Dangers of Self-Diagnosis

Dicey? Yes. Could it be deadly? Don't risk it. Leave the evaluation up to your doctor and avoid discomfort big and small.

By Sarah Huschke, M.D.

With the advent of the Internet, media coverage of continuing medical breakthroughs, and the increasing social acceptance of alternative medicine, many people feel an increased sense of empowerment when it comes to making decisions affecting their health. In addition to the amount of information available to patients, there are also hundreds of OTC medications and nutritional supplements available for use without a professional's guidance. As it is important that patients are their own advocates in our increasingly complicated health care system, they need to proceed with caution before starting new medication and treatment plans for self-diagnosed illnesses.

The growing popularity of Web sites such as WebMD.com, and the increased frequency with which health insurance companies are urging clients to utilize educational Web portals before going to see a physician, often gives health care providers the challenge of overcoming patients’ preconceived notions. While the Internet can be a powerful tool, people can avoid serious complications by being aware of any changes in their health and should never ignore prolonged discomfort. In many cases, these concerns turn out to be minor illnesses that are easily treated by a physician; in some unfortunate instances, a preventable situation can become dire when left to self-diagnosis.

Within the first few months of my career as an ANP, I learned a very valuable lesson in listening to my instincts and being a responsible provider. Jane was a new patient to the practice and was requesting an antibiotic for a “sinus infection” she had been dealing with for the past few weeks. I had never seen Jane, so I requested she come in to be evaluated. Jane felt this was a huge waste of her time; she just wanted the antibiotic to be called in. After further urging from my assistant, she finally agreed to come in for an appointment. During our visit, she complained of headaches, dizziness and bloody noses. I first checked her blood pressure, which read 220/110! This would be diagnosed as severe hypertension. With further discussion, I learned Jane had been treated for hypertension at one point, but quit the medication she was given because of side effects and had never followed up with her previous provider. Had I just called in the antibiotic and not given her the appropriate treatment for her hypertension, it's possible that her uncontrolled hypertension could've lead to a stroke or other serious complications down the road.

Another patient I'll never forget is Caroline. Caroline was a professional in her 40s, who looked young and healthy and was coming in for severe stomach pain and indigestion. She was sure she had an ulcer, which she had been medicating at home off and on for the past few weeks with over-the-counter medications such as Tums and Zantac. It was only after these products failed to provide relief that she came in to see me. With further discussion, she informed me that she had been taking a supplement with Ephedra for weight loss. I also noticed her blood pressure was elevated, so I ran an EKG, only to find she was having a heart attack! Had she continued with her dietary supplements and over-the-counter treatment for her “ulcer,” she would have missed out on treatment by the cardiologist who saved her life.

Common patient misdiagnoses run the gamut from bladder infections (one woman came to me complaining of persistent pelvic pressure and a hard time having bowel movements; with further evaluation and multiple tests we unfortunately found that she had ovarian cancer) to skin issues. Oftentimes someone may have a pesky rash or sore that doesn't heal, which turns out to be skin cancer.

Also, recurrent vaginal infections that are never cultured or that do not clear with over-the-counter meds may turn out to be symptoms of other disease states.
Many women refer to any vaginal irritation as a yeast infection, whereas many times other disorders may mimic the discomfort of yeast infections. One of my patients had been seeing a different provider for several years off and on, and would call in numerous times a year asking for Diflucan to treat her persistent yeast infections. After two to three years of this, she showed up in my office sobbing because she was so miserable. After some simple testing, we found that she had uncontrolled type-2 diabetes, which was making her prone to recurrent and persistent yeast infections. Now that we have her diabetes well controlled, she has been free from discomfort.

When it comes to your health, the lesson is, err on the side of caution. Patients should be aware of changes in their health status and should discuss them with their health care providers, detailing the symptoms, onset of the problem and severity. If using over-the-counter medications, remember that if your symptoms do not improve within a few days, contact your health care provider; he or she is the only one who can properly diagnose your illness, and recommend the most safe and effective treatment.