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DDx

60 episodes - English - Latest episode: 9 days ago - ★★★★★ - 335 ratings

A podcast about how doctors think. Presented by Figure 1, the knowledge-sharing and collaboration app for physicians and healthcare professionals. Learn more at Figure1.com/ddx

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Episodes

Undoing the Long-Held Misunderstandings of Hemophilia in Women

March 20, 2024 07:05 - 10 minutes - 12.7 MB

A 30-year-old was in labor with her first child. Everything was going to plan … until it wasn’t. Dr. Azusa Nagao, a hematologist at Ogikubo Hospital in Tokyo, Japan, shares a case that illustrates how historically it was thought that women and people assigned female at birth could only be carriers of the disease, not have the disease themselves. This misunderstanding of hemophilia in women has led to women going undiagnosed and untreated with severe repercussions. For the patient in this sto...

The Ups and Downs of Hemophilia Treatment

March 13, 2024 07:05 - 13 minutes - 15.9 MB

A patient was experiencing severe knee pain. Unfortunately, this wasn't anything new. For decades, he’d been suffering from joint disease, caused by severe bleeding in his knees from a rare blood disorder — hemophilia A. The patient was born in the 1960s, a time when the life expectancy for patients with hemophilia was only 10 years. But as Dr. Annette Von Drygalski, a board certified hematologist and the director of the Hemophilia and Thrombosis Treatment Centre at the University of Califor...

Go Inside the Minds of Doctors Who Specialize in Hemophilia

March 08, 2024 08:05 - 1 minute - 1.47 MB

Go inside the minds of doctors who specialize in hemophilia — a rare, inherited bleeding disorder that once meant possibly not surviving past the age of 20. This season, we’ll explore the medical milestones that enable patients today to live longer, richer lives and examine the challenges yet to be tackled.

When the Doctor is the Bully

November 22, 2023 08:00 - 14 minutes - 13.2 MB

What can you do when your attending physician is a bully? Hear from two nurses, Melissa and Laura, about their experiences being bullied by a physician. For Melissa, it was notifying an on-call physician that a baby was ready to be delivered, only to be scolded for calling too soon. For Laura, it was being reprimanded by a physician who questioned her abilities as a nurse in front of a patient. So how do you respond to a bully, especially when the bully is in a position of power? C...

Critical Learning on the Job

November 15, 2023 08:00 - 15 minutes - 13.9 MB

When is it okay to admit that you don’t know how to do something? Hear the story of Tamara Kuhn, a bedside telemetry nurse, who in a moment of crisis, used her problem-solving skills to keep her patient (and herself) safe. Tamara was caring for a patient who suddenly became violent. After calling for help, Tamara was given what she thought would be a standard restraint system. But what she received was not equipment she was used to. So how do you set yourself up for success in these si...

Trusting Your Gut

November 08, 2023 08:00 - 15 minutes - 14.5 MB

What do you do when you know something is wrong with a patient, but don’t have the data to back it up? Hear the story of Diana Struthers Stanton, who, at the beginning of her 46 years in nursing, cared for a 10-year-old patient with Reye syndrome. The patient’s capillary refill had changed and was slowly getting worse and worse. Concerned, Diana spoke to her charge nurse and was told not to worry about it. She spoke with her colleagues who also told her not to worry. She paged the on-call ...

When Generic Symptoms Turn Serious

November 01, 2023 07:00 - 11 minutes - 11 MB

How do you know when generic symptoms are masquerading as something serious? Hear the story of Molly Lalonde, a pediatric nurse practitioner, who met an 11-year-old patient with an unexpected concern. While surprised by the patient’s inquiry, Molly took the time to listen and ask questions. In response to the patient’s heightened level of concern, Molly investigated further. Following an assessment by a specialist, it turned out the patient’s concern was warranted. So how do you recogniz...

Raj recommends our new show: They Don't Teach That In Nursing School

October 25, 2023 07:00 - 2 minutes - 2.02 MB

While nursing school equips you with valuable knowledge and skills, it doesn't prepare you for the real-life challenges you’ll face on the floor. They Don't Teach That In Nursing School is your go-to guide, offering unique solutions to the unexpected problems you'll encounter as a nurse. Each week Connie Levie (RN) presents the story of a nurse facing a specific challenge and its possible solutions. Our episodes are snack-sized, designed for your commute, break time, or just when you need...

RAJ WANTS YOUR VOTE

September 21, 2023 07:00 - 31 seconds - 501 KB

DDx has been nominated for three Signal Awards. Click the links below and vote for us now! Documentary: https://vote.signalaward.com/PublicVoting#/2023/shows/general/documentary Health & Wellness: https://vote.signalaward.com/PublicVoting#/2023/shows/general/health-wellness Best Writing: https://vote.signalaward.com/PublicVoting#/2023/shows/craft/best-writing

SPECIAL ANNOUNCEMENT FROM RAJ

September 06, 2023 18:24 - 49 seconds - 786 KB

Hi DDx listeners! We’ve got something special in the works, and we want you in on it. We're developing a new podcast by and for nurses - and we're searching for a host! It’s a show about innovative solutions to the most intense challenges - whether clinical or personal - that nurses face. In each episode, you, our host, will connect with fellow nurses who are grappling with specific challenges and unravel solutions that not only elevate their practice but also enhance their overall j...

Hypoplastic Left Heart Syndrome and a Trip Across State Lines

February 01, 2023 08:00 - 10 minutes - 9.78 MB

Following a normal first trimester, a pregnant patient starts spotting. The patient’s care provider books an urgent ultrasound to see what is causing the bleeding. The main concerns are if the spotting is caused by a miscarriage or something else. Following the ultrasound, the technician calls in obstetrician Dr. Ashley Brant to review the results with the patient. There is a problem with the fetus’ heart — specifically, a condition called hypoplastic left heart syndrome. Essentially, the l...

Pregnancy Reduction in a Twin Pregnancy

January 25, 2023 08:00 - 12 minutes - 11.7 MB

A 35-year-old with several children discovers she is having a twin pregnancy. This is happy news, until a potential abnormality in twin B is found.  Twin B is measuring much smaller than twin A — almost a full 10 to 14 days behind — and there is fluid around the fetus. While it is too early to diagnose, it appears there is a brain abnormality. The patient, with a lot of apprehension and many questions, sees high-risk obstetrician Dr. Maeve Hopkins. Genetic testing is needed for decision-ma...

The Complicated Decision-Making of a Molar Pregnancy and an Intrauterine Pregnancy

January 18, 2023 08:00 - 10 minutes - 10.3 MB

A pregnant person is referred early in pregnancy to high-risk obstetrician Dr. Stacey Ehrenberg after an ultrasound detects an abnormally developing placenta. Dr. Ehrenberg diagnoses the patient with a molar pregnancy; a placenta that forms into a benign tumor with the potential to become cancerous. While the molar pregnancy will not survive, the patient also has a viable intrauterine pregnancy. Faced with this diagnosis, Dr. Ehrenberg counsels her patient about the risks of continuing or d...

Abortion as Healthcare (a Miniseries)

January 11, 2023 08:00 - 1 minute - 1.43 MB

Meet three obstetricians who perform an essential medical procedure: abortion. Learn about their patients and how abortion affects both physical and mental health. From a molar pregnancy to fetal chromosomal abnormalities, these stories illustrate the life-saving impact of abortion, and its necessity within healthcare.  

Non-Specific Symptoms Lead to Complicated Diagnosis

December 07, 2022 00:00 - 11 minutes - 10.7 MB

It starts small. A slight pain in the foot, followed by an achy shoulder. There's some fatigue. The type of non-specific symptoms that often go ignored … until they can’t be anymore. A 37-year-old visits the family doctor, complaining of foot, shoulder and chest pain that progresses over weeks. And she's really tired. Otherwise, there’s nothing notable.  She's just a busy parent. Being tired is normal, right?  Sometimes that’s true, but in this case, this would prove to be a dangerous ass...

A Lump on the Skull and the Misdiagnosis of a Rare Bone Disease

November 30, 2022 00:00 - 11 minutes - 10.1 MB

In 1964, Nancy, a 5-year-old, is having her evening bath when her parents discover she has a lump on the skull the size of a grapefruit. This would mark the onset of a mysterious and debilitating disease that researchers are still struggling to understand.  Over the next 40 days, medical professionals struggled to discover what was causing the lump on the skull. Each test seemed to exacerbate the swelling in Nancy's neck. In hindsight, that was a big clue, but it took doctors a while to rec...

Metatarsal Bone Fractures and a Rare Bone Disease Hiding in Plain Site

November 23, 2022 00:00 - 12 minutes - 11 MB

A patient in her mid-50s complains of foot and leg pain. She's post-menopausal with low bone density. A classic case of post-menopausal osteoporosis. Not exactly.  And it won’t start to become clear until it gets to the point of her having repeated metatarsal bone fractures. Let’s go back a little. It’s 2005. Our patient visits her family doctor complaining of pain in her legs and feet. But the discomfort she's experiencing isn't your typical aches and pains associated with aging.  “She ...

Hypophosphatemia and the Secret Locked in a Child’s DNA

November 16, 2022 00:00 - 12 minutes - 11.3 MB

A toddler is taken to his pediatrician because his parents are concerned he might be small for his age. The pediatrician diagnoses him with knock knees, but there’s no cause for alarm. Although the child doesn't have any other known medical conditions, something is happening in secret, inside his DNA that won’t be discovered until a diagnosis of hypophosphatemia is discovered some time later. And if this disease is ignored, it can quickly become deadly.  But back to that first appointment....

Overlooked Diagnostic Test for Blood Calcium Levels Leads to Rare Diagnosis

November 09, 2022 00:00 - 10 minutes - 9.61 MB

A 23-year-old presents to the emergency department with progressive symptoms. It starts with tingling in the fingertips that lead to leg cramps that turn into feeling like she’s turning into stone, frozen in one position with stabbing pain. And perhaps most troubling, she can't concentrate. In fact, the brain fog is so severe that she’s afraid to drive.   Over the course of three days, her life has been turned upside down.  She takes a taxi to the emergency department and is seen after wai...

Mysterious Arterial Calcifications and One of the World’s Most Unique Patients

November 02, 2022 00:00 - 12 minutes - 11.6 MB

An infant is born with no complications in a hospital in Los Angeles. Within days, that same baby will suddenly have mysterious arterial calcifications, making him one of the most unique patients in the world. After being released from the hospital following the birth, within five days, the infant’s parents discovered the child breathing quickly, sweating and unable to eat. The child is brought back to the hospital and quickly transferred to UCLA for specialized care.  The situation quickl...

Paediatric Seizures and The Race Against Time

June 29, 2022 00:00 - 11 minutes - 10.3 MB

A toddler’s parents noticed him having muscle twitches before falling asleep and when waking up. They’re told nothing is wrong. This episode of DDx reminds us that sometimes when you hear hoofbeats, it really is a zebra.

Diagnosing a Complex and Mysterious Form of Paediatric Epilepsy

June 22, 2022 00:00 - 12 minutes - 11.3 MB

A child was referred to a specialist on the suspicion he has pediatric epilepsy, a complicated and fickle condition. In this episode of DDx, we explore a case with several peculiar symptoms and diagnostic test results that baffled doctors. The answer may lie in genetic testing.

Mapping a Complicated Genetic History of Epilepsy

June 15, 2022 00:00 - 11 minutes - 10.2 MB

A 5-month-old was brought to the emergency department with staring episodes. In this episode of DDx, we’re reminded that even when initial tests come back normal, keep thinking about the patient in front of you and probe parents for any new signs.

The Many Questions and Few Answers of a Rare Disease Diagnosis

June 08, 2022 00:00 - 12 minutes - 11.5 MB

A toddler has episodes where his face changes, his arms shoot up, and he collapses. On this episode of the podcast, we address when rare disease diagnoses offer more questions than answers, and treatment options don’t lead to a cure.

Classic Symptoms of Rare Diseases and Avoiding Diagnostic Odysseys

June 01, 2022 00:00 - 11 minutes - 10.4 MB

Rare diseases are … rare … which makes even textbook cases difficult to diagnose. In this episode, we’ll talk about the patterns and characterizations of a rare disease and how we can avoid diagnostic odysseys.

DDx Returns for Season Five

May 25, 2022 00:00 - 1 minute - 1 MB

Rare diseases are … rare … which makes even textbook cases difficult to diagnose. In this season, we’ll talk about the patterns and characterizations of a rare paediatric disorders.

The Importance of Genetic Screening

March 23, 2022 00:00 - 9 minutes - 8.62 MB

Genetic screening is vital for early diagnosis and management of genetic diseases. In this episode, dig into how it works, how it can help treatments reach patients sooner, and how it informs traditional treatments like physical therapy. Genetic screening works to determine which people might have a greater likelihood of developing a specific trait or disease, while genetic testing is concerned with testing an individual for a specific condition. One method of screening takes the form of a...

ALS, DMD and Adapting Treatment Mechanisms for Genetic Variations

March 16, 2022 00:00 - 10 minutes - 9.83 MB

In this episode, we’ll dig into the different mechanisms by which gene therapy can potentially treat specific genetic diseases – such as amyotrophic lateral sclerosis, or ALS, and others. In 1993, a multinational group of scientists and doctors solved a medical mystery 150 years in the making. And they did it, in part, by examining the genealogy of a particular family in Vermont. In 1835, a farmer named Erastus Farr died of a mysterious illness characterized by a progressive weakening of h...

Gene Therapy in Action: Adeno-Associated Viral Vectors

March 09, 2022 00:00 - 11 minutes - 10.6 MB

Adeno-associated viral vectors, or AAVs, are the tiny shells of viruses. And today they are the most common vessels for delivering gene-based therapies.  In this episode, we’ll launch into the past, present, and future of AAVs.  Imagine a rocket ship blasting off from Earth with cargo bound for a distant space station, and you have a pretty good idea what adeno-associated viral vectors are all about. But instead of ferrying hardware and supplies, AAVs carry genes. It’s an achievement nearl...

The Future of Gene Therapy and Genetic Diseases

March 02, 2022 00:00 - 10 minutes - 9.42 MB

Peek into the future of gene therapy and its capacity to treat – maybe eliminate – genetic diseases like cancers and hemophilia. Plus, the potential to reverse the effects of aging.  It’s a future scientists have been working toward for years: How to treat complex health  problems with gene therapy. And researchers have been making progress. Diagnoses once thought to be fatal are now being looked at in a new light. This is a welcome sight for physicians, caregivers, and – most of all – for...

How Does Gene Therapy Work? Correcting Disease-Causing Genetic Variations

February 23, 2022 00:00 - 10 minutes - 9.28 MB

Not all genetic variations are associated with threats or harms to human health. Some even  protect us, such as genetic variations that have been shown to make bones harder or the heart more impervious to disease. But while some genetic variations are positive, others can cause or contribute to disease.  In this episode, we answer the question of how does gene therapy work, and learn how gene therapy replaces and repairs certain gene variants, and is changing the trajectory of genetic disea...

A Brief History of Gene Therapy and the Discovery of DNA

February 16, 2022 00:00 - 11 minutes - 10.7 MB

In this episode, we explore some of the major scientific findings – like discovering DNA – that set the stage for the development of gene therapy and its groundbreaking potential when it comes to the treatment of genetic diseases.  The very idea of gene therapy wouldn’t be imaginable had two pairs of pioneering scientists not bonded decades earlier. In 1951, a young chemist named Rosalind Franklin and her colleague Maurice Wilkins at King’s College in London were using X-ray crystallography...

DDx is Back for Season Four

February 09, 2022 00:00 - 1 minute - 1.14 MB

Take a deep dive into one of the most awe-inspiring medical innovations of our time: gene therapy.  It's comparable to some of the greatest scientific explorations ever undertaken. Like landing astronauts on the moon or sending spacecraft toward the edges of our galaxy.  Except, instead of probing the vastness of outer space, this season, we’ll explore the infinite universe inside the tiny molecules of our DNA, and look at medical technology with the potential to reshape our approach to tr...

Searching for zebras

September 08, 2021 00:05 - 8 minutes - 8.58 MB

Few patients. A scarcity of literature. Working in rare disease can feel like you’re standing at the edge of an abyss with just a flashlight in your hand. And someone’s life depends on you--Meet the doctors who spend their time searching for zebras, and find out what motivates them. Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.

A fractured childhood

September 01, 2021 00:05 - 12 minutes - 11.9 MB

When a baby girl is born with two broken femurs, doctors don’t notice the bluish-grey discoloration of her sclera, her bowed and shortened legs, or her larger-than-normal head. And it will be months before they piece together the puzzle Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.

Hunting for a diagnosis

August 25, 2021 00:05 - 10 minutes - 10.8 MB

After a patient in his early 30s develops muscle weakness so severe he requires a wheelchair, he’s diagnosed with multiple sclerosis, and starts treatment for the disease. But when a bone scan reveals multiple fractures, his physicians start to question their original diagnosis. Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.

When the fever breaks

August 18, 2021 00:05 - 8 minutes - 8.77 MB

A one-year old boy is brought to his doctor with a history of febrile seizures, odd movements, and developmental delay. His seizures continue, but the fevers stop. And doctors realize they’re in a race against time. Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.

Code blue

August 11, 2021 00:05 - 9 minutes - 9.24 MB

“Code blue, unit 305. Code blue, unit 305.” After an 8-year-old boy with recurrent episodes of rhabdomyolysis is hospitalized for treatment of a rare inherited disease, his condition quickly deteriorates. Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.

The forgotten disease

August 03, 2021 00:05 - 11 minutes - 11.4 MB

A 35-year-old man thought he had outgrown the rare disorder which he was diagnosed with as a child. But as his movement becomes increasingly limited, he realizes that he never escaped it, and now there’s more than just his mobility at stake. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

DDx Returns for a Third Season

July 28, 2021 00:05 - 1 minute - 2.53 MB

Welcome back to DDx, a show about how doctors think. In Season 3, focused on rare disease, you’ll meet the doctors searching for the zebra among a herd of horses. Join host Dr. Raj Bhardwaj as he explores the challenges in distinguishing rare diseases from common ones, and how to recognize them when the stakes are life and death. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

When an Infection Isn't an Infection

July 08, 2020 09:00 - 13 minutes - 12 MB

A routine surgery leads to a puzzling reaction. Is more surgery required, or is it something else? Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

Psoriasis and Mental Health (Sponsored)

July 01, 2020 09:00 - 12 minutes - 11.5 MB

A common skin condition affects much more than a patient’s skin, and misinformation only exacerbates the stigma. This episode is brought to you by Novartis Pharmaceuticals Corporation.  Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

Pattern Recognition Can Save a Life

June 24, 2020 09:00 - 11 minutes - 10.2 MB

A dermatologist is paged to examine a rare condition. But something doesn’t add up. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

More Than Skin Deep (Sponsored)

June 17, 2020 09:00 - 9 minutes - 8.99 MB

While skin findings can sometimes help with a diagnosis, they can also distract from other undiagnosed symptoms. This episode is brought to you by Novartis Pharmaceuticals Corporation. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

Rash Decision

June 10, 2020 09:00 - 9 minutes - 8.91 MB

What do you do when faced with a set of symptoms that has two contradictory courses of treatment? Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

Why Skin Color Matters

June 03, 2020 09:00 - 8 minutes - 7.94 MB

Unconscious bias can run so deep that patients and doctors alike can miss a potentially fatal diagnosis. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

Scratching the Surface (Sponsored)

May 29, 2020 16:19 - 9 minutes - 8.32 MB

A patient presents with fever, swollen digits, and skin "the color of a red delicious apple." She’s been scratching so hard that she’s bleeding through her shirt. What’s going on? This episode is brought to you by Novartis Pharmaceuticals Corporation.  Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.

Sudoku seizures

December 20, 2019 04:00 - 10 minutes - 9.85 MB

As DDx gets ready to launch season two, we're re-releasing our first season. A young man’s near-death experience results in a very puzzling diagnosis on the season finale of DDx. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.

The Source of the Bleed

December 18, 2019 04:00 - 12 minutes - 11.1 MB

As DDx gets ready to launch season two, we're re-releasing our first season. A patient with an acute subdural hematoma presents with no sign of head trauma. The search for an answer almost overlooks an obvious question. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.

The near-miss

December 11, 2019 04:00 - 13 minutes - 12.2 MB

As DDx gets ready to launch season two, we're re-releasing our first season. A patient says she feels fine. A quick-thinking doctor arrives at a dire and uncommon diagnosis. Then it happens again. And again. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.