What I Learned in the Emergency Room. Part 2.

Last week I discussed my recent trips to the emergency room due to extreme pain in my left abdomen. One minute I was excitedly starting the Netflix series The Queen’s Gambit and the next minute I was keeled over in pain on my way to the emergency room. Once there, I saw multiple nurses, a nurse practitioner, a doctor, and a specialist to help diagnose the issue. I also had blood tests, urine tests, and x-rays that all came back negative. The only thing they saw was some fecal build-up in my colon. Nothing extreme, not a blockage but some build-up that could trap gas and be extremely painful. Like I mentioned last time, I became quite skeptical of this diagnosis because I exercise regularly, eat tons of fiber, don’t take medications and wasn’t dealing with a lot of stress. Despite raising my concerns to the staff, they couldn’t find anything. That was until they decided to take another x-ray and have a second look.

This time, with a new x-ray and second set of eyes, they identified a small stone passing through my left ureter. A kidney stone. Now kidney stones are known to be extremely painful as they’re essentially a spiky rock running through small tubes in your body. This made more sense to me but still I was confused. Kidney stones commonly form in people who consume lots of meat, added sodium, alcohol, or medications. And to that end, I consumed none of those. I even mentioned that to the doctors I saw but they seemed just as skeptical of my answers. I mean who doesn’t consume any meat, added sodium, alcohol, or medications. Few people. But I’m one of them! So eventually, the stone passed, the pain disappeared, and the doctors were never quite sure what caused it.

Throughout this experience, I saw how easy a misdiagnosis can happen. I also started to learn that I was a key player in identifying the issue, finding the cause, and implementing a prevention strategy. And by the end of it, I think I found the reason a person as healthy as me got a kidney stone. Let’s get into it!

Hospital Misdiagnosis Problems

The emergency room is a fast-paced environment where nurses and doctors don’t always have a lot of time for their patients. On top of this, there’s numerous shift changes for hospital staff and information exchanges between your nurses and doctors. Despite everyone’s best effort, communication breakdowns are bound to happen. We’re all human and it’s not easy to brain dump everything someone’s learned to their replacement colleague. And lastly, a nurse, doctor, or specialist are all going to have their set of questions they ask you. Some of these questions overlap but some are different. Every one of them is trying to get a complete picture of your health and situation to diagnosis the problem but this is difficult too. They only get the information you give them, and they don’t have time to hear your entire life story.

Obviously, you can see how these factors play a significant role in misdiagnosing a patient’s issue. It’s why around 10% of all diagnoses are incorrect which account for 12 million misdiagnoses each year in the United States. And women and minorities are 20-30% more likely to receive a misdiagnosis compared to a white male. Because of this, a second opinion can usually prove helpful. 88% of people who receive second opinions discover a changed or refined diagnosis. But it’s not always that the doctor giving a second opinion doctor is smarter than the first doctor. A lot of the time it’s because you’re more knowledgeable on the topic and you’ve found a more effective way to communicate the information to your second opinion. You’ve already been through the process once and can convey a more complete picture in a more effective manner.

You Are The Best Problem Solver (is Your Tool)

And that brings me to one of my two main points. You are the best person to help solve your own issue. You have all the information and experiences. You know your lifestyle, habits, and history. You know of any medications you’re on, allergies you have, or substances you’ve consumed. Everyone else is just trying to tease this information out of you to help. But you are the source of all data. Because of this, I believe you should be thinking of yourself as a leader and the nurses, doctors, and specialists like extremely helpful team members. They can provide recommendations, information, and opinions that can help you come to the correct conclusions. And you can think of tests, examinations, and scans as your tools to correctly identify the issue. But the key here is that you’re an active player in helping find the issue, correct it, and prevent it from happening again in the future. Here are a few ways you can help with the process.

Living a Healthy Lifestyle Makes the Visit Way Easier

My second main point is that living a healthy lifestyle makes your emergency room visit and diagnosis easier. When they asked me about alcohol, marijuana, smoking or drug consumption I could easily say no and rule out any of those possibilities. When asked about stress or issues as home, I could say no to that too. My blood pressure, cholesterol, resting heart rate, and weight were also optimal. I don’t have any underlying diseases and limit my consumption of processed and salty food. So, when I and my healthcare team researched the many reasons risk factors for kidney stones, it became much easier to narrow down the options. Let’s look at a list of the causes for kidney stones I found on Dr. Fuhrman’s website.

• Chronic disease like diabetes, obesity, gout, and hyperparathyroidism
• Dysbiosis or imbalance of the healthy gut flora
• Poor nutrition high in animal protein and sodium, low in calcium and magnesium
• High oxalate consumption found in spinach, swiss chard, rhubarb, beet tops, chocolate, and tea
• High fructose consumption
• Vitamin C and calcium supplementation
• Low fluid intake
• Increased alcohol intake
• Medications like diuretics, anti-virals, and anti-seizure medications

And here’s where I identified the top two causes. First, low fluid intake has always been a problem for me. So much so that someone once purchased me a flashing water bottle light that reminded me to drink every 30 minutes. Coincidentally, the battery died a year ago and I haven’t replaced it… 🤦‍♂️. Second, through some more research, I found out that spinach, swiss chard, and beet greens have ~100x more oxalates than all other leafy greens like Kale or Romaine. And if you consume 2 cups or more of those specific greens everyday then it can cause kidney stones. And surprisingly, I was eating 3-4 cups of spinach and chard a day with my salads and smoothie bowls… 🤦‍♂️. It’s difficult to give yourself kidney stones on a whole foods plant-based diet. In most cases, it prevents it. But an exception to this rule are high oxalate foods. Spinach, chard, and beet greens being the worst culprits. So now I need to replace the battery in my water bottle reminder and diversify my greens consumption. But living a healthy lifestyle allowed me to narrow down the risk factors significantly. And now I’m confident I can prevent this issue from occurring again. But the doctors never would have known I was eating 3-4 cups of spinach and chard a day. It’s only through my own research and the teams help that I could identify the true causes.

But it certainly helped being healthy. As an example, there was an elderly person next to me at the emergency room that had been admitted for blacking out and falling. I could overhear their conversation and found out he’d been smoking marijuana and had a couple drinks just before blacking out. He was also a type 2 diabetic with high blood pressure and cholesterol. He didn’t exercise and consumed a diet high in processed foods. There were so many things that could’ve caused his blackout that they couldn’t determine the cause. Too much alcohol? Mixing alcohol with marijuana? Too low blood sugar? A combination of everything? Who knows?

Final Thoughts

The emergency room is a fast-paced environment with frequent staff changes that can cause communication breakdowns. This in combination with time limitations and their limited view of your health makes misdiagnosing issues very possible. The good thing is, you can help diagnosis the issue and prevent it from happening again. Keep a list of your symptoms with time and date stamps. Ask your doctors good questions and perform your own research. Lastly, make the entire process easier by living a healthy lifestyle to begin with. All of this made it easier for me to diagnose my issue and put a plan in place for prevention. A plan that’ll help me live healthier and happier.

Are you looking for a program that prevents disease, death, and disability? And kidney stones?

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Sources:

• How Common is Misdiagnosis – Infographic
• Why Getting Medically Misdiagnosed Is More Common Than You May Think
• 8 Ways to Help Your Doctor Make the Right Diagnosis
• Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much
• Kidney Stones