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Editorials, Ethics, evidence based medicine, Lasso of truth

Why double pneumonia is like irregardless and why it matters

MSNBC is reporting that Rick Santorum’s daughter, Bella, has unfortunately been hospitalized again. Considering she has Trisomy 18 multiple hospitalizations are sadly expected.

The article started out well enough, using the National Library of Medicine and a pediatric palliative care expert as sources and reviewing the medical issues faced by children with trisomy 18 who survive. And then I saw it. The dreaded double pneumonia.

Sigh.

There is no such medical diagnosis. Just like the word irregardless, people use it, but that doesn’t make it correct nor prevent it from sounding like fingernails down a chalk board. I once broke up with someone because he used irregardless 3 times in an evening. I mean, really.

So let’s get one thing straight. Double pneumonia is not a medical diagnosis. When I hear it, I wonder do they mean:

A) twice as bad
B) 2 lobes
C) both lungs
D) 2 organisms
E) all of the above (although that’s typically reserved for the dreaded The Double Pneumonia, because according to my 83-year-old dad adding The in front of a medical diagnosis makes it really, really bad).

Many people use news sites as a valid source of medical facts, so being factual, which includes using correct medical terminology, is essential. What if double pneumonia came from a Santorum press release? Ignore any inaccuracies and report the facts.

Lay terminology is fine if it has a widely accepted meaning (think heart attack for myocardial infarction), but double pneumonia is sloppy and makes me wonder what else is wrong with the piece.

Because that boyfriend who used irregardless? Well, I broke up with him that night. And a wise move it was, because later I found out that he also listened to Rush Limbaugh!

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Discussion

11 thoughts on “Why double pneumonia is like irregardless and why it matters

  1. Thank you. Both for the “irregardless” bit which likewise makes me grind my teeth, and the saying that trisomy 18 children are going to more or less LIVE (such as life is) in a hospital. My son’s ex-wife’s second pregnancy was a trisomy-18 fetus. She got no pre-natal care for the first 22 weeks (thank you military medical system), and as soon as she found out, she instantly elected to end the pregnancy.

    I think she took some serious emotional hits for her lightening-fast, no time for assimilation choice, but did approve of her choice. Not electing to have a child that if it survived, would live in and out of hospital and emergency rooms did seem wise to me.

    The press constantly making a big deal of every trauma the little Santorum girl goes through annoys me; her father belongs to a party that could give a damn less whether EVERY American family could afford that kind of care for their children is like a constant thorn in my side. So, I fond the cloying concern hypocritical to say the least.

    Posted by Labrys | April 8, 2012, 2:15 pm
    • I am starting out in medical coding and do see that one of the terms in the ICD-9-CM index for pneumonia is double. It make absolutely no difference whether double is present or absent in terms of a specific diagnosis. I am wondering if it is appropriate to ask a physician that used the word double with pneumonia what they meant; 2 lungs, 2 lobes, 2 organisms?

      Posted by Rich Hartmann | April 8, 2012, 6:46 pm
      • The ICD coding book is notoriously inaccurate! One of my pulmonology professors told me there was no such thing, my pulmonologist friends tell me there is no such thing, and you don’t find the term used in medical textbooks, so that’s good enough for me!

        Posted by Dr. Jen Gunter | April 9, 2012, 10:18 am
  2. When my mother was little and learning to read she read “pneumonia” with the “p” sounded, and thought it was just a worse disease. Peenewmonia, deadly.

    Posted by jennyjames53 | April 8, 2012, 4:04 pm
  3. Sad for Bella. Hope she gets better soon. I always interpreted “double pneumonia” to mean both lungs, like “double ear infection,” meaning both ears. Hope they’re giving her some of those “stronger antibiotics” irregardless if it’s a double or not. So, according to your Dad, does that mean places like The Bronx, and The Hague are really, really bad as well? Hope you have some time to enjoy your time off

    Posted by d walker | April 8, 2012, 5:07 pm
  4. Reblogged this on doctorforyou and commented:
    Something that I really agree with-

    Posted by Melissa Gastorf | April 9, 2012, 4:22 am
  5. The difference between “double pneumonia” and irregardless is that the latter is not a word (i.e., it’s WRONG), and the former is just an annoying phrase that makes something sound worse than it it. Adding “the” before a diagnosis, in my subjective experience, only subtracts IQ points from the speaker, without changing the signification of what follows.

    Posted by Rob Lindeman | April 9, 2012, 10:34 am
  6. Thanks for the response Jenn! I definitely understand that a term like double has no meaning when specifying pneumonia. The ICD-10 index still lists double, disseminated and interstitial as supplementary terms that make NO difference on the code used. disseminated, double or interstitial add nothing in a medical document to describe lobar pneumonia. ICD-10 Index entry for Lobar pneumonia lobar (disseminated) (double) (interstitial) J18.1

    I wonder if ICD being an international coding book has physicians in the world using the term double speaking with their patients and also document the same way. The only reason the term double appears in ICD is there are physicians that use it in documentation.
    Rich Hartmann

    Posted by Rich Hartmann | April 9, 2012, 1:03 pm
  7. Just finished reading your excellent blog about the botched abortion and have 2 corrections for you. “Blindsided” is all one word. “Myriad” means “many”, so one doesn’t use “A” or “of” with it, just as one doesn’t say “There were a many of problems today”. Rather, “There were myriad problems today.”

    Posted by Martha | April 16, 2012, 1:07 pm
  8. Actually double pneumonia is in fact a more severe form of pneumonia. For the simple logical reason being it affects BOTH lungs. As my amazing Dr. at the time put it when I had it (and didn’t want to go in the hospital) “You have double pneumonia, meaning it’s in both lungs…which also means that its probably even harder for you to breathe and will undoubtedly take even longer for you to recover.” Which ended up being true for me, because I needed a few (yeah, a few) rounds of major antibiotics. It did take longer to recover because I had double pneumonia for 3 weeks, then finally pneumonia (because it cleared up in one lung but not the other) for about a week, then walking pneumonia for two weeks, then another month or two until I was back to feeling like my old self. Also when your have double pneumonia (meaning both lungs) you are more susceptible to developing pleurisy. There is a reason why it has a different code in books, it’s to imply that pneumonia has affected both lungs. Think about lung transplants. If someone has a single lung transplant, one would assume that the other lung is pretty decent at least. It one has a double lung transplant, well then both lungs are in really bad shape. Yes, a lung transplant (single and double) is a very serious surgery either way, however there is a reason for the specifics. Also, if you have double pneumonia you have a possibility to have scarring in not just one lung, but two. Again, logically that would tell you that you could possibly be in a worse off position. I’m not trying to make it sound like “Omg, double pneumonia is a million times worse then just regular old pneumonia.” Pneumonia affecting one lung can absolutely be as serious (depending on how much of the lung is covered) as having both lungs infected.

    Posted by Roxanne Wilmath | September 2, 2013, 12:42 pm

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