Urologist Reacts to HOUSE MD | Hematuria & Nephroptosis
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- Опубликовано: 21 окт 2024
- A Urologist reacts to a House MD season 4 episode 12 where Dr. House solves a diagnostic dilemma for a patient with loss of urine control and hematuria. After multiple tests based on a hunch that "people never change" at the last moment he realizes she has nephroptosis a rare disease where a kidney drops 5cm upon standing creating her symptoms. In this episode you'll learn about what is hematuria, what are some causes and how we work it up in real life. Is the way these doctors go about testing patients accurate? Whats the history behind nephroptosis and how do you fix it? I also discuss informed consent and uphodling patients wishes/autonomy even if it may go against the recommended treatment.
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DISCLAIMER: This video is purely educational and does not constitute medical advice. The content of this video is my personal opinion and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of the information contained in this video including but not limited to economic loss, injury, illness, or death.
I find it great and hilarious how medical professionals in the real world loathe House and his character. It truly is fun to hear opinions from medical specialists. That being said, great video!
Thanks as always!
It's because House isn't a doctor. He's a reimagining of Sherlock Holmes. He has a terrible bedside manner, is wrong for most of an hour to drum up drama, and the focus really isn't on medicine. The medical cases are just a vehicle for the puzzle to be solved.
Also this is one of the few episodes where House's atheism is nearly unbearable. Sherlock had similar rants (time appropriate) so it's in character, but it can be a bit annoying. And it would be very inappropriate to go off on a religious rant while treating a patient.
Even other doctors on the show hate his guts
His character pulls no punches, something a lot of doctors should work at.
My mother and grandfather once saw a specialist who made House look like a sweet and lovely guy.
Urology is often little known and I like the idea of your channel: having fun and learning at the same time. 😃
Stay safe in the US! (and stay safe all!)
Thanks so much! Stay safe as well!
@@RenaMalikMD Thanks, I will! :-)
Most people have no idea of what urology or other spedecialized disciplines are unless needing a specialist. I never knew what a neurosurgeon did until 24 years ago and have had my skull sawed open 6 times ever since. I had one operation through my sinuses and been burnt with radiation numerous times. Most doctor shows are a joke to me as I have spent too much time with them.
It's known. The "urine" part is just what drives most folks away from the profession, faster scrawny 17 year olds flee the showers at Pelican Bay
Having been diagnosed with Nephroptosis myself after MANY years of intermittent symptomatic pains I appreciate your candor and explanation. It’s believed my right kidney has been floating since a childhood accident that caused trauma to my kidneys but the only symptom I showed for a couple decades was hematuria. Fast forward to my thirties and I went into numerous episodes of Deitels Crisis with no one figuring out that’s what was going on. I had severe pains, hydronephrosis, hematuria, etc. for almost three years before a urology nurse put all the symptoms together, including pain that worsened after being in my feet all day. In my situation, when my kidney fell, it was falling at a 90 degree angle and blocking drainage through the ureter causing the hydronephrosis but again, since scans are done when you are lying down, my pain was misdiagnosed as probably passing a kidney stone just prior to hospital arrival. While the episode and show definitely overdramatized the symptoms of the condition, I am pleased to see a urologist discussing it since it was long thought to “not be an actual condition”.
Number One Rule. People lie all the time, that's true being an ER Resident
Wrong. People can forget, sure, but it my experience people are less likely to lie when they feel a threat to their life than they would in normal day to day routine. When it comes to life or death situations and you're depending on someone to save you, the impetus to lie goes out the window real fast. Non-emergency situations, particularly situations resulting from shameful or embarassing actions, are the only common situations where lying occurs and usually the lie is just to save face/dignity while still presenting the majority of truth.
Not sure what crack you're smoking or where you're working, but like everything else with House MD, the "every patient lies" is complete meldramatic BS.
True, especially with this corona epidemic. We've had an entire shift quarantined because a patient lied about their history and only told the truth because a doctor died.
@@elizabethheyn5365 It is true that patient's lie sometimes and that person really should not have done that because it's fucked up. But the doctor should never just assume a patient is not telling the truth unless the have serious reason and evidence
@ i work in a hospital and am from a complete doctor's family, both parents, 2 of my grandparents, my brother and also both aunts and a cousin of mine are in the medical field: there is a lot of lying in the ER. Being in the ER doesn't mean that you are in mortal danger. quite a few of the ER patients did something unsave/stupid and are (understandibly) embarrassed. we are not here to judge, we are here to help, treat discomfort and pain and do the best we can to get people back into their daily lifes. but saying stuff like "are you smoking crack" because you just don't want to believe that people lie (embarrassment, guilt [parents], health insurance) is not ok.
no, not everyone lies. but the ER has more than enough people bending the truth for various reasons. the ER is not just a "close to death" ambulance.
You can't tell them you smoke weed because every doctor you see subsequently will ask about it. How do I know?
I am so happy I found your channel! I am a veterinary lab tech and very interested in urology, as this is a topic that is rarely touched on.
I hope you get a lot more subscribers, you deserve it!
Thank you!!
Sistoscopys are not fun but are very important. That exam found the problem immediately and my urologist was able to save my left kidney. Although its not a comfortable exam its an important one
Thanks for sharing!
I finally am watching this video! Thank you so much for doing it. I actually requested it just a couple weeks ago! Your reaction videos (and your other terrific content) are my favorite on RUclips.
Thanks for watching and suggesting Katie!!
Oh there is an episode of a boy with a blind uterus, have you seen that one? might be a great one to collaborate on with Dr. Jones
Looks like she hasn't made it that far in life over the past three years
You also have to remember that House his team is one that supposedly is called in when all the "normal" stuff has been done and didn't work.
"What is normally done" is what happens before people end up with the mad scientist, it's an (IRL non existent) last resort.
It actually exists, look up Dr. Thomas Bolte.
I was checked for bladder cancer, with a camera. I can't believe how quick it was, I was thinking to myself, was the Dr thorough enough? Everything was fine, but I sure did worry myself. Thank you doctors for looking out for us.
Hi Rena, thanks for your video. I had left sided nephroptosis and had nephropexy surgery in 2017, I unfortunately suffered for 1 1/2 years with all of the mentioned symptoms and debilitating pain. I really struggled for a diagnosis and subsequent treatment due to the rarity of this condition. I am currently doing my Masters in Medical Art in the UK and for my thesis project I am going to create a website with 3D models and illustrations/ animation on nephroptosis in the hope to raise awareness of this condition!
Awesome!
I also had nephroptosis, right sided. I suffered for almost 12 years until I found the right urologist who took my symptoms seriously. I agree, it’s so awesome to see this content!!
Hi @@catehennard6626, I am so sorry to hear you had 12 years of suffering before you eventually found the right consultant! I hope you are now keeping well. I would love to hear from you and it would be great if you would like to view the website I am creating on Nephroptosis for your feedback. If you would like to get in touch you can contact me through my contact page at my website www.caitlinla.com
You should react to "Untold Stories of the ER" season 6 episode 2, the "campstove stuffing" incident. The urologist comes in at the end and saves the day. It's pretty interesting.
Will look into it thanks!!
That wasn't nearly as fun as the botfly episode
Nice video, I didn't have any idea about those early treatments from back in the day. Good job🤗!
Thanks!! I didn't either until researching this video!
I love the fact that u give both good and the bad side of house(real medical aspect) I learn something new every time I see your channel
Every House MD Episode: "well you actually have Medical Condition XY"
Every medical professional: "That condition is actually extremly rare"
💯Truth!
I mean wasn’t he hired for the rare cases diagnosis ?
the thing is that Dr. house is the "zebra guy" who is contacted when a specialist fails.
Indeed that is the entire point. House is the guy you ask when you run out of ideas what it could be. Of course he will stumble across extremely rare conditions all the time.
Well done. Look for you post every Monday. Thank you.
Thank you!!!
The pause you did had me subbing girl 😝😝 lol
Thanks for a great explanation of everything. Love your videos! I’m an interstitial cystitis patient so I know all about cystoscopies and hematuria. 💗 Victoria from Ohio
Thanks Victoria. Sorry you have to deal with IC - hope you've come up with some managable treatment plan!
Rena Malik, M.D. Would you ever want to make a video about interstitial cystitis? I’ve seen a recommendation on here for pelvic floor dysfunction, which is also another good one. Certainly, IC and PFD are different, but some patients have both.
IC continues to be a poorly understood condition, even urologists not always agreeing on diagnostics and treatment modalities. Several urologists I know seem to think cystoscopy w/ hydrodistention should still be the gold standard for diagnosis, but I know that ultimately has fallen out of favor because it excludes many with the clinical presentation IC. Not to mention glomerulations do not appear specific to IC. I would be interested to hear your thoughts about this condition if you plan on such a video in the future!
Can you do a video talking about Kidney stones? My friend has them but i just don't understand it enough :/ I love this reaction btw 💛
I have two, check them out: ruclips.net/video/l_yLs5eyROk/видео.html (part 1) ruclips.net/video/uVGmnE7UFtw/видео.html (part 2) and ruclips.net/video/sPXRyA10mP4/видео.html
Thanks for watching!
@@RenaMalikMD Thank you so much!!!
Great comments Dr. Malik - if I may add my two cents' worth. I was "seduced" in medicine by watching Dr. Kildare and Dr. Ben Casey which presented a much better picture of my experience following my uncles (MD)'s practice principles and values. I was horrified by Grey's Anatomy (the show, even though I had to study the book which I discarded for Netter's library). "Things do happen in hospitals" but the life of attending and residents in major medical centers is very demanding. Besides, the department heads and the chief residents keep a close eye on their trainees. The only show that has interested me was House MD, not because of his bedside manners but because I saw it as a challenge to try to "out-diagnose" him, especially since the show comes up with ailments I have never seen. Yes, there is drama but I take House MD as an intellectual challenge and effort to maintain my "medical curiosity" for the unusual cases. As for Grey's Anatomy's staff, they would not last long at our institutions (USA/Canada). Peace be with you, Ciao, L (Family Medicine/Aerospace Medicine).
Great perspective, thank you for sharing!
House is just a story about a SOFTWARE developer working as a physician.. because that is exaclty how software bugs are solved.
I didn't know software development require breaking into coder's house
I’ve had two nephropexy surgery’s one on each side 2014 and 2019. I had a MAG 3 renogram laying down and sitting to diagnose mine.
I got sick of House myself, I'm not even a doctor, but I shared an office with an ME, and I asked him if any of that was realistic, and he just laughed and said "Oh man, [TV doctors] get everything wrong.
I just laughed and said, I thought so 😄
Oh yes, if you see an excess of blood anywhere, call 911! Um...I see blood, but it's just from hemorrhoids...don't worry unless you see an excess. Just ask your pcp for a topical treatment.
As for blood in the urine...call 911! I'm not sure what can cause it, but it could be cancer...especially if you feel pain.
One of my real life experiences was that I thought I had a peptic ulcer...it was actually a gall stone 😆 luckily I passed it, but it wasn't fun. The ER doc diagnosed it accurately, and I concured...they both have pain in the same area.
really fascinating, thank u for the history lesson!
Imagine if the show was real. The hospital & doctors would be rich from all the procedures and treatments that weren't needed!
Ever since I got kidney stones I’ve been terrified of urologists 😳.
Having a string hanging out of one’s tallywhacker is AWFUL. 😱
And having them yank it out is even worse!
I don't think anybody believes House M.D. is realistic or appropriate. I have only seen a few episodes, but he broke into a patient's home to see what medications were in their medicine cabinet.
How do you talk to a Dr. at the VA to make them take you serious? I’ve been going for years now with pains in my groin only to hear that it’s nothing to worry about. The best way to describe it would be to say it feels almost like anxiety in my groin. It’s so painful at times that the only way to make it any better is to urinate and that is temporary. I’ve had ultrasounds, prostate, and CT scans. They say it’s nothing because I’m in my 30s.
I think sometimes doctors juts don't have all the answers so it seems like they aren't taking you seriously. I'm sorry you had that experience. try to see if you can get a pelvic floor therapy referral after COVID-19, might be high tone pelvic floor.
I LOVE HOUSE
Great video! Subbed 😁
Awesome thank you!
The thing to remember about house, it was a Sherlock Holmes version but as a Doctor, Sherlock is a sociopath , he really does not see the feeling's of people, in the books he needs Watson to say, would you like a chair, or a drink of water, Wilson is his Doctor Watson.
Very informative
"Hey, stop that jew!" - a line that never gets old!
Dr your explanation is so and you are pretty and smiling too
Rena, the idea for House MD partially came from me thru another. The idea is not how medicine is, but rather should be. So some of your complaints are off. Think about the series, it follows. Lots of testing, the training,
9:11 MRI's are expensive? Never knew that. Seemed routine where I worked.
Well that's perfect house is a board-certified diagnostician with a specialty in infectious disease and nephrology something to do with the kidneys it would be him to find out
House is so disrespectful
Truth!
That's what makes most people actually like him. He's different and because it's unusual more people are interested in the character
So is Sherlock. House is based on Sherlock Holmes (which, fun fact, was based on a doctor that Doyle knew)
Thanos too.
I rather would say that House is honest. He doesn't sugar coat things.
14:05 the only thing that house doesn't respect is patient autonomy😂😂
Ah yes, House MD. We don't know what it is but we know it isn't Lupus. :P
:-) So my two cents, if anybody is watching a “Dr. reacts and “video and hasn’t seen the show house and doesn’t know who Wilson is,… Yeah that doesn’t exist :-) if you watch Dr. reacts RUclips videos clearly Irin to some level of medical stuff if for nothing else than entertainment and house is the best there is in that category
17:45 so like tacking a testicle to the scrotum if someone has Doppler defectect? After testicular torsion surgery?
similar., yes.
Are you seriously a urologist named RENa? That’s utterly hilarious 😂
House was a real ass whole I personally belive big hospital test for everything just to bill insurance but not care about the co pays that patients have to pay and if you be rich
I’ll take House over Fauci any day of the week and twice on Sunday.
Its funny I have watched every episode of this show numerous times and I have learned that A) its never Lupus (lol) and B) I will overstimulate my brain on this show and even once thought I had Rhabdo when I just needed water...
I watched House religiously not so much for the medical information ( I mean which medical show is accurate) but humor
It's not lupus
I like your content! New subscriber here!
Thanks so much!!
Can " nutcracker" syndrome also lead to hematuria? Thank you doctor.
Love your videos
Thanks so much!
Any recommendations for a surgeon on the West Coast that would do the nephroptosis? I am in the process of getting this evaluated.
Where specifically West Coast?
Rena Malik, M.D. Ideally AZ but will travel to states close by for a good surgeon.
@@RenaMalikMD Thanks for bringing some attention to this rare condition. Would love a recommend for a urologic surgeon well-versed in all things nephroptosis located in Southern CA. Thanks.
@@1sm08 how can I get the name of a person you recommend?
@@hilarylucero6499 Unfortunately, I haven't had any luck finding a urologist in my area who has experience treating patients with the condition, and/or is willing to learn about it. A doctor in Austin, TX, however, comes highly recommended on nephroptosis forums, Dr. Eric Giesler, at Urology Austin. I plan to contact him as soon as finances allow it. All the best.
It's his personality that he is what he is and a doctor can be like him if he or she have an IQ of 200.
Mam I am from right nephrotosis/floating kidney, I am in pain almost whole day back side ,front lower abdomen sometimes, cloudy urine occasionally.
Now flank pain lower right rib.
One urologist say no surgery because results r not good other say surgery.
What would I do I am not feeling well.🥺🥺
I am from India
Let's go BUFFALO
Dr. Malik, have you every performed a nephropexy?
Yes in residency. It's not a common procedure
It's not what happens, but it CAN happen.
If it's a plumbing issue ... shouldn't you call roto rooter?😆
I believe I have floating kidney but the urologist doesn't even believe that it's a real thing
Girl this man was never appropriateI don't know how many episodes you seen probably all just episodes fan suggested so you don't really know what this show was about it's not the typical medical drama where there's just a whole bunch of sex happening between patience this was different house the smartest guy in the building was a drug addict because of injury he got a while back that he refused to get surgery on cuz he was concerned about the risks so he just like has a bottle of Vicodin in his pocket that he pops like tic tacs all day he doesn't know anything about bedside Manor he doesn't know anything about dealing with people and there's definitely something different in his mind than everybody else's I would say he might be artistic but they never directly said it he would constantly be telling the more professional doctors that they're idiotssomething happening in the beast story would always make something click in his brain as to what the hell is causing this problemlike one time it was two kids in the same family who are hitting puberty way way too early the boy was about the age of girl would normally hit puberty but his sister was only five it turns out their dad was using somehormone cream at the gym because he's boinking his daughter's teacher and couldn't keep up with a 25 year old sexually he was in his forties he said he'd never had the cream at home so his kids could get into it but apparently since he applied it at the gym and hadn't you know been in the shower enough was coming out of his pores to cause his kids bodies to go haywire there was also an episode where there had to be a tick on somebody but nobody could find it but everything about her illness said she has a tick on herso he stops the elevator on the way to wherever they were headed and starts doing a pelvic exam and pulls the tick out of her in another episode he hadgorgeous girl who came in almost legally of age everybody's all over her hadn't had her first period yet and something was really fucked well every sign lead to cancer and they scanned her entire bodythere is nothing anywhere and he said well what about the ovaries they said if anything they're under-sized and that made it click in his head why she hadn't had a . Yet there's ovaries were actually testicles hence the reason she never had a period and when she came into the hospital everyone was thinking STD cocktail because she's been with like every guy she knows but no it was actually testicular cancer
Just out of interest, why does it more commonly present on the right side and in slim women?
Unsure the exact reason but the right kidney is lower than the left anatomically due to the liver so it's attachment may be less robust.
My last urologist was not nearly as pretty as this bright Doctor
It's interesting to see how House pissed of doctors in show and real life
React to code black.
Do you have a specific episode in mind?
if you want a real dilemma patient and no surgeon wanting to touch me let you tell me my story
You had aids?
Why House is so popular is because of how inappropriate he is.
You need more art on your walls. You have some odd Iron ship framed photos that as presented, would make an impressionist turn his head in shame for your utter lack of taste.
how old are you rena malek?
too much zinc? lol
Hi Rena do you have an email I wonna reach out to you, just some medical issues regarding my kidneys please ??..
Nageb Abdi , she can’t provide medical advice to someone she hasn’t actually examined. It’s unethical.
House is given special leeway as a board certified diagnostician because he's presented with cases nobody else can solve, and he has a track record of finding answers nobody else does. His recklessness is also his success as he saves more people due to his out of box thinking. A regular doctor will follow the regular rules. You can do everything correctly by the book, and lose the patient. If you break the rules, but the patient lives, is that justificaton? That's the basis of the show. Houses abusiveness and wit are just byproducts for entertainment.
Well the questions is whether this is accurate in the real world. Certainly there are some official procedures that are awful, like not allowing people to die when they suffer and their iillness is incurable. I think doctors should prevent needless suffering.
@@bluewizzard8843 no, that’s not the question. This is an entertainment show, not a documentary. Of course house doesn’t and cannot exist in the real world, neo. But the idea is the focus, not the reality.
Indian/Pakistani?
Indian!
@@RenaMalikMD great. I am a medico in final year of study. I think you were born and raised in the US. Put more episodes. We loving it. Namaste
Imagine having so many antisemitic doctors.
> being annoying by begging for subscribe
oh no i've missed the button, why is the thumb down symbol blue?
EDIT: Fine i do it, but i won't be happy about it >.
Girl, lose the ads.
In an odd way all these real doctors hating houses actions makes the show more believable. It really shows that there is a reason, beyond his personality, that his colleagues despise him