Diagnosis

I'M NOT a journalist nor do I understand the process of editing the Daily News, but I know you have better sense than to write in big bold letters "A schizophrenic is missing" (City/Region, May 19). Our society is polluted because of the misunderstanding and stereotypical views of how someone is categorized with a mental illness. The schizophrenic that your article so insensitively wrote about had a full description of the person missing. You had her age, weight, height and what she was last seen wearing, but instead led off with the schizophrenic piece.

A psychiatrist who helped establish the professional criteria for diagnosing mental disorders testified yesterday that surrogate mother Mary Beth Whitehead is not suffering from a personality disorder, as other mental- health experts have asserted. Appearing on behalf of Whitehead at the Baby M trial, Dr. Donald F. Klein testified that Wynnewood psychiatrist Marshall D. Schechter improperly diagnosed Whitehead as having a "mixed personality disorder. " In his diagnosis, prepared for the baby's court-appointed guardian, Schechter said he used the criteria established in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, referred to as DSM- III. Klein, a practicing psychiatrist in New York City and a medical professor at Columbia University, testified yesterday that he had been on the 19-member task force that helped write the manual.

For young Joshua Knobel, life consisted of one crisis after another as he lay in a hospital bed, vomiting hour after hour, sometimes for days. Life was hell for his parents, as well, as they watched their child suffer, and waited for his death from Fazio-Laude Disease, one of the world's rarest neurological illnesses. But Joshua Knobel, now 14, of Langhorne, Bucks County, never had fatal Fazio-Laude. Yesterday, a Philadelphia jury awarded $9.9 million to Joshua and his parents in a medical malpractice suit against a former Children's Hospital of Philadelphia neurologist who diagnosed the disease.

Through Wednesday, Philly.com/health and The Inquirer will mark breast cancer awareness month by publishing a profile a day of transformative moments reported by patients. The series will culminate in a special Philly.com/Inquirer section on Thursday, and can be viewed at www.philly.com/breastcancer . When Valerie Miller turned 25, her mother began nudging her to get a mammogram. Age 25 is extremely young to begin this check for breast cancer, but Valerie's mother had breast cancer, and Valerie's aunt had breast cancer, and both grandmothers had breast cancer.

Given his credentials, one might presume that Jeffrey Lerner would have had an easier time finding the best medical treatment for his mother. But he bounced along like anyone else trying to gather sound answers for a grim cancer diagnosis. As a senior executive for a nonprofit health-services research group in Plymouth Meeting, Lerner could read whatever was available about malignant melanoma. Even so, his efforts did not equip him for his mother's three-year struggle with the disease.

Betsy Smetona of Haddon Heights quit her job last summer to stay home with her children. Her 23-year-old twins, Megan and Michael, have graduated from the Bancroft School in Haddonfield and can't be left alone. Both have autism, although in different degrees. "It's a big shock to the system when they graduate," Smetona said. "Their schooling was everything to them. It met their social and extracurricular needs. It's hard to find something in the community for Michael and Megan to do. " For the Smetonas and other New Jersey families in a similar situation, help could be on the way. Gov. Corzine signed laws in 2007 and 2008 that are now taking effect to enable early diagnosis of autism, develop screening guidelines for physicians, create a statewide patient registry, and educate emergency responders to recognize developmental disabilities.

The two men were brothers, they were friends, but they also were physician and patient. And one diagnosis made on a winter day five years ago changed everything. In December 1993, Joseph Labricciosa, a family practice physician in Springfield, Delaware County, examined his brother Robert and diagnosed a case of hemorrhoids. But he was actually suffering from rectal cancer. That first diagnosis recently culminated in a Delaware County courtroom, where a jury ordered Joseph Labricciosa to pay $8.2 million to his late brother's widow - one of the largest verdicts in recent county history, in a case that has divided a family.

It was only a little hand tremor. That's what the doctors said. All kids shake a bit, get a little clumsy. Maybe 7-year-old Eli Vivian was dehydrated. Maybe his motor skills lagged a little behind those of his two older brothers. Not to worry. Not so easy - for a mother. So Becky Vivian kept watching. Everything Eli did got the mom once-over, even a potato sack race at Oaks Elementary School. While his classmates stepped into their bags and hopped away, Eli was left behind.

Through Oct. 17, Philly.com/health and the Inquirer will mark breast cancer awareness month by publishing a profile a day of transformative moments reported by patients. The series culminates in a special Philly.com/Inquirer/Daily News section Oct. 18, and can be viewed at www.philly.com/breastcancer . For Cynthia Besteman, a real estate broker in New York, the diagnosis of breast cancer came out of nowhere. She was 46, a vegetarian, with no history of cancer in her family, a daily exerciser.

The U.S. Attorney's Office yesterday announced that Presbyterian Medical Center in West Philadelphia had agreed to pay $535,448 to settle civil allegations by the government that it improperly obtained Medicare payments by using an inaccurate diagnosis reimbursement code for pneumonia patients from October 1992 to March 1997. The agreement, under which Presbyterian officials did not admit liability under the False Claims Act, was one of three such agreements filed by prosecutors in Philadelphia and in Chicago.

The Inquirer is presenting a daily profile of participants in next Sunday's Broad Street Run. In the summer of 2008, Joe Diana was 41, a smoker, overweight, and out of shape. He was playing volleyball at a pool party. He was diving for a shot, hit the poolside, and thought he broke a rib. He went to the emergency room. He never found out if the rib was broken. Doctors saw something much worse - a tumor in his right lung. On Aug. 13, the lung was removed, improving his chances of surviving the cancer.

Complex picture of ADHD Based on speaking with families as an ADHD (attention deficit hyperactivity disorder) coach and teacher, I know some pediatricians do lack the information needed for a comprehensive diagnosis. But depicting hyperactivity as the hallmark of ADHD is misinformed ("Too many children being diagnosed as 'hyper,' " April 11). ADHD is a medical diagnosis that represents a decrease in neurotransmitters that inhibit the message-carrying ability of neurons. The prefrontal cortex is underdeveloped, which is also why symptoms reflect deficits in executive functioning: time management, transitions, organization, emotional control, initiation, and working memory.

You know you're in trouble, Maria Kefalas said sadly, when you're fast-tracked for the Make-a-Wish Foundation. Kefalas, 45, is a St. Joseph's University sociologist whose daughter Calliope, 3, has a rare and untreatable genetic disease, MLD. It's a diagnosis without hope: Most patients don't live beyond age 5. Kefalas, along with her husband, Patrick Carr (also a sociologist), and their three children were sponsored for a trip to Martha's Vineyard over the summer by the foundation, which attempts to enrich the lives of children with life-threatening medical conditions.

By Melinda Henneberger Oprah says she found Lance Armstrong's doping confession just mesmerizing: "We were mesmerized and riveted by some of his answers," Winfrey told CBS News. Liars can have that effect, of course, and she has a show to promote. But some of us who have lost years, friends, and body parts to cancer are not quite so fascinated. Even after he started cheating in the mid-'90s, Mr. Livestrong had a chance to strike an important blow against cancer, which has been linked to steroids and human growth hormone.

It was only a little hand tremor. That's what the doctors said. All kids shake a bit, get a little clumsy. Maybe 7-year-old Eli Vivian was dehydrated. Maybe his motor skills lagged a little behind those of his two older brothers. Not to worry. Not so easy - for a mother. So Becky Vivian kept watching. Everything Eli did got the mom once-over, even a potato sack race at Oaks Elementary School. While his classmates stepped into their bags and hopped away, Eli was left behind.

Through Wednesday, Philly.com/health and The Inquirer will mark breast cancer awareness month by publishing a profile a day of transformative moments reported by patients. The series will culminate in a special Philly.com/Inquirer section on Thursday, and can be viewed at www.philly.com/breastcancer . When Valerie Miller turned 25, her mother began nudging her to get a mammogram. Age 25 is extremely young to begin this check for breast cancer, but Valerie's mother had breast cancer, and Valerie's aunt had breast cancer, and both grandmothers had breast cancer.

Through Oct. 17, Philly.com and The Inquirer will mark breast cancer awareness month by publishing a profile a day of transformative moments reported by patients. The series will culminate in a special Philly.com/Inquirer/Daily News section on Oct. 18, and can be viewed at www.philly.com/breastcancer . Shona Sladyk works at the Vermont College of Medicine and is a registered member of the Breastcancer.org Online Community. This is her story: "My most difficult moment in my cancer journey was the day I found out that my biopsy did, in fact, show cancerous cells.

Through Oct. 17, Philly.com/health and the Inquirer will mark breast cancer awareness month by publishing a profile a day of transformative moments reported by patients. The series culminates in a special Philly.com/Inquirer/Daily News section Oct. 18, and can be viewed at www.philly.com/breastcancer . For Cynthia Besteman, a real estate broker in New York, the diagnosis of breast cancer came out of nowhere. She was 46, a vegetarian, with no history of cancer in her family, a daily exerciser.

JOSH HAMILTON was back in the lineup Monday against the visting Oakland Athletics after missing the last five games because of blurred vision and balance issues. In the Texas Rangers' 5-4 win, Hamilton played the part of Triple Crown spoiler - for a night, at least - hitting his 43rd homer of the season in the fifth inning to move ahead of Miguel Cabrera in the AL home run lead. Cabrera, the Tigers slugger, is bidding to become the first AL Triple Crown winner since Carl Yastrzemski in 1967.

Over her life, June Sams has been told she has schizophrenia and four mental health disorders: bipolar, post-traumatic stress, major depressive, and personality. The 60-year-old Chester woman's current diagnoses - she thinks these fit - are major depressive and generalized anxiety disorders plus PTSD due to childhood trauma. A doctor told Elisa-Beth Gardner, 51, of Swarthmore, that she had borderline personality disorder (BPD) in 1996. Three months later, she was told she had bipolar disorder.