Today I saw my 5th case of inn-sue-lynn-no-mah (intentionally misspelt*, but you know what I'm talking about) in the last 1 year. Something that comes up frequently on medical school exams just because it's rare and exotic enough. And probably something some of us here have begun to take for granted, because we see these rare conditions so frequently, because of the referral bias. The rule of "when you hear hoofbeats, think horses not zebras or unicorns" may not apply here.
It's pretty amazing, thinking about it. Incidence of 4 per 1,000,000 patient years. Many endocrinologists and most doctors never see a case in their careers, and this is my 5th in a year, plus a case of hypoglyc@emi@ from islet hyp_erplasi@ and another case of insulin @ntibodies. Not that I'm expecting these cases to be a part of my practice in the future, but it's nice to have seen some rare medical conditions. I do feel blessed and fortunate, to be able to work here, with some leading experts in these fields. After all, our patients travel the country, even across oceans, to see them.
He's gonna have surgery Friday. I pray things will go well, although the surgeon is undoubtedly one of the most skilled in the world, and if I was to have my pancreas screwed with, it would be by his hands. I remember that adage in my medical school surgical rotation:
Rule number 1- Don't f*ck with the pancreas
He'll be in good hands, so I suspect the patient will sail through this.
*Apologize for the intentional typos. These conditions are rare enough that I don't want a patient or a future patient Googling my blog.