Non-helpful medical tests

A few weeks ago I had a sleep test and then an elbow MRI for separate issues. And the results? Nothing, nada, zip, nil. For both.

My PCP ordered the sleep test to see if I have apnea or other issues which may be interfering with my sleep. She said in addition to apnea, it can diagnose all sorts of problems. I did not sleep through the entire night of the sleep test even though I had taken an Ativan to ensure that.

And the results say 'no apnea' and nothing else. I asked my PCP about it and her suggestion was talk to behavioral (psychiatry) medicine about it and/or come see her when she has an opening. I am doing both.

Since I was headed to my meds therapist yesterday, I asked her about it. She said to try mild sleeping pills and take half a tablet when I can't sleep. And I can take up to two a night if needed. I don't remember what they are but will pick them up later today.

I also have an appointment to see my PCP in November. The problem with not sleeping and having RA and fibromyalgia, that cause fatigue, I need to get more sleep. And then I can't sleep. Which really sucks.

And my MRI, as I think I said previously, says it shows some bursitis but my doctor disagrees.

Aren't these helpful? Not really.

You don't understand, don't worry, your doctor doesn't either

With all the new medical advice out there, they always end with two statements:

• More research is needed
• Ask your doctor if this is right for you.

Well in this case, more research was done and it turns out doctors aren't as smart (or Gods) as we might think. First of all how are doctors supposed to keep up on all the latest research. Second all the numbers come out in percentages - which are generalizations - and not round numbers.

This new article is long but very interesting (and definitely worth the read) about some new research showing how doctors do not necessarily understand the benefits of screening tests, as used as their examples. If 100 women get mammograms, how many will show something? Of the ones that do, how many will test positive for cancer? How many will be false positives? How many lives will be potentially saved?

"There are three other questions Gigerenzer advises patients to ask doctors to ensure they get all the facts:

• "What are the alternatives?"
• "What's the benefit and what's the harm?"
• "Please tell me this in terms of absolute numbers. If 100 take this medication and 100 people don't, what happens after five years?"

Once they get the answers it is up to them to make up their own mind about treatment, he says."

That should get you where you need to be to make a decision. If your doctor can't answer this or hesitates, maybe they should do some reading and get back to you or find a doctor who can answer the questions.

3D Mammography

3D Mammography, also known as digital breast tomosynthesis, has been around for the past few years. Originally I hadn't heard such great things about it but now I have heard more and find it an acceptable addition to cancer screening. Or at least in my opinion, which is what counts for me.

Basically in 3D mammography they take lots of pictures of slices of your breast as opposed to the single image from regular mammography. (Think CT vs x-ray) It takes a little longer for the radiologist to read all the pictures because there are so many of them, but they do  provide much clearer images, better detection, and fewer false positives.

When I went for my annual mammogram a few weeks ago, something I chose not to discuss until I got the results, I had a 3D mammogram. The hospital has added the newer machines in the past year. Their current arrangement is that if you have a doctor appointment the same day, you get a regular digital or screening mammogram. But if you do not have a doctor appointment the same day, meaning the radiologist has lots of time to read all the pictures from a 3D mammogram, that is what you get.

I had decided I see too many doctors and cut back on my radiation oncologist - I don't know why I was still seeing her anyway - and canceled that appointment this year. Some how my surgeons office never scheduled my annual appointment with them, even though I thought I was supposed to be followed by them for life, so I am down two appointments for the year. I will talk to my medical oncologist and my primary care when I see them to make sure I am getting the follow ups I should.

And I learned something, I will have my annual mammogram without a doctor appointment the same day so that I get the 3D mammogram. And my results this year were clean.

3D Mammography

3D Mammography, also known as digital breast tomosynthesis, has been around for the past few years. Originally I hadn't heard such great things about it but now I have heard more and find it an acceptable addition to cancer screening. Or at least in my opinion, which is what counts for me.

Basically in 3D mammography they take lots of pictures of slices of your breast as opposed to the single image from regular mammography. (Think CT vs x-ray) It takes a little longer for the radiologist to read all the pictures because there are so many of them, but they do  provide much clearer images, better detection, and fewer false positives.

When I went for my annual mammogram a few weeks ago, something I chose not to discuss until I got the results, I had a 3D mammogram. The hospital has added the newer machines in the past year. Their current arrangement is that if you have a doctor appointment the same day, you get a regular digital or screening mammogram. But if you do not have a doctor appointment the same day, meaning the radiologist has lots of time to read all the pictures from a 3D mammogram, that is what you get.

I had decided I see too many doctors and cut back on my radiation oncologist - I don't know why I was still seeing her anyway - and canceled that appointment this year. Some how my surgeons office never scheduled my annual appointment with them, even though I thought I was supposed to be followed by them for life, so I am down two appointments for the year. I will talk to my medical oncologist and my primary care when I see them to make sure I am getting the follow ups I should.

And I learned something, I will have my annual mammogram without a doctor appointment the same day so that I get the 3D mammogram. And my results this year were clean.

Non-helpful medical tests

A few weeks ago I had a sleep test and then an elbow MRI for separate issues. And the results? Nothing, nada, zip, nil. For both.

My PCP ordered the sleep test to see if I have apnea or other issues which may be interfering with my sleep. She said in addition to apnea, it can diagnose all sorts of problems. I did not sleep through the entire night of the sleep test even though I had taken an Ativan to ensure that.

And the results say 'no apnea' and nothing else. I asked my PCP about it and her suggestion was talk to behavioral (psychiatry) medicine about it and/or come see her when she has an opening. I am doing both.

Since I was headed to my meds therapist yesterday, I asked her about it. She said to try mild sleeping pills and take half a tablet when I can't sleep. And I can take up to two a night if needed. I don't remember what they are but will pick them up later today.

I also have an appointment to see my PCP in November. The problem with not sleeping and having RA and fibromyalgia, that cause fatigue, I need to get more sleep. And then I can't sleep. Which really sucks.

And my MRI, as I think I said previously, says it shows some bursitis but my doctor disagrees.

Aren't these helpful? Not really.

You don't understand, don't worry, your doctor doesn't either

With all the new medical advice out there, they always end with two statements:

• More research is needed
• Ask your doctor if this is right for you.

Well in this case, more research was done and it turns out doctors aren't as smart (or Gods) as we might think. First of all how are doctors supposed to keep up on all the latest research. Second all the numbers come out in percentages - which are generalizations - and not round numbers.

This new article is long but very interesting (and definitely worth the read) about some new research showing how doctors do not necessarily understand the benefits of screening tests, as used as their examples. If 100 women get mammograms, how many will show something? Of the ones that do, how many will test positive for cancer? How many will be false positives? How many lives will be potentially saved?

"There are three other questions Gigerenzer advises patients to ask doctors to ensure they get all the facts:

• "What are the alternatives?"
• "What's the benefit and what's the harm?"
• "Please tell me this in terms of absolute numbers. If 100 take this medication and 100 people don't, what happens after five years?"

Once they get the answers it is up to them to make up their own mind about treatment, he says."

That should get you where you need to be to make a decision. If your doctor can't answer this or hesitates, maybe they should do some reading and get back to you or find a doctor who can answer the questions.