I do realize there are a lot of crappy doctors out there, but about the person putting a reflex hammer in your face -- are you sure that was an actual doctor?
To your other point, while I often realize the futility of responding to the direct commenter, this is a public forum so maybe others can get some information or entertainment, whatever might be.
A hemoglobin of 4 must be corrected irrespective of the underlying etiology.
Furthermore, I am also in complete agreement that such a patient without obvious source for anemia requires a hematology consultation. That may be the only error that happened here.
I would greatly welcome your rationale as to how we can safely discharge a symptomatic patient with a Hgb of 4 as this directly contradicts all of my medical training. In fact, I would lose my license if I ever did that.
If you happen to know information about anemia I do not, please provide your rationale.
After asking some scary questions and ruling out that I wasn't going to die then and there, I was sent on my way and told good luck.
I figured out myself that the problem was a potassium deficiency. I hadn't eaten any leafy greens in a week or two (lots of veggies, just none that had significant levels of potassium) and I don't normally eat any processed food.
A couple handfuls of baby spinach later and my headache was gone.
A lack of effort in diagnosis is the norm, not the exception. I have plenty of other stories! As does damn nearly every one else.
Computer techs don't bother diagnosing PC problems and just prescribe a reboot. Many Doctors seem to have the same attitude, but for the patient things are a bit more personal.
I will however address the gaping flaw in your story. Depending on which doctor you see, their job isn’t necessarily to diagnose you.
When I used to work in the ED as a resident our job was to make sure no one died, workup for non-life threatening headache was not our job and was for the outpatient physicians. Depending on the type of clinician and context this may not have been their job.
If this was an urgent care/ER visit, I would be shocked if they did not draw serum lytes and other basic labs. If they did, then you would have known if you had hypokalemia
Furthermore, your timeline does not prove causality. Most headaches go away on their own and this may have been simply what happened to you.
Lastly, I don’t buy that you corrected a symptomatic hypokalemia with a “couple handfuls of baby spinach”.
My point is that a lot of doctors don't try to root cause problems, they just look at the most obvious symptoms and send patients on their way.
Not bothering to figure out why my BP was dangerously high was, odd, to say the least.
A bag of baby spinach can provide the entire RDA for potassium. Go a couple weeks with 0 potassium in your diet (it requires effort, oops on my part) and see what happens. (I'd been working on an eggplant curry recipe literally every night for a couple weeks trying to get it perfect) thankfully such dietary stupidity is easily fixed.
As another example I just witnessed a case of roseola being misdiagnosed as an ear infection.
My primary care doc misdiagnosed a leg length difference as arthritis in one of my knee joints. (Pain was due to muscle imbalance causing the knee to be pulled out of position, I visited a podiatrist and he was a bit upset at my primary care doctor...)
You may be a good doctor who does proper investigations, but my point is a lot of people have encountered doctors with very bad diagnostic abilities, or doctors who just ignore them outright.
I’ve treated hypokalemia in thousands of patients. It takes days with oral routes.
Also, a BP of 160 is not dangerously high. Particularly if you are young, healthy or known to the doctor as it is most likely white coat.
I could describe out the flaws in the leg length discrepancy and your podiatrists argument but I think I’ve made my point.
I have repeatedly demonstrated your believed truths to be largely invalid yet you feel the confidence to speak with absolute certainty, as if your experience is ground truth.
Please stop spreading falsehoods and vitriol about my profession. I have sacrificed over a decade and given up a more lucrative career to help others and your actions are dismissive.
If you have had multiple expert opinions (I.e. not he said she said with podiatrist and doctor) or a legal proceeding demonstrate your doctor was negligent then please don’t speak as your opinion is medical truth.
Edit: On second thought I can’t believe I responded seriously to a poster who thinks they gave himself symptomatic hypokalemia because they were “testing an eggplant curry recipe literally every night for a couple of weeks” and treated it by eating a single bag of baby spinach.
This is obviously a joke, right…? You do know that eggplant contains potassium..?
Lots of sodium, no potassium, things get out of wack quickly.
If you were critically and symptomatically hypokalemic a couple handfuls of baby spinach would not have corrected that deficit.
> Lots of sodium, no potassium, things get out of wack quickly
If you don’t have an endocrine or renal disorder or taking certain medications - no, they really don’t.
Sitting in the position of the doctor - there’s no way to counter this. You immediately jump to the conclusion you’re symptomatically having headaches because of hypokalemia based on no evidence whatsoever and just a coincidental diet pattern but with no concept of potassium homeostasis - there’s really not much I can do to convince you otherwise if you are inclined to jump to conclusions that quickly. It isn’t supported by basic biology and a practitioner actually has to show some consideration in their diagnosis. You’re going to chalk it up as being ignored. And there we are.
When somebody generally healthy comes in with an episode of a non alarming headache - conservative management is the evidence based standard of care. Come in for follow-up make sure the BP was a transient thing. Maybe have you do some home monitoring. Perhaps your diet is shit, but the potassium would likely not be the problem.
If you really think you’re chronically hypokalemic - maybe get a basic blood test (you can order them yourselves these days - take it when you think It’s low) and take it to a doctor if it’s low. I’m sure it’ll be normal though - and you will have no further diagnosed your headache - just like your doctor.
Also 160/90 is not a great blood pressure to be living with day to day - but it is not "dangerously" high - or what we would call urgent or emergent. BP can be transiently elevated in pain or stress states and 160/90 isn't going to kill you. If you keep coming in with that or better yet you have multiple readings at home like that, we'll talk about lifestyle changes and then maybe talk about a chronic BP medication. But there is no reflex reason to do any lab workup just because a BP is 160/90.
What is considered safe blood pressure and how we should control it both chronically and acutely is something that has undergone a stupendous amount of thought and research since hypertension became a major health concern 75-80 years ago. Not immediately doing every lab test and imaging study in the book for a one time BP reading that high is not based on some capriciousness - it's based on some of the most basic and well-trodden evidence based medicine. It's not as cavalier as the assumption of many here.