Monday, May 14, 2012

X-Ray Adventures

This afternoon I saw an article about x-rays on my iGoogle Sydney Morning Herald widget. It's an alarmist type story.  

Thousands of x-rays in Australia are not being read by the proper professionals.  Ailments are being missed.  People are being misdiagnosed.

The article was extremely timely for me.

Here's my tale.

It's kind of funny now that it's probably (hopefully) over.

Last Monday I had my yearly physical.  Before I saw the doctor ,the nurse asked if I had any concerns.  I mentioned a mild pain I had been having on my left side since Friday...below my ribs.

Later I talked to the doctor about it.  She didn't seem very concerned, and even asked if perhaps I brought it up because I felt pressured to come up with something when the nurse asked for problems.

I tried not to be annoyed, and told her this wasn't the case.  Although that being said, I doubt I would have gone to the doctor for the issue if I hadn't already had an appointment. It was one of those things.  Well, since I'm here, I might as well mention it.  

After our initial brief chat, the doctor checked my eyes and nose. I was very fine there.

Then she did the stethoscope stuff.  She did a more thorough check than usual.

She asked me to cough, which she usually doesn't request.

I didn't think anything of it, though.  I thought she had just tweaked her procedure a bit.

But then she explained that she heard a noise in my left lung. She wanted me to cough because sometimes coughing would clear the lungs. That didn't happen.

She requested that I get a chest x-ray, and also decided it would be a good idea for me to get my blood work done.  That worried me a bit because the doctor doesn't usually suggest blood work.  And yeah.   I usually don't need my chest x-rayed.   

On Thursday I spent a big chunk of the day doing the medical tests.  By then, I was fairly convinced I was deathly ill.  I had done some research on the internet.  I couldn't quite find a match for noise in the lungs minus coughing and breathing difficulties, but wondered if I could be some kind of medical anomaly.
Plus, I realized I HAVE been more tired than usual the past few weeks. I've been more lazy with exercise.  And I've had a mysterious weight loss and some loss of appetite.   

I asked the medical test people about result times.  They said it would take them 24-48 hours to get back to the doctor.  I figured if I was fine I'd hear from the doctor about it like 3 months later.   So unless I heard something fast, I'd assume I was in good health. My doctor's office takes a long time to return healthy test results.

On Friday I got a message from the doctor's office.  I had missed the call. They asked me to call them Monday morning.  I figured I must have SOMETHING.  My experience with this particular office is that they don't call when everything is okay.

I knew it couldn't be a dire emergency.  Otherwise they wouldn't have me wait until after the weekend.  But I figured it still could be something awful.  I'm ignorant about these things really. My guess is that there ARE serious illnesses that aren't treated immediately. I also guessed maybe they were trying to give me a peaceful happy Mother's Day before my life turned to medical hell.  

I don't know.

A lot of shit was going through my head. 

For the most part, I kept it to myself.  I didn't want to make other people worry, and even more so, I didn't want my feelings belittled.  I didn't want to be made to feel that I'm a drama queen.  Well, because that's how I'm usually made to feel when I bring up any health issue I'm experiencing with my family.     

I did bring it up briefly twice and there was no indication that I had made the wrong choice in mostly keeping it to myself.



I put on a brave face and played the Happy Mother's Day game.  Despite my worrying, I did actually manage to have moments of joy.  Every so often I could even forgot my worries. But those moments were rare.

I had a lot going on in my head.

As the hours went by, I became more and more convinced I was sick.  I started feeling pains in my chest; my left side of course.  Now I was somewhat rational and figured it COULD be my imagination.  At one point, I thought about how I could be totally healthy but end up killing myself just by worrying so much.  Getting concern from a doctor could be like an Aborigine pointing the bone at you.  

By Sunday night, I was feeling awful.   I was crying a lot and really wanted to talk to someone. But I didn't know who to talk to.

I wiped away my tears and managed to not kill myself with stress and despair.   

Early this morning, I added to my weight loss issue by having to use the toilet about every 30 minutes.

I wasn't in great shape.   

I called the doctor's office at 8:30 and waited to hear that I needed to come in today, or I needed more medical tests.

It took me about an hour to actually connect with someone.  There was some phone tag going on.

Finally, I talked to the person I was supposed to talk to. She told me I was fine, except for a minor bladder thing that doesn't even need to be treated as long as I'm feeling okay.

She was very suspenseful about it though.  She could have just said, I'm just calling to tell you you're fine except for a minor bladder issue.  Instead she went through each test. We got your chest x-rays back....(dramatic pause).  Everything is fine there.  We got your blood test back....(dramatic pause)...everything is fine.  

A few hours ago, I was too relieved to be angry, but now I'm kind of annoyed.  And I'm also annoyed that they didn't just leave me this message on Friday.  Do they not understand how much agony they put people through when they act so mysterious?  Why couldn't they leave a reassuring message.   There's no need to worry. You're fine.  Just a minor bladder issue. Call us on Monday.  

The only excuse I can think of is that I made a mistake when signing the privacy forms at the office.   There was something where you give permission for them to leave detailed messages on answering machines.  Maybe I forgot to check it off?

I don't know.

And maybe it's good for us to have these medical scares sometimes.  It gives us a chance to appreciate our health.

There's the x-ray article, though. That reminded me of the fact that doctor's don't know everything.   They get it wrong sometimes.

Tests don't catch everything.

And we might not get the test that we needed.

Then there's the fact that I could be in perfect health today and get horribly sick next week.

I might be fine and someone I love might come down with a deathly illness.

Or one of us could be hit by a truck.   

We can be relieved for only so long.

In the end, death is going to get us...along with everyone we love.  

At least for today though....I'm going to be happy, relieved, and grateful.  I'm going to look forward to lots of wonderful things like our upcoming trip to Disney World and a possible future trip to Australia.

Later I'll go back to being paranoid.


Carole said...

Nice post. I agree about doctors.
For a bit of light relief, you might enjoy this Cartoon

Mike Fuery said...

Oh Dina, there's nothing like a little medical investigation to evoke all those doubts and worries. It's so hard to maintain a perspective when you're subject to them, but the upside is that if the doc is doing a great job if he/she is picking up on unusual findings. Early detection of many treatable clinical problems is usually good as the success is high. Rather than letting things linger for months and let the nasties spread or take a firmer hold. It is certainly a good time to celebrate life and the miniscule amount of time we occupy within it as sentient creatures marvelling at the universe around us. Sorry, I just had a 'Carl Sagan' moment!

FruitCake said...

Love the weight loss cartoon, Carole :)

I have a specific clinic to go to and have built up a good working relationship with my own GP [and a few of the others in the clinic I see if mine is away]. I guess I'm lucky because I can afford to pay "the gap" and don't have to shop around for a GP who bulk bills.
My GPs are very thorough about investigating stuff, and there is only one GP at the clinic with a bad 'tude, so I just avoid her.

The system is this; there's usually a one to three day turn around on most tests [and that is usually confirmed by people conducting tests]. Results go direct to my GP. We have a "results line" number to call on the date results are expected, and my GP's practice nurse will either say the Dr has reviewed the results and everything is fine, or Dr would like you to make an appointment to discuss results.

This takes all the stress out of the test business. When writing a referral for tests the GP explains the why, the possibilities, and the probabilities. You get the results over the phone the day they are in, and if the nurse won't tell you... then it's time to be concerned [but not necessarily worried].

My GPs all have long term relationships with their customers because they are not just out to see as many people as possible for government rebates, and because they have an established business they want to look after.

They have their own ideas about whom to trust and whom to avoid when it comes to specialists or surgeons, and they listen to patient feedback.

The radiologists who check the x rays etc are experts at looking at images of particular parts of the body. I once had an MRI and the radiologist said I had X. I asked the surgeon to show me where this appeared on the image, but he couldn't. [This was a general surgeon I went to off my own bat, but I won't ever go to one again.] My GP referred me to someone who specialised in the field, the specialist was able to show me what the radiologist had found, and we got on with fixing the problem.

This is like the difference between taking a car to a general garage or to an auto electrician who only deals with specific car problems.

If you are getting the right help, you probably shouldn't worry too much about radiologists missing anything.
People who can only afford a public health system or public hospital are at a disadvantage, because everyone is overworked, and not everyone has the years of experience it takes to recognise all the various problems that are possible, and they are not always able to check with someone more experienced. I'm not criticising anyone in the health system because no one in the health system deserves it, but if you have choices you make the best one you can.

As for lung pain... it could be something as simple as your back. Some people think chiropractors are quacks - and some are - but after a serious accident I've come to rely on mine. For instance, yesterday I went to see about pain I could feel in my back, and I knew it was a rib, because whenever this particular rib complains I always feel short of breath, and start to belch. He fixed the problem and ten minutes later I could breathe easier and had stopped belching.

With current medical advancements, there is no reason for too many surprises. Tests are primarily for providing reassurance, or catching a problem before you get a death sentence. Tests can help eliminate possibilities and make a diagnosis more certain, though a good doctor will probably have an idea and then just want to be sure they are right.

But you are right. You shouldn't gamble with tomorrow, but you should definitely live in the now.

[Glad you are recovering from the stress of all that uncertainty!]

Dina said...

Carole: Thanks.

Mike: Hi! I love your Carl Sagan moment.

I think you're absolutely right about it being hard to have perspective when you're in the midst of a medical-wait. I end up thinking more about all the bad case scenarios and horror stories.

Also, it seems like SO many people get sick. Maybe because with the internet we're exposed to more people than we were before?

Anyway, there's that sense that if bad things are happening to so many other people; how can I expect to escape?

And really we can't. I guess the hope is that it happens when we're much older, rather than when we're young (relatively speaking).

Fruitcake: It sounds like you have a great doctor's office. Are you saying they know you on a personal basis? I mean not that you're best friends. But do they remember things about you without having to consult your chart about everything?

I think the system of having the patient call for results is a great one. It puts much much control in the patient's hands.

When you say the doctor gives you information about the test; do you have to ask? Or does she just volunteer the information.

My doctor told me nothing, and I was too surprised and speechless to ask about the chest thing. I know if I asked, she would have told me.

I wonder if some doctors feel they should wait until asked?

I'd rather them just explain things without having to be asked. OR at least they could say "Do you have any questions about this?"

FruitCake said...

I think they have an umbrella organisation because I've seen other surgeries with the same "name" except for the location. It's not a franchise, but a prof org that has set standards of practice etc. When I joined The Other in Frankston she was the one who asked them to add me to their books. [They don't take new clients unless someone they know grovels, but they will bend]. So I've been going there for 8 years or so.
So yes, my own GP knows me and remembers bits about me. The others know my face but wouldn't know my name if they saw me down the street.
Michael always opens my file [the software is open to any GP in the clinic] because he has little reminders pop up to say I'm due for one thing or another, notes from previous visits, all test results etc.
Like I said, I think one of the GPs there is a fruitcake, so I just avoid her.
It's important to feel comfortable with someone who plays such a significant role in your life. Also I hate being patronised and would not go to someone who would not discuss things with me as an equal. Just because I'm not a doctor does not mean I'm an idiot and, besides that, there is no need for anyone to be rude. Pulling rank is a very UNaustralian thing for anyone to do.
It only takes a few moments to say "the worst it could be is X, but it's probably A or it might be B, so let's test for A or B first."
But most of the time it's not even anything that needs testing.
There's no charge for repeat prescriptions, you just turn up and they'll squeeze you in between appointments.
Whether a doctor volunteers info would probably depend on the patient. There's no point in confusing people, it depends on their capacity to understand, or even desire to know. I always ask for copies because otherwise The Other would just want to know why I didn't get one.
Most pathology reports - e.g. blood tests - will have a chart with the acceptable or unacceptable "range" of results e.g cholesterol should be whatever [mine's fine] but if it was too high you could read it for yourself. That sort of thing.
As a rule in oz if you move house, you just fill out an authority for your new gp to request a copy of previous files from where you used to live. This provides some continuity. But I would never bother transferring my history unless I was sure I was happy with a new clinic.
Your body, your money, your choice. It sounds to me like your doctor is a grump or a prat. Is there a reason you keep going there?

Dina said...

Fruitcake: Good question there at the end. Unfortunately I don't have a good answer.

All I can say really is that through my experiences with other doctors (either for myself or family/friends) I've developed a strong prejudice against them.

I do know that there are doctors out there who will talk to you like an equal, and don't have an awful attitude. Jack's pediatrician is like that. But in most cases I think doctors are arrogant and condescending.

So I guess I have major doubts that I'd ever find anything much better.

My feeling is that it's probably more productive to change MYSELF than change my doctor. I need to be more firm and keep my head on straight. I need to remember to ask questions and not let them intimidate me into not doing so.