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Her Face Started Drooping. What Was Wrong?

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Her Face Started Drooping. What Was Wrong?

That fall, a buddy instructed the affected person a few clinic at New York College that specialised in facial palsies. She shortly discovered it on the web: the Facial Paralysis and Reanimation Middle. She studied the faces of the docs on the clinic. Dr. Judy Lee was a specialist in issues of the ear, nostril and throat and a plastic and reconstructive surgeon. She had a heat smile and a form face. The affected person made an appointment to see her.

Lee listened to the girl’s story. She too questioned the prognosis of Bell’s palsy. Though the affected person’s signs have been in line with Bell’s, the story didn’t fairly match. That kind of nerve harm comes on shortly — often over hours, typically days. This lady described a course of that took months. The 2 M.R.I.s proved she hadn’t had a stroke — the commonest explanation for a droopy cheek and lip. Shingles may additionally trigger this form of palsy, however the affected person didn’t produce other signs of the sickness in order that appeared unlikely. Lee ordered yet one more M.R.I. She, too, was anxious a few mass, and she or he had solely seen the experiences of the earlier M.R.I.s.

Lee offered the brand new M.R.I. to her colleagues the next week. It was a gathering they held month-to-month to debate the hardest instances. The neuroradiologist identified a brightness within the nerve that appeared like irritation. It was on the level after the nerve passes via the inside ear and enters the temporal bone, on its method to the muscle groups of the face. That’s not the place you’ll often see irritation in Bell’s palsy. Furthermore, that kind of irritation, brought on by damage to the nerve, needs to be healed after a 12 months and a half. And there was nonetheless no seen mass. Was this brightness, this irritation, proof of a tumor? Most likely, the workforce agreed. They simply needed to discover it. The affected person wanted a biopsy. If a tumor was seen, they might have their prognosis. And, it doesn’t matter what else they noticed, they might biopsy the nerve itself.

Lee referred to as the affected person and defined what they proposed. “We are able to’t see something, however we all know it needs to be there,” she mentioned. A biopsy would present precisely what they have been up towards. The affected person was reluctant. In the event you can’t see something, she requested, why do you assume it’s there? As a result of, Lee defined, nothing else is sensible.

The surgical procedure came about a number of weeks later. Within the working room, Dr. David Friedmann reduce away the bone behind the ear. He recognized the nerve and traced its course because it made its means towards the facial muscle groups. No mass was seen anyplace. He reduce out a number of tiny segments of nerve. Testing indicated that the nerve was already useless, however he didn’t need to threat inflicting any further damage. Friedmann despatched the samples to the lab. The reply got here again inside the week. She had a squamous-cell carcinoma rising in her nerve.

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That reply provoked extra questions. The place had this come from? It was unlikely to have began there within the nerve. Was it unfold from a pores and skin most cancers, some of the frequent types of squamous-cell carcinoma? The affected person had a number of pores and skin cancers eliminated when she was youthful, in order that was potential. Nonetheless, squamous cells are discovered nearly in all places within the physique. The docs at N.Y.U. ordered a PET scan. There was no signal of most cancers anyplace else.

Even so, the most cancers cells in her facial nerve needed to have come from someplace. Because the docs nicely knew, simply because a most cancers isn’t seen doesn’t imply there’s no most cancers. She was handled for what is known as a metastatic illness with an unknown main: She had radiation and chemotherapy that lasted till early this summer season. However even earlier than being handled for the most cancers, she had an operation to repair her face. A muscle from her leg was fastidiously positioned over the atrophied muscle in her left cheek. It would take months for these muscle groups to begin working to switch those destroyed by the most cancers. She realizes that the face she had recognized her complete life won’t ever be again. However she hopes that the surgical procedure, plus bodily remedy, will at the least let her smile once more.

Lisa Sanders, M.D., is a contributing author for the journal. Her newest guide is “Analysis: Fixing the Most Baffling Medical Mysteries.” If in case you have a solved case to share, write her at Lisa.Sandersmdnyt@gmail.com.

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Mercury Direct 2024 Horoscope: What’s in Store for You From April 25 to May 15

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Some patients who see female doctors could live longer, study suggests: ‘Higher empathy’

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Some patients who see female doctors could live longer, study suggests: ‘Higher empathy’

Patients who are treated by a female physician could live longer and have a reduced risk of hospitalization, new research has found.

These benefits were seen more in female patients compared to males, according to the study, which was published in the peer-reviewed journal Annals of Internal Medicine.

“Among older adults hospitalized for a medical condition, mortality and readmission rates were lower for patients treated by female physicians than those cared for by male physicians — and the benefit of receiving treatment from female physicians was greater for female patients than for male patients,” lead study author Dr. Yusuke Tsugawa, associate professor-in-residence of medicine in the division of general internal medicine at the David Geffen School of Medicine at UCLA, told Fox News Digital.

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The study included 700,000 Medicare beneficiaries 65 years of age and older who had been hospitalized between 2016 and 2019. 

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The mortality rate was 8.15% for female patients treated by female physicians — compared to 8.38% for those treated by male physicians, according to a press release from UCLA Health.

Patients who are treated by a female physician could live longer and have a reduced risk of hospitalization, new research found. (iStock)

Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, who was not involved in the research, noted that the findings are “clinically significant,” as the difference translates to an additional 1,053 female patient deaths.

Male patients also had lower mortality rates when treated by female physicians, but the difference was smaller.

Why the difference?

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the study but called the findings “fascinating.”

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“Women tend to have a higher empathy quotient, which can impact patient care and diagnosis and treatment directly,” he told Fox News Digital. 

“There has been a patriarchy in medicine for a long time, and there still may be some residual discounting of women’s health issues or [doctors] seeing them as emotionally based,” Siegel added.

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There is a “growing awareness” that doctors are more sensitive to health issues when they can relate directly to their patients, the doctor noted.

“This applies to screening, diagnosis and treatment,” he said. 

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“Women tend to have a higher empathy quotient, which can impact patient care and diagnosis and treatment directly,” one doctor old Fox News Digital.  (iStock)

The findings were not surprising to the researchers, they said.

“Previous studies have shown that female patients treated by a female physician (versus female patients treated by a male physician) are less likely to experience underappreciation in symptom/illness severity assessment and communication challenges,” study co-author Atsushi Miyawaki, M.D., PhD, senior assistant professor in the Department of Health Services Research at the University of Tokyo, told Fox News Digital.

“Also, female physicians may help alleviate embarrassment, discomfort and sociocultural taboos during sensitive examinations and conversations [with] female patients,” he said.

“Mortality and readmission rates were lower for patients treated by female physicians than those cared for by male physicians.”

Other research has shown that female physicians are more likely to “adhere to clinical guidelines” and spend more time listening to patients compared to their male counterparts, which are “indicators of high-quality care,” added Tsugawa.

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Johnson agreed, pointing out that prior studies have found male physicians may underestimate pain, gastrointestinal symptoms and heart symptoms when experienced by women. 

Female doctor with female patient

There is a “growing awareness” that doctors are more sensitive to health issues when they can relate directly to their patients, one medical professional said. (iStock)

“For instance, if a male and a female presented to the emergency room with upper stomach pain, the male would be checked for a heart attack and given medication for an upset stomach,” she told Fox News Digital.

“The woman, however, may only be given medication for an upset stomach.”

Study limitations

The study had some limitations, the researchers acknowledged.

“Due to limited clinical information available in our data, we could not identify the specific mechanisms underlying better outcomes for female patients treated by female physicians,” Tsugawa told Fox News Digital.

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More research is needed to better understand the differences between female and male physicians, the researchers said. (iStock)

Miyawaki also noted that the study focused on older patients admitted to hospitals for medical conditions.

“Hence, our findings may not be generalizable to younger patients, commercially insured patients, those treated by other specialists or patients receiving care in an outpatient setting,” he told Fox News Digital.

“Individuals may focus on the importance of the doctor-patient relationship rather than on whether to choose a female doctor.”

More research is needed to better understand the differences between female and male physicians, Tsugawa said. 

“Those include guideline concordance and communication style, which lead to better patient outcomes for female physicians.”

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Johnson also noted that while the study is of “good quality,” there are “inherent limitations to the study design.”

She said, “With a retrospective review, unmeasured factors can affect and skew the results. The findings do align with other research in the area, however.”

doctor listens to patient

The research suggests that increasing the number of female physicians could benefit women’s health overall, one of the study authors said. (iStock)

At the society level, Miyawaki said, the research suggests that increasing the number of female physicians could benefit women’s health.

“At the individual level, patient-physician interactions, rather than physician gender itself, are important for patient outcomes, our study suggests,” he said. 

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“Thus, individuals may focus on the importance of the doctor-patient relationship rather than on whether to choose a female doctor.”

Tsugawa agreed, noting, “It is important to consider multiple factors about physicians, such as their clinical experience and training, your prior experiences with them, and their communication style, rather than focusing solely on the physician’s sex.”

For more Health articles, visit www.foxnews.com/health.

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These Two Sisters Walked Off 373 Lbs – Here’s How Walking Poles Helped Them Succeed 

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These Two Sisters Walked Off 373 Lbs – Here’s How Walking Poles Helped Them Succeed 



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