That damn clavicle of mine

[LexieCat]

Went for followup visit this morning with ortho surgeon re broken clavicle. We were discussing the failure of the fracture to heal at this point, and he said, "Well, when you've got a pathologic fracture from bone metastasis..." I said, "You know, my oncologist is still not convinced that's the case--that it's pathologic." He kinda rolled his eyes and said, well, the scans tell both me and the radiologist something different.

I told him oncologist says even if it IS the result of a metastasis, he's not worried because I've had such a good response to treatment and that the chemo/immunotherapy should address any met there. 

The ortho guy did note that even assuming there isn't active cancer going on there right now, chemo targets fast-growing cells, which can interfere with healing.

He WAS happy to hear I'm not experiencing any pain, which he thinks is a good sign. At the same time, he doesn't see any point in doing surgery or anything to stabilize it because it wouldn't do me that much good. He suggested just continuing to follow it (made an appt for February), and that I try to limit the amount of heavy stress I put on it.

*sigh* I'm gonna go with my oncologist in terms of what I need to worry about. As I told this guy, the cancer is my top priority. As long as I'm not in extreme pain and can function with the clavicle as it is, I'm not in any rush to do something more extreme.

 

 

[LouT]

Lexie,

Wow...sounds like dueling doctor opinions there.  I can understand that your first priority is to get rid of the cancer, but I can certainly understand concern over an unhealed fracture.  My only question is this; "if the lack of healing of the fracture continues what would be the course of treatment?".  Once the cancer is gone (notice the affirmative outlook) you can't very well walk around with a chronic fracture.  I'm guess that at that point the doctor may then consider a surgical intervention to correct the issue.

Lou

[BridgetO]

Dueling docs!  Sorry you're having to deal with one more thing.  I think your plan tis a good one to prioritize the cancer and just hang in with the bone as-is, so long as no big-deal pain. 

Bridget O

[LexieCat]

I did drop a note to my oncologist about the visit today (I didn't mention the detectable snark), just in case it made a difference to anything. NP replied and thanked me for info. Presumably, if there's anything to be seriously concerned about, oncologist will do something. He DID move up my spinal MRI just in case. He's confident the chemo/immunotherapy did its job, so for now, at least, he's not worried about the fracture.

[Tom Galli]

Good decision Lexie! Always kill the most dangerous enemy first.

Stay the course.

Tom

[Rower Michelle]

Well ain’t that a daisy (NOT).  One of my friends had a bone fracture from mets & in addition to Zometa, her integrative oncologist started her on low dose naltrexone (4.5mg) and acupuncture.  You might want to check out the acupuncture. 
 

Two years later my oncologist is finally willing to acknowledge that he thinks acupuncture helped the bone mets heal.  

[TJM]

Go with the your gut....same as saying ho with the doctor you like the best. Scientific... no. Logical?

Best for you

Tom

[LouT]

Lexie,

If I ever need advocates I'm going to get you, Michelle and Tom when the big guns are needed.  Glad you're continuing to push this.  

Lou

[Susan Cornett]

Lou - they would be a formidable team!

[LexieCat]

Oh, fer fox's sake. I just got a notification I have a new test result at the patient portal. It's the report of my X-ray of the clavicle I just had. 

Check out the radiologist's finding: "There is no definitive evidence for fracture medial right clavicle."

I mean, WTF???? After all that discussion regarding the ortho surgeon's certainty I have an unhealed pathological fracture, and THIS is what the report says?

I'll drop a note to the ortho surgeon to ask for an explanation, but geeze.

[Rower Michelle]

Bad version of Doctor’s Who is on First?!!

[BridgetO]

Jeez Louise! Very strange. Maybe you need a 3rd (or 4th or 5th opinion). Or maybe you've had miraculous healing. 

[LexieCat]

All the CT scans I've received (since the first one, right after it happened, which failed to mention it) note the "comminuted fracture of the clavicle," so I have no doubt it's there (plus I can feel it). And the ortho surgeon was reading the images in his office minutes after these X-rays were taken. It's probably a typo, but stuff like this makes me nuts. It's like those FAIL photos: "These guys had ONE JOB to do, but...." 

[LexieCat]

So I finally sent a note to the ortho surgeon about the mysterious Xray report. His NP replied that it's "probably" a mistake, noting the surgeon's own report of our visit. I said, well, I'd like it to be corrected--I don't want inaccurate reports in my file. 

The surgeon then responded and said *I* would have to contact radiology--he can't change their report.

Now that really got me steamed. First, I didn't ever suggest HE should change the report. But, as I told him in my reply, as the requesting physician, he's in a position to make a phone call or send an email to have it corrected. When I tried calling Penn Radiology (Penn Medicine is a HUGE organization, and there's no direct contact info for this radiologist), all I got were menu options to make an appointment, etc.

Ugh. If he doesn't deal with this I'll contact my oncologist's NP--she should at least be able to make contact with this radiologist and ask her to call me or something, so I can explain what the issue is. 

[LexieCat]

Reply from ortho surgeon: "I've forwarded the message."

Fer cryin' out loud--if I were a doctor, and another doctor misinterpreted my patient's Xray, I'd be all over getting that corrected--for liability reasons, if nothing else.

*SMH*

[Jennedy]

Me too! 

[Tom Galli]

Maybe a law suite would get their attention...

Just for once, I'd like a physician to be a normal person trying to get a simple thing done to a medical record. Just once I'd love them to experience the baloney we put up with and pay for.

"Its been rough and rocky traveling but I'm glad I'm standing upright on the ground..."

Stay the course.

Tom

[Rower Michelle]

Ha! I believe CFR 45 provides patients with the right to have their medical records amended when the provider makes an error.   I’m sure a nice memo to their GC will get someone moving.  My Mom always said start at the top!
 

I’m just as steamed as you are about the many gerbil wheels we run around in.  Time to break out the lawyer bat!  Rock ‘em sock ‘em, totally BS.  

[GaryG]

I bet there won't be any hesitation to correct an invoice if it's in their favor. A patient record however can wait. 

[LexieCat]

Oh, I know I have legal rights--trust me. As a lawyer, though, I've found it's far simpler to pursue the less nuclear options first. Besides, I have a feeling their legal departments probably have their hands full with pandemic issues right now. And this isn't something with immediate medical consequences for me--even *I* can see on the Xray itself that the bone isn't right. It's more irritating than anything else. 

I'll give it a few days and if it's still messed up, I see my NP on NYE when I go for my next infusion, so I'll ask her to help me. She's terrific and I have no doubt she'll get the wheels moving for me. It's just annoying that the ortho is taking such a lackadaisical attitude and putting the burden on the patient. 

[ChiMama]

When I went to the ER in July with the pneumothorax & heart palpitations, the CT report they did said something about what they saw in the "upper left lobe."  I was like, um, the upper left lobe shouldn't even be there, so what are they talking about? My oncologist noticed it and called over to the radiologist to get clarification and have it corrected.  He got clarification but it was never officially corrected.

And the worst part is my insurance denied the charges and I'm being billed for that scan!

[Rower Michelle]

I guess my Mom only believes in the nuclear option- over the years she’s written probably hundreds of letters ( and still does) to CEOs about what she perceives to be errors or defective products.   
My Dad was going through her “stuff” during the lengthy hospitalization this summer, when he called me “Hey Shell, did ya know your MOTHER has over $80k squirreled away in a passbook savings account?!!!!!”   That’s a lot of refunds!  We had no idea.  

[LexieCat]

1 hour ago, ChiMama said:

When I went to the ER in July with the pneumothorax & heart palpitations, the CT report they did said something about what they saw in the "upper left lobe."  I was like, um, the upper left lobe shouldn't even be there, so what are they talking about? My oncologist noticed it and called over to the radiologist to get clarification and have it corrected.  He got clarification but it was never officially corrected.

And the worst part is my insurance denied the charges and I'm being billed for that scan!

Exact same thing with my last CT. Although mine said "left upper lobe"--which I guess is subject to interpretation. I checked with my oncologist and he said what that means is the upper part of the (remaining, lower) left lobe. And actually, when you look at the CT scans now, three years post lobectomy, my remaining left lung has inflated to occupy the space formerly held by my upper left lobe. 

[LouT]

Lexie,

I was occupied this past week and am just catching up.  But I understand the frustration.  We depend so heavily on these reports and interpretations and such and when they are blatantly wrong it can diminish our sense of security in future ones.  I look forward to hearing that one of the medical team responsible for your tests and treatment get this corrected for you.

Lou