Thursday, September 08, 2011
Medical diagnoses are not always clear

By Dr. Anthony Policastro

Diagnosis is a term that physicians often use and it relates to the actual cause of a set of symptoms. Fever is not a diagnosis, however, there are many diagnoses that can cause fever. Rash is not a diagnosis but there are many diagnoses that can cause a rash. Many individuals are proud of their diagnosis. They tell everybody what they have.

Some of these people are so proud of it that they will tell you what they have without being asked. Hello, my name is John Doe. I have ____. Most of the time a patients diagnosis is clear. In others, it isnt. The question is how important is it to have a diagnosis?

For example, if a child has a fever and the doctor cannot find anything on exam, he/she may not be able to give a diagnosis. But if the fever disappears on its own in three days, what difference does it make? The same thing is true with doing lab tests to make a diagnosis. If someone has a minor illness, doing a bunch of lab tests just to get an answer might not make sense. That is especially true if the illness goes away in a few days. The lab tests would be an unnecessary expense.

The question arises as to what to do when the patient does not have a minor illness. The question is how important is it to have a diagnosis in long term conditions. An example of this is bipolar disorder. Patients with bipolar disorder have symptoms of depression and mania. Some have more of one than the other. However, regardless of whether we call it depression or bipolar disorder, the treatment is the same. Therefore, the exact diagnosis is not important. Another example is autism. There are three disorders in what is called the autistic spectrum of disorders.

The disorder with the most profound symptoms is called pervasive developmental disorder. The disorder with moderate symptoms is called autism while Aspergers Disorder has the fewest symptoms. There is a lot of overlap between the three diagnoses. It is sometimes hard to tell the difference. However, parents want a specific diagnosis of the three which is not always easy to do. It also does not change the need for services. As long as the child gets the needed services, the specific diagnosis does not matter.

Related to this is the fact that 20% of children with autism have genetic abnormalities as the cause of the symptoms. Those abnormalities are present from birth and are not correctable. Finding the abnormality does not change the treatment. So why do we even need to do an expensive test to find this result? Does telling the parents that we have a reason for the childs autism justify the expense when it does not make a difference as to what we do for the child? If it does, should the parents pay for the test themselves as opposed to the insurance company? These are questions that the insurance companies are now considering. Given the high number of children with autism and the expense involved in the test, parents might be facing this cost in the future. Making a certain diagnosis might give someone peace of mind. It might also cost a lot of money to find something that will not change treatment at all.

Healthcare in our country costs a lot of money already. Spending money just to find something that will not have the treatment affected one way or another might not be the way we need to pay for healthcare.

Hospice hosts conference

Delaware Hospices Family Support Center will hold a professional conference, Peace at Last:A Warriors Journey from Wartime to End-of-Life, with national speaker and author Deborah Grassman, RN, MS, NP, on Friday, Oct. 28, from 8 a.m. to 4:15 p.m., at the Delaware Hospice Center, 100 Patriots Way, Milford. Deborah Grassman has been a nurse practitioner with the Veterans Administration for 26 years and director of the VA Hospice Program for 15 years.She pioneered the identification of post-trauma effects on the quality of a persons dying process, as well as ways to effectively respond to issues that surface at the end-of-life. Registration fee is $99 per person and $75 per student. Seats are limited, so early registration is recommended. Application has been made for 6.0-7.5 contact hours for nurses, social workers, counselors, nursing home administrators and funeral home services. For more information or reservations, contact Vicki Costa, 478-5707, ext. 1129 or

NMH offers first aid classes

Nanticoke Memorial Hospital will offer community First Aid classes to anyone interested in learning first aid from 6:30 to 9:30 p.m. on Tuesday, Sept. 13, at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn basic first aid that will enable them to administer help during the first few moments until emergency responders arrive. Classes are open to participants 13 and older. The course covers cognitive learning, role-playing and skill practice. Cost is $30. Payment and registration is required by no later than five business days before the class. Late registrations (if seating is available) will be an additional $5 fee. To register, or for more information, contact the Nanticoke Memorial Hospitals Training Center office at 629-6611, ext. 8919.Pre-registration is required.

Prostate screenings offered

In honor of Prostate Cancer Awareness Month in September, the Cancer Care Center staff at Nanticoke Memorial Hospital will provide prostate screenings on Friday, Sept. 16 from 8 a.m. to 5 p.m., in the lobby of the Miller Building, located at 121 South Front St., Seaford. There is a $5 screening fee and pre-registration and fasting are not required. Nanticoke Memorial Hospital encourages men over the age of 50 to take advantage of this service. Men who are age 40 and at high risk of developing prostate cancer are also encouraged to participate. African-American men and men who have a family history of the disease have a higher risk for developing prostate cancer. For more information, call Melinda Huffman, nurse navigator, at 629-6611, ext. 3765.

Stroke Support Group offered

Nanticoke Memorial Hospitals next Stroke Support Group meeting is Tuesday, Sept. 20, 1:30 p.m. at the Seaford Library. This free support group is designed for individuals who have survived a stroke as well as their families and caregivers. Modeled from the American Stroke Association, the hospital is engaging with speakers to provide education, community resources and emotional support to those who have been affected by this life-altering event. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support, and allow for networking. Refreshments will be provided. Pre-registration is not required. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Free prostate cancer screenings

Bayhealth Medical Center will offer prostate cancer screenings free to those who qualify during Prostate Cancer Awareness Month in September. These screenings are part of Bayhealths continuing efforts to educate the community and help people identify cancer in its earliest, most treatable stage. Prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of cancer deaths for men according to the American Cancer Society. Annual screenings are recommended if youre a man over the age of 50, or over the age of 40 with a family history of prostate cancer in a close relative diagnosed before age 65. African-American men are twice as likely to die from prostate cancer and should begin screenings at the age of 40. The Bayhealth Cancer Institute is providing prostate cancer screenings which consist of a prostate specific antigen (PSA) blood test, and a digital rectal exam (DRE). The screenings are free to those who qualify but pre-registration is required no later than one week before the screening. For any questions, and to register, call 430-5064 or 744-6752. In Milford, screenings will be held from 9 to 11 a.m. on Saturday, Sept. 17, at Bayhealth Cancer Center located at 21 W. Clarke Ave.

Bereavement luncheons

Delaware Hospices New Beginnings bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program. The location rotates each week of the month throughout Sussex County. New Beginnings luncheons are open to the public. Registration is not required.There is no fee except the cost of your lunch. For more information, call Midge Dinatale or Paul Ganster at 856-7717.

Walk hopes to raise $70k

The Sussex County Making Strides Against Breast Cancer walk and run will be Sunday, Oct. 2, at Delaware Technical and Community College in Georgetown. Organizer Mary Catherine Hopkins, Bethel, hopes to raise $70,000. For details, call Hopkins at 875-7308. Information about the run is also available on the website

Relay for Life fundraiser

Dr. Marie Wolfgang is again sponsoring a 12 night Winter Getaway Cruise to the Southern Caribbean as a fundraiser for Relay for Life, sailing from Cape Liberty, N.J. on Feb. 10. The itinerary includes St. Thomas, St. Kitts, St. Johns (Antigua), St. Lucia and St. Maarten (Philipsburg). Transportation to and from the dock is available. For a brochure, call or visit Dr. Wolfgangs office at One Cedar Ave. in Seaford, 629-4471. Space is limited.

Alzheimers Support Group

Nanticoke Memorial Hospitals next Alzheimers Support Group meeting is at 1:30 p.m. on Tuesday, Sept. 13, at LifeCare at Lofland Parks first floor resident lounge, 715 E. King St., Seaford. This group provides support and information about Alzheimers and dementia to families, caregivers and anyone who is affected by this disease. Refreshments will be provided. Pre-registration is not required. For more information, call 628-3000, ext. 8302.