“Doc Martin” diagnoses a POTS patient

[Sushi]

Many of us watch this British TV show that is also broadcast on PBS in the States—a curmudgeon but a brilliant local doctor saves the day with diagnosis and treatment of puzzling cases. The patient was refreshingly male and of course I diagnosed him before the Doc! Doc Martin gets B + though as he explained it simply and immediately gave the fella electrolytes. His prognosis was a bit rosy though. Still, public education on POTS! 

[BuddyLove]

I used to watch Doc Martin with my Mom, I was just thinking today about the old woman who was dying of dehydration because she didn't want to pee in the bed.

I had my tilt table test done a couple of months after Hugh Calkins and Peter Rowe wrote their breakthrough report. January 1996.  I used to call the Secretary in their office, I asked her if I was bothering her, she said she was glad for the feedback. I asked her what happens to everybody who is diagnosed, she said she had no clue, they didn't have the funding to find out. 

I did corner one Doctor, he was telling me what I had, I could look in his face he was sharp as a tack, so I prodded him, I told him he had the wrong chart, nothing he was telling me sounded like me, At that point he broke training and actually leveled with me "The main side effect from what you have is poor quality of life"

He nailed it. I never heard it put better. One great Doctor is better than 100 average Doctors. 

 

 

 

 

 

 

[MaineDoug]

On 2/21/2024 at 12:58 AM, BuddyLove said:

One great Doctor is better than 100 average Doctors. 

I couldn’t agree more! I’m currently in NYC, 12 hours from home because the docs in Maine were hopelessly overmatched by my diagnoses!

 

[Sarah Tee]

@Sushi, that is great! I must have missed that episode. Was it in the final series?

[Sushi]

7 hours ago, Sarah Tee said:

@Sushi, that is great! I must have missed that episode. Was it in the final series?

I saw it in February so it must’ve been in the final season.

[Sarah Tee]

I heard this once, but have not managed to verify it, but apparently when British tv programs show medical conditions the portrayal is supposed to be factually correct. It’s part of the broadcasting code of conduct or somesuch.

So having POTS on a British program is sort of significant.

[Sarah Tee]

I noticed that hypermobility and EDS got a brief but fairly accurate mention on QI (British comedy panel show). There was even a hypermobile person in the audience.

They did dwell on the “party tricks” aspect at first but also mentioned that some people get joint pain and other complications.

[Sarah Tee]

I found the episode – it’s series 10, episode 2.

The diagnosis scene was a bit rushed – the patient didn’t get a ten-minute stand test! – but I agree with @Sushi’s B+ grade.

[Sarah Tee]

I wonder whether one of the researchers on QI has a connection with dysautonomia. In the “Quizmas” episode, Sandi Toksvig poses a question about an old dialect word, quobbles.

It turns out to refer to the pruney wrinkles you get on your fingertips when you soak them in water, but she goes on to mention the autonomic nervous system, and how quobbles may be used in diagnosing autonomic dysfunction.

Not something many doctors know! (I’m sure our specialists know it.)

Does anyone know the medical term for pruney fingers? It was also featured on Operation Ouch, but I don’t remember them giving a medical term for it.

[Sarah Tee]

Article about using wrinkly fingers as an autonomic test:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892617/

The authors just call it skin wrinkling, so there must not be an obscure medical name for it.

Funnily enough, in this test the fingers of subjects with autonomic function failed to wrinkle after immersion in warm water. Healthy subjects’ fingers got very wrinkly.

I am sure there are posts here about the opposite – fingers going wrinkly without being immersed in water. It must be dysfunctional in both directions.