Entries in Diagnosis (18)


Guidelines for Diagnosing Psychiatric Disorder May Overlook Physical Illnesses 

Keith Brofsky/Thinkstock(NEW YORK) -- The addition of a newly-labeled psychiatric disorder called somatic symptom disorder to the Diagnostics and Standards Manual, or DSM-5, has fueled a debate among patients and advocacy groups who fear that broader and "looser" criteria may make it easier for doctors to dismiss patients as mentally ill when in fact they have a physical illness.

Somatic (or bodily) symptom disorder or SSD is characterized by symptoms that suggest physical illness or injury that are either "very distressing" or result in disruption in a person's functioning. The symptoms are also often accompanied by "excessive and disproportionate thoughts, feelings and behaviors," according to the American Psychiatric Association.

Critics worry that patients will be misdiagnosed as mentally ill and won't get treatment, affecting mostly those with chronic and difficult to diagnose neurological disorders and multi-system diseases like ME/CFS, ones that are poorly understood and can take years to get medical answers.

"A lot of people will be written off as crocks -- it's just in their head," said Dr. Allen Frances, who was chair of the task force that created the DSM-4 and professor emeritus of psychiatry at Duke University. "They won't get the medical work-up they need. A lot of times they diagnose it as depression and anxiety and they get stigmatized."

But Dr. Joel E. Dimsdale, chair of the committee that reviewed the SSD diagnosis and professor emeritus in psychiatry at University of California, San Diego disagrees, noting that the new SSD diagnosis replaces four somatic disorders that were "confusing" and rarely used by doctors.

The goal was to simplify the diagnosis, according to Dimsdale. One older diagnosis, somatization disorder, had a checklist of 37 symptoms and was modified three times. "Doctors throw up their hands and can't even keep the stuff straight," he said.

But critics like Frances argue the new diagnosis could "mislabel" 1 in 6 people with cancer and heart disease; 1 in 4 with chronic pain and irritable bowel; and will have an astounding false positive rate of 7 percent in the general population, based on projections from the DSM-5 working groups.

"I think they have gone overboard," said Frances.

Frances is worried about people like Bridget Mildon, a 36-year-old mother of three from Salmon, Idaho, who said she was misdiagnosed with "conversion disorder," an older classification of somatic disorder, when she actually had a rare neurovascular disorder that causes transient seizures or full-blown stroke.

"It took me almost five years to get a doctor to finally reevaluate and look at my symptoms from a different perspective," Mildon said.

But Dimsdale defends the updated DSM, which he said is more "patient friendly" than the older DSM-4, which was written 20 years ago.

“I see it as a useful working guide to help doctors diagnose and treat patients. If it doesn't work, we'll fix it in the DSM-5.1 or DSM-6," said Dimsdale. "Perhaps some people fear they will be labeled or mislabeled, but my perspective is that it's important to treat people who are suffering," he said. "That's what we are about."

Copyright 2013 ABC News Radio


Heart Weakness Common Yet Undiagnosed in Some Older Patients

Comstock/Thinkstock(NEW YORK) -- Older people living with heart abnormalities that could lead to heart failure may have never had those abnormalities diagnosed, meaning they miss out on treatments that could help, according to a new study.  But deciding whether someone would benefit from taking these drugs in the last stages of life is important too, doctors say.

The heart naturally gets weaker as people age, but Bernard Keavney, a professor of cardiology at Newcastle University in Tyne, England, and the study's lead author, said scientists don't often study heart failure or the best way to treat it in the very old.

"We can only treat heart failure if we know it's there," Keavney said.

Keavney and his team went to the homes of about 375 people ages 87 to 89 living in northeast England, armed with equipment to test their heart function.  They found that about one-third of them had a heart with a reduced ability to pump blood, called a left ventricular systolic dysfunction.  Another 20 percent had a diastolic dysfunction -- heart muscles that could not relax enough to allow the heart's chambers to fill with blood, keeping the heart from pumping enough blood to the rest of the body.

People aren't born with these abnormalities, but they increase as people age and develop cardiovascular diseases, such as high blood pressure and coronary artery disease.  They can also lead to heart failure, a condition in which the heart can't pump blood effectively to the rest of the body.

For 26 percent of the people in the study, the problems had never been diagnosed by a physician.

The findings were published Tuesday in the journal Heart.

It's not clear why these people had never gotten a diagnosis.  Doctors say it could be that they simply didn't realize there was a problem and may have thought their symptoms, such as shortness of breath and fatigue, were simply part of old age.

"Likely because the level of activity in these patients in these kinds of home care settings is low, they don't stress their heart enough to know that there is a problem," said Dr. Robert Myerburg, a professor of medicine and physiology at the University of Miami Miller School of Medicine.

About 5.8 million Americans have heart failure, according the National Heart Lung and Blood Institute, and as greater numbers of people reach old age in many Western countries, it's possible that that number will grow.

Keavney said because greater numbers of people survive heart attacks, these kinds of heart abnormalities may increase.

"There would have been people in previous years who would have come into the hospital after a heart attack and died from it.  Now more may survive, but they're going home with a weakened heart," he said.

Doctors say although the symptoms of these heart abnormalities seem pretty common for older people, it's important that they not be dismissed as simply signs of "old age."

"There is no clinical diagnosis of 'old age,'" said Dr. Clyde Yancy, chief of cardiology at Northwestern Memorial Hospital and a past president of the American Heart Association.  "We should keep our antenna up at all times for treatable diseases that may reduce symptoms and improve the quality of life."

Copyright 2012 ABC News Radio


Study: Late Stage Cervical Diagnosis Linked to Lack of Insurance

Siri Stafford/Photodisc/Thinkstock(NEW YORK) -- This year, more than 12,000 women in the U.S. will be told they have cervical cancer. Over 4,000 of them will die.    
Diagnosing cervical cancer in the early stages means a better chance of conquering the disease. Receiving a diagnosis at the later third or fourth stage may mean more aggressive and expensive therapies, and an increased risk of death.
A new study published in the American Journal of Public Health took a closer look at how insurance coverage affected 69,000 American women with cervical cancer.
Researchers at the American Cancer Society found that 24 percent of privately insured women were diagnosed with stage three or four advanced disease, compared to over 34 percent of those with Medicaid, and just over 35 percent of those without insurance.
The study concludes that uninsured women are at higher risk of being diagnosed with advanced cervical cancer because they lack access to screening. Researchers suggest that all women who need it should have access to affordable screenings.
Copyright 2012 ABC News Radio


Ann Romney's MS Revelation: The Trauma of Diagnosis

ABC News (NEW YORK) -- Ann Romney told Robin Roberts Thursday on Good Morning America that the multiple sclerosis diagnosis she received 14 years ago was her "darkest hour" that left her "humbled" and "crushed" to dust.

Romney was diagnosed with multiple sclerosis in 1998 at age 49, after experiencing severe numbness and fatigue. While the average age at which a patient is diagnosed is 37, so many other patients, are at the beginning or middle of careers, marriages and raising children.

Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord. The disease attacks the myelin sheath, a protective covering that surrounds nerve cells, and approximately 400,000 Americans have MS, according to the National MS Society. About 200 people are newly diagnosed each week.

While the disease is degenerative, symptoms, which affect the muscles, bowel function, vision, nerve and sexual function and personality, can vary and range greatly in severity.

Helen Solinski of San Jose, Calif., said she felt like the "rug was pulled out from under" her when doctors gave the diagnosis. She had just given birth to her son, and she said she ran from neurologist to neurologist seeking a cure.

"How would I take care of my child?" she wondered. "Was I going to be a little league mom in a wheelchair? Would I ever feel my son's hand in mine? I was completely numb on my left side during the first attack."

For Michelle Clos, 45, of Texas, her MS diagnosis sounded like "a lot of alphabet soup," she said, and she struggled to find a strategy that allowed her to address the challenges of MS without letting MS define her.

After she was officially diagnosed with the disease in 2001, she said she had to change the way she thought about life, "get rid of the non-essentials and use a positive approach to handle everything that life was throwing my way, which worked well for me, led me to reduce how much I worked and take what I learned about myself to start coaching others who were impacted by MS," said Clos.

People have spent their entire life up until the point of diagnosis imagining their life in a certain way, so they have to interpret how they're going to let go of that picture and how they see themselves, and fit that new information into the sense of who they are, Rosalind Kalb, a clinical psychologist and director of the Professional Resource Center at the National Multiple Sclerosis Society, told ABC News in June.

"It's a grieving process," she said. "And you can't move ahead on how you're going to live with MS until you spend a little time with the loss of a life without MS."

While the diagnosis can throw one's life into disarray, patients should not jump to any conclusions about how the disease will run its course, said Kalb.

It's important for patients not to rush out and quit their jobs or break up relationships because they may be able to live a full life with manageable symptoms," Kalb said.

 Doctors and patients do not know how their multiple sclerosis will behave in the early weeks and months after diagnosis, and it is really only in hindsight that one can understand the severity of their disease.

Some days are harder than others, Solinski said, but "the sun will come up every morning," she said. "It does and so do I. We all adapt …What truly drives me is my mission to stop this disease."

Solinski found purpose in combating her disease when she began working at the Myelin Repair Foundation, a nonprofit dedicated to funding research for myelin repair treatment targets.

"The Myelin Repair Foundation was exactly what I needed to get involved to channel my fear and anxiety of the what the future might hold," said Solinski. "MS can run in families, my greatest fear is my son receiving a diagnosis of MS. I can't stop fighting the disease."

For Clos, she said she takes the disease day by day by focusing on her goals.

She encourages "individuals in the MS community to pursue their own goals and overcome their challenges." She adds, "I continue to practice gratitude daily."

Copyright 2012 ABC News Radio


EEGs May Someday Be Able to Diagnose Autism

iStockphoto/Thinkstock(BOSTON) -- A readily available brain test could someday be used to diagnose autism in children as young as 2 years old, offering the potential for earlier intervention, according to a new study published online in the journal BMC Medicine.

Researchers at Boston Children's Hospital used electroencephalograms (EEGs), tests that measure electrical activity in the brain, to compare the brains of 430 children with autism and 554 normal children between the ages of 2 and 12.

Children with autism showed reduced connectivity among a number of areas of the brain, and these patterns were different than the patterns observed in normal children.

"Most of these patterns provide enough information to cleanly separate 2 to 12-year-old autistic children from neurotypical controls," said Dr. Frank Duffy, a study co-author and director of developmental neurophysiology at Boston Children's Hospital.

Part of what sets this research apart from other studies, Duffy explained, is that the subjects were children with classic signs of autism, including communication difficulties, compulsivity, impulsivity and problems engaging other people.  As a result of these symptoms, research can be very challenging.

"The problem with studying autistic children is that they aren't very cooperative," Duffy said.  "Many of the studies have taken extreme cases, such as high-functioning autistics, adults with autism or people with Asperger's syndrome."  Asperger's syndrome is a milder form of autism marked by language and communication difficulties.

While not yet ready for real-world diagnosis, Duffy said it's possible EEGs, which are easy to get and relatively inexpensive, could eventually be used to diagnose autism at younger ages.

But Dr. Max Wiznitzer, an associate professor of pediatric neurology at Case Western Reserve University School of Medicine said the value of EEGs lies in areas other than making a diagnosis.

"This is more of a confirmatory tool," he said.  "An autism diagnosis is primarily clinical," he added, meaning a specialist makes the diagnosis.

Wiznitzer also said that some of the connectivity patterns observed in the study could also be signs of other types of disorders.

Duffy said he does plan to repeat the study in children with other types of autism to determine whether the same patterns exist.

Copyright 2012 ABC News Radio


'Sensory Integration Therapies' Lack Evidence, AAP Says

File photo. Michael Blann/Thinkstock(NEW YORK) -- Woody Sims was a gifted boy. His mother said he began reading at a very early age, and he was a bright student in preschool.

To those around him, his development in his early years seemed normal. But in his college essay, Woody, now 18 years old, described a childhood experience marked by "deep fears of loud noises, cooked carrots and handwriting."

"I was over-stimulated, which meant I couldn't handle certain textures, and freaked out at loud noises," Woody wrote in his essay. "I also had problems managing tasks with multi-sensory inputs, like handwriting and catching a ball. These sensory problems meant that sports, driving, and concerts would all be things I couldn't ever do or see without a great deal of difficulty."

For Woody, the diagnosis of sensory processing disorder, or SPD for short, came very early, at age 4. His mother, Pam Sims, now 52, of Denver, Colo., had arranged for him to be tested for his school's gifted program. It was the tester who informed her that he believed her son fit the bill for the disorder.

In a coincidence that Pam Sims calls a "luck of the draw," a center devoted to the research and treatment of this disorder happened to be located in Denver, where they live. It was here, at the STAR Center, that Woody engaged in sensory-based therapies aimed at improving his coordination and social and interactive therapies to help him deal with stimuli in his environment that he found harsh and jarring.

"It is amazing what it did for him," Pam Sims said. "As time went on, we had more treatments. We stopped when he was about 7 or 8 years old, as he had learned to regulate himself."

Stories like Woody's appear to support the existence of SPD -- and there are many such stories. Nevertheless, solid research confirming the existence of SPD is in far shorter supply, many in the medical community say. And on Monday, it would seem that new recommendations from the American Academy of Pediatrics have dealt another blow to the legitimacy of SPD. Specifically, the AAP recommends, "At this time, pediatricians should not use sensory processing disorder as a diagnosis."

The recommendations also suggest to pediatricians that they inform families that the evidence for sensory-based therapies is limited and that outcomes from these therapies should be monitored closely.

"I think the academy statement reinforces the decision that there is not enough information at this time to conclude that this is a distinct disorder," said Dr. Michelle Zimmer, a professor in the UC Department of Pediatrics and a lead author of the recommendations. "Moving forward, there needs to be a lot more research in this field."

Dr. Larry Desch, director of developmental pediatrics at Advocate Health Care and also a lead author on the recommendations, said that he did not anticipate that the recommendation would be well-received among parents and doctors who believe sensory processing disorder should have its own place as an official condition.

"I think they'll be unhappy, some of them," he said. "But I'm hoping it will lead to more research studies being done."

Dr. Lucy Miller, founder and executive director of the STAR Center Foundation, where Woody received treatment, said she, too, hopes the recommendations will lead to more research. But she said that there is no doubt in her mind that SPD is a distinct condition.

"There is an unbelievable amount of evidence not cited in [the recommendations]," Miller said, adding that much of the most recent research "just has not hit the mainstream pediatrics literature yet."

Miller agreed that more research is needed to further define the condition and those who suffer from it. But based on two studies that have looked at its prevalence, she estimated that 1 in 10 children may experience it to some degree -- maybe more.

But in light of the current research, SPD seems a tough sell.

"There is more that is anecdotal than anything else," Desch said. "There were a lot of problems with studies."

It probably doesn't help that the signs of SPD are a mixed bag. For some, it takes the form of an aversion to loud noises, rough textures in clothing and the taste and textures of certain foods. It is also said to manifest itself in what are known as "vestibular" effects -- poor balance, clumsiness and a delay in milestones such as learning to walk and talk. Some appear overstimulated by the world around them. Others are understimulated.

And then there is the treatment, part of which involves what is known as sensory integration therapy. This therapy is aimed at improving a child's ability to correctly process the stimulation he or she receives from surroundings. This usually means modifying the stimuli to which these children are exposed using swings, unstable platforms, weighted vests and a vast array of other equipment.

It is this therapy that the AAP recommendations singled out, encouraging pediatricians to "communicate with families about the limited data" on its use.

Critics of sensory integration therapy point out that the sensory issues targeted are signs of an underlying condition -- and that focusing on these symptoms ignores the larger problem, be it autism, ADHD or something else.

But, Miller argued, the therapy has evolved drastically from its origins in the 1970s. She also said the AAP recommendation ignores the other, newer therapies for sensory processing disorder -- approaches that emphasize social participation and require that relationships and engagement be a priority of the treatment.

Still, the generally lukewarm assessment of the studies published to date suggests the broader medical community has not yet recognized the existence of this disorder as a standalone condition, and it is even less convinced of the legitimacy of its treatment. As a result, few insurance companies cover the therapies. This can make this therapy an expensive proposition for parents. Pam Sims says Woody's treatment cost about $100 per hour and was not covered by the family's health insurance.

"I think that the cost prevents some people getting treatment they need," she said.

The insurance situation is just one of the things that proponents of sensory processing disorder hope to change. They have pushed for the inclusion of sensory processing disorder in the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, expected to be released next year. The DSM is considered to be the authoritative compendium of psychiatric disorders, and a place in its pages would mean that sensory processing disorder would become an official diagnosis. By extension, sensory-integration therapies would get a much-needed boost in credibility.

Whether or not the AAP's policy statement will undermine those efforts remains to be seen. Miller said she has already been told that the DSM-5 will not list SPD as a new diagnosis. She believes that it will get a mention as a sub-criterion for autism spectrum disorder. But what she is holding out hope for now is that it will be included at the end of the manual, as a novel diagnosis in need of research.

Even the authors of the new AAP recommendations appear to agree that more solid research on SPD would be a welcome development. And Zimmer said that despite the fact that one of the new recommendations explicitly urges caution with sensory integration therapy, she does not feel that this means the approach has no place in treatment.

"Certainly I think sensory-based therapies can be helpful," she said. "But these treatments have to be done on an individualized basis. It should be one component of a more global treatment program."

She said parents should consult their pediatricians if they are considering sensory-based therapies, and they should set out a specific period of time with a specific goal in mind -- a measurable reduction in episodes involving behaviors associated with oversensitivity, for example. She said that parents should then monitor their child's progress to see if these goals are being met. If not, she said, treatment should be discontinued.

Dr. Richard Besser, ABC News' chief health and medical editor and a pediatrician himself, agreed.

"It is so important that parents talk with their child's doctor openly about treatment options," he said. "Sometimes, there are treatments that lack scientific evidence because they are new and innovative. As long as they are safe, it may be worth undertaking in particular situations. However, as studies are done, doctors need to be open with their patients to let them know the findings."

Copyright 2012 ABC News Radio


Many Children with Autism Diagnosed Late, Study Finds

iStockphoto/Thinkstock(NEW YORK) -- Many children may be diagnosed with autism years too late to benefit from early behavioral intervention, according to 2011 national survey findings released Thursday from the National Institute of Mental Health.

Intensive behavioral therapy for autism, which can begin as early as age two, can significantly improve language and thinking skills in children with autism, according to the National Institutes of Health.  The therapy, which helps develop a child's social and behavior skills within different environments, is considered among the best forms of treatment by the American Academy of Pediatrics.

However, the survey found that more than half of the children had reached age five before they were first identified as having an autism spectrum disorder.

Although children can continue to benefit from behavioral interventions after age five, earlier behavioral intervention is associated with better outcomes, according to many experts.

"It is critical that we address the barriers that are preventing children from receiving early intervention," said Geraldine Dawson, chief science officer of Autism Speaks, who was not involved in the study.

More than 1,400 children ages 6 to 17 with autism were included in the survey.  The survey looked at diagnosis of the disorder within the last 17 years.

The older children may have been receiving some sort of medical assessment for their condition before receiving a formal diagnosis, according to Lisa Colpe, chief officer of clinical and population epidemiology research at the National Institute of Mental Health's and co-author of the study.

"It's still a very complex disorder to diagnose and does take some time," said Colpe.  "These ages mean that they have been getting assessed for some period of time before getting a diagnosed."

Ninety percent of the children diagnosed participated in some form of developmental service including occupational therapy, speech and language therapy, and social skills training, according to the study.  However, fewer than half of the children underwent behavioral therapy.

Copyright 2012 ABC News Radio


Cancer Diagnosis Ups Risk of Suicide, Cardiovascular Death

Monkey Business/(BOSTON) -- The shock of a cancer diagnosis can have deadly consequences, according to a new study that linked the diagnosis to an increased risk of suicide, heart attack and stroke.

The Swedish study followed more than 6 million adult men and women, 786 of whom were diagnosed with various cancers during the 15-year follow-up. Compared to their cancer-free counterparts, people who were recently diagnosed with cancer had a 12.6-percent higher risk of suicide and a 5.6-percent higher risk of cardiovascular death from heart attack, stroke or heart failure.

"Our findings suggest that a cancer diagnosis constitutes a major stressor, one that immediately affects the risk of critical, fatal outcomes," the researchers wrote in their report published Wednesday in the New England Journal of Medicine.

The risk of suicide and cardiovascular death was highest the week following a cancer diagnosis and decreased over time.

"What we're really looking at is the psychological stress associated with receiving the news," said study co-author Dr. Murray Mittleman, director of cardiovascular epidemiology at Beth Israel Deaconess Medical Center in Boston. "It can be a very big shock."

More than 1.6 million people will be diagnosed with cancer in 2012, according to the American Cancer Society.

"I think a lot of people would be surprised to know that the news of a cancer diagnosis would have such a profound effect," said Holly Prigerson, director of psychosocial oncology at the Dana-Farber Cancer Institute in Boston. "We should recognize that it's alarming, it's shocking, and there needs to be a way to protect vulnerable people who are psychologically fragile and less able to withstand the emotional blow of the bad news."

Prigerson said the news can trigger post-traumatic stress disorder and depression, both of which increase the risk of suicide. It can also have dangerous effects on heart rate and blood pressure, which boosts the risk of heart attack and stroke.

The risk of death from either suicide or cardiovascular disease was highest for patients with poor prognoses associated with brain tumors and cancers of the esophagus, liver, pancreas and lung.

"Patients might be thinking, 'I'm going to die a grizzly death, so I'm going to kill myself now rather than wait for this to unfold,'" said Prigerson.

The risk was lowest for patients diagnosed with skin cancer.

Prigerson's own research suggests more than half of patients are traumatized by their cancer diagnoses.

"Fifty-seven percent of our sample said they were made terrified or horrified by the news," she said. "It speaks to the psychological devastation wrought by a cancer diagnosis and the need for clinicians to be acutely aware of and sensitive to the impact of this news."

The suicide rate in Sweden is 12.7 per 100,000, according to the World Health Organization, which is slightly higher than the 12 per 100,000 reported in the U.S. But Prigerson said the study's findings can be generalized to American patients.

"These findings are consistent with research on the psychological trauma of a cancer diagnosis here in the U.S.," said Prigerson, adding that Swedish registries allow detailed epidemiological research. "It demonstrates, I think, fairly unequivocally, the impact of psychological stress on physical health."

All the cancer diagnoses reported in the study were confirmed. But Mittleman said the results also have implications for cancer screening programs, which have been criticized for generating false positives that lead to risky tests and procedures as well as anxiety.

"It points to the fact there may be unintended adverse effects of programs we think are strictly beneficial," he said.

Copyright 2012 ABC News Radio


New Autism Definition Could Exclude Many

iStockphoto/Thinkstock(NEW YORK) -- Proposed changes to the definition of autism might make it much harder for a person to be diagnosed with the disorder. The change would likely slow the rapidly increasing rate of autism diagnoses but also spark fears that some children with autism would no longer fit its definition, excluding them from services and treatments they depend on.

A panel of experts from the American Psychiatric Association re-evaluating the definition currently published in the “bible” of psychiatry, the Diagnostic and Statistical Manual of Mental Disorders, which is used to determine treatment, insurance coverage and access to services for a variety of mental illnesses.

That definition includes a number of disorders under the umbrella of autism spectrum disorder, including autism disorder, Asperger’s disorder and  pervasive development disorder not otherwise specified, which usually includes people who don’t fit neatly into the other categories of autism. Currently, people must show at least six out of 12 possible behaviors to be diagnosed as autistic.

According to a report published Wednesday in the New York Times, proposed changes to the definition for the new DSM edition, slated to be published next year, would exclude Asperger’s and PDDNOS and consolidate autism diagnoses under a narrower category of autism. The person would have to show three deficits in social interaction and communication and two repetitive behaviors, a stricter set of criteria.

Many autism experts support the proposed changes, saying they will make it far easier to diagnose autism.

Experts say the changes will probably also arrest the rate of autism diagnoses, which have been rising sharply in recent years. The Centers for Disease Control and Prevention estimates that one in 110 children in the U.S. has autism under the old definition.

Dr. Fred Volkmar, director of the Child Study Center at the Yale School of Medicine, led a team of researchers who analyzed data from a 1994 study testing the criteria used in the current edition of DSM. According to a statement from Yale University, the researchers found that half of the people diagnosed with autism in that trial would no longer merit a diagnosis under the new proposed criteria.

In the statement, Dr. Volkmar emphasized that these preliminary findings suggest that, “only the most cognitively able” would be excluded from an autism diagnosis.

Lori Warner, director of the Hope Center for Autism at Beaumont Children’s Hospital Center in Royal Oak, Mich., told ABC News that these cognitively able, "high-functioning" autistic people still require a number of treatment and support services.

If patients lose their diagnosis status, they might not be able to get the treatments and services provided for autistic patients and their families, which often require a diagnosis to qualify for insurance coverage, special education and other assistance.

“Really, in a lot of states, you need that diagnosis in order to have treatment covered. If you don’t have that diagnosis, you’re going to try to pay out of pocket or you have no access to these services,” Warner said. “It could be devastating for a lot of families.”

Copyright 2012 ABC News Radio


Golf Ball to the Head Leads to Life-Saving Cancer Diagnosis

Digital Vision/Alexander Hassenstein (File Photo)(WEST CHESTER, Pa.) -- Chris Logan never saw it coming -- that is, the golf ball that nearly knocked him unconscious or the cancer diagnosis that followed.

The 25-year-old from West Chester, Pa., was at the final round of the AT&T National when his favorite golfer, Sean O'Hair, drove a shot into the crowd and right into Logan's temple. When doctors examined Logan for a concussion, they found a lump in his neck that turned out to be thyroid cancer.
"I guess it was fate," said Logan, who quickly underwent two operations to remove the tumor and a bout of radioactive iodine treatment to kill any leftover cancer cells. "I was lucky to be there."
Logan almost wasn't there. Had his friend not dragged him out against his will in 95-degree heat on July 4, 2010, someone else might have taken the wayward ball to the head. A year later, a cancer-free Logan finally met and shook hands with the man who gave him a life-saving headache at Waynesborough Country Club in Paoli, Pa.

"It was funny," Logan said of meeting O'Hair, who also lives in West Chester. "Right as he apologized for hitting me in the head, I thanked him for starting this whole process off."

O'Hair called the fluke a "cool experience."

"You feel bad about hitting him, but yet you feel good that he found out about the cancer, found it early, and got it worked on," the 28-year-old told the Philadelphia Inquirer.

When it's detected, thyroid cancer is one of the most treatable cancers. Logan's first operation was to remove the tumor alone with hopes of sparing his thyroid -- the butterfly-shaped gland in the neck that produces hormones that regulate metabolism.
But the tumor proved to be malignant and capable of invading nearby tissues, so doctors decided to remove Logan's thyroid, too. Then they used radioactive iodine, which is absorbed by the thyroid, to wipe out any tumor cells left behind.

"I was so radioactive that I had to be in isolation," said Logan, who stayed in his old bedroom at his parents' house during the four-day treatment. "It was pretty awful. It felt like a hangover, a radioactive hangover, each morning for about two hours."
Without a thyroid gland, Logan has to take synthetic thyroid hormones every day -- a routine he happily accepts.

"If being a cancer survivor means taking two pills each morning, I really can't complain," he said.

Copyright 2011 ABC News Radio

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