Diagnostic error for Serban Ionescu? Perplexing news...

(Image source) It has just emerged that the Lyme disease diagnosis given to the much-loved actor, Serban Ionescu, may have been erroneous. Mr Ionescu was diagnosed three weeks ago, after having presented with debilitating symptoms, perhaps following a tick bite last summer. Doctors at the Cantacuzino Institute are looking into the possibility of amyotrophic lateral sclerosis (ALS) as another hypothesis.

I am surprised. Firstly, tests carried out at Fundeni (which tests, no one has said, but the two that specifically diagnose Lyme are ELISA and the Western Blot) were false positives. Or false negatives. Whatever. It is true that results of false positive can appear for Lyme - but ONLY in the first few days after having been bitten by the tick, simply because the antibodies have not had enough time to declare themselves. Since Mr Ionescu was bitten last summer and tested recently, the antibodies would have had more than enough time to be present in his system and thus visible in either test. One can therefore draw the conclusion that these tests were not carried out at Fundeni hospital - and they are the only two that can pinpoint Lyme accurately. 

Secondly, doctor academician Constantin Popa suspects ALS as the cause of Mr Ionescu's condition. This, too, is odd. What brings him to this conclusion? Test results have not yet been received (judging from the press) and, apart from that, ALS affects only 1-3:100 000 people - it is rare, in other words. It is also idiopathic in nature (ie. cause unknown) and therefore would have nothing to do with the tick bite.

Is this simply a case of doctors still having absolutely no idea of what beleaguers this poor man and are thus throwing big words into the arena to seem impressive and knowledgeable? It has been suggested that this is indeed the case.

One thing is clear to me - all the antibiotics and other drugs pumped into Mr Ionescu over the past few weeks will have masked the original bacterium, making any kind of diagnosis far more difficult to obtain. All in all, they have been about as useful as an elastoplast on a wooden leg...

Lyme disease is treated by and responds to antibiotics prescribed as early on after contagion as possible. It is curable. In this day and age, people no longer die of Lyme disease. ALS, however, is a degenerative disease and has no link whatsoever with the bacterium that causes Lyme. Palliative treatment is given to slow down the development of the disease, but, as yet, there is no cure - it is ultimately fatal, much like motor neurones disease, for example. The treatments are far from being the same and the outcomes are worlds apart. How on earth can two such different diagnoses be given for one man? It makes no sense at all. And the longer his condition is left to evolve, the more dangerous things become for Mr Ionescu, who has since discharged himself from hospital (who can blame him?) and is now being looked after by friends and family. If he has ALS, then not even the 20 000 euros put aside by the powers that be to pay for his treatment in a clinic abroad will be of use. Let us pray that this is a completely inaccurate diagnosis.

(Image source) The declaration that Mr Ionescu was suffering from Lyme caused wide-spread panic across Romania - and without being the least bit sure of the diagnosis, doctors continued to appear on television and in news articles, talking of the disease. 18 people showed up at hospitals in Bacau after having been bitten by what they thought to be ticks, terrified that they too were infected. In Brasov, 5 people were diagnosed with the disease. Victor Ponta's ministry of health stated two days ago that 34 people have been infected by Lyme out of a total 208 cases presented, which is an improvement on 2011 when 64 people out of 130 cases were infected.

I have been told that Lyme is new to Romania, hence the slowness to diagnose and the inefficiency of tests. However, Lyme disease has been monitored in Romania since 2010, when 312 cases were apparently diagnosed. Not that slow, then... The advisor to the minister of health at the time, Dr Geza Molnar, said 'that doesn't mean there weren't 380 or 500 cases'. Brilliant calculations....

It would be interesting to find out whether or not diagnoses for the above cases were obtained following the necessary test procedures. If not, then the statistics are likely to be misleading at best.

The press have reported a load of rubbish (spouted by a doctor for Cancan and Realitatea - okay, not reliable sources but unfortunately very widely read and believed) about how the disease was 'imported from the US', could be spread from person to person, and that the ticks lived on dogs. Piffle. But this was very beneficial for officials looking for excuses to continue with the extermination of the maidanezi. Handy publicity indeed. It makes you wonder what lies behind every single declaration and who is benefiting from them.

Mr Ionescu's condition has been shamefully hijacked for marketing techniques by certain companies and individuals to increase traffic to websites, expand sales, spread advertising and improve sales figures - a hallucinating lack of respect and sensitivity.

However, it has also brought about mass sympathy from all over the country for a much-loved actor leading to donations flooding in right, left and centre. Tomorrow at TNB, a theatre performance of 'Dineu cu proşti' will take place at 11h starring Caramitru, replacing Serban Ionescu. All funds will be donated as aid to Mr Ionescu. Also starring are Horaţiu Mălăele, Medeea Marinescu, Alexandru Bindea, Costina Ciuciulică, Dorin Andone/ Tomi Cristin and Alexandru Georgescu. Victor Ponta also saw to it that a substantial sum was released by the government (ministries of health and finance) to foot the bill for Mr Ionescu's medical costs. I suppose it was helpful also that the stand-in minister of culture is/was an actor. The concern and desire to help this man has been both touching and phenomenal.

Some are critical, though - while patients suffer from misdiagnoses and negligence in hospitals all over the country (and sometimes even die as a result), who helps them and their families? Nobody. Perhaps a valid point? It should be underlined though, perhaps, that even for public figures like Mr Ionescu, the treatment is no better than for anyone else. Perhaps he has a nicer room with a nurse who demands less spaga for changing the bedsheets daily, but en gros, the errors are no less likely and the fobbing off just as omnipresent.

THIS appeared on FB yesterday written by the journalist Lucian Mindruta and has since been published on various blogs and sites. It makes for valuable reading. At gone midnight last night, there were 409 'likes' and 191 shares. Good. I certainly hope it does the rounds - and that it hits home. In it, he says that Lyme has become the trend along with an occasion for profiteering. Doctors are profiting too, using the opportunity to get their mugs on television in order to discuss the erroneous diagnosis (which still hasn't been confirmed, note) - and anyone in the medical field can participate in the throng of wanna-bes - including vets. Go see the complete text for yourself (in Romanian).

In the meantime, with all this going on, Mr Ionescu must send an application to the ministry of health in order to receive the promised funding put aside for his treatment. He has not yet decided on the clinic of his choice, nor whether he will go abroad for medical care.

Money is spent, wasted, frittered away in Romania on things nobody wants - ridiculous roads, absurd statues, ugly renovations of parks, for example. Had, long before now, money been put into the health service and the decent training of medical staff as is the case elsewhere, perhaps Mr Ionescu would not be in the state he finds himself today. That and the fact that Romanians are just not taught to question the opinions of their doctors (or anyone else with 'authority' for that matter). It is rare to find people who check symptoms online (or elsewhere) to compare with and thus confirm/refute their doctor's diagnosis - and many medics, therefore, consider themselves above and beyond reproach. That desperately needs to change. In terms of the necrotic health 'service', one can defend it all one wants - pitiful budget, tough jobs, long hours, pathetic (and frankly, offensive) salaries, staffing shortages etc etc... The fact remains that it is diabolical and way below EU standards. The Romanian Times (March 2012) reported that "statistics show since 2008, 11,000 doctors have left the country to work in the West. On a general note, in Romania there is one doctor for 400 patients, double the patient/doctor ratio in the EU, while the income of a Romanian doctor is a tenth that of his or her EU counterparts."

But, valid excuses or not apart, doctors who put their patients' lives at risk from erroneous diagnostics and malpractice should be struck off and their licences revoked. This rarely happens in Romania, although errors, botched jobs, corruption and negligence hit the headlines at pretty regular intervals. See THIS blog, a dictionary of medical malpractice in Romania, for individual cases, those responsible and what the consequences were. On the other hand, those who do wonderful, dedicated jobs are rarely praised.

May Mr Ionescu find the treatment he so urgently needs as soon as possible in a clinic comprising of doctors who know what they are doing. I hope future news will be more optimistic - and that the medics presently treating him get their act together sharpish.

30th May: Update: Serban Ionescu has arrived in Munich for treatment and is said to be doing well, according to the Ministry of Health.

Comments

[sairj]

Dear Silviu - well, if you've learned it from movies, you have done an excellent job! Bravo! The day I speak Romanian as well as you write in English will be a day for great 'petrecere'!!



All the best,

Sarah

[Silviu]

Actually, lyme disease is so old in Romania...just that it had other names (sm,als, lupus, fibromialgia, arthritis, CFS, etc). Lyme is NEW in Romania as starting with last year (maybe 2010) it became a real and visible problem. a major health problem. I personally know several persons which after being bitten by a tick contracted lyme disease. Even today, MDs in Romania still prefer to keep their eyes shut and ignore the unignorable. Unfortunalty this is happening in US also and also the rest of western civilization.

Lyme disease is often misdiagnosed, more people are suffering ignored by medical services and no one seems to care. It's a real epidemic which reminds me of syphilis era and something need to be done. Otherwise, in the following years we'll have a serious health problem as lyme can transform you from a healthy, active person into a bedridden one.

Thank you for your time, Sarah! I wish you all the best and....excuse my english, I only learn it from the movies...as the majority of romanians :)

[sairj]

Hi Silviu



Thank you for the news update. I had heard he was back in Romania but I'd be delighted to hear that was not the case and that he continues to be treated in Germany.



What you say is indeed extremely cruel. It's outrageous. And that's my point, really - that Romanian doctors are STILL unable to correctly diagnose despite the tests that are clear and concise (noted on another post somewhere) - if it really IS Lyme that Serban Ionescu has, now, I suppose, with additional complications due to so much time passing, then I hope to God he stays put in Germany for treatment (my point also) so that he can get the attention and professionalism he deserves.



Someone told me that Ro doctors often misdiagnose beacuse Lyme is 'new' in Romania. Ever heard anything sillier than that? Is that an excuse? rare? Not rare? Whatever. Either one is a doctor or one isn't. The tests are there, the antibiotics are there (and if not they can be obtained)...why this continous misdiagnosing, messing about, wasting time and putting lives at risk. NO ONE today need die of Lyme disease. It is treatable. But not in Romania, it would seem...

[Silviu]

Actually, Serban Ionescu is now being treated for LYME DISEASE (borreliosis) in Germany (see news updates). ALS was just a manifestation of borrelia spirochetes. That means that "so called" lyme disease is not "en vogue", it's a real thing that medical services fail each time to recognize (or simply don't want to) and so called "journalists" like Lucian Mandruta failed once again to be impartial/or competent on this matter. If you search the internet you'll see that in Romania there are thousands of missdiagnosed MS people which have LYME DISEASE and instead to receive antibiotics they receive imunosupressor drugs. Hos cruel is that?

[sairj]

Thank you for commenting Geta P, and also for the above link to more info on ASL/Lou Gehrig disease in Romanian