Sunday, February 01, 2009

Having an MRI? They are Not Created Equal

Someone once told me an X-ray is only as good as the technician taking it and the radiologist reading it. I was told before getting my first mammogram. The woman said despite getting routine yearly mammograms she ended up with late stage breast cancer she only found with self-exam. I said "Whoa, how can that be, with mammograms so highly touted as the first best early diagnosis defense?"

That's when she said she found out that mammograms and any scan are only as good as the tech doing them and the radiologist reading them.

Read the above article about MRI's by clicking the post title. I guess you can add to that statement that scans are only as good as the machine doing them too.

Seems some MRI machines are not accredited and some have very low capacity magnets, especially the open MRI machines currently popular with claustrophobic and obese patients. The gold star is Tesla 3 strength magnet, according to the article and to have a radiologist reading the MRI specialized in reading images and knowledge of the problem body part or organ.

I remember when I got back X-ray once. It showed something nobody expected--a large lesion in my pelvic bone right at the hip joint. My doctor said I needed to see a bone specialist, to look at the X-ray and determine if this was cancer or just what. He sent me to somebody at the Corvallis clinic. But he was hardly an expert on bone lesions. His bone speciality experience was mostly broken bones.

The night before seeing him I memorized a medical student short cut to the I think it was 11 possible causes of a bone lesion. At the appointment, the doctor did not even know these common causes. I had to spit them out for him. All eleven.

In the end, he said to come back in six months to see if it had changed. When I came back, he had not ordered from records, or could not find, the orignal X-ray so there was no way to even compare the X-ray taken that day and the one of six months ago. He then told me he thought he could remember that the X-ray six months ago looked exactly the same and had not changed in size from the one taken just before this appointment. He wanted me to come back in six months again. I told him this was bullshit, that nobody could remember with any accuracy an X-ray taken six months ago when he could not even remember my name. I never went back.

It was bullshit. The worst bullshit of it was in the initial appointment. He didn't apparently have knowledge or memory from medical school of bone lesion causes. This would make him inept at interpreting an X-ray of a bone lesion.

I was, at that time, on the Oregon Health Plan. So both appointments and one X-ray were a waste of taxpayer dollars. If a person had paid out of pocket for those two visits and the second X-ray (the first was ordered due to my severe back problems), only to go be sent to a doctor that really knew nothing about bone lesions at all, what a total waste of money that is. It's like if you had something wrong with your car and had to go to only one certain mechanic to get that problem fixed, (due to enrollment in a managed car repair plan) and he said "well I don't know anything about this" and charged you hundreds of dollars anyhow. Same thing. Rip off!

I don't know if that lesion is still there or not, what caused it, if its gotten bigger or filled in. A couple months prior to that first X-ray I had come out of my little shack in Corvallis, in the dark, totally exhausted, to unload cats just fixed at a clinic, from my car. I'd forgotten about the cinder block sitting to the side of the front porch and tripped over it hard. I went flying, landing on my right hip, immediately sparking horrendous pain. I couldn't even get up and thought for sure I'd broken my hip or pelvis. I was eventually able to crawl back inside. I had a huge bruise from the fall (I landed on a fist size irregular rock). It is possible that very bad fall jammed my leg bone up against my pelvic bone at the hip joint and that the trauma of the blow to my pelvic bone created the lesion right above the hip socket.

It's also possible I was born with it. It's also possible it is something worse, too. So far so good. I was told if it remains, I have a far greater risk of breaking my hip right there. There was only a teensy bit of bone left between the lesion and the margin of the hip socket.

I"ve been skeptical of mammograms somewhat. I know they save many lives. My skeptic nature is only because of one incident in which I had a mammogram in the afternoon of one day and received the results, saying everything was fine, in the mail the next day. This is impossible. I was told the mail had to go through the whole hospital complex mailing system too, which further led me to skepticism, about this event.

It led me to wonder if the results were premailed out accidentally and the mammogram was never really read. This was years ago, when my inferiority feelings and paranoia were far greater than they are currently. Those problems coupled with an active imagination, led me to wonder if the mammograms of people with bad or no insurance were never really read by an anesthesiologist, in a cost cutting measure. That one incident has colored my skepticism of mammograms ever since, however. I know its silly.

But I no longer feel getting my yearly mammogram is really very helpful. I do it anyway, because it's so ground in. It's like I think I'll die for sure if I don't get one. Almost like being raised a Christian. Even though I'm extremely skeptical about man made religion, I want at least one foot on the heaven train just in case.

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