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Friday, September 25, 2009

When I attempt to make a Differential Diagnosis during a panic attack

A couple of weeks ago I had a panic attack.It was this vague abdominal pain that won't go away.And being the doctor that I am I just had to make a diagnosis -A bunch of differential diagnosis all without any lab tests or other aids..
So,,all the racing differential diagnoses in my head finally gave me a panic attack..then i went to twitter and made a record of my thoughts..Just so that i can blog about them later..

Here goes

Had a severe panic attack compounded by abd pain,nausea.I have been sick this week.makin dramatic differential diagnoses doesn't help either from web

see.It is could be a ruptured ovarian cyst with Intraperitoneal infection leading to sepsis.could be a strangulated hernia.vaginal prolapse? from web

No wait, maybe i have had anemic hypertrophy of the heart due to constant blood loss due to hemarroids,or maybe my complication of swine flu from web
could it be sinusitis leading to sepsis causing the nausea?oh wait,Myab from web
maybe i have had undiagnosed Hypertension all this while which explains the headache..or wait, is the headache due to sinusitis? from web
Am i just a hypochondriac? or maybe psychosomatic disorder? gosh! knowing too much is sometimes a problem when you get sick.doctors=bad pts! from web
You know what my worst fear is .what if the ovarian cysts have already undergone that rare cancerous transformation and have metastasized ! from web
what if the metastasis to different areas of the abdomen is what is causing abdominal pain which random and what if the nausea is cachexia? from web
want to see what a doctor tweets when she has a panic attack? read my previous 12 tweets.Maybe i must make them into a blog entry! from web
yeah.maybe metastatic secondaries all over giving me pain ..that is one thing i hope it NOT true.could be intususeption/volvulus/strangulatn from web
see the headache could be plain frontal sinusitis/inf associated with it/migraine/temporal arteritis/Hypertension associated ..soooooo from web
yeah.I also thought about if it is a progesterone producing ovarian cyst causing me rt lower quadrant pain with nausea from web
absolutely not getting yeah, the chance of pregancy or ectopics is thankfully ruled out unless there is one of those evil twin thing from web
very very loud grumbling and bowel movement-some kind of obstruction?strangulation ?intususseption?volvulus?ovarian cyst pressing on bowel? from web
Seriously, being a doctor and being sick this whole thing sucks...the abd pain sucks,headache sucks,panic attack sucks most! from web
I am so sane and accurate when it comes to diagnosing my patients.Only when i do have to diagnose myself I go totally overboard!totally! from web
Now,see ,when i now read these tweets as i Import them from my Twitter stream.I find them Hilarious and outrageous...A progeterone producing cyst?What the hell? And suddenly it dawned on me that THIS IS HOW PATIENTS FEEL..They are stressed, they are scared and they are probably angry .I realized that when patients come to me with breast masses and other pains, they are very distressed and the fear is irrational but they can't help it ..
this panic attack help me understand their pain on a first hand basis and probably more receptive to their seeking my help..Hmmmm...

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