leukemia

[Guest guest]

Dear Group,

I would like to share a story with you. I work with a

couple of M.D.'s. The other day one of them called me

in to see one of their patients. The patient was an 11

year old boy with an enlarged left cervical lymph

node.

my colleague asked me what I thought about it.The

swelling started the week before, the day after his

school bus made a sudden stop and the boy suffering a

mild whiplash. The mother and boy could not think of

any other cause. The boy had a pale complexion with

red lips, a somewhat red tongue body, peeled coat and

a rapid choppy pulse. the node was large firm and not

tender. Based on the acute onset of the mass and the

possible injury, I speculated some sort of local

blood/phlegm stagnation. I discounted the pulse,

tongue and lips, figuring that children tend towards

fast pulses and somewhat red tongues. I was told he

had a slight fever a few days ago and tested positive

for strep. My colleague's approach is to have the

child finish the antibiotics and see if the node goes

down.

After the patient left he confided in me that he

suspected leukemia. That was why he called me in; he

wanted me to feel a leukemic lymph node. He told me he

has seen 3 cases in his 18 or so years in practice and

he feared the worst. He hoped it was just strep, but

he worried it was a " red herring. " He wasn't sure if

he should wait a week or tell the patient's mother,

and have the child brought in for testing immediately.

I was shocked and humbled. I jumped to conclusions

based on the limited one minute intake and ignored

many relevant signs. In my practice I do not regularly

see patients with (possable)ying level heat. Therefore

I ignored them. Perhaps if I had a proper intake I

would have fleshed out a proper TCM Dx, But I would

not have suspected leukemia. That is what bothers me.

prior to this meeting I did not know that this lymph

node presentation is a " red flag " and that it just

suddenly starts, with no apparent cause.

I write this e-mail, not as a confession, but rather

to share an interesting clinical experience from a

primary care setting that many of us do not regularly

get to work in....yet.

Food for thought.

 

Jacob Gerlitz, Dipl.Ac,C.H.

 

 

Talk to your friends online with Messenger.

http://im.