Reviewing results of annual MRI ?

[leapyrtwins]

Question for those of you who have had annual MRIs since your AN treatment and for those of you who are currenting watching & waiting.

Is it customary for the doctor who orders your followup MRIs to go over the results with you even if there is no problem with the results?  By this, I mean, do you actually get to sit down at an appointment and go over the results, have the medical terms translated, review the films, etc., with him?

I'm asking this because I'm in kind of a dilemma.

I had my first annual MRI back in mid-April and at the time the doc ordered it he said we'd go over the results at my next appointment.  Well, my next appointment was today (obviously about 6 weeks later) so not wanting to wait that long to make sure everything was okay, I sent my doc an email asking him to please let me know via email that everything was status quo.  I figured this was fast and easy for him and fast and easy for me too.  I also mentioned that I would like to go over the results "formally" at my appointment today.

My doc subsequently emailed me and said the results were great.

About a week ago I emailed my doc again and reminded him of my BAHA appointment and said I'd like to review the films with him.  He said okay; bring the CD.  When I got there today, the CD wouldn't work on the laptop computer he had, so he went to use another computer in his office while I went to work with the audiologist.

While I was with the audiologist, the doc stuck his head in the room and said "everything's perfect", handed me the CD and said "don't forget you need another MRI in a year".  This wasn't really my idea of sitting down and reviewing the results, but in all fairness I didn't protest or ask him to spend time showing me the films.

Shortly after I left his office, I was kicking myself for not speaking up and telling him what I wanted, but I also wondered if my expectations were unrealistic.  I thought that maybe I was being childish or too demanding.

On one hand, I trust him implicitly and know he's not lying to me about the results.  On the other hand, I have a need to have the surgical site pointed out to me so that I can see with my own eyes that the AN is gone (note - the CD contains tons of images of my head and I'm not even sure which pictures are relevant).  I thought I had communicated this need very clearly in my email.

In his defense, he did have another patient - with her spouse - there at the same time I was and I know he was running behind schedule.  She was definitely a new patient and for all I know she was an AN patient and I know from experience that he spends lots of time with newbies.  I also generally find my doctor to be a great doctor and despite today's lack of attentiveness I still do.

I guess my question is, do I schedule another appointment so we can really review the results? or do I just let it go, despite the fact that it's obviously bothering me?  I won't have another MRI for about 10 months.

Input, please.

Thanks,

Jan

[Debbi]

Hi Jan-

I think that you and I are both "information junkies" who need to know a lot more than some of our doctor's other patients.  That being said, if it were me, I would probably call and schedule another appointment for the specific purpose of sitting down and actually reviewing the MRI. 

I am glad you brought this up, becuase when I go back in Sept for my first MRI I will want to make sure that I am clear with Dr. G that I want ALL the details.  Like you, I will want to see the pictures where the booger used to be! 

Meanwhile, enjoy the BAHA!!

Debbi - vancomycin junkie...

[er]

My  doctor that did the surgery never wanted me to bring the CD he wanted the real negatives and the old ones so he could compare himself to make sure everything was ok. So I have my old negatives except for this time because I have moved to Texas and I just had a regular doctor order my MRI.
That reminds me, does any one know how many MRIs or how many years do they check on you to make sure tumor is not coming back.? I would like to know so I can schedule an appointment with a neurologist.

But if you feel that you need to have that one on one visual exam and comparisons you need to do it you are paying him for his time not the other way around.

eve

[cmp]

Even if it's not standard for a doctor to do an in-depth review when MRI results come back OK, I think your desire to have a better understanding of what the films show and to be able to decipher them visually is perfectly reasonable and understandable, especially since this is your first annual check and you don't have another MRI for 10 months. I'd certainly request a second appt--a much better idea than resigning yourself to feeling unsatisfied and underinformed for almost a year!

Probably for most folks, just knowing they're in the clear is information enough, and I know that, for myself, before this new round with the AN I found looking at MRI films kind of creepy and wasn't really keen on seeing them (guess I associated them with that traumatic long-ago appt when the doc showed me the albino plum in my head!)

But I'm with you now, information is power, and I fully anticipate wanting to scrutinize the spot where the AN was and then wasn't!

(Also--how do you like your BAHA processor?)

Carrie

[leapyrtwins]

Thanks for the responses.  I'm still debating this one.  I don't want to be known as a "needy" patient, yet I don't personally want to think of myself as a "marshmallow" who can't stand up for herself.

I realize I'm a control freak at heart and I don't want that to play a part in this.  I'll probably sleep on it and then decide what to do.

Carrie -

the BAHA is "different" - which is not to say that I don't like it.  But it will take some getting used to.  There are more details under a subject titled "Can you hear me now?" started by my partner-in-crime, Lori 

Jan

[cmp]

thanks for pointing me to that thread, Jan--will have to check it out... I'm intrigued by the BAHA, though I don't know that I'd be a candidate since I have so little hearing in my usable ear.

Have fun getting used to yours, and good luck with your decision!

[sgerrard]

Jan,

I would call back and say that you thought you would be able to look at the MRI yourself on the CD, but once you did, you realized that you didn't know what to look at, so now you would like someone to show you where to look. Don't mention that you explained that three times already; act like it is a new request. Maybe you can coordinate it with a second visit to the audiologist on the new BAHA for whatever reason.

Steve

[leapyrtwins]

Interesting thought, Steve.  Never considered that, but it's not a bad idea.

Thanks for the input 

[wendysig]

Hi Jan -
Hope you don't mind if I put my two cents in.  Steve's idea is great and I agree with you that if you need the doc to go over the MRI with you, then he should, no questions asked.  Thsis is about you, not him.  It's his job to make sure you are taken care o of mentally as well as physically.  If this is what you need, then this is what you need.

Wendy

[leapyrtwins]

Wendy -

many thanks for your two cents.  I definitely want any and all opinions - I'm looking for different perspectives - which is why I started this post.

I understand that if this is what I need, then this is what I need.  But am I being too needy here?  If you were the doc, would you feel like I was questioning your judgement or undermining your authority?  I certainly don't want to make him feel insulted - as that is definitely not my intention.

Jan

[Jackie]

Hello Jan,

I am watch and wait and have had MRI's every 6 months. I always get the CD WITH the Radiologist's report then see my doctor for a complete explanation of both. He is an ENT and if he doesn't know the answer to my questions he is great about getting the answers for me! Next MRI is in July and I fully expect to sit down at his computer and go over the results, along with the new Audiologist's report too! I think you have a right to have the visual of what you went through explained to you! After all you have endured, it's called peace of mind, that you well deserve. Go girl!!!
Jackie

[leapyrtwins]

Hi Jackie -

thank you so much for your thoughts.  You are confirming that I decided just about an hour ago. 

I need the peace of mind and although my doctor may or may not understand this (I can't speak for him here), I don't think he'll object to giving me what I need. 

I appreciate the validation. 

Good luck with your MRI,

Jan

[GM]

If I don't ask for details....I don't get them.  Even though this has been a LONG process, and the same doctor is treating me, he still forgets that I am an informed patient.

So...ask about the results...I ask to see the tumor with him to see if my measurements were the same as his   

Gary

[Jim Scott]

Jan:

Here's my take.  I'm usually the curious type but on my last MRI/doctor visit, my appointment with my neurosurgeon was canceled on short notice because he was in surgery longer than he intended.  Since its a 60 mile round-trip to my neurosurgeon and the MRI facility, I didn't reschedule.  Instead, I called back a few days later inquiring about the status of my MRI result and after checking with the doctor, his secretary informed me that the doctor said "everything was O.K."

I trust this doctor implicitly so I was fine with that.  But I also decided that on my next visit, I would insist on a consultation regarding my latest MRI results.  Well, my next (6 month) MRI is scheduled for June 30th and I have a consult with the doctor scheduled for an hour after the MRI (his office is next to the hospital where I have the MRI scan).  Based on past experience, I expect my doctor will put the MRI disc on his computer and explain what we're looking at because, like you and most non-physicians, it might as well be a map of ancient Phoenicia for all I can tell.  I expect to be told that he sees shrinkage and necrosis and to show me that on the MRI photos, as he's done on previous occasions.  I'll let you know.

In your case, I suspect that you were probably a tad too diffident with the doctor (a common patient reaction to physicians) but were pleased with the good news and, as you admit, didn't want to be thought of as a 'needy patient'  Hardly, Jan.  A pro-active, well-informed patient is more accurate.

I would call back, using whatever pretext you think is most effective, and make another appointment with the express purpose of having the MRI photos explained.  To justify the visit, you may have to simply explain that you need this information for peace of mind.  Put the onus on you, not the doctor, and I doubt he'll take offense.  Besides, he'll be paid for his time by your medical insurance carrier.     

Frankly, as long as I'm assured that no growth is evident (but necrosis is) I don't care that much about actually seeing the MRI scan results, but I find that my neurosurgeon gives me such a clear and detailed explanation of the MRI scan that I find myself really interested.  He also gives me a mini neurological exam and is very inquisitive about my general health, which is reassuring.  In every past visit he's praised my recovery, which is encouraging.  I trust you'll have a similarly rewarding experience if and when you choose to see your doctor again to explain the results of your latest MRI scan.  To be honest Jan, I'm pretty sure you'll make that appointment. 

Jim

[leapyrtwins]

Thanks for the input Gary & Jim.

It's reassuring to know that I'm not considered "needy" - I'm considered well-informed 

Yesterday wasn't one of my better days, despite my shiny new processor, and I thought that maybe I was just being a little too sensitive about not reviewing the results.  My doctor and I have a very good rapport and he always listens to my concerns and answers my questions.  In addition to that, although he's not known as a "funny guy", he very obviously makes an effort to be humorous since he's realized I just can't live without a good laugh   I think one of the goals of yesterday's appointment just wasn't met for several possible reasons.

I have decided to communicate my frustration directly to my doctor and see if he is willing to sit down and review the results with me.  I thought that was much more honest than scheduling an appointment through his staff and then handing him my CD once again.  I also didn't want him to hear from one of his staff members secondhand that I was somewhat unhappy yesterday.  I think I owe him the courtesy of a firsthand explanation.

I'll keep you posted.

Jim - good luck with your MRI on June 30th; I hope the results are outstanding    And I just have to add, it's amazing how well you know me; you are very intuitive 

Jan