Saw this interesting Article about a girl who almost died in the hospital. It all started after a root canal procedure.

Crazy thing is they mention that it was an overload of copper but dont mention how the copper got there? Hmmm, and what materials were in this girls mouth? Copper?

Instead they mention the cure is a new liver. So where are the wise words of prevention? Interesting way to detect copper problem by examining the eye. Story is below.

“There’s a young woman sick as hell in the I.C.U. — if you have time,” read the note left on Dr. Steven Walerstein’s desk chair. It was late on a Friday afternoon and Walerstein, the medical director at Nassau University Medical Center in East Meadow, N.Y., was already going to be late for his weekly racquetball game. But he would come back. Stuck behind a desk far too much of the time, he was drawn to what promised to be a tough case.

It was early evening by the time Walerstein got to see the patient. She was young — the chart said 22, but the slender figure surrounded by life-support equipment appeared even younger. She looked tired and sick and very, very yellow — highlighter yellow. He introduced himself and asked her to tell him when all this started.

It began, she told him, with a root canal, maybe a month ago. The tooth kept bothering her, even after two different Antibiotics . Then she started noticing blood in her stools. At first it was just an occasional episode, but then, a few days before she came to the hospital, the trips to the bathroom became more frequent and the blood more obvious. She felt feverish and tired. She had a headache; she was nauseated. She spent a couple of days in bed and felt well enough at least to take a shower. When she looked in the mirror, she barely recognized the yellow face that looked back. Even the whites of her eyes were yellow. That scared her. That’s when she came to the hospital.

At first, the doctors thought it was viral hepatitis. But tests indicated that it wasn’t. Walerstein examined the patient. She was febrile, her skin hot and dry. Her lips were parched and cracked. Her abdomen was distended but soft, and he could feel the firm edge of an enlarged liver a couple of inches below her rib cage.

2. Investigation

Her chart was filled with numbers that testified to how very ill she was. It seemed that every test they ran was abnormal. Her white blood count was very high, suggesting that she might have an infection. And she had barely half the amount of blood she should have. Walerstein saw that she had already received several transfusions, and she was still profoundly anemic — something in her system was destroying the blood as fast as it could be pumped in. Her kidneys weren’t working. Her blood wasn’t clotting, and her urine and stool were stained deep red with uncontrollable bleeding. She was dying, and no one knew what was killing her.

These are the most difficult cases — patients who have so many things going wrong that it’s nearly impossible for a doctor to process them all at the same time. The current theory focused on the bloody diarrhea. She’d had two courses of powerful Antibiotics before coming to the hospital. For reasons that are not well understood, Antibiotics put you at risk for becoming infected with the bacteria known as clostridium difficile, familiarly called C. diff. The bacteria cause a devastating diarrhea and a severe systemic illness that can be fatal. They’d looked for the dangerous toxin made by the bacteria but hadn’t found it. Still, the test is notoriously unreliable. The I.C.U. team started antibiotics to treat C. diff. in case the result was wrong. But doctors still weren’t satisfied with the diagnosis. Too many pieces didn’t seem to fit.

Dr. Tom Manis, the senior nephrologist, was brought in because the patient’s kidneys were badly damaged. As he read through the chart, he became increasingly alarmed. The team was right — their diagnosis didn’t fit well at all. For one thing, C. diff. colitis was usually a disease of the sick and elderly. The patient was young and had been healthy. And C. diff. couldn’t account for the profound jaundice and the persistent destruction of her red blood cells. Of greatest concern to Manis was that the patient was getting worse. “I was unhappy with the way the case was going,” he told me later. “I started talking with all the smart people I could find.” He added, “That’s why I left the note for Steve.”

Walerstein was a general internist, admired for his broad knowledge of medicine. If he didn’t know the answer right off the bat, he was known to ask questions that would lead to the answer. And this young woman needed an answer, or she would die. Having examined the patient and her chart, Walerstein took a moment to step back and look for some kind of pattern buried in the chaotic assemblage of numbers and tests. Everyone else started with the bloody diarrhea. Maybe that was the wrong way to think about it. The fact that the patient’s blood was not clotting made Walerstein think that her liver was no longer working — the liver makes most of the protein that causes blood to coagulate. So she had liver failure. And her red blood cells were being destroyed. That combination stirred something in his memory.

See the following for the rest of the full story.

http://www.nytimes.com/2007/06/17/magazine/17wwln-diagnosis-t.html?pagewanted...