Finding zebras in a world of horses
By Dr. Anthony Policastro
Seaford is full of zebras. We don't always see them. However, they are there. An old saying in medicine is: "If you hear hoofbeats, think of horses". While zebras have hooves too, we don't often hear them or see zebras. In medicine, common diagnoses are seen on a regular basis. Unusual diagnoses are not often found. We refer to the common diagnoses as horses. We refer to the unusual diagnoses as zebras. When a patient presents with confusing symptoms, the odds are that it will turn out to be a common diagnosis. Therefore, we think of the common diagnoses as we try to come up with an answer. Unfortunately, every now and then we come across a patient with a strange diagnosis. We tend not to look for that particular zebra. So we may not make the diagnosis quickly because of that. For example, I cared for a patient about 25 years ago. She was an adolescent that had a major fight with her boyfriend. Her brother came home to find her staring out into space and not responding to him. She was admitted to the hospital. The common diagnosis here would be an acute psychiatric reaction to the fight with her boyfriend. My intern decided to check for zebras because of the unusual nature of the symptoms. An EEG showed that she was having a prolonged seizure causing the staring spell. She responded to seizure medication. It had nothing to do with the fight with her boyfriend. I had another child who had some routine elective surgery done and hemorrhaged after the procedure. The intern had carefully asked about a family history of bleeding problems prior to the surgery. The answer was no. However, when we told the parents about the hemorrhage, they then told us that there was a history of hemophilia in a distant relative. They didn't mention it because they thought the relative was too distant. However, the relationship fit the inheritance pattern for hemophilia exactly. I have seen a child with a straight pin in his appendix. I have seen a child with a collection of orange peels in her stomach. These were not the first thing you would think of. I have seen many such episodes over the years. Sometimes it takes longer than others to come up with the right answer. You would think that a small town like Seaford would not have many zebras. That is true. There are many unusual diagnoses out there. In a small town like Seaford, you do not see them very often. However, sooner or later one or another of these will occur. When it occurs in a small town, that is when the physicians and the hospital in that town need to look for the zebras. The problem is knowing when to start looking for the unusual diagnosis. We cannot do that with everyone, because we will submit them to many unnecessary tests. When it takes a long time to figure out what is wrong with someone you know, it may not be that the physicians could not find the answer. It may just be that the diagnosis was so unusual that it was not obvious at first. It may just have been a zebra galloping down that street.
Family Caregiver Training
The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series four times per year in each of Delaware's three counties. Easter Seals at 22317 N. DuPont Blvd. in Georgetown will host the training on April 26, from 8 a.m. until 4:00 p.m. This program includes a Medical Overview; Legal and Financial Issues; Communications, Behaviors and Activities of Daily Living and Community Resources. This training for family caregivers is free and lunch will be provided, but pre-registration is required. For additional information or to register, call Jamie Magee, Branch Office Coordinator, at (302) 854-9788.
Relay for Life Friendraiser
The Western Sussex Relay for Life committee members are busy making preparations for this year's Relay for Life. This year's event will be held on May 18, at the Mears Campus in Seaford. If you have participated in previous years, you know that the Relay for Life is an overnight event that helps raise money for the American Cancer Society. During the event, teams of people walk laps and each team tries to keep at least one team member walking at all times. But, Relay is much more than a walk. It is a time to remember those lost to cancer and celebrate those who have survived. More importantly, Relay gives you the power to help in the fight against cancer. If you are interested in receiving information on how to register a team or for further information, contact Mary Catherine Hopkins at 302-875-7308.
Take steps to end Alzheimers
Congratulations to the teams and individual walkers who participated in Memory Walk Rehoboth 2006 raising almost $100,000! On April 16, 2007, the Alzheimer's Association Delaware Valley Chapter will host an open house from 9 a.m. to 6 p.m. Individual walkers and team captains are invited to attend and register for Memory Walk Rehoboth 2007 and tour our new office at 109 North Bedford Street in Georgetown. Computers and assistance will be available to register online. Start off on the right foot, register early. A ribbon cutting with the Greater Georgetown Chamber of Commerce will be held at 4 p.m. and a wine and cheese reception will follow. For more information or to RSVP, call 854-9788.
Family Caregiver Training
The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series four times per year in each of Delaware's three counties. Easter Seals at 22317 N. DuPont Blvd. in Georgetown will host the training on April 26, 2007 from 8:00 a.m. until 4:00 p.m. This program includes a Medical Overview; Legal and Financial Issues, Communications, Behaviors and Activities of Daily Living and Community Resources. This training, for family caregivers, is free and lunch will be provided, but pre-registration is required. For additional information or to register, please call Jamie Magee, Branch Office Coordinator, at (302) 854-9788.
Benefit for Alzheimers
The Outback Steakhouse in Rehoboth Beach will host a luncheon for the Alzheimer's Association Delaware Valley Chapter on Sunday, April 22, 2007 from 11:00 a.m. to 1:00 p.m. The menu consists of a 9-oz. Sirloin steak, baked potato, Caesar salad, roll and non-alcoholic drink. Alcoholic beverages will be available at an additional cost. Desserts will not be available and gratuity is not included. Outback is donating the lunch and the cost of the tickets will benefit the Association. Tickets must be purchased in advance at $10 each, and can be obtained by calling the Georgetown Branch Office at (302) 854-9788. Please plan to attend and support the Alzheimer's Association.
Join Antionette Wright Johnson, Holistic Health Counselor, as she presents "Cancer Cleansing" on Monday, April 9 at 5:30 p.m. at The Wellness Community - Delaware, Sussex County Facility. Antionette will show you how to detoxify and renew your body, mind and spirit by using natural remedies to release toxins from your body. To reserve your seat call Kaye or Lori at 645-9150. The deadline for registering is April 6. We are located at The Medical Arts Building, Suite 312, on the Beebe Medical Campus, Rehoboth. All programs offered by The Wellness Community-Delaware are free of charge to people affected by cancer and their loved ones.
Bloodmobile local stops
Bloodmobile is just a hop, skip and jump away this April. It will be in: Blades, on Thursday, April 5; Tuesday, April 10; and Tuesday, April 24; in Federalsburg, Md. on Wednesday, April 25; and at Seaford High School, Monday, April 2.