Interesting issue. Thanks for raising it, Cathy.
When I presented to my PCP with longterm, profound unilateral hearing loss, stabbing pains on one side of my head, loss of the sense of taste (and subsequent 30 pound weight loss), imbalance and fatigue he did some blood work, which showed nothing amiss, then sent me for an MRI scan, ostensibly to 'check out my sinuses'. The MRI scan showed that my sinuses were fine but that I had a large acoustic neuroma. He called me the same day I had the MRI (at 7:00 P.M. from his cell phone) to give me the news. Frankly, although I initially thought the MRI was 'overkill', I'm very glad my doctor was cautious enough to order it as quickly as he did and not waste my time and my insurance company's money chasing illusory problems when the MRI made it strikingly clear what the real source of my symptoms was.
I feel bad when I read posts from AN patients who were misdiagnosed for months and years, took useless medications and suffered because a doctor (often an ENT) didn't think it was necessary to order an MRI scan. Whether this reluctance to order an MRI scan stems from a physician's hubris or an aversion to annoying the health insurance companies who pay most of the doctors fees, it needs to be rectified. Frankly, because we can't control what doctors think, we have to be proactive with our health. My wife (who has never had an acoustic neuroma) is very good at that. She chooses doctors that listen to her and if she has a medical problem they can't find a reason for, they'll order the kinds of tests that can find the source - or rule it out, in some cases.
In the final analysis, it's not only our money paying for the tests and doctor's fees (via premiums, co-pays and taxes) but more importantly, it's our health and quality of life at stake. We can't afford to be passive with that and simply depend on the medical professionals to know everything and always come to the right conclusion, especially when a condition persists despite numerous, fruitless attempts to address it, usually with medicine. I'm certain that some doctors order 'unnecessary' tests as a CYA measure but I believe that if you have a good relationship with your doctor, he won't do that. If my doctor orders a test, I'll ask him why. If he dismisses my question or offers a vague answer, I'll press the point. A responsible physician should offer a cogent explanation. If that doesn't happen, consistently, find another doctor. I would, in a heartbeat. Again, it's your body and your quality of life at stake. You have to be proactive with your own health. This seems obvious but often, lack of information and a willingness to accept whatever the doctor says, even when what he says doesn't seem to make much sense (your symptoms don't improve) can lead to bigger problems and frustration, even anger, when the source of the symptoms are finally revealed, as with some AN patients who waste time with ENT-prescribed ear remedies when the problem is really an acoustic neuroma. If something isn't working, push for a test that may help you and your doctor find the source of the problem. In that scenario, no medical test, especially an MRI scan, is 'unnecessary'. Even if it shows nothing, an acoustic neuroma or brain tumor has been ruled out. That's significant information. Once again, I want to emphasize that the key is to be proactive.
Jim
