Monday, 1 June 2015

Update: The Search For Ultrasound

"Still getting pain -- right here specifically -- Guyons canal, the ulnar canal tunnel -- the anatomical term for the canal containing the ulnar artery and ulnar nerve right here at the base of your pinkie. The best current guess, and it is just a guess because the physiotherapy isn’t taking the pain away, that what it is is a tear of the triangular fibro cartilage complex, which you can see right here -- that’s the TFCC. Possibly that or possibly damage to the meniscus (Gesundheit!) a disc of cartilage found in some joints serving to adapt the artricular surfaces to each other. You have one meniscus in your wrist and two meniscuses in your knee."
 ~ Dave Sim (Weekly Update #83, 22 May 2015)

(via email, 31 May 2015)
Dave asked if I could share / repeat our phone tag conversations (I have both saved on my smart phone, but cannot figure out how to send it to you. Any ideas?). It was about Dave’s Weekly Update #83: The Search for Ultrasound.

Most of the comments posted were in reference to a facility or hospital where the test can be done near upstate New York. Well, I live in Eastern Pennsylvania too far to recommend a place. So, I thought I could help by finding the best equipment possible, upon my research I found that a Hitachi Airis II Open Air MRI is the latest and modern equipment being used. A closed MRI Might take a stronger image, but it might be a case of whose technology is up to date. The equipment must be ACR accredited and the software updated regularly.

I also found out that in Pennsylvania that it is a state requirement that you must have a doctor's referral and an appointment. I'm not sure if it is a federal requirement. An ultra sound for the hand/wrist area is a multi skeletal image which is not doable from what one representative had said. An MRI is better. One facility I spoke with will charge $500 for an MRI and $250 for an ultrasound. Hospitals charge way more.

Dave is very specific on what he wants. He wants NO APPOINTMENT, NO DOCTORS REFERRAL. He wants to walk in, take the test, and pay for the test get the results put on a disc, pay for it and walk out. Dave believes "doctors cover for each other", and he said,
" if he is an absolute butcher and has no idea what he is doing and if I'm going to have the surgery and find out 5 years later to have someone else say, no,no,no that’s not what you should have done. Now my hand is completely shot."
I'm just paraphrasing the voice message.

Every one I spoke with over the phone sounded like I was fool or something worse when I mentioned that I wanted to walk in, take the test, pay for it, and get the results and leave. I guess it's unheard of to take any medical test without insurance or doctor's referral. If you can imagine a dog looking at you funny when it hears a hi-pitched sound, if you know what I mean. I can't believe a person willing to pay for something and cannot get wants he wants is absurd.



Once posted, he believes there might be enough people on AMOC who might have a better understanding of the test results and gather their information/input and then he'll go to a specialist and show him/her what he wants the doctor to do to correct the problem.

I figured out if I used my wife's cell phone to video tape my voice mail from my smart phone to hear Dave's response from our phone tagging. So here it is, not very professional, but it worked. ~ Mike


Glen said...

So Dave wants to be able to see the best hand surgeon in the world and have state of the art medical tests done WITHOUT a doctors referral and appointment?

I can't even see my dentist without an appointment.

Good luck to him.

Anonymous said...

Words fail.

- Reginald P.

Jeff Seiler seilerjeff said...

Well, I totally see Dave's point of view, except for the no appointment part. Especially if he wants to do it in America. Still don't see why he couldn't do it in Canada, once he found out the exact specs of what "state of the art" is, except that I believe pretty much all medical procedures in Canada, except emergent ones, require a lengthy wait (essentially, an appointment months out from the current date). AND, I can certainly see why he would want it (whatever it ends up being) done sooner rather than later, even if it means doing it in the land of the free.

Someone needs to speak truth to power, so to speak, and get him to see the light about the no appointment part. I don't have the medical info, and I doubt that even if I could find it out from, say, The Mayo Clinic here in Minnesota, he would come here to have it done. But if any of you think he might, then I'm willing to contact The Mayo and see what I could find out. Hell, I need to talk to them about my hip anyway...

Michael said...

Good grief, Why in the world would the readers of AMOC know more about this issue than the specialist. The reason you go to a trained individual is you want to make use of their training and expertise.

If you fear the Doctor then crowdsource the Doctor search Get a list of the X best and independently see all of them to see if there is a consensus.

Regards Michael

A Moment Of Cerebus said...

It seems to me that Dave has made an incorrect assumption.

On their web-site Buffalo MRI state that although "You will need a doctor's referral prior to scheduling a study at our facility... You will leave Buffalo MRI with your films or CD in hand."

Jeff Seiler seilerjeff said...

My earlier comments here notwithstanding, it seems to me that the operative phrase in this voicemail from Dave, that best describes what he is doing here, is "swimming uphill". A Freudian half-slip?

Kacey said...

Dave's odyssey certainly sounds trying! However, being able to see a specialist like the doctor he describes under his terms is likely going to be difficult at best. Much often depends on his insurance carrier, his location (it sounds like he is in a more rural area, so travel to a larger city is generally a must), and his financial status. I hope he finds what he is looking for and reports back!

Kacey @ Glendale MRI