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On the subject of xrays, too many doctors, etc. and Kudos to Wendy

Posted by Kathy G on 2/16/05 at 09:24 (169142)

About two weeks ago, I don't remember when, I went and had my neck xrayed as I told you all. Time flies when you're having fun and I don't remember when it was!

Yesterday I went to see my Rheumatologist for a shot of cortisone in my hand, the pain in which has been ungodly. I made a special point of going to pick up a copy of the xrays and never actually saw them myself. I should have picked them up sooner but I kept forgetting or thought of picking them up when the idea of driving was just out of the the question so I picked them up just before my doctor's appointment. The xrays were ordered by my PCP.

The Rheumy, a nice guy who really seems to know his stuff, said he'd look at them later and seemed a bit dismissive of them. It annoyed me a bit but mostly it brought to mind what Wendy has been going through. Since it's not vital because it's been established that I have OA in every joint in my body, I guess it won't matter but I have this feeling that he may not even look at them. He was commenting on how bad my neck felt upon exam and I told him the xrays would show why but I don't know if he picked up on my message.

This Rheumy is not affiliated with the same hospital my PCP is and in fact, I chose him based on good things I'd heard about him. I could have gone to Boston but he's closer. Locally, we have a dearth of good rheumatologists.

When I first saw him, the Rheumy insisted on my having a total spinal series done to rule out Ankylosing Spondylitis, despite the fact that I assured him that my spine has always been this rigid. The series naturally showed that I didn't have it, which I'd already told him! He also insisted on a repeat of the same blood tests for RA that my PCP had done three times.

Apparently these people just don't realize that the affects of radiation is cumulative and they seem to think that their xray machines and radiologists are better than everyone else's. That's why I think it's so important to get all your prescriptions from your PCP and have him manage your case and that copies of all tests be sent to him.

My PCP says that doctors build up a relationship with radiologists and he has one particular one he likes to use. He thinks all the radiologists at his hospital are good but if he has a question, he will have a specific radiologist review the films because he thinks he's the best. I guess that may be why they're all so territorial but it makes the patient feel like a guinea pig - a glow-in-the-dark guinea pig!

I know they're not doing it to make money because they get no kickbacks and the insurance companies don't like having to pay for all these xrays and tests and they'll actually call a doctor on the carpet for it.

Anyway, Wendy, good for you! You have to take a stand and manage your own case, hopefully with the advice of a good PCP whom you trust. Doctors have a tendency to lose sight of the fact that they aren't treating just a body but a whole person.

Re: On the subject of xrays, too many doctors, etc. and Kudos to Wendy

wendyn on 2/16/05 at 22:36 (169217)

Thank you Kathy...I am sorry to hear that you can so relate to this. How is your pain lately? I like your phrase 'Rheumy' but it sounds like a very large doctor. With a very roomy smock.

I feel much better since Monday. I talked to a nurse friend today, and she was horrified with my description of everything that went on around the MRI and the dye. She's familiar with my history - and her basic attitude towards me taking a firm stand was 'You go girl!'

As an added note, my husband and parents are very supportive (and I'm actually surprised) of the idea of saying 'enough.' My mom has watched this go on since I was 11; she used to cart me around from doctor to doctor - each one scaring the crap out of her by suggesting I had some horrible ailment that was just starting to rear its ugly head. At 15, they had her convinced that I had lupus or a sever rheumatoid arthritis. Nice things to think about for your child.

Anyway, I feel great these last few days, and I think I won't dwell on the cumulative effects of radiation!

Re: On the subject of xrays, too many doctors, etc. and Kudos to Wendy

Ed Davis, DPM on 2/19/05 at 10:57 (169425)

Expense wise, I cannot give them the edge but safety wise, MRI's have no radiation and are probably a bit underutilized, that is, could have been used in place of bone scans and many CT scans...