What's Up With Some Doctors?

Message

Appa23 · #1 Post by **Appa23** » Thu Jan 31, 2008 3:50 pm

I had posted last August about our baby having an operation to remove a large birth mole (congential nevus) from her scalp. The plastic surgeon removed approximately half at that time, and planned to remove the rest in six months.

As I mentioned in passing, the plastic surgeon did the second operation last Thursday, remvoing what little bit was left (as I noticed nothing on her scalp I am guessing that it was more below than above). He was in and out rather quickly, and it was performed in his office rather than the hospital this time (although still under general anesthesia).

Back in August, the pathology came back good.

My wife gets a call today (after having taken the baby in to the doctor's office on a scheduled appointment to see if the stictches were ready to come out). The nurse says that they have the pathology report, but they would not give the results over the phone. The doctor wants to see us. He has an opening in his schedule in TWO WEEKS.

Crazy-with-worry mother will not make it two weeks, so the rest of the household (including daddy who wants to see the postive side, but also worries) will not make it two weeks. [Except for blissfully-ignorant baby]

Fortunately, our pediatrician is a good friend, and her nurse (lets call her Betty) often takes pity on my wife. When she called our pediatrician, Betty told my wife, "That is totally unacceptable! Dr. ******* will not be in the office until tomorrow, but we'll call first thing to see if they will give her the results over the phone. Two weeks is to long to worry over nothing, and too long to wait to start any treatment."

MarleysGh0st · #2 Post by **MarleysGh0st** » Thu Jan 31, 2008 3:57 pm

Argh!

I think you and MarleysDad could have a good rant together.

ghostjmf · #3 Post by **ghostjmf** » Thu Jan 31, 2008 3:59 pm

Here's hoping for good news. Nevi usually are just overly vascularized blobs. I've read of kids made to live with them until puberty, because "some magically go away by then" (you kinda want to shoot whatever doctor makes that decision), but few that are or turn in to "the bad stuff". I've read of a dramatic case where the amount of vascularization going into the growing nevus was draining blood away from the kid's brain, but your kid's nevus is gone, so you don't have to worry about that part.

tlynn78 · #4 Post by **tlynn78** » Thu Jan 31, 2008 4:01 pm

SOmetimes dealing with doctors can be a challenge. Sounds like you've got a terrific pediatrician, however, so that's a blessing. Good vibes to you and yours.

t.

Appa23 · #5 Post by **Appa23** » Thu Jan 31, 2008 4:03 pm

ghostjmf wrote:Here's hoping for good news. Nevi usually are just overly vascularized blobs. I've read of kids made to live with them until puberty, because "some magically go away by then" (you kinda want to shoot whatever doctor makes that decision), but few that are or turn in to "the bad stuff". I've read of a dramatic case where the amount of vascularization going into the growing nevus was draining blood away from the kid's brain, but your kid's nevus is gone, so you don't have to worry about that part.

This nevus fell into the "giant" category. (Perhaps 2-3 inches in size, which is large on a newborn's scalp.) Apparently, in those situations, there is a migher risk of malignancy, at that time and in the future.

Part of me wonders if there isn't something pushing on her pituitary gland, seeing that she has skyrocketed up the growth charts in 10 months.

silvercamaro · #6 Post by **silvercamaro** » Thu Jan 31, 2008 4:26 pm

Sending best wishes that the pathology report comes quickly and offers total reassurance! I'm with your wife (and you) on impatience being absolutely reasonable in this case. In addition, I will remain hopeful that your daughter simply is destined to be very tall, which will assist her in gaining many opportunities, whatever her interests.

PlacentiaSoccerMom · #7 Post by **PlacentiaSoccerMom** » Thu Jan 31, 2008 4:45 pm

I think that if something was really wrong, you would be called in right away.

I wouldn't put up with waiting for two weeks. Hopefully you can get the results over the phone.

tanstaafl2 · #8 Post by **tanstaafl2** » Thu Jan 31, 2008 4:54 pm

ghostjmf wrote:Here's hoping for good news. Nevi usually are just overly vascularized blobs. I've read of kids made to live with them until puberty, because "some magically go away by then" (you kinda want to shoot whatever doctor makes that decision), but few that are or turn in to "the bad stuff". I've read of a dramatic case where the amount of vascularization going into the growing nevus was draining blood away from the kid's brain, but your kid's nevus is gone, so you don't have to worry about that part.

Perhaps you are thinking of hemangiomas? Nevi are neural crest cells and are made of melanocytic cells and sometimes neural tissue. They can sometimes lead to melanoma or rhabdomyosarcomas and other poorly differentiated tumors.

Henagiomas typically are a benign collection of capillary or venous structures that don't typically progress to malignancy although they can cause problems if they grow large rapidly or in an awkward location, such as around the eye. Superficial capillary hemangiomas often regress over time and even resolve completely.

tanstaafl2 · #9 Post by **tanstaafl2** » Thu Jan 31, 2008 4:56 pm

PlacentiaSoccerMom wrote:I think that if something was really wrong, you would be called in right away.

You would think but I wouldn't count on it.

PlacentiaSoccerMom wrote: I wouldn't put up with waiting for two weeks. Hopefully you can get the results over the phone.

Much too long. You should at the very least get a report ASAP and if there is a concern then f/u should be ASAP as well.

marrymeflyfree · #10 Post by **marrymeflyfree** » Thu Jan 31, 2008 5:08 pm

That is some crap imo.

I think a lot of md offices have policies against letting nurses interpret results or giving any results over the phone. I guess there are some good points to that, but the bonus for the doc is that he gets to bill for another visit even if there is nothing to discuss and everything is all clear. Or maybe I am cynical.

If the surgeon was away for that long, I think the prudent thing to do for your sake is to forward the results to your pediatrician at the very least, for peace of mind if nothing else. You did the right thing by calling them imo. Good luck!

jsuchard · #11 Post by **jsuchard** » Thu Jan 31, 2008 5:09 pm

I found this quote from the movie Juno to be apropos:

"Doctors are sadists who like to play God and laugh at the lesser people's pain."

mrkelley23 · #12 Post by **mrkelley23** » Thu Jan 31, 2008 5:44 pm

jsuchard wrote:I found this quote from the movie Juno to be apropos:

"Doctors are sadists who like to play God and laugh at the lesser people's pain."

Thank you, Dr. Suchard.

geoffil · #13 Post by **geoffil** » Thu Jan 31, 2008 6:35 pm

That is too long to wait and have to worry.

A lot of doctors here in Chicago have a results hotline. As soon as the results are known you get a call telling you to call an 800 number. You punch in your code and password and the recording gives you the results. If the results require an explanation it tells you to contact your doctor during a specified time.

TheConfessor · #14 Post by **TheConfessor** » Thu Jan 31, 2008 6:59 pm

Doctors could at least do what WWTBAM does. They should mail you a happy card or a sad card!

Hope you get good news soon, HD!

marrymeflyfree · #15 Post by **marrymeflyfree** » Thu Jan 31, 2008 7:04 pm

TheConfessor wrote:Doctors could at least do what WWTBAM does. They should mail you a happy card or a sad card!

hehe...my gynecologist does this for the annual chick exam. A postcard=good, a phone call=not good.

PlacentiaSoccerMom · #16 Post by **PlacentiaSoccerMom** » Thu Jan 31, 2008 7:48 pm

jsuchard wrote:I found this quote from the movie Juno to be apropos:

"Doctors are sadists who like to play God and laugh at the lesser people's pain."

You laugh a lot, don't you sweetie.

PlacentiaSoccerMom · #17 Post by **PlacentiaSoccerMom** » Thu Jan 31, 2008 7:51 pm

marrymeflyfree wrote:That is some crap imo.

I think a lot of md offices have policies against letting nurses interpret results or giving any results over the phone. I guess there are some good points to that, but the bonus for the doc is that he gets to bill for another visit even if there is nothing to discuss and everything is all clear. Or maybe I am cynical.

Doctors aren't reimbursed by insurance companies unless they do an exam.

HIPPA laws are really strict about who has access to information. For instance, legally, Jeff isn't supposed to look at my records at his hospital because he isn't my doctor. The nurse probably isn't allowed to look at your daughter's records.

fantine33 · #18 Post by **fantine33** » Thu Jan 31, 2008 8:08 pm

tanstaafl2 wrote:Much too long. You should at the very least get a report ASAP and if there is a concern then f/u should be ASAP as well.

This is very funny. And if it was unintentional, all the better. Ha!

Disclaimer: I partially emboldened Snoopy strictly for my pleasure and amusement.

Appa23 · #19 Post by **Appa23** » Thu Jan 31, 2008 9:37 pm

marrymeflyfree wrote:That is some crap imo.

I think a lot of md offices have policies against letting nurses interpret results or giving any results over the phone. I guess there are some good points to that, but the bonus for the doc is that he gets to bill for another visit even if there is nothing to discuss and everything is all clear. Or maybe I am cynical.

If the surgeon was away for that long, I think the prudent thing to do for your sake is to forward the results to your pediatrician at the very least, for peace of mind if nothing else. You did the right thing by calling them imo. Good luck!

Just to be clear. The surgeon is not away from the office. He simply does not have an appointment opening for two weeks.

The "evil" side of me couldn't help but think: "Maybe Mrs. Jones could wait until another day to discuss her mid-life crisis boob job and tummy tuck."

My thought was that they would have told us if it was anything serious, but am I 100% convinced of that point . . .?

BTW, we got the earlier pathology over the phone, from the nurse. (IIRC)

Appa23 · #20 Post by **Appa23** » Thu Jan 31, 2008 9:42 pm

PlacentiaSoccerMom wrote:
marrymeflyfree wrote:That is some crap imo.

I think a lot of md offices have policies against letting nurses interpret results or giving any results over the phone. I guess there are some good points to that, but the bonus for the doc is that he gets to bill for another visit even if there is nothing to discuss and everything is all clear. Or maybe I am cynical.

Doctors aren't reimbursed by insurance companies unless they do an exam.

Our insurance has paid for meetings where there has not been an exam (pre-surgery and post-surgery). It is good insurance.

HIPPA laws are really strict about who has access to information. For instance, legally, Jeff isn't supposed to look at my records at his hospital because he isn't my doctor. The nurse probably isn't allowed to look at your daughter's records.

It certainly has not been the case with our Pediatrician's nurse. We constantly are dealing with her over the phone on minor medical issues.

thguy65 · #21 Post by **thguy65** » Thu Jan 31, 2008 11:25 pm

fantine33 wrote:
tanstaafl2 wrote:Much too long. You should at the very least get a report ASAP and if there is a concern then f/u should be ASAP as well.
This is very funny. And if it was unintentional, all the better. Ha!

Disclaimer: I partially emboldened Snoopy strictly for my pleasure and amusement.

For those who are not familiar, the abbreviation "f/u" is standard medical shorthand for "follow-up".

MarleysGh0st · #22 Post by **MarleysGh0st** » Fri Feb 01, 2008 6:47 am

thguy65 wrote: For those who are not familiar, the abbreviation "f/u" is standard medical shorthand for "follow-up".

Of course, it is.

gsabc · #23 Post by **gsabc** » Fri Feb 01, 2008 7:34 am

MarleysGh0st wrote:
thguy65 wrote: For those who are not familiar, the abbreviation "f/u" is standard medical shorthand for "follow-up".
Of course, it is.

My favorite "Odd Couple" line, from Oscar (Walter Matthau):

"I'm sick and tired of your little notes! 'We are all out of orange juice, FU.' Took me all morning to realize that FU stood for Felix Unger!"

fantine33 · #24 Post by **fantine33** » Fri Feb 01, 2008 10:33 am

thguy65 wrote:
fantine33 wrote:
tanstaafl2 wrote:Much too long. You should at the very least get a report ASAP and if there is a concern then f/u should be ASAP as well.
This is very funny. And if it was unintentional, all the better. Ha!

Disclaimer: I partially emboldened Snoopy strictly for my pleasure and amusement.

For those who are not familiar, the abbreviation "f/u" is standard medical shorthand for "follow-up".

That's what makes it funny. Even more so if he was just writing it straight and didn't realize how it would read cold. Then again, maybe it's just me, because my doctor and I always make f/u jokes when he does his doctor's notes.

tanstaafl2 · #25 Post by **tanstaafl2** » Fri Feb 01, 2008 11:00 am

fantine33 wrote:
tanstaafl2 wrote:Much too long. You should at the very least get a report ASAP and if there is a concern then f/u should be ASAP as well.
This is very funny. And if it was unintentional, all the better. Ha!

Disclaimer: I partially emboldened Snoopy strictly for my pleasure and amusement.

Ya got me this time. Unintentional and still something of a mystery to me.

But as long as you are amused I'm happy!