Educating docs along the way
 

After telling my GP about consulting with surgeons out of the country since we lost the appeals for fusion with Regence, she got on the horn with the MRI doc.
Since previous MRI reports didn't mention the magic word- spondylosthesis that is required for fusion coverage, nor did the surgeon, she asked this MRI doc if this was so. He tells her that, "Yes, Shay has spondylosthesis, I didn't know they wanted me to use that word." AHHHHH!

So now he is writing an amendment to the MRI, sending it to the surgeon, also trying to talk to the surgeon as to why he didn't see it himself.
This is craziness.

Months of pain, and stress and appeal work, all because the report was written up incorrectly.

Anyway, I'm trying to see this as an opportunity to get clearer on my diagnosis, before rushing into the planned fusion. This is a red flag for me with the original surgeon. I plan on asking him about it.

Meanwhile I have consultation pending with 4 other surgeons to get clarity.

Just a reminder to pay attention to EVERYTHING! This only happened because my partner Yona came to the appointment with me and pestered the doc.
On a Butrans patch today, feeling less pain and kinda high.

Shay

I mentioned this years ago but it's worth retelling the story given your lead-in. Six years ago Laura was working with a radiologist, the only radiologist in Utah that we were actually able to speak to ourselves. He understood Laura had an artificial disk at L5S1 and what that meant to her spinal mechanics and had adjusted the MRI parameters to "throw" the metal artifact away from her facets at that level. While he was reading the MRI, composing his report, and explaining things to us, he casually mentioned that most radiologists wouldn't read or report facet joint condition. He pointed our that, with fusion as the only option, radiologists "knew" that facet joint condition wouldn't be the deciding factor for treatment and they didn't bother trying to look. He was willing to acknowledge that the whole situation shifted with use of ADRs but told us not to expect that look from anyone else in his profession unless significant education efforts were made ahead of time.

On top of that, another doctor just told us about the very high likelihood of the radiologist reports in this area being dry-labbed, but that's due to another problem, unrelated to education and experience.

This is very good news -- better to find this out now -- than later! Yona, good job. Please clone yourself and we'll issue a YonaClone to every patient who needs an appointment companion. :laugh:

Jim, can you talk a little bit more about this notion of "dry-labbing?"

There's not much I can say other than (doctor's office who shall remain unnamed) accused many of the radiologists in the greater Salt Lake City of writing MRI and x-ray reports around the description of symptoms and age of the patient instead of actually reading the images. One report stated that my wife was bone on bone when a simple perusal of the films showed that she wasn't and, when we spoke with the unnamed doctor, he said that kind of behavior was more common than we would have wished.

i have found that good pain docs and surgeons ALWAYS look at their own images... and usually comment on much more than radiologists.

there are countless stories of missed calls by radiologists... head bleeds, collapsed lungs, fractures, you name it.

radiologists also have their own normal "macro"... if what you're needing to have looked at isn't in their macro, it may or may not be normal.