice.

For example, maybe she notices a slight tremor in the wife's thumb, and it leads to a Parkinson's diagnosis.

I might go with that or a brain tumor.

Any other ideas?

Thanks,

Al
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Old 06-19-2016, 12:32 PM   #2
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Dr. Famous could make eye contact with her hostess and notice a Kayser-Fleischer Ring, which is a subtle sign of Wilson's Disease (hepatolenticular degeneration). It's a genetic condition which leads to liver failure and neurological symptoms. But the PhD might not be aware of this condition.

https://en.m.wikipedia.org/wiki/Wilson%27s_disease
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Old 06-19-2016, 12:34 PM   #3
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Faint jaundice of the eye sclerae indicating impending liver failure? Often people seeing each other every day don't notice it because it is so gradual.
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Old 06-19-2016, 01:19 PM   #4
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On one of the "Doctor" shows my wife watches, one of the Docs was going through a separation/divorce, and went out to a strip club. He noticed a mole on one of the strippers, in an area not normally exposed. He waited around to meet her as she got off her shift to warn her that she should have it checked out, it could be cancerous, and of course she thought he was some kind of creep/stalker.

That would give you a chance to work strippers into the book, or some kind of kinky dinner party activity. That should boost sales?

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Old 06-19-2016, 03:51 PM   #5
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How about adapting this from real life: tv-viewing nurse notices HGTV star has a lump on his throat, turns out to be thyroid cancer.

A Flip or Flop Viewer Discovered Tarek El Moussa's Cancer | POPSUGAR Home
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Old 06-25-2016, 01:17 PM   #6
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Great ideas, thanks. The stripper thing sounds like House.

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Old 06-25-2016, 03:41 PM   #7
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Im reminded of a time when a doctor misdiagnosed the commissioner of Major League Baseball with heart problems, based off of fingernails spotted on a TV close-up.

This sort of explains the event...

http://articles.philly.com/1989-09-0...is-fay-vincent



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Old 06-25-2016, 04:08 PM   #8
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Misophonia - The woman could fly into a rage when some sort of crunchy dessert is served.
https://en.wikipedia.org/wiki/Misophonia

That's not too serious, though. Maybe some swallowing problems (dysphagia) leads to a diagnosis of serious digestive system issues.

Or maybe the behavioral variant of frontotemporal dementia. It starts very gradually and is often misdiagnosed as a psychiatric issue in the early stages. A person may act outside their normal interpersonal range at first (rude comments, quick to become annoyed), then gradually progress to behavior outside social boundaries (compulsive or reckless spending, loss of inhibitions). Might make for some interesting "What's gotten into the neuroscientist's wife?" story lines. It's rare enough that it could be plausible that a neuroscientist might not see a connection when symptoms begin to appear.
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Old 06-25-2016, 04:20 PM   #9
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I worked with a guy, a co-worker noticed something in his pupil. It turned out he was on the edge of having a stroke. I can't remember if it was dilated, or different between two eyes, or something else. He took 3 months off to get better and now is OK.
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Old 06-25-2016, 07:30 PM   #10
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Lupus has a number of fairly obscure symptoms that could be picked up on. A butterfly shaped rash across the nose and cheeks, swollen joints, hair loss, dry mouth and eyes, discoloration of the toes and fingers. A veritable smorgasbord of symptoms.
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Old 06-27-2016, 05:19 PM   #11
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It's a full moon, and lycanthropy is detected through the subject's uncomfortable behavior.
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Old 06-27-2016, 08:57 PM   #12
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There are so many of these signs from what I refer to as 'The Days of the Giants'. The students love to hear about these history of medicine 'pearls' - not!. My personal favourite is associated with aortic insufficiency (AI) or regurgitation in which the aortic valve is incompetent and allows blood to flow back into the heart after each heart beat. There are at least 14 eponymous signs associated with the condition but the one I am most fond of is referred to as 'Lincoln's sign'. Named after President Abraham Lincoln of course. When the aortic valve starts to fail (this can occur over quite a prolonged period though it can also occur suddenly in some cases), the heart has to pump more forcefully and the extra blood ejected combined with the back flow into the heart as the heart relaxes leads to a very forceful pulse that is quickly dissipated. This causes many 'signs' which are things that can be observed as opposed to 'symptoms' which are things that patients report. Lincoln's sign is seen when this forceful pulse in the popliteal artery behind the knee causes the top leg of crossed legs to jump or bob with each heart beat. This is seen when legs are crossed in the manner of knee on top of knee rather than heel on knee. Evidence that Lincoln had aortic valve insufficiency was that in seated pictures of him with his legs crossed, his foot was always seen to be blurred due to the motion of the bob. Exposures were long back then. There are many causes for aortic valve insufficiency. It is thought that Lincoln likely had Marfan's syndrome which usually gives one a tall and spindly body habitus, long digits and excess flexibility and is due to a connective tissue problem that also results in a weakened and widened aorta. A 'sexy' cause of damage to the aorta leading to eventual aortic insufficiency is syphylis. Another interesting cause is damage to the heart valves by the diet drug fenfluramine which was withdrawn from the market for this reason.

One of the reasons that I remembered this sign was that I had it. As a slim runner with a resting heart rate of around 40 and therefore a large pulse volume I could show people the sign quite easily. A quick listen to my heart would reveal that I didn't have the easily heard murmur that is associated with aortic valve incompetence.

Another sign associated with AI is a bobbing of the head for the same reason. This is referred to as De Musset's sign after a French poet. Both of these signs are usually quite subtle but can be observed from a distance. Damage to the aorta as it exits the heart can develop slowly but be rapidly fatal if not detected and repaired. The same is true for the aortic valve.

Your doctor could be caught 'staring' at the hostess's shapely legs! Only to reveal that he was in fact exercising his keen eye for diagnosis.
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Old 06-27-2016, 09:10 PM   #13
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Quote:
Originally Posted by TromboneAl View Post
Here's a subplot for a book I'm writing.

I want it to be a subtle symptom that the wife or the hubbie (who has a Ph.D in neuroscience) might not even notice.
If the husband has a Ph.D. in neuroscience maybe he wouldn't notice that his wife (who is in denial) is morbidly obese. Let's see how the famous doctor handles that.
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Old 06-29-2016, 09:33 PM   #14
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Google carcinoid syndrome. My ex had it. I'd say his first symptoms were pains on the side of his chest. Later, he developed "rosacea" that was actually flushing from the carcinoid.
Digestive issues were dismissed as "irritable bowel" and "stomach bug"

Really hard to catch until it's too late.


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Old 07-02-2016, 10:09 AM   #15
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Signs vs. symptoms. Good to know, thanks.
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Old 07-02-2016, 11:20 AM   #16
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A coworker told me how he was saved. A nurse friend told him that he should have a mole on the middle of his back checked out. It was cancerous.
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