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How hard should I push?

How hard should I push?

Posted by Spinoza75 on Sep 22, 2020 1:59 pm

Last week, an incidental CT scan revealed renal lesions suspected to be small renal cell carcinoma (RCC). If it is cancer, it is small and it would appear that we caught them early.

The ER physician put in a requisition for an MRI on Sept 29th and even contacted the urologist to expedite the process toward diagnosis and treatment.

Unfortunately, the radiologist disagrees with the need to rush and has pushed back my MRI to Oct 26th. Perhaps there have been discussions behind the scenes but no one has been able to tell me why we need to wait and why we can’t go sooner. The only response I’ve received thus far is “well, they’re really small”. I’ve got a booking angel in my corner but she can’t help unless the radiologist concurs. It sounds like a/he disagrees with the ER physician, surgeon (who performed my appendectomy), and urologist.

It’s maddening to think I have to wait another month for a diagnosis but I am also concerned that the longer I wait, the greater the risk that every step along the way will be delayed. (For example, my consultation with my surgeon is contingent on the MRI.)  

I don’t want to be unreasonable but I’m also not wanting to wait around for no reason.

Any thoughts on how I should proceed? 

P

PS- I fully appreciate the challenges many of you have faced in waiting for tests/results/etc and that this is probably a minor inconvenience by comparison. Completely open to a reality check as needed.

Re: How hard should I push?

Posted by Laika57 on Sep 22, 2020 2:50 pm

Hi Spinoza75‍ ,
What can i say, depends on who you're dealing with...
hubby was diagnosed around the holidays. (Biopsy, 2 weeks to diagnosis, 2 weeks to see the surgeon, another week to have a more current ct done and another appointment with the surgeon...)
They gave him a follow up appointment with the surgeon and scheduled his CT for the week after (useless, right?).
i managed to call the imaging department and get his CT moved to the same morning before the appointment - more surprising still, the surgeon had the results by the time we made it across the street to his office.  (Though, i understand this surgeon is a big deal at that hospital, and that may have greased the wheels a bit).

You can try calling the imaging department at the hospital directly and see if they have an earlier date. though circumventing channels without good reason may peeve some people a bit.

Another thing to note is that not everybody is as good at reading these scans as a specialist. I'd probably trust the radiologist's opinion over an ER doc. And I'd be sceptical the urologist even bothered to look at the scans - but that's just my opinion of the system lately...

here you can get digital access to your scans and reports - that may give you a better idea if what the radiologist saw on the scan is deemed real or a blip.
Have you hugged your dog today?

Re: How hard should I push?

Posted by Spinoza75 on Sep 22, 2020 4:34 pm

Laika57

Thanks for writing back. Agreed it’s about who you speak with. We also have digital access to records and it’s been extremely helpful. Unfortunately, one thing I can’t access is the discussions behind the scenes. So I can only speculate on the decision.

Here’s the sequence of events (not speculation):
-Radiologist read CT scan (for appendicitis) and identified renal lesions making recommendation for consultation with urologist. (This is THE radiologist for the hospital.)
-ER physician (famous for going above and beyond) contacted urologist to advise of my case and contacted radiology to request urgent MRI.
-Urologist waiting for MRI prior to consult.
-Surgeon (for appendectomy) assured me no issue with MRI shortly after operation.
-MRI set for Sept 29th (2weeks after appendectomy)
-Admin handling booking in radiology thought 2 weeks was too soon and cancelled my appointment.
-Despite urging from urologist and ER physician, MRI set for Oct 26th (I.e. per booking, it’s now considered non-urgent) 
-Only rationale I’ve been given is from a different radiologist who advised that “6 weeks won’t make a difference”.

I’ve since met a “booking angel” and a nurse who are trying to move the appointment up but to no avail.

Just wondering if I should accept that radiology has deemed my case non urgent (this isn’t speculation either: I was told it’s not being treated as urgent).

In addition to wanting to know whether or not I have cancer, I’m concerned that the second wave of COVID will result in cancellations (and subsequent delay to diagnosis/treatment).

Re: How hard should I push?

Posted by Laika57 on Sep 22, 2020 6:12 pm

Ugh, sounds like it was a paper pusher and not a medical person who made that decision then. I would ask your specialist or even GP to advocate for you. But from what numbers other people are mentioning, 6 weeks is actually not a huge wait. (Sad, considering every time they let my husband get out of bed and he falls and hits his head, they do a CT right away...)
Have you hugged your dog today?

Re: How hard should I push?

Posted by CCC888 on Sep 22, 2020 7:37 pm

Hi Spinoza75‍ ,
I am not sure which province you live. In BC, my family doctor was (retired) always able to push forward a MRI scan to within 2-3 weeks before COVID. If I understand correctly, what he did was to specify urgent when he ordered the scan. CT scans was anyway walk-in if without contrast.

Two years ago, I had even tried to ask if he could push forward a bit for my CT/MRI scans which were ordered by my onco and obviously he said NO. 😁 Anyway, both scans happened in one and half week.

This was his reply in email.
"Cancer clinic always have priority to test appointments. Usually the onc see you when they have results to talk about. I think test likely before onc appointment."

 
 

Re: How hard should I push?

Posted by TorUkie on Sep 28, 2020 8:51 pm

Spinoza75‍  I was in exactly same situation exactly one year ago - when there was a strong suspicion for uterine cancer but MRI was far away. I was able to push it through, by literally coming to the MRI department in the hospital, explaining my situation and, honestly, crying, as I was so very scared.  I asked/begged for consideration and ended up having the scan 1 week after the referral - September 19th.  

The irony of it is that the MRI was is not an effective imaging morality for the kind of tumour I ended up with, so I only got properly diagnosed after the surgery.  

Still, no regrets in terms of helping move process along.