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I open this thread here as I don't think it would be appropriate to continue such a discussion on Bill Forum's thread which is a memorial to our dearest Vicky…no longer of this world.

And why do I start this thread?

Because I received an email which is very poignant as to a timely diagnosis that may well have saved our wonderful Vicky's life…and also may serve as a 'heads up' to many of us…possibly saving a life in times to come, meaning we must take personal responsibility for our medical care management, and be more proactive in 'demanding' certain diagnostic tests from our providers when assailed by concerns.

On his forum Bill wrote


This really continues to bother me when I think Vicky could have been spared a horrible death had her Health care providers used foreseeability more in tune with a medical standard of care_ given her 'bad stomach' complaints and pains over the years.

Bill indicated the prevalent view of doctors and Health care insurance companies

True enough…but Vicky's stomach pains were of years' duration…

I replied

I don't know what exact symptoms Vicky had…but any reasonably prudent primary care physician should have exercised more diligence in her given situation.

Keep in mind what Bill wrote….i.e., the right tests were not done.

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Van

Here the email I got

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Van

In another situation …a neighbor of mine was involved in an auto accident with resulting chest impact by the exploding air bag.

The EMTs responding to the scene determined she did not need immediate medical care but suggested she go to her doctor/hospital later to have herself checked out.

She did not because the chest discomfort was not 'too bad' and hoped it would get better in days to come.

I kept telling her to go see her doctor as soon as possible and have some tests done.

The pain did not subside and it began to spread through her back. Still…she was reluctant in seeking medical attention.

Finally one day, meeting her outside in the yard, I insisted that she go to her doctor and 'demand' a C-scan or MRI over any possible objections by her PC or Health Insurance carrier.

So she did…and her doctor [smart' sent her for a C-scan_

Well, don't you now_ the test revealed a mass in the center of the chest…a Thymoma…cancer of the thymus gland.

A mass about the size of a lemon…that was touching upon lung tissue and the pericardium.

The surgeon scheduled her for immediate surgery where the sternum had to split to get at the tumor.

Fortunately the surgeon was able to remove the entire mass…and after a follow up regimen of radiation therapy…she is free of cancer.

Any symptoms before the auto accident? Yes…she had had pains of long duration to her chest while sleeping on her side…but never told her doctor about it.

Thymoma is a slow growing cancer...like ten years…


Now, think about it…but for the auto accident…but for her doctor's good sense to set up a c-scan…this woman would have died a horrible death.

And her doctor told her that she had had a patient…a man who ran five miles a day…great shape…come to her office with chest discomfort which he had ignored as due to his running so much.

This smart doctor had ordered a c-scan…and well…don't you know…a thymoma in early stages was found…and because of its small size [not encroaching upon adjacent organs tissue]
It was 'aspirated' ….no big surgery required.

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Van

I haven't sorted out my opinion on this. I guess I've sort of been hoping the low-power MRI technology would someday make it a no-brainer for MRIs to replace x-rays as a first-line imaging technology. Anyway, here are some personal anecotes.

My father endured years and years of facial pain and various neurological medications because of a simple auditory nerve tumor that today could have been diagnosed PDQ with the right scan. In his case the scanning technology had to catch up, but now it exists.

My wife had an MRI of her hip done (was really just a bursitis thing), but the marrow had a certain appearance on the MRI that suggested the possibility of some kind of cancer there. So it was off to a hematologist and some blood tests. The hematologist checked her out but said he expected nothing was wrong: "That's why we don't use MRIs to diagnose that kind of cancer." I suppose one could look at that in more than one way, but the way we looked at it at the time was that it was needlessly frightening and stressful.

When I experienced my first optical migraine (an odd but painless visual experience), I didn't know what it was and went to the emergency room. Unfortunately for my insurance company, my BP was a little high, and I got a rather inexperienced resident, who did EKG, CAT scan, held me overnight, and sent me for an MRI of the head and neck the next day. It was cool for me to get all those scans and come out "normal" (and now I can say that, yes, I already did have my head examined, and they said there was nothing wrong with it, thank you very much), but the seasoned neurologist who saw me the next day was obviously amused that so much had happened over so little, given that my description of the optical migraine was "textbook".

After I had a wrist injury that wouldn't heal, an MRI revealed that the problem was arthritic (which turned out to be gout). I wish I'd had the MRI after a few weeks instead of after a few months.

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Mike

Better to be safe than sorry, Mike.

As I indicated, in my professional capacity I have handled quite a few cases of medical malpractice...and what I have seen that, supposedly, was passed for 'doctoring' would make you blanche.

The human body is a complex machine constantly in the process of evolution/changing....and diseases seem to find all those 'roads leading to Rome' in befuddling ways.

No such thing as _ 'that disease does not have these manifestations you complain of' and I cannot justify to the insurance company these tests'...BS...a doctor is supposed to practice medicine...not insurance.

If the discomfort, pain, problem of any kind persists....such as in Vicki's case...any doctor following a reasonable medical standard must go the extra step to reach a proper diagnosis before it is too late.

Again, Vichi could have been spared a horrible end...had she been under the care of a smart physician...

And today it is more and more important that the patient speak up...become more demanding...call the health carrier and fight like hell on his behalf.

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Van

I'm just not sure about that, though it stands to reason that she would have had better chances with chemo, radiation, or surgery if done sooner. I think the rarity of detecting pancreatic cancer in an early stage discounts the notion that the property we're lacking is "smartness" of the doctor. Probably what we lack are standard protocols that put emphasis on detecting the insidious and less common, though not actually rare, causes of non-specific symptoms. What happens now is that you go see your doctor with something non-specific, and unless standard blood tests raise alarm bells, you go home with a facile explanation.



I hear you. I used to watch the show Mystery Diagnosis on what was Discovery Health Channel. It's the one show (I think) Oprah picked up when she bought that network and changed it to OWN. It's mind-boggling how many doctor visits seem to occur before the correct diagnosis is made. In some cases you can kind of understand this because of the nature of the symptoms and such (and sometimes turns out to be a rare genetic disorder), but in others it does seem outrageous how easily PCPs and ER doctors would attach to some mundane and completely unproven diagnosis and send them on their way.

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Mike

All good points Mike.

Nothing beats being your very own 'bodyguard'

When experiencing symptoms of any nature...it is best to do a google search....or get onto Web Md site etc. and keep searching for opinions.

When finding something of personal concern...make a copy of it and show it to the doctor and say...'I found this on the web...wanted to ask your opinion on it'

And...'I would feel a lot better if such and such tests were done'

It puts the doctor on the spot and opens him to a med mal suit if something should go awry.

If the doc won't do it...ask for a second opinion.

In Vicki's case...Bill did say the docs didn't do the right tests...

She might well be alive if they had done their job...after all the symptoms she had had for years did tell a story as per my post from Web MD...

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Van

Pancreatic cancer took my dear mother-in-law 3 years ago. She had very much te same symptoms that Vicki had from what's described here.

She was scoped and scanned every which way and nothing was discovered until it was too late.

All this techology for nothing.

So it looks like the 'right tests' wouldn't have made any difference? Bill??

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Van

I might be wrong, but when Randy Pausch ('The Last Lecture', http://www.youtube.com/watch?v=ji5_MqicxSo) was testifying in Congress, he basically stated that this type of cancer is 100% fatal.

and told my doctor about Vicki.

He said that in Florida chances are very good that the cancer would have been discovered earlier, however. . . Vicki was lucky it wasn't!!!! The treatment is horrible and makes the patient very ill and. . . the disease is almost always fatal after a prolonged agonizing period of time.

According to him, most doctors agree with him on this, although most would probably not admit it.

It is a most terrible cancer!

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GEM
"Do or do not. there is no try!"

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Van

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Van

We live our lives in great expectations_ for so many of us our lives are fine _

- until our wonderful life turns on a dime or come to an unexpected screeching halt _ when hit by a car, a diagnosis, a fire, violence, a devastating loss.

And we all know now, as extended members of the Uechi family, that our own lives will never be the same again as the passing of Vicki collides with our own unsettling dose of grim realities.

Where do we find the resilience to put one foot In front of the other?

Maybe the answer is as taught by Vicky…to love life with as much unbridled passion as she did.

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Van

Dear Vicki...may your soul rest in peace forever and ever in the arms of God.

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Van