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09/25/2011 10:30 AM

Frustrating MRI

AKmama
AKmamaPosts: 210
Member

My doc ordered an MRI for me. I called the lab ahead of time to make sure it was ordered with and without contrast and it was NOT. Luckily, the tech was really helpful and said that most brain MRI's are done w / and w/out contrast so, because my docs office was closed Friday and they couldn't verify she would do it both ways for me. When I went for my MRI yesterday, the tech was asking me questions about my diagnosis. She was confused because the docs MRI order (and she showed me order) had NO INFO on it besides some random number on there that she had to look up. The number was for "general malaise and fatigue". What the heck?!? Do I have this disease or not? This has me so confused. This makes me feel like my doc is not taking this as seriously as I am. Anyone else have experiences like this? I am so frustrated right now because I'm still not stable. I'm still having episodes and I need my doc to be on my side here while we get this figured out, you know?! Arrrrrhh! I feel like that was a pretty huge detail to miss, no?
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09/25/2011 10:59 AM
ssinnge
 
Posts: 598
Member

I see you listed as secondary AI. Is this why the doc wants the MRI done?

To confirm a suspicion or to see if there is something wrong with your pituatary? I don't give my docs time to screw up. I go in with guns loaded asking questions that a regular patient doesn't even know to ask, so I suggest getting all the ammunition you need. Also, sometimes, the docs will put a slightly dg on the order to get ins. to pay for it. MRI are very expensive. I would check it out at both ends.


09/25/2011 12:18 PM
bob3bob3
bob3bob3Posts: 4213
Senior Member

Well its not always a bad idea to widen the possible diagnosis net. Its the same when you have been pre-diagnosed with something else when you see a new doc. They tend to concentrate on links to something known rather than start afresh. Kind of like getting an xray looking for a herniated disc, but totally missing a cracked vertebrae. Your doc may not have even had faith that the person looking at the MRI would look "outside the box"!

There is also a good chance it will "force" the MRI reader to consult with your doc to verbally discuss things. That's is far better than getting a written report.

I don't feel that the lack of specific notation is relevant to "proper" care and attention. The eventual outcome is where you make a judgment.


09/25/2011 03:24 PM
hypomama
hypomama  
Posts: 772
Member

What they have to fill in is a pre-diagnosis code. What he put in is a broad category. As Bob said - it is better to have the radiologist not be prejudiced as to WHAT he/she is looking for - it is better for them to have to look closely at everything - does that make sense?

09/25/2011 04:06 PM
AKmama
AKmamaPosts: 210
Member

Ah, I see. That does make sense. Thanks for talking me off my mountaintop. I was starting to second guess everything there for a minute. Great. Now I wonder if I've ticked my doc off by insisting on contrast. I really thought that a pit MRI was kind of useless if you didn't have it done with contrast. I guess we shall see. I have an appt in 4 weeks to discuss.

ssinge: My doc agreed to check pituitary for any tumors, though he highly doubts there will be any. I have low adrenal hormones combined with "inappropriately low ACTH" (docs words). I don't have the typical visual disturbances, HOWEVER, I do have strange visual disturbances when I wake up sometimes and I see stars sometimes?? Also- I have met my deductible so it's only costing me $300. It's worth it to me to have peace of mind, you know?


09/25/2011 08:33 PM
1busiteacher
Posts: 158
Member

When I talk with my doc, he always says adrenal fatigue, but puts fatigue on blood work orders and the MRI order. I think it's his way of keeping the door open to whatever shows up and the best way to make sure insurance doesn't jump to deny something. Just be thankful that you have a doc willing to order the MRI and pursue things with writing you off. I know I am after having a "specialists" laugh in my face and write me off.

09/26/2011 11:08 AM
AKmama
AKmamaPosts: 210
Member

Yeah, no doubt! Very good point. Been there too.

09/30/2011 05:42 PM
DukeNLucy
DukeNLucyPosts: 200
Member

Yes, Drs can easily write you off. That's why you have to take a stand and not let them get away with it. I know - easier said than done. Tell the dr you really want GAD (contrast) to rule out any tumor. It's well-worth the cost to know. If he still gives you a hard time, tell him if he won't agree, you'll go elsewhere. He'll most likley give in - he doesn't want to lose business or reputation.

When I saw the reason scribbled on the prescription for my MRI I almost laughed. It said "poor balance", with that code. So... I copied that Rx onto a 8.5x11 piece of paper, then jotted some notes at the bottom such as "Secondary Adrenal Insuff - Pit tumor?", names of meds, the name of the neurgosurgeon I used to have and his phone number, and other misc items. I made it look just a scribble notepad. Then when I was scheduling the MRI, I told them I could fax the Rx, and they agreed. I'm sure the extra info I put on the paper below the Rx would be seen, and that would have an influence on how they decided to do the MRI. The vague code - that can be used for insurance purposes.

When I went to the MRI and had to fill out a form where one section wanted to know what my recent symptoms were - I didn't give any. Instead I said in cryptic words: "ACTH <5, cortisol 0.6, corresponding symptoms." THAT also caught their attention much more than the "poor balance" wording on the Rx. Radiologists know more than you think they know. And they do MRIs all day long - what could you say in a tiny spot on the form that would stand out?

You have to think like medical professionals think. The medical field is a business. They don't want a long story. Just things that can quickly point them in the right direction. I'm glad I did what I did, because besides the usual 5mm slices in the scan, they decided to do some extra sections of 3 mm slices of the stella region.

Always ask that you receive a copy of the films (usually nowadays they put them on a CD along with SW to see the images), and a copy of the radiologists's report to the dr. NOT a fuzzy-wuzzy meaningless report sent to patients, but the real thing. Don't give any excuses or explanations. They can't deny you, and should not charge you either. Why should you have a copy? You always ask yourself what reports say, right? And sometimes you go to some other Dr and they ask if you've had recent bloodwork, right? So just get a copy, learn what you can from it, and give copies to other drs that ask for it.

I had a post-MRI followup with my Endo today, and to our dismay found the MRI result had not come in yet. On calls to the hosp, we were first told the radiologist hadn't faxed it yet; the report was in a To-Fax pile. And then a few calls later we were told he hadn't read it yet. That's a bunch of baloney. The endo dr told me this excuse game really meant they wanted to confir with one another before deciding what to report. He told me they just weren't sure what was going on in 'that head of yours'. He's pretty sure I have a tumor, and wants me to make an appt now with a neurosurgeon. I told him I wouldn't; let's do a wait and see what the report says first. That freaked him out - he said, "which one of us is the doctor?" and then we laughed. I am not going to think negative thoughts unless there is good reason to do so. So, don't worry about ticking your dr off. As was said earlier, go in with your guns loaded. You're paying him, and he owes you good service for that pay. Drs have so many patients and details to handle; you'll be out of his mind before you even leave the office.

For me, come Mon or Tues I am going to politely bug the living daylights out of the radiology dept asking when I'll receive my copy of the report. That will prompt them to get rid of me and fax it to my drs office first, which is just what I want. I can wait for my own copy in the mail.

My point in all this is: Before you see your Dr, do your homework and learn what you can. Be prepared for how a medical business works, and tweek how you approach it so it best meets your needs. Bring a typed paper outlining items you want to bring up, and let the dr keep it. Later on, when he's reviewing your chart, he might read what you wrote and refresh his mind on what's going on. And last but not least: always stand up for yourself!


09/30/2011 06:20 PM
AKmama
AKmamaPosts: 210
Member

Wow - well done on the MRI! Smile I have SOOOO much to learn still. I was able to get the MRI done with contrast. I talked to the tech directly and told her if they couldn't do it w/ contrast I would reschedule because I didn't want to waste my time and money. But geesh, feels like we have to have a degree in this stuff to get the help we need sometimes. THANK GOD for the internet and sites like these. lol

09/30/2011 08:40 PM
DukeNLucy
DukeNLucyPosts: 200
Member

Good for you! Sounds to me like you know how to get things done. Aren't you glad you stood your ground? W're all here to help one another out. And you have done much to help others!
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