"Look at this!" I said as I reviewed the copy of my husband's chart after his discharge from the hospital. "Here is a copy of your blood chemistry test results done a year ago. Your BUN (kidney function test) was slightly above normal then! Did the doctor ever tell you that it was high? Was it ever repeated?"
I drive my husband crazy when I fire multiple questions at him before he can answer the first one.
"No and no. I do not remember the doctor saying any results were abnormal or saying he needed to repeat a test," he replied.
"I just do not understand why it was not repeated six months ago when your blood pressure suddenly increased or later when you turned that strange yellow color."
"Egad! Here are the results of the Retinol test the doctor did a couple of months ago. in fine print under the results box that says, 'high results are an indication of kidney failure.' He must not have read the note.
My heart sank. I began kicking myself for not paying more attention to and being more involved in my husband's medical care. He had been in very good health until the day he was admitted to the hospital on an emergency basis, told he was in kidney failure and might not live through the night. He had been reporting new symptoms and symptom changes to his doctor for six-months, but the doctor had failed to connect the pieces of his health story: symptoms, test results, and underlining chronic conditions.
During that time, we did not realize hidden clues in his test and procedure results.
Things have changed since then. We prepare well for, go to each other's appointments and take good notes. Due to this and past experiences, we now make sure we get a copy of every medical test we have done and read it very carefully.
You too can discover hidden clues in your medical tests and procedures.
1) Obtain copies of results for every medical test and procedure done.
2) Read each report carefully. If you do not understand the words, ask your doctor or his nurse to explain them to you.
3) Create a chart and record results from routine blood chemistry and blood count tests. As you look across each test result row on your chart, look for upward or downward trends over time or wide variations in test results in general. If one of these occurs, review your chart with your doctor.
4) Do the following to prevent important information from slipping through the cracks:
a) Read all notes included in the report to see if there is any information not mentioned by your doctor.
b) Verify that all tests reported to you as "within the normal ranges" are in the normal range.
c) If a test is just outside the normal range and the doctor told you everything is OK, he probably did not think the result a significant finding or was due to lab variation. This may be the case, but this is where it gets sticky. As you see from the story above, just outside the normal range results can be significant. Press the doctor, particularly if the test is remotely related to your symptoms, your condition (s), or conditions in your family history.
d) Ask your doctor to explain the implications of the result, if the test needs repeating in a reasonable time frame or at a different lab to verify the results, which you are risking if nothing is done, and what symptoms refer to an abnormal result ? You may have symptoms you had not thought to tell him.
5) Do your own research on the test. You may learn something that will help him understand why the result may be significant for you.
6) Seek a second opinion if your instincts are gnawing at you and saying something is wrong.
We have had other experiences of missing or hidden test information that led to medical errors, ineffective doctor appointments, or the need for additional appointments. By following the steps above, my husband and I have eliminated these problems. Not only that, we have been able to show copies of test results to physicians during emergencies, at specialist appointments, and during test procedures. The result: we have saved time, money, and anticipated errors. SO, CAN YOU.