Pathology labs are so utterly useless, it was quite disturbing to work out how bad they are.
When I first got back from Africa convinced I had been successful infecting myself with hookworm, because of multiple rashes and a night of violent coughing, I tested negative 3 times in a row at a lab in California.
I was convinced I had failed. I was crushed. I was broke.
Then my allergies and then my asthma went and I began to wonder, and I bought a microscope.
After that I had multiple tests over the next year or so with different labs looking for one that knew what they were doing. I was being asked to prove I had hookworm, and everyone thought as I had that it was a simple test.
You can imagine, back then there were no blogs, almost no news or research, and a lot of people thought I was lying. After all, where were the test results?
Later on I wanted to be able to refer clients to an independent lab, a lot of people were preoccupied with McMaster egg counts, worthless though they are. As well as to confirm their ongoing infection with hookworm.
I did not want to do stool tests because it was going to be believed I was just making results up. A lot of people did not believe we actually had worms back then is what I mean.
I have only ever tested positive once with a third party, the Clinic associated with the Liverpool School of Tropical Medicine, this was after we had had to leave the USA and fully four plus years after I went to Africa and more than two years after I went to Belize. That clinic even gave decent estimates of my worm burden for both Hookworms and Whipworms, as in Heavy of hookworm and moderate for whipworm.
I imagine lab techs are people who “know” no one in the States or Europe can possible have a helminth infestation.
So when a sample comes in from someone wanting a test for hookworms and they say they have not travelled abroad in the last three years, in the Tech’s mind the person asking for the test has to be an obsessive, a Hulda Clarke acolyte.
The Tech does, at best, a cursory examination of a single slide, wretches a few times, and bins the sample, ticks “Negative” on the carbon paper form and then furiously washes their hands, and liberally applies hand sanitiser.
That is how I imagine it goes most of the time, at $90 a pop.
We had another experience where a client went to their doctor, the client was nuts by the way, convinced they had a deficiency disease, and the Dr. ordered blood work.
At the time I was working with a clinical pathologist, someone who ordered and interpreted sophisticated tests for doctors, and had done so for years working for the National Health Service here in the UK.
On the basis of the blood results the doctor ordered iron infusions, and a regimen of supplementation for things like magnesium.
The client went nuts.
The client very shrilly blamed her predicament on hookworms and on me, it was still early days so I wasn’t equipped to refute both her and a doctor or so I thought. She was fulminating online and everywhere that we were a threat to life and limb, grossly irresponsible, etc., etc.
So we obtained a copy from her of her blood results, and according to the clinical pathologist had they been correct the blood could only have been drawn from a corpse.
The Dr. had not noticed, or more likely had decided it was easier to treat a condition that did not exist than to confront the lunatic.
The lesson of this story is that you should always obtain a confirming test when lab results indicate anything other than a mild course of treatment, iron infusions are not mild. You can apply the same reasoning to the opinions of doctors. I never go myself, but when I do and if a diagnosis is rendered I will definitely be getting a second opinion and a new set of tests.
If you doubt me maybe you should do some searching, here is one link I found by Googling “number of misdiagnoses per year usa”.