Tuesday, February 16, 2010

Read your Own Medical Reports!

Doctors and hospitals don’t always make it easy to take control of your health. Last week, I had a CT scan of my heart. It was harder to get a heart scan than a mammogram, even though nobody in my family has ever had a breast condition more serious than a pimple. This effective, inexpensive but under-used tool in cardiac medicine takes pictures of your heart that show how much calcium is there (i.e., a calcium score). The more calcium you have in your arteries, the more likely you are to have a heart attack or stroke. In many cases, the calcium buildup, or plaque, can be reduced or prevented. Since my biological mother died of a massive stroke at 54, and many members of her family have or had heart disease, I thought it would be wise to have a scan before my own heart attack or stroke. That’s just good planning.

Everybody I talked to at the hospital wanted to know which doctor ordered the test and seemed confused because I ordered it myself; today I had to sign a release form to get a copy of my own heart scan report. It’s a good thing I did.

Yesterday, after I left a message at my doctor’s office to find out the results, the doctor’s assistant left a message that the doctor hadn’t ordered a CAT scan and she couldn’t find anything in my file. Ten minutes later, she left another message that my CT scan (not CAT scan) was okay, but since I had a small nodule on my heart that was consistent with smoking, the doctor wanted me to have another CT scan in a year.

In contrast, here’s what the report actually said:

Coronary calcium score of 0….[There is a soft-tissue] 2-mm nodule….Based on current internationally recognized recommendations, no specific imaging followup is recommended for nodules of this size, unless there is a history of smoking, in which case a 1-year…followup CT is suggested.

Since I’ve never had a cigarette in my mouth, I won’t be getting the one-year follow-up. I also know now that if I’m careful, I might be able to avoid any calcium in my heart and arteries.

The report also stated that there may be a small hiatal hernia, which the doctor’s office didn’t mention. That would explain my stomach problems.

I may keep this report on me. In case I ever have chest pains, I can show the doctors that it isn’t my heart, and avoid a $40,000 medical bill for indigestion or a pinched nerve.

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