Will a letter to my lab force them to give me a copy of the reports?

For every one patient like you that understands hyponatremia, I get 50 (usually with CHF) that think their low sodium means they need to put more salt on their food.

I can explain this to them easily enough but that takes time. And spending time with patients takes money or the practice goes under.

For those commenting about the misinterpretation of labs by their physician, wait until most of your care comes from a midlevel with far less training.

You hit the nail on the head with the skewed view of the medical world. I am a human being and of course am guilty of generalizing my patients. Most patients do not know latin and medical jargon, therefore, they accuse doctors of being arrogant “gods” for using such language around them. Other patients who are more knowledgable, think we are arrogant for using the words “low sodium” and assuming they don’t know what hyponatremia is. It starts to feel like a lose-lose situation that ultimately results in worse care for patients and unhappy medical personnel.

I personally give the lab print-outs to my patients if they ask and think that patients should be as informed as they want to be. I even *gasp* refer them to certain websites (up-to-date has a new patient website that is pretty good.) And as far as the comment about patients knowing enough about their disease to keep themselves alive…I agree. But as a doctor, I MAY know more about the other diseases that the patient doesn’t have. That’s where you need us to help interpret the tests.

This should be cooperative, not adversarial. Back to my original statement….caution needs to be exercised. A negative HIV 2 weeks after you engaged in high-risk behavior does not mean you don’t have HIV and I certainly don’t want that person interpreting their own test.

Amen, Robin.

I can tell you umpteen dozen causes of low sodium, explain the relation of low sodium to endocrine function, and give you step-by-step biochemical analysis. And why do I know that? Because I have to deal with it in relation to adrenal insufficiency and pituitary malfunction. So, no, I don’t need to know why just anyone might have low sodium. I just need to know why I might. And when I’m in a hospital/urgent care/ED, etc. facility which has no clue because they aren’t used to dealing with patients who have had pituitary surgery, it pays to know. I’ve been there and done that. If I hadn’t known, I’d have been in a heap of trouble.

I can give you names of a large number of patients just like me who needed to know that low sodium is a problem (and we know it’s called hyponatremia). Often delayed hyponatremia causes major problems for us even though it may be symptomless until at very dangerous levels. We understand DI and SIADH. We know what CSW is. We know the differential tests between those, and we know when, even normal, the difference between two of the normals means something (i.e. serum osmolality vs. urine osmolality).

My point: I didn’t ask you (the doctor) to sit down and explain this to me. I learned it with the help of a wonderful support group and some research. Oh, and a rare endocrinologist. There aren’t many like him. I know…I’ve seen way too many of them.

Don’t sell your patients short. I talk with lots of pituitary-dysfunctional folks like me, some who have next to no education and some who have more education than you. Both sets understand enough to keep themselves alive. They know what that report means as far as their disease goes. That’s what they need to know.

As for those few who don’t understand at all, that’s what caregivers are for. We use them for all other aspects of life, including finances and legal issues. You deal with caregivers all the time, I’m sure.

And why not have a doctor explain it to me? Gladly, if that doctor doesn’t wait 7 days or longer while I’m seriously ill. However, I’ve learned the hard way I can’t count on that from any doctor/doctor’s office. In a perfect world….well, you know…

Don’t judge all folks by your skewed view of mankind through the picture-frame of your small medical world. You don’t see the rest of us because we fight hard to stay out of your way. That’s why we get those lab reports.

And me…I keep putting those rose-colored glasses back on and seeing where faith in my doctors will get me, but I’m also skeptical enough to keep getting my own reports.

Peace…

On one hand, doctors on this board seem reluctant to give copies of test results to patients, or even if they are not, oftentimes it is their office staff who makes it difficult.

On the other hand, I’ve had doctors who were very appreciative that I’ve got blood test results going back 12 years.

Here in Virginia, Quest Diagnostics will directly mail a patient their test results, after the patient makes the request in writing. And they doesn’t charge the $10 per page that my internist does. In fact, the one time I did this, I got the results in approx. 7 days from Quest

I was perfectly happy to bypass the doctor’s office on getting this information.

Anyone with a complicated medical problem, I recommend they keep copies of their own medical records. It’s very helpful when they see multiple consultants, different hospitals in different cities. I ask the radiologists to make a copy of films; even better, the image is burned onto CD’s these days. Labs, operative reports, that sort of thing.

I get reports all the time I have to have help deciphering, from my car to my finances. That doesn’t mean I shouldn’t get the reports asap! And so do you.

Moof, I, too, get my lab results as soon as or sometime sooner than my doctors. I did the same as you. I do think that amenity varies by state, though, just from what has been shared on the Cushing’s boards.

Just because a patient is not a medical doctor does not mean a patient is a) dumb or b) uninformed. Nor does it mean that I, the patient, will call and expect you to help me for free. However, I do expect YOU to get in touch with me in a TIMELY manner when you receive reports with abnormal values. And I expect you to realize those values are abnormal.

Case in point: WHen I was first testing for Cushing’s, the lab ranges for serum cortisol at midnight (late-night) were posted as the 4 p.m. ranges. My PCP had no clue the ranges were wrong, thus my abnormally high cortisol which was reported as “normal” was not normal. Because I requested a copy of the test results, I could point this out to her. She has been very gracious to help me since then and listen, in turn. I believe we are partners in my healthcare. So does she. That’s the way it ought to be.

I also get copies of CT and MRI scans via CD and send those to other experts to read. If I had not, my pituitary tumor would have gone unnoticed by my local radiologists. The experts to whom I sent them saw it. This would never have happened without my own intervention.

I could tell more tales, and I know hundreds of other Cushing’s patients who could tell the same. For those hundreds, there are hundreds more whose stories I have not heard. And this is just one fraction of the sufferers of one disease.

Regards…