Tag Archive | ultrasound

Check and Double Check

The trip to Philadelphia was for my 6-month check up. I had four appointments in all: 2 ultrasounds, 2 doctors. I’m grateful for my hubby, who sat in the lobby watching Star Wars movies on his iPad, since he was not allowed in with me to any appointments. He refuses to let me go alone, and he insists on doing all the driving.

My first appointment was for a repeat thyroid ultrasound. This is the third one I had. The first two were done locally but the PennMed docs reviewing those reports and films did not think they were done well, and there was no recommendation action in the report. Since I will be going to Penn every six months anyway, it made sense to just have them re-do it. It was certainly a much more thorough ultrasound, but my developed test anxiety had me nervous. The amount of time the doctor spent doing the test made me start to panic a bit, since my default assumption is always that something is wrong. I waited the longest (about a week) for these results. Everything was stable, but they did want me to start seeing an endocrinologist. I have an TeleMed appointment with a Penn doctor at the end of March. Part of me just wanted to find a local doctor for ease of visits, but the quality of care at Penn can’t be beat, so… Penn it is. For those of you wondering why thyroid… This was an “incidental finding” from a prior CT scan that they are required to follow up on.

Appointment number two was a chest ultrasound to continue monitoring the “lump” that we all believe to be a “surgical remnant” but want to monitor to be safe. Everything was stable/same, so that’s good.

Before my doctors’ appointments, I had my vitals taken and my meds/history reviewed. Apparently, my heart rate was higher than normal. I didn’t realize this until I got into my third appointment was with my oncologist. She said, “oh, I see you were tachycardic…” Really? Heart rate was 103. I have to believe it was an error or typo or something. I didn’t feel like my heart was racing or anything like that, so I’m not really worried. But hearing the word “tachycardic” was surprising.

Everything went well. She was happy with how I was doing, that I’m continuing to exercise, that I got my first covid shot (at her recommendation), and that my side effects from the meds were all manageable.

My last appointment was with my surgeon, who I haven’t seen in a year, due to the pandemic. She finally got to check out said “lump” and her thoughts are that it’s a suture. It isn’t the size, shape, etc. of a surgical clip, per her assessment, and it’s just something we’ll watch to be on the safe side.

I love all of my Penn doctors. They always spend a good amount of time with me, and they seem interested in me as a person. Am I still exercising every day? Am I still writing? How is that grandson of yours? I think it’s important to feel a connection with your physicians and I feel so comfortable and confident every time I go there. I could conceivably stop seeing them and stay local only, but I just feel so much better going there (in addition to my local doctors). I am getting checked and double checked.

I will return in August for a repeat of all the same appointments.

IMDb: Check and Double Check (1930)

Broken


Thank you to all of you who wrote or called to offer your prayers, support and positive energy after Monday’s diagnosis. I am forever blessed by all the wonderful people in my life, from so many different facets, and your kind words have uplifted my spirit. Thank you, thank you, thank you!

*****

I alluded in my last post to my recent experiences with the healthcare system (and I use the word health”care” very loosely). Things have changed so dramatically from my days as a caretaker in the late 1990s when Ray was sick. Back then, we had healthcare facilities who really worked with us on things like payment. As long as I was paying something every month, they didn’t care. Copayments were a thing, but I never remember any really crazy expenses. We even had a patient advocate assigned to us who helped us navigate the system. She helped to pursue coverage for a Medicare facility that was not covered by our plan. Basically, she went to the Board, presented our case, and got the insurance company to pay for the long term care program Ray needed after his meningitis.

In those days, not all that long ago, the doctor made the decisions. We were never refused any test that was requested by the doctor, and we had the opportunity to go anywhere. There was no fighting with the insurance to get coverage when we moved his treatment to Cleveland.

But that was then, and this is now.

I am horrified every day by what our health care industry has become. Not just in my own experiences, but in the experiences of women that I encounter every day in my breast cancer Facebook groups — women who give up, tired of fighting, and not wanting to bankrupt their families.

With all of my recent tests, I have paid at least $100 out of pocket. (Of course, our plan year started on November 1st, so no deductibles were met). In the past, facilities would call ahead of time to pre-register me; now they call to advise me how much I will owe when I get there. For my biopsy, the out-of-pocket cost was $1,472. I’m one of the lucky ones… we can pay that. But how many people will walk away from that test, not as lucky? How many will forego groceries, or other medicines, or any other necessity to pay this bill? The system is broken. Healthcare is a for-profit industry and the richer you are, the better care you can obtain. I try not be political on this page, but this is something we all need to fight for. Shouldn’t healthcare be a right for everyone?

And, of course, the decision-making of the past has been removed from doctors and now rests firmly with the insurance companies. Given my history of cancer, my oncologist wanted me to have a PET scan. I waited 3 days to find out that my insurance would not approve it. So the test MY DOCTOR wants, is not allowed by the insurance company. So, instead, I need TWO tests… a CT scan and a bone scan. I can’t help but wonder the overall cost benefit of that, as well as the health impact on the patient. I now will require TWO exposures to radiation, instead of one. And the kicker is, if they find something on either of those two tests, THEN I will be required to have a PET scan. What a scam!! With the amount of radiation I have had over the years, I absolutely worry about the cumulative effects of radiation and having to have multiple tests both scares me and infuriates me.

My last comment on health care? The red tape is insane.

I get all my testing done at a local imaging place. I have used this place since the beginning of my health care journey in 2008. I used to pre-register by phone, walk in to the facility, check in within 30 seconds, sit for a few minutes, and then get called back for my test. This facility has since been bought out by a larger health care conglomerate. There is no pre-registration over the phone (just the call about cost). I now wait 10-20 minutes in line, just to get to the desk. It’s then another 20 minutes at the desk doing paperwork. Yep. Real, honest-to-goodness PAPERS! Piles of papers! Once I’m taken back to the testing room, I have to do more paperwork! And then I wait some more. For my biopsy, which took 10 minutes, tops, I was at the facility for 1:45. Why? I’m already in the system… I was just here last week… you guys are the ones who ordered the biopsy, why don’t you have the order… why all the paperwork? When I’m already stressed, there’s nothing more likely to push me over the edge than red tape and inefficiencies!

Rant over. It’s been a frustrating few weeks, with more frustration to come, I’m sure. Today I will have another ultrasound (full chest wall, since they only looked at one specific spot last time). Tomorrow is my bone scan. And Tuesday is my CT scan. After that, I will wait a week before meeting with my oncologist to discuss results and game plan. Yep… my appointment is the day before Thanksgiving!

Let’s pray we have a lot to be thankful for!

 

IMDb: Broken (2012)

 

The Year of Living Dangerously

It was one year ago today that my breast cancer journey started.

July 27, 2012 is the day I went for an ultrasound to check out the cysts that I had in my right breast.  I had been regularly having mammograms and ultrasounds to watch these “cysts”.  My 2011 tests showed only the cysts and I was told to come back in a year.  I’m glad I didn’t wait the full year to have them checked again, but I wish I had followed up sooner.  When the density of the cysts changed, I should have gone back.  But I waited, as I was convinced they were cysts (I could feel them like a cluster of grapes), and no one seemed particularly concerned.

But lurking behind that clump of cysts was a tumor and it got pretty big before showing up on any tests.  During my 2012 ultrasound, the tech spent a lot of time looking around.  I was taking this all in stride until she said the doctor would have to look at it.  Uh oh.  And then when the doctor insisted that I have a biopsy done before I left for vacation in two days, I knew I was screwed.

The biopsy wasn’t too painful (thank God for numbing drugs); just the feeling of pressure as she took 4 samples and then added the clip to mark the tumor.  At that time, they thought the tumor was about 2-3 cm.  What a surprise it would be when we later found it was actually 8 cm!!!

And what a year it’s been…

The Mystery of Edwin Drood

After several phone calls to multiple facilities — and a brief spat with my oncologist — the mystery has been solved regarding my MRI. As you may remember, my follow up MRI for my renal cell carcinoma showed “evidence of breast prostheses”. Considering I did not have reconstruction, I challenged this (and questioned the validity of the whole report). A subsequent read of the films said they could be expanders, which left me with no further resolution.

I called my surgeon again and haven’t heard back. I left a message for my oncologist last week but she was on vacation. She did call me yesterday, trying up understand the message I left and, when I explained, responded with “and why are you involving me in this?” Really???? I don’t have to tell you that response really ticked me off.

So I said that, as my oncologist, I just thought she might be able to help get this resolved because despite my best efforts I had had no luck to date. She said there was nothing she could do since she was not the ordering physician. I would have to go back to my urologist (who really was only interested in my kidneys).

As I was seething over this whole conversation and ordeal to get my question answered, I noticed later. that I had a missed call. Apparently my oncologist had a change of heart and intervened after all. She called in a favor from a radiologist pal (who just happened to be the brother of my surgeon). She felt compelled to tell me that he, too, asked “why are you involving me in this?” Is this really what our health care system has become? Does anyone really care?

At any rate, they agreed to send me for an ultrasound to resolve the issue. I had that done this morning by the woman who did the ultrasound that found my breast cancer. I was surprised she remembered me and many of the details of that day (including that I was on my way to Florida for vacation).

The ultrasound revealed that what appeared to be implants were really just saromas, those pockets of fluid that form post-surgery. The radiologist did explain why the initial report indicated they might be implants (location and shape of saromas, where the MRI ended, etc). He was very understanding if why I pursued it, given my history.

Case closed.