Friday, March 22, 2013

incompetence or arrogant laziness?

I told the tale of the radiologist who failed to read my PET scan far enough south to find the obvious lesions in my femur a few posts ago (here) as I contemplated the emergent February pattern on my skeletal event horizon. To recap, there is lesion on my femur that was obviously visible in my December 2012 PET scan, providing the one looking actually looked.

The next time I saw my R.O. (Radiation Oncologist), Dr Z, she had the computer in the exam room, showing me the MRI I had done of the thoracic region right before my surgery. I asked her if she would pull up July's PET scan and see if the lesion in my femur had also been there in July.

YEP. There it was. Clear as day, if one but scrolled farther south through the slides.

If your brain isn't connecting the dots right now, let me help. The lesions that in December put me at risk of a femur fracture were also there in July. Also unreported. Had they been viewed and reported in July, would we have been able to stop those cancer cells in their tracks with some radiation, before more damage was done, and avoid this recent surgery and month of hell-pain and expense completely?

I have to think yes.

I saw my PCP/PA yesterday and she recounted to me her "chat" with the reading radiologist when she requested, over a month ago, that he take a re-look at the scan. Apparently, he was an arrogant prick (her words) to her on the phone, told her that if he had seen something he would have written it in the report (obviously he needs to be reminded that he won't see anything if he doesn't look), and that even though he didn't mention past evidences in the pelvis, since there was nothing new or active, no, he wasn't going to make an addendum.

Arrogant bastard. This was before Dr Z called him with evidence that he did, indeed, need to make an addendum, and that he had, indeed, failed to "see" and to "look". Again I hope she was her arrogant best on the phone with him.

When I see her next week, I will ask if she ever received that addendum.

I have cancer all over my bones. A PET Scan scans from mid-forehead to mid-thighs. I expect that whomever reads that scan looks through ALL of it, not just the areas where there was activity noted on the previous scan report. Cancer on the bones spreads. It grows. It travels. One of the reasons I have PET scans is to look for spread, growth and traveling.

While visiting with my PCP/PA yesterday, she confirmed that the same arrogant jerk read the December scan and July scan. My next move is to see if he read the one prior to that, and see if I can tell (by comparing to Dec and July) if the lesions were there, and how far back.

After I compile what I can discern from my reports and CD's that I always insist upon having, I plan to write a letter to the head of whatever practice this A-hole is with, and copy whatever board by whom he is certified. Or write to the board and copy the practice?

Suggestions on chain of command for writing this letter are appreciated. 

What are your thoughts?

What other measures would you take?


tccomments2013 said...

dear shelli,

i can only imagine how angry and shocked you must have felt about finding out it appears the lesions were there all that time; it's outrageous that the whole scan was not read! no one, NO ONE should ever have to experience such shoddy care and such an arrogant attitude; it will be interesting to find out if that asshole does provide an addendum. you might want to ask the doctor who discovered the incomplete read/documentation
of the scan if she documented her follow up with him. once you get the complete picture of the time line and what was there or not there on the scans and the written reports, you may be able to glean a direction to take by checking your state's medical board's site on line. i am so sorry that on top of all you are going through with bone mets, you have such a shitty issue like this to deal with. from what you have reported on this post my vote would be
incompetence AND arrogant laziness.

love, XOXO

karen, TC

The Dirty Pink Underbelly said...

THANK YOU, Karen! I really needed to hear that. I see the Rad Onc on Monday, and I hope to have more info compiled from my reports by then. I will definitely ask about the addendum, and about any documentation she may have done. Thank you!

Anonymous said...

How infuriating and hurtful to think that your femur could have been addressed so much earlier. The reading radiologist obviously has let his won arrogant laziness result in a dangerous incompetence.

I would insist on a second reading by an outside radiologist and use the findings (and those of your doctor) to put this in front of everyone he could possibly answer to, including the state boards. And mention the suffering that could have been avoided or ameliorated by prompt care. And don't leave out the lawyers and comments about potential liability. I'm not saying you should sue him, his medical corporation, the hospital where the scans were performed, etc. But if you don't get the responses you deserve, don't be afraid to go there.

I'm so sorry this happened to you Shelli. We put our trust in these people and it's hard when they show they don't care. I just left an arrogant, lazy AND incompetent neurologist. We've got much better things to do than deal with shit like this!

XOXO, Acacia

The Dirty Pink Underbelly said...

Thank you, Acacia. Follow-through is overwhelming, but I feel this isn't something that I can just let go. For one thing, how do I trust any reading I get again? Thank you for the encouragement and suggestions. I SHOULD get another radiologists to review my scans up to now. I hadn't thought of that. I will ask around about where I could go for that.

What response would make me happy and make feel I didn't need to bring suit? I don't know. Maybe a serious sanctioning of him, black mark on his record; what do they call it when someone is written up by their board? That's what I want. And for him to call and apologize to my PCP/PA for being an arrogant jerk. Thank you!

Carolyn said...

I'm so sorry Shelli, this crap is so hard to rationalize. I know, they missed the lesion on my vert twice, three different radiologists. It grew another 6 months before they relieved the pain. Just saying, I get it, the frustration, the anger, the overwhelming feelings... I

have let it go here, I didn't want to spend what time I have left with lawyers and courts. I'm told by my oncologist that the "men" have been dealt with. I don't know if that means more than a hand slap, but I hope so. Legal action here in Canada would lead virtually nowhere anyway.

My oncologist now personally reads all my scans. I have to count on him fully for that, rely on him, or drive myself nuts.

much love,

The Dirty Pink Underbelly said...

Carolyn, I haven't decided how far I want to pursue this. Definitely a stern letter, copied to everyone I can think of. That may be all the effort I can muster. I like the place where I get my scans done, the PET scan techs have always been incredibly kind, but I don't want that man ever reading my stuff again. I got the report in the mail today from xrays I had done earlier this week, and it sounds like my femur is more of a crumbled mess than I was led to believe, but I guess the surgeon is confident that it is stable now. I see him Monday.

I'm glad your oncologist will personally look at all your scans. I hope my Rad Onc knows I expect that out of her from now on, too. All we can do is stay on top of this cancer and combat the pain, which means being aware of what's going on, right? I'm so sorry you went to long in pain before it was figured out. I plan to nag everyone about my pains from now on until they can tell me exactly what is causing it. That's the plan anyway. I hope you're living more comfortably now! <3

Carolyn said...

Whatever it takes to help your mind process it, or let it go... I hope you do. Absolutely, we have to know what is going on! And, but the doctors, especially when things are not making sense. My last radiation onc told me to be the squeaky wheel, I have trouble being that woman, but I'm doing it anyway.

Nag away Shelli, I hope they listen... I am disturbed that your femur is so messed, and hope your doctor is right, that it is stable. I'm doing ok thank you dear. More pain in right side now than before surgery, so next weeks scans may help figure that out, or not. :) Left side is now livable. New pains are as disturbing as always. Onward darlin'... <3

Carolyn said...

"but" the doctors, I don't recommend butting the doctors. :)

Carolyn said...

Bug! Damnit. Bug!!! serious brain finger disconnect happening here.

The Dirty Pink Underbelly said...

Bless your heart, Carolyn, you made me grin. ;-)

Be the squeaky wheel. I am trying too. Trying not to let things drop, doctor to doctor. We have to do that!

The Dirty Pink Underbelly said...

I think I need to make a spread sheet for times when my brain can't keep tabs on the fact that Carolyn here is Carolyn on my FB blog page, and has a powerful blog also. It's a bit embarrassing, but I feel like I've made a breakthrough today! Rereading old comments in new light and connections.

I think I recently almost made the Karen TC connection...and now it escapes me.

tccomments2013 said...

dear shelli,

i saw what you wrote about the connection escaping you (karen, TC - that's me!) i used to be mostly annonymous or karen sutherland, but recently opened a google account, so now it's tccomments - which is SO confusing - why did i do that??!! but i digress.

i don't have a blog - i wish i was able to write my story, but it's been such a long and intense ride, and i have chemmobrain that is insane. "my" story is acutally "our" story. both my husband and i have cancer; hugh was dx'd with multiple myeloma in 2009, and just as he was recovering from the 2nd of 2 stem cell transplants, i was dx'd with ST IV metastatic BC in dec. 2011.

hugh has achieved CR, complete response from the SCT, and i am NED. since both our cancers are
"incurable", we both have never-ending check-up, scans, tests up the wazu - our calendar is a testament to dueling pillar to post all things medical.

when i first discovered the BC blogosphere, i was blown away. the people, the stories, the issues - at first it was soooo scary. but i decided i needed to put my own fears on the shelf, get involved in what i could, and eventually, this blogger wannabe found a way to give back for all the kindness and support hugh and i have received. i comment to provide support, to give validation, to offer whatever i am able to participate in conversations and initiatives to change the BC and the MM landscape, to share bits of hugh's and my story to help others know they are not alone.

it has been a privlege to be able do so; the responses from the comments overwhelm me with gratitude to feel included, to feel that i have something to contribute, and that i have learned so much from stories, like yours, written with such candor, such passion and healthy doses of humor, rants, tears, and hope.

i look forward to the next installment of your story, shelli. please know i think of you, and that i am sending you waves abd waves of my most powerful vibes for comfort and strength. i wish i could reach through the screen to give you a hug - but i KNOW you will feel the ones i send you compliments of cyberspace.

love, XOXO

karen, TC