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Old 07-25-2019, 01:54 PM
 
Location: South Dakota
4,166 posts, read 2,539,838 times
Reputation: 8380

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Quote:
Originally Posted by katharsis View Post
JERK is right!!! (Well, actually, I would say "arrogant jack*ss"". Absolutely frightening!
I'll say! And if he is doing that to the OP, he is probably doing the same to others as well. This reminds me of something I heard from somewhere, maybe here.

"Do you know what they call a person who graduates last in their class at medical school?

A doctor!"
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Old 07-25-2019, 02:09 PM
 
2,391 posts, read 1,389,601 times
Reputation: 4209
Well, the ENT wanted a fine needle aspiration which is more or less worthless for lymphoma. Instead I suggested that we go with a core biopsy which would let us test for both. It is not the gold standard for lymphoma but it also isn’t worthless. It can also rule out the other cancer he’s now made me quite angstful about. And I will have it tomorrow!

I am both angry and having these hopefully irrational fears at the moment as metastatic esophageal cancer has a much worse prognosis than lymphoma. I am worried that the ENT will put suspected esophageal cancer down on the order and that will somehow bias the pathologists. Does anyone know how this works? Is it something to be concerned about or am I worrying about nothing? I am really convinced I don’t have throat cancer. I have few to any risk factors. I forgot to mention it in his office because I was in semi-chock. But I had one of those tests (forget the name) where they scope your digestive tract from the mouth and down (sort of the opposite of a colonoscopy.) I was having issues with my pancreas and my GI performed the test to be on the safe side. My esophagus looked completely normal. It is possible for throat cancer (and others) to appear in the nodes without a primary lesion ever being located, but it is rare.

Nevertheless I am feeling anxious about this. I don’t want to have it of course, but I am also hoping the pathologist will not be biased and read the slides inaccurately.
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Old 07-25-2019, 02:15 PM
 
Location: planet earth
8,620 posts, read 5,607,399 times
Reputation: 19639
Quote:
Originally Posted by Jill_Schramm View Post
Well, the ENT wanted a fine needle aspiration which is more or less worthless for lymphoma. Instead I suggested that we go with a core biopsy which would let us test for both. It is not the gold standard for lymphoma but it also isn’t worthless. It can also rule out the other cancer he’s now made me quite angstful about. And I will have it tomorrow!

I am both angry and having these hopefully irrational fears at the moment as metastatic esophageal cancer has a much worse prognosis than lymphoma. I am worried that the ENT will put suspected esophageal cancer down on the order and that will somehow bias the pathologists. Does anyone know how this works? Is it something to be concerned about or am I worrying about nothing? I am really convinced I don’t have throat cancer. I have few to any risk factors. I forgot to mention it in his office because I was in semi-chock. But I had one of those tests (forget the name) where they scope your digestive tract from the mouth and down (sort of the opposite of a colonoscopy.) I was having issues with my pancreas and my GI performed the test to be on the safe side. My esophagus looked completely normal. It is possible for throat cancer (and others) to appear in the nodes without a primary lesion ever being located, but it is rare.

Nevertheless I am feeling anxious about this. I don’t want to have it of course, but I am also hoping the pathologist will not be biased and read the slides inaccurately.
You need to find doctors you can TRUST and start all over again!

You have to be able to TRUST experts who can diagnose accurately, and lead you through whatever remedies are appropriate.

No one could blame you for feeling anxious!

Good luck!
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Old 07-25-2019, 02:21 PM
 
Location: Southern California
29,267 posts, read 16,619,492 times
Reputation: 18902
Quote:
Originally Posted by mlulu23 View Post
I'll say! And if he is doing that to the OP, he is probably doing the same to others as well. This reminds me of something I heard from somewhere, maybe here.

"Do you know what they call a person who graduates last in their class at medical school?

A doctor!"
Yeah, and then we have all the C-D doctors, where did they graduate in their class.
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Old 07-25-2019, 02:23 PM
 
Location: on the wind
23,015 posts, read 18,343,985 times
Reputation: 74489
Quote:
Originally Posted by RamenAddict View Post
It isn’t appropriate to tell a provider that he is proposing to perform the wrong procedure on the wrong site? I don’t know how that is being a know-it-all. Clearly the ENT was given the wrong information and needed to be informed so he didn’t do the wrong procedure.
Apparently I didn't clarify what I meant very well. My apologies. The story is confusing TBH. Instead of telling an ENT how to diagnose lymphoma or how rare the other cancer is in general (stuff he knows) I would have kept him focused on the dis-connect with the chart and report and why he was misinformed instead of challenging his medical knowledge. If he refused to listen, that's when I would have ended the appointment.

Last edited by Parnassia; 07-25-2019 at 02:42 PM..
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Old 07-25-2019, 02:47 PM
 
2,391 posts, read 1,389,601 times
Reputation: 4209
I didn’t actually say he was wrong. The “worst” part was this:

ENT: “I don’t think it’s lymphoma because in lymphoma the lymph nodes enlarge randomly throughout the body, not all in one place.”
Me: “Well, that’s true of some lymphomas. It is not true of Hodgkin’s.”
ENT: changes topic.


Well, it’s true. I have unfortunately spent way, way too much of my time reading about lymphoma and the fact that Hodgkin’s tends to progress in an orderly fashion from node to node and nodal region to nodal region is one of the things that distinguishes clinically from other lymphomas. In fact, there are medical text books with maps of exactly how it tends to spread in the body. In fact, it usually starts in the nodes in one side of the neck.

So, I challenged him in that one particular exchange. But it wasn’t exactly his specialty. I mean he’s an ENT, not an oncologist.
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Old 07-25-2019, 02:50 PM
 
Location: Michigan
2,741 posts, read 2,980,598 times
Reputation: 6540
Quote:
Originally Posted by Jill_Schramm View Post
Today, I saw the ENT to whom my oncologist referred me. The idea is that he was going to exam me, then set up an excisional biopsy of a lymph node/tumor. Both my PCP and my oncologist told me they think I have lymphoma.

The very first thing that happened was that the nurse told me they had an extra copy of the report from my oncologist’s office. Would I like to have a copy?

I thought was a little strange, but, sure, why not?

Well ... it was really eye-opening. My oncologist repeatedly suggests that I am a chronic smoker and drinker and am lying about it! For the record, I am a “never smoker.” Not even one drag once. Not even marijuana. Nothing. However, when I saw him for my initial visit, the very first thing he said: “Well you smoke! You said you don’t smoke but you do!” I have never had any medical professional act like that before, so I was perplexed. Eventually after about 5 back and forth accusation and denials, I said: you know I walked up the stairs, instead of taking the elevator. Maybe people smoke in the stairwell?” He seemed to agree with me and I thought the issue was solved but apparently not.

In the report, he appears absolutely obsessed by this — he brings it up in no less than 5 different places in the report. He also states that I was “counseled on the health risks of excessive alcohol use.” Um, what? I have not had a single drink in 3 years. Before that I was a very light social drinker (one glass of wine a week).

Anyway, although the oncologist told me in the office that he suspected lymphoma, lymphoma appears nowhere in the report he sent to the ENT. It’s just all about my “smoking,” my “chronic cough” (I had a bad head cold when I saw him, with a cough), that fact that I look “malnourished and chronically ill” (got a good laugh out of that one).

So, the ENT tells me they are going to do a fine needle aspiration. I said, that is not how you diagnose lymphoma. What are you looking for? He finally said that he suspects me of having squamous cell carcinoma of the esophagus! I said ... hmmm... that is actually kind of rare. I think lymphoma is more common (OK, there is no “I think” about it, I was just being polite.) Maybe it is more common in smokers and drinkers? Hmmm?

Just feeling so incredibly peeved about this.

Are you SURE they didn't mix up your report with another person of the same name? They used to mix me up with another person with my exact name (except for middle name) who is actually 5 years older than me and lives in my area.

He has back problems, and I have damage to my neck vertebrae, which was finally fixed by surgery.

Now they always confirm date of birth, and address before pulling my chart.
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Old 07-25-2019, 02:54 PM
 
2,391 posts, read 1,389,601 times
Reputation: 4209
Quote:
Originally Posted by MikeBear View Post
Are you SURE they didn't mix up your report with another person of the same name? They used to mix me up with another person with my exact name (except for middle name) who is actually 5 years older than me.

Now they always confirm date of birth, and address before pulling my chart.
No. I remember having an argument about the smoking during the exam. I just had the (apparently) mistaken impression that he listened to and believed my perfectly rational explanation about why he may have smelled smoke (I walked up some stairs apparently used by smokers instead of taking the elevator). I also told him I was a singer and that was why I never even tried cigarettes when I was younger (in the age of experimentation). He seemed to visibly relax and joke around after that. All a show, I guess.
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Old 07-25-2019, 03:15 PM
 
1,491 posts, read 874,925 times
Reputation: 2107
Quote:
Originally Posted by Jill_Schramm View Post
No. We had a dispute about “my smoking” during the exam. I thought I had cleared it up. Apparently, not. It just seems like he connected all the dots in the wrong way. Sick looking, thin person who is coughing and smells like smoker == smoker for him and not someone who is naturally thin, happened to have a bad head cold and just walked through a smoke-filled room.
Sorry to hear about this Jill..

Well you have two choices....report this doc to your state board for unprofessional and false info he put in your records.....you likely will have to find a new doctor before you do this....but do you want this guy on your team?

Or.....threaten him...hopefully in person...and tell him your plan....if he does not correct your record in your presence, get up, leave, and just say you will hear from my lawyer and the state licensing board..your choice

Do not let this continue..

Even if he promises to remove the info, he may not..

Good luck
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Old 07-25-2019, 03:21 PM
 
Location: northern New England
5,427 posts, read 3,990,335 times
Reputation: 21253
Quote:
Originally Posted by Jill_Schramm View Post
I didn’t actually say he was wrong. The “worst” part was this:

ENT: “I don’t think it’s lymphoma because in lymphoma the lymph nodes enlarge randomly throughout the body, not all in one place.”
Me: “Well, that’s true of some lymphomas. It is not true of Hodgkin’s.”
ENT: changes topic.


Well, it’s true. I have unfortunately spent way, way too much of my time reading about lymphoma and the fact that Hodgkin’s tends to progress in an orderly fashion from node to node and nodal region to nodal region is one of the things that distinguishes clinically from other lymphomas. In fact, there are medical text books with maps of exactly how it tends to spread in the body. In fact, it usually starts in the nodes in one side of the neck.

So, I challenged him in that one particular exchange. But it wasn’t exactly his specialty. I mean he’s an ENT, not an oncologist.

DH's initial presentation was ONE enlarged lymph node in the neck (on the side, where neck meets shoulder). I wouldn't be concerned about correcting your doctor, they forget 90% of what they learned in med school, by their own admission. If it bothers them, that's an ego problem.
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