Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Friday, January 05, 2007

Updates

1. The lady with the locally advanced breast cancer welcomed her fifth grandchild on New Year's Eve. February will be the second anniversary of her diagnosis.

2. Rad Rage: The guy with asbestosis (ridiculously abnormal chest x-ray with new pneumonia) got the CT of his chest, which was negative for anything really scary (ie, cancer.) There was bibasilar consolidation read as "either acute or chronic" that was probably what was read as the original infiltrate. But...it also showed left hydronephrosis*.

So...I had to call him back in to tell him about it; get a CT of abdomen and pelvis and refer him to urology. I steeled myself as I walked in the room. He was worried too. (We've known each other a long time; he can tell when I have something to tell him.) As soon as I said "Kidney" he said, "The left one? I was wondering if that stent was still working." Turns out he had stones (all my chart said was "nephrostomy 1978") twenty years before I met him. We still have to go work it up, but he's not the least bit worried; and he totally made my day!!

3. I haven't heard back yet from Urology about the guy with gross hematuria, but I tried asking about him when I called about the hydronephrosis guy I'm sending. I was told, "He doesn't work Fridays." Nice work if you can get it.


*Swollen kidney and ureter, presumably from obstruction. Possible stone, bladder or ureteral tumor, or something else. Plan: "punt."

2 Comments:

At Sat Jan 06, 03:35:00 PM, Anonymous Prof Scrub said...

Dear pleased,

Thank goodness for Fridays! May there be more merriment to come on the day before our beloved weekends, where we may spend time away with the woman next door!

Your happy Friday well wisher
Prof Scrub
http://www.scrubbingup.com/blogs/profscrub/blog.asp

 
At Tue Jan 09, 11:52:00 PM, Blogger Dreaming again said...

Those hard diagnosis' just really aren't easy on you docs are they?

My body carries 2 dx's that docs don't like. I've actually seen doctor's wince when I tell them I have them. Lupus and Myasthenia Gravis.

My primary care doc is on maternity leave (hopefully is a mommy by now) and today, I saw her partner for my general, check in, how ya doing ..you ok (well, no not really) and lab work for the high risk meds I'm on.

As she was looking to verify what labs are done, she noticed the thyroid had been checked regularly ... she found that odd. (me too)

It's strange ... my thyroid, is consistently normal, very normal. Yet, my doctor checked it over and over and over again last year (8 out of the 12 lab checks!) hoping to find an easy answer to explain my hair loss.

The fact that hair loss is common with lupus (but unfixable) that fatigue is common with lupus and MG (but unfixable) and I already have those two dx ...solid and unmistakable ...didn't seem to matter ...she wanted so badly to have the easy answer. Something fixable to give me an answer!

It's odd ... I'VE accepted the diagnosis (sometimes better than others ...sometimes not at all ...depends on the day) but my doc? She wants to fix it, and fix it now.

Maybe, that's why she's my doc.

 

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