Detective Work

I haven't been a frequent user of the health-care system for the last 10-15 yrs (i.e., I haven't been sick or injured - except for those stitches in my lip a few years back from playing basketball...) I know it sounds funny considering my EE background any my career as a patent attorney, but everything in the doctor's office is so fancy-schmancy these days - it's all high-tech and stuff. I'm still getting used to it. The thing that confuses me though is why you still have to fill out so many forms by hand - name, address, phone number, social security number, insurance carrier, this number and that number. Goodness, what a colossal waste of time - that shouldn't be necessary. Of course, I do understand the red tape and the bureaucracy that impedes the infusion of technology into the health-care community. Oh well.

I've talked to several people now that have convinced me that it is unacceptable for me to have waited this long without any information regarding a diagnosis. At this point, the only information I had was that the pathologist thought it might be lymphoma but had deferred the diagnosis, pending a second opinion. Surely there was more information to be had than that. So, I started making phone calls today.

I talked to the surgeon's office and they gave me very little information; however, I probed just enough for the nurse to mention the name of the pathologist doing the tissue analysis. Google gave me some info about the patholgist, including his phone number. His secretary assumed I was another doctor and offered to give me his cell phone number since he was out of the office. She was surprised when I told her I was the patient, but she was very helpful. She faxed me a copy of the pathology report. Sure enough, the report was lacking much in the way of diagnostic info. However, I was able to glean a few things: there was a lot of fatty tissue in the sample and there was evidence of "crush artifact." As best I can tell, crush artifact is basically tissue that has been smashed and is, therefore, fairly useless. Ok...

Next, I noticed that the pathology report included the name and address of the "second opinion" doctor. Why not give him a call? Google actually gave me his direct line, which caught me a little off-guard when he answered the phone. Fortunately, the health-care industry isn't that far behind the technological times. A simple "Engstrom, that's E-N-G..." and he pulled up my file on the computer. He said that they're going to do the best they can with my sample - hopefully, they'll have something back by tomorrow. It turns out that he's not sure they have enough tissue to render a diagnosis. Based on my previous detective work, it's obvious that between the "abundant amount" of fatty tissue and the "crush artifact," there just isn't a lot of good tissue available for diagnosis. But the doctor sounded hopeful that they could make it work with the sample they have. We'll see.

I finished our conversation by asking whether or not I'd need to have another biopsy. He was a little surprised when I told him the first biopsy was done with "the scope" (i.e., mediastinoscope). I suppose his thinking at that moment was that it should have been a relative slam-dunk to extract ample tissue with the scope. I would have thought the same thing. Anyhow, he did say that I may need to have another biopsy.

Great.

I'm pretty laid back and take most things in stride and I'll do the same in this case if I do end up needing another biopsy. It's not worth getting hot and bothered about it. However, I will follow the fool-me-once-shame-on-you-fool-me-twice-shame-on-me approach from here on out. I already have an excellent oncologist lined up thanks to several personal recommendations and a fair amount of research. Perhaps I'll need to tap into my personal network again to find a new surgeon...