Lesia

[Lesia @LesiaOA]

@drkeithsiau It’s a new world we’re navigating, but patient confidentiality isn’t new. As the mother of an undiagnosed child, I know how urgently data and case studies must be shared so medicine can learn. However, share the lesson, not the patient’s identity. Too harsh IMO.

[Lesia @LesiaOA]

@DrLongissimus Here’s a paper published by a Grade 8 student in a peer-reviewed pediatric journal. By your reasoning, she was already one step ahead of medical students without publications before she’d had a day of medical training.

[Lesia @LesiaOA]

@DocPriyamMD Here’s a pattern that no one is questioning. Biopsy confirmed liver fibrosis. Wilson disease carrier. Undiagnosed & untreated.

[Lesia @LesiaOA]

@DrLongissimus Why should publications gatekeep residency? Published or not, no doctor has explained the whole picture: 8 years of recurring Mees' lines & AST>ALT, plus biopsy-proven liver fibrosis. Publications fill a CV. Curiosity recognizes when a patient is the paper waiting to be written.

[Lesia @LesiaOA]

@drkeithsiau If you need a chuckle, there’s Sam O’Nella… https://t.co/c2wVleicYd

[Lesia @LesiaOA]

@grok Thank you, @grok. Could you explain what liver fibrosis is and why identifying and treating its underlying cause is important even when routine liver enzymes and platelets remain within the normal range?

[Lesia @LesiaOA]

@grok What do you think of this?

[Lesia @LesiaOA]

@ebtapper @WilliamAird4 Dr. Tapper, If AST remains consistently higher than ALT for 8 years despite both being “normal,” and platelets were also normal, but biopsy showed fibrosis - how often would you monitor a teenage patient with a BMI of 18 who was also a known Wilson disease carrier?

[Lesia @LesiaOA]

@DrSuneelDhand Clearly the body is talking but no one is listening.

[Lesia @LesiaOA]

@DrSuneelDhand These nail lines have recurred for 8 years. Add low ceruloplasmin, persistent AST>ALT, biopsy-confirmed fibrosis and an ATP7B variant-yet no clinical explanation. This is where AI can change medicine: seeing the whole pattern when the system keeps separating the pieces.

[Lesia @LesiaOA]

@ilyassahinMD Thanks for sharing. Proud mom of a UofT grad! 🇨🇦

[Lesia @LesiaOA]

@drkeithsiau Have you worn one? Family hx of DM so I wear one every now and again. Large spike is from eating a bowl of grapes.

[Lesia @LesiaOA]

@mfalmeqdadi Excellent acute algorithm but what about chronic disease with normal-range enzymes? Labelled a “Wilson disease carrier,” this hypothetical pt has persistent AST>ALT over 8 years, no alcohol exposure, and biopsy-confirmed zone 3 fibrosis at 16. How should this be interpreted?

[Lesia @LesiaOA]

@StevePhillipsMD Some "experts" have such big egos that they would rather dismiss the patient, ignore unexplained evidence and cling to their original opinion than admit they could be wrong. Not all is "textbook".

[Lesia @LesiaOA]

@LouisePars38310 @Elo_Musculoso @Doctors_GUILD Thank you for sharing your experience. It's helpful to hear from someone who experienced similar nail changes. I'm sorry you had to go through chemotherapy, and I wish you continued health and happiness.💕

[Lesia @LesiaOA]

@Elo_Musculoso @Doctors_GUILD ‘Probably’ isn’t evidence. Can you explain how pressing causes recurrent transverse white bands on multiple nails at the same time, recurring over several years and growing out with the nail? If you’re aware of published evidence supporting that, I’d appreciate the reference.

[Lesia @LesiaOA]

@mfaizanjaved What is the point of posting a photo if you don't post the cause? If you don't have a cause, look into Wilson disease. Nine cases of leuconychia in this study. https://t.co/NhwNcHqLoh

[Lesia @LesiaOA]

@StevePhillipsMD Exactly! If you need an interesting case study…Unexplained recurring Mees’ lines in a symptomatic Wilson disease carrier. I’ve lost track of how many drs have seen these. Undiagnosed. Not textbook.

[Lesia @LesiaOA]

@mfaizanjaved What caused the Mees’ lines?