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Re: How could he have got it so wrong?From: anonymous (anonymous@obgyn.net)Wed Feb 14 18:53:01 2007
Pathologists are sometimes wrong that is why there is such a thing as "false positive" and "false negative". I had "normal" pap smears year after year so imagine my surprise when during an exploratory laparoscopy I was told that I had cervical cancer to the degree that it had invaded most everything else around it requiring a life-saving hysterectomy, removal of both ovaries and of course the cervix. This surely should have shown up in my pathology reports as cervical dysplasia first, right? I mean for 3 years I kept telling my doctor something felt wrong. But he, one of the top-rated ob/gyns in my town kept telling me I was just over-stressed and over-tired and I should nap during the day. (!!! do they teach them to say THAT in medical school?) Even "TOP RATED IN THE UNIVERSE" specialists can come up against a case they cannot completely resolve to the desired outcome of the patient. They are human and limited by their skill, knowledge, experience, regulations, guidelines, your disease AND your body's ability to recover! That's a lot of obstacles to overcome on the way to the top of that pedestal. A significant number of patients do not follow the directions on their medications taking either too much, too little or not properly spacing their doses. A significant number of patients abruptly discontinue treatment and cause the treatment to fail. And a significant number of patients do not recognize side-effects that they should report to their doctor. More worrisome is the significant number of patients being put on pain killers or other medications that are not appropriate to their condition. Pain killers are not all alike and they do not all work the same. (SPECIAL NOTE FOR THOSE ON NSAIDS: are you having trouble sleeping - either falling asleep or staying asleep? Don't take your NSAIDS near bedtime use something else instead and if you still have trouble sleeping ask your doctor about taking melatonin. NSAIDS interrupt the body's normal production of melatonin which is what lets you sleep.) All of these things can lead to the frustrated cry of "How could he have got it so wrong?" SO - to help make sure that our doctors get it right we have to do our part. We have to listen, read, follow directions to the letter and most importantly pay attention to our bodies and our symptoms and keep accurate records. BEFORE you accept a doctor's diagnosis and treatment ASK QUESTIONS and if you don't get answers that make you feel confident in making a decision get a second opinion. It doesn't matter whether the doctor is prescribing a drug or surgery you owe it to yourself to UNDERSTAND why this particular drug or surgery is being recommended to YOU. It really doesn't matter what your friend's aunt had done - she is not you and her disease is not yours. Far too many people make comparisons between themselves and other people and try to draw conclusions about their own treatment. You really are doing yourself a disservice by doing this. YOUR disease is unique and your treatment should be too. I don't particularly want a doctor who hands out cookie-cutter treatment plans because that means this doctor isn't interested in ME or MY health and can't be bothered to consider what other conditions I may have as well. Even things that are not seemingly related will affect how your body reacts to the treatment. For instance, a person with certain food allergies may not be able to tolerate a certain type of drug because of the way it is manufactured. So - with that having been said I must address a certain amount of inaccuracy in another statement. Adenomyosis is not "just endo in the uterine muscle" it is completely different and left untreated with repeated pregnancies can lead to a life-threatening emergency. Adenomyosis comes from trauma to the uterus and is 100% curable via hysterectomy whereas endometriosis is not. Please also note the use of the word MAY in the sentence that MRI and ultrasound MAY be used to diagnose adenomyosis. Because adenomyosis is thickening within the uterine wall it is not easy to see on MRI or ultrasound and would result in a report of PROBABLE or SUSPECTED adenomyosis and post-hysterectomy pathology would then provide a 100% positive diagnosis - it also provides a 100% cure.
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