Another argument for patient's access to their test results

Vic Nicholls nichollsvi2 at GMAIL.COM
Tue Apr 22 12:16:21 UTC 2014


I just got a "everything is NORMAL!" from one doc and there were several 
high and low values blatantly listed AND values that are *high/low for me*.

Yet doctors are the ones who tell us not to have the computer diagnose 
you. Obviously couldn't have been read by a human and if read by a 
doctor, this is scary ... I mean when 30 is the high for CO2 and your 
CO2 value is 32 ... you know?



As for that, *I* am the one who is explaining to doctors high albumin is 
caused by dehydration. Hypoalbumenemia causes metabolic alkalosis (why 
the CO2 is high, one of the things missed).

"Albumin is the major unmeasured anion and contributes almost the whole 
of the value of the anion gap. Every one gram decrease in albumin will 
decrease anion gap by 2.5 to 3 mmoles. A normally high anion gap 
acidosis in a patient with hypoalbuminaemia may appear as a normal anion 
gap acidosis. This is particularly relevant in Intensive Care patients 
where lower albumin levels are common. A lactic acidosis 
<http://www.anaesthesiamcq.com/AcidBaseBook/ab8_1.php> in a 
hypoalbuminaemic ICU patient will commonly be associated with a normal 
anion gap."

http://www.jcsm.info/documents/1302/Why_cachexia_kills_examining_the_causality_of_poor_outcomes_in_wasting_conditions.html
Thrombosis leading to expansion of unstable plaques leading to acute 
coronary syndrome and/or sudden cardiac death. Why my MPV & platelets 
are high.


I'm not suing these people, none of them have one shred of evidence that 
I have lawyers, but I do have the local medical schools' library use ... 
I'm trying to educate them. What does this say when a patient has had no 
TV in years and uses UpToDate, ClinicalKey, and medical journals, as the 
evidence to their doctor & they still miss it? I had one article from 
2003 that proved an issue and the doctor said in my notes, I don't know 
about anything that can cause this from the surgery.

A lot of us just want medical care and people to learn from their 
mistakes. Rescue us before the damage is done. My priority is Team 
Patient. If I'm wrong I suffer for it. If the doctor is wrong, I've 
never seen them suffer for it.

Victoria



On 4/21/2014 8:45 PM, Therese Rey-Conde wrote:
>
> I wonder if the group is reading too much into this dreadful mistake. 
> Isn’t it possible it was a simple “typo” i.e. the technologist pushed 
> the “reply all” button or something similar, in error?
>
> We’ve all been caught in that trap that at least once.
>
> Systems should be set up in organisations to prevent this from occurring.
>
> Therese Rey-Conde MPH
>
> *Therese Rey-Conde*
>
> Queensland Audit of Surgical Mortality Project Manager
> Northern Territory Audit of Surgical Mortality Project Manager
>
> RoyalAustralasianCollegeof Surgeons
>
> PO Box 7476 East Brisbane QLD 4169 Australia
>
> t: +61 7 3249 2903  |  m: +61 0488 585 301 f: +61 3 9249 1217
>
> _www.surgeons.org <http://www.surgeons.org/>_
>
> 	
>
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> Description: Description: Description: Description: Description: 
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> <https://www.facebook.com/pages/Royal-Australasian-College-of-Surgeons/114629924749>| 
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>
> *From:*Peggy Zuckerman [mailto:peggyzuckerman at GMAIL.COM]
> *Sent:* Tuesday, 22 April 2014 2:18 AM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* Re: [IMPROVEDX] Another argument for patient's access to 
> their test results
>
> Quite similar to this is the very frequent situation in which a 
> patient is told re the blood labs, "We'll call if there is a problem; 
> otherwise, don't expect to hear from us".  Stats indicate that some 
> 15-18% of labs with abnormalities are not reported to patients.  With 
> the millions of tests done, that percentage reveals a tremendous 
> weakness in our system, and another reason to be pro-active in getting 
> and reviewing one's own labs.
>
> Moreover, that statistic does not indicate whether the reported 
> problems suggested by the abnormal labs ever trigger the proper follow 
> up, not to mention are used efficiently in the diagnosis.  Case in 
> point:  a PSA test is higher than normal, and patient is told to see 
> specialist.  Is there a formal referral, are the abnormal labs 
> provided to the new specialist, are new labs prescibed, does the GP 
> inform expect and prepare for a response from the specialist?  No 
> stats on any of that, which are certainly "delayed diagnosis" incidents.
>
> If these labs and the value of them were EXPLAINED to patients, so 
> that they understood the importance of the abnormal reading, more 
> appropriate follow up by both patient and doctor would happen.
>
>








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