Protein grams and portion control??? Pastorio?

Discussion in 'Food and nutrition' started by OmManiPadmeOmelet, Feb 16, 2006.

  1. Boron Elgar

    Boron Elgar Guest

    On Thu, 23 Feb 2006 12:45:55 -0600, OmManiPadmeOmelet
    <[email protected]> wrote:

    >In article <[email protected]>,
    > Boron Elgar <[email protected]> wrote:
    >
    >> On Thu, 16 Feb 2006 15:00:45 -0600, OmManiPadmeOmelet
    >> <[email protected]> wrote:
    >>
    >>
    >> >Be sure to get a hemoglobin A1C

    >>
    >> Unless there is some reason to run an HBA1c, it will not be done.
    >>
    >> IIRC, you work in a lab, so you know that fasting BG is part of the
    >> usual blood work conducted for routine exams. Unless the fasting BG or
    >> a GTT is unusual or something else is suspected or being monitored for
    >> some reason, they wouldn't even be able to code it to get an insurance
    >> company to pay for an HBA1c.
    >>
    >> Me? I get one every 3 months, but I am a diabetic. (Always below 6.0
    >> for me)
    >>
    >> Boron

    >
    >Fortunately, that test is being ordered more frequently now as a
    >SCREENING test for type II diabetes early onset as it's more indicative
    >than a fasting glucose. If you can catch that condition in time, it can
    >be corrected with diet (and Metformin) before it does irreversible
    >damage...


    Insulin resistance shows up in fasting BGs, too, if they are tracked
    over time or repeated if out of range.....and unless there are some
    other risk factors involved, some indication of metabolic syndrome,
    the HBA1c is an unusual test to order. There has to be some reason
    for it. It is not part of a "normal" screen. It just isn't and I have
    seen no guidelines that suggest it should be.

    >Insulin resistance with obesity is becoming more and more common
    >nowadays and often indicates a good chance of becoming a type II
    >diabetic.


    But just being obese will not trigger any protocol for including an
    HBA1c . I mean, it'd be swell and all, but unless something else shows
    in the blood work, or other risk factors are involved, it is an
    expensive test to use as a common screen and no medical source I have
    seen recommends that it be used that way.

    I had a real porky mama whose blood sugar was normal her whole life. I
    had a skinny dad who developed diabetes in his 40s (along with a lot
    of other skinniest on his side of the family). Go figure.

    >A glucose tolerance test is not a bad thing, but it's kinda being phased
    >out now except for pre-natal workups.


    Quite true, but you'd be surprised at what some docs will order. AND
    there are a lot of docs who will work with a patient to make sure that
    they are treated for any developing insulin resistance in order to
    prevent a diagnosis of diabetes being on the records. Once a diagnosis
    like that is made, all hell can break loose with health insurance,
    life insurance, etc. Even ordering an HBA1C can raise eyebrows at an
    insurance company. Again, it has to be coded to be done and that means
    some reason needs to be found to do it.

    Boron
     


  2. In article <[email protected]>,
    Boron Elgar <[email protected]> wrote:

    > Insulin resistance shows up in fasting BGs, too, if they are tracked
    > over time or repeated if out of range.....and unless there are some
    > other risk factors involved, some indication of metabolic syndrome,
    > the HBA1c is an unusual test to order. There has to be some reason
    > for it. It is not part of a "normal" screen. It just isn't and I have
    > seen no guidelines that suggest it should be.


    It's a recent development. :)
    It's happening at our hospital, especially with docs that do a lot of
    weight loss work with their patients.

    Granted, more docs still use it for tracking diabetic therapy, but we
    are seeing more and more of them ordered with people's annual lab work.

    When you only have 1 set of blood tests per year, the A1C is going to be
    far more indicative of an "average" daily blood glucose level than a
    random fasting BG.
    --
    Peace, Om.

    "My mother never saw the irony in calling me a son-of-a-bitch." -Jack Nicholson
     
  3. Boron Elgar

    Boron Elgar Guest

    On Thu, 23 Feb 2006 13:36:02 -0600, OmManiPadmeOmelet
    <[email protected]> wrote:

    >In article <[email protected]>,
    > Boron Elgar <[email protected]> wrote:
    >
    >> Insulin resistance shows up in fasting BGs, too, if they are tracked
    >> over time or repeated if out of range.....and unless there are some
    >> other risk factors involved, some indication of metabolic syndrome,
    >> the HBA1c is an unusual test to order. There has to be some reason
    >> for it. It is not part of a "normal" screen. It just isn't and I have
    >> seen no guidelines that suggest it should be.

    >
    >It's a recent development. :)


    The increased usage is, but I'd like to see them get it past the
    insurance companies without a diagnosis code to cover it.

    >It's happening at our hospital, especially with docs that do a lot of
    >weight loss work with their patients.


    Docs doing a lot of weight loss work are dealing with a specialized
    population.
    >
    >Granted, more docs still use it for tracking diabetic therapy, but we
    >are seeing more and more of them ordered with people's annual lab work.


    That is more likely do to the increase in diagnosed T2s and increase
    in risk factors in the pop.
    >
    >When you only have 1 set of blood tests per year, the A1C is going to be
    >far more indicative of an "average" daily blood glucose level than a
    >random fasting BG.


    But why do an expensive test without cause? Of course it is more
    accurate than a random fasting BG, but spending money on unneeded
    tests makes no sense. I think you'll find that there are reasons you
    are running more HBA1cs, and that it is due to cause.

    How fortuitous....

    I just got off the phone with my GP, as I had lab work done on Monday
    (pre-cert for minor surgery). I asked her about this and she told me
    that she never orders it without some reason to do so and that a
    annual physical in an otherwise healthy adult is not cause. It would
    only be ordered for someone who is in a high risk category and being
    watched or tracked (long term steroid use was one example she used) or
    someone already diagnosed as diabetic.

    Why not go talk to some of these docs who are ordering these tests in
    your hospital and find out why they are ordering them?

    Boron
     
  4. Dee Randall

    Dee Randall Guest

    "OmManiPadmeOmelet" <[email protected]> wrote in message
    news:[email protected]
    > In article <[email protected]>,
    > "Dee Randall" <[email protected]> wrote:
    >
    >> At my doctor's last visit, regarding two different tests in the same
    >> day -
    >> he had his nurse call me and tell me to take calcium (Dexascan -
    >> osteopenia)
    >> and on the other test results, he had her call me and tell me to stop
    >> calcium altogether. When I questioned this with some other nurse who
    >> called
    >> to see what the trouble was with my thinking, I never got a return call
    >> when
    >> she said she would look into it. There have been other things along
    >> these
    >> lines, too. Time to look for ANOTHER doctor.
    >> I say, Bullshit, too.
    >> Dee Dee
    >>
    >>

    >
    > <lol> Sounds like someone too busy to correlate results...
    >
    > Why did they want you to stop taking Calcium?
    >
    > And for the record, Calcium by itself is not really utilized properly
    > anyway.
    >
    > Short story here:
    >
    > When I first started weight lifting and eating a high protein diet
    > wayyyyy back when when I was about 30, I started developing leg cramps.
    >
    > Not just ANY leg cramps, but Quadricep cramping that would wake me up at
    > 2 am and have me nearly passing out with the pain. :-( I have a very
    > high pain tolerance but this was about a 12 on a scale of 1 to 10!
    >
    > Turns out that eating more protein tends to cause the kidneys to dump
    > more calcium, so you need a higher supplementation rate. One good reason
    > to eat yogurt and cottage cheese. <G>
    >
    > Anyhoo, I tried 4 different types of calcium supplements over time with
    > varying results, but none of them were adequate for stopping those early
    > morning episodes of sheer hell. :-(
    >
    > I spoke with one of or ER docs about it, (one that I knew had a side
    > practice of "complementary medicine" where he used nutritional and
    > herbal therapies in combination with standard medical practices).
    >
    > He told me that the problem was that I was taking CALCIUM, by itself!!!
    > He said that calcium works together in balance with Magnesium and
    > Phosphorous to keep blood levels stable.
    >


    Thanks for the information. Yes, I know about the balance. DH gets legs
    cramps awful and he pops about 5 sublingual magnesium pills under his tongue
    when this happens (he does take calcium & phosphorous supplements.)

    I am not a big believer in calcium supplements. I do believe in eating
    cheese and yogurt and not necessarily milk. I've read the stastics on the
    Bantu who do not drink milk and don't get osteoporosis. When I stopped
    supplementing and stopped drinking milk, but eating cheese, I acutally
    gained 6% bone. (I do take a regimen of vitamins, but basically they are at
    the rates that are mostly recommended and I don't overdo any of them.)

    However, my blood test results have always showed a couple of .points (as
    in .3) points over the calcium level of around 10. I've been told that it is
    nothing to worry about this smaller .point number above normal; and I've
    also been told that the reason for a higher level of calcium in the blood
    backs up the fact that you are leaching calcium from the bone and it is
    showing up in the blood.

    The doctor said to take more calcium because I was still a little under the
    numbers on the Dexascan and still considered having osteopenia. That was
    the first call. Then the second call he related to the 'blood test' being a
    few .points over and he said to not take calcium. I had discussed the above
    average calcium level previously and he said there was nothing to worry
    about. Now all of a sudden he tells me to stop taking calcium. It was the
    nurse who relayed this information to me, but his notes on the report
    confirm that these were his recommendations in both instances.

    A day before the above relaying of information, the nurse wrote me a note
    and said that my spine showed better improvement and my hips less; when
    actually any person could read the chart and see that it was actually the
    opposite. She said she got this information from the doctor's words.

    This is not a matter of great importance in the great scheme of things, but
    if and when something greater does happen I don't want anything to do with
    these rattled people. There have been a few things that I consider more
    crucial to my health that has happened. This has just been the straw that
    broke the camel's back.
    Thanks for listening.
    Dee Dee
     
  5. In article <[email protected]>,
    Boron Elgar <[email protected]> wrote:

    > On Thu, 23 Feb 2006 13:36:02 -0600, OmManiPadmeOmelet
    > <[email protected]> wrote:
    >
    > >In article <[email protected]>,
    > > Boron Elgar <[email protected]> wrote:
    > >
    > >> Insulin resistance shows up in fasting BGs, too, if they are tracked
    > >> over time or repeated if out of range.....and unless there are some
    > >> other risk factors involved, some indication of metabolic syndrome,
    > >> the HBA1c is an unusual test to order. There has to be some reason
    > >> for it. It is not part of a "normal" screen. It just isn't and I have
    > >> seen no guidelines that suggest it should be.

    > >
    > >It's a recent development. :)

    >
    > The increased usage is, but I'd like to see them get it past the
    > insurance companies without a diagnosis code to cover it.


    Docs are going to be skilled at coding...
    Obesity is rampant in the US and puts one at higher risk for Type II.
    IMHO that seems to justify it?

    >
    > >It's happening at our hospital, especially with docs that do a lot of
    > >weight loss work with their patients.

    >
    > Docs doing a lot of weight loss work are dealing with a specialized
    > population.


    Yah. About 60% of the US population. :-(

    > >
    > >Granted, more docs still use it for tracking diabetic therapy, but we
    > >are seeing more and more of them ordered with people's annual lab work.

    >
    > That is more likely do to the increase in diagnosed T2s and increase
    > in risk factors in the pop.


    I see you just made my point, thanks!

    > >
    > >When you only have 1 set of blood tests per year, the A1C is going to be
    > >far more indicative of an "average" daily blood glucose level than a
    > >random fasting BG.

    >
    > But why do an expensive test without cause? Of course it is more
    > accurate than a random fasting BG, but spending money on unneeded
    > tests makes no sense. I think you'll find that there are reasons you
    > are running more HBA1cs, and that it is due to cause.


    I see your point there, but again it has to do with the fact that adult
    onset type II can come on rather quickly and cause a lot of damage
    before you pick it up. The cost for that test at our hospital, including
    the venipuncture and administrative fees is $75.00.

    A standard profile runs more than that and if it's only annual, well,
    let's just say it's not a bad idea!

    Indications? If you feel you are at risk for whatever reason, I'd say
    that's indication enough?

    >
    > How fortuitous....
    >
    > I just got off the phone with my GP, as I had lab work done on Monday
    > (pre-cert for minor surgery). I asked her about this and she told me
    > that she never orders it without some reason to do so and that a
    > annual physical in an otherwise healthy adult is not cause. It would
    > only be ordered for someone who is in a high risk category and being
    > watched or tracked (long term steroid use was one example she used) or
    > someone already diagnosed as diabetic.
    >
    > Why not go talk to some of these docs who are ordering these tests in
    > your hospital and find out why they are ordering them?


    I've only talked to my own doc. She orders them as an annual test on all
    of her patients because she feels it is far more accurate.....

    >
    > Boron

    --
    Peace, Om.

    "My mother never saw the irony in calling me a son-of-a-bitch." -Jack Nicholson
     
  6. Dee Randall

    Dee Randall Guest

    >
    > Why not go talk to some of these docs who are ordering these tests in
    > your hospital and find out why they are ordering them?
    >
    > Boron


    OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read the
    fine print (on the front page) that this CT would NOT be done without the
    submission of proof of blood test level of one particular thing, which I do
    not remember at the moment.
    This was an imaging facility/office where people come and go all day, but I
    was not asked if I had had this blood test as a requirement for getting the
    CT.

    In my case I should be asking the doctors at that facility why in the h....
    absolutely no one had ordered this test prior, or reception personnel didn't
    required that I had the papers to prove that I had had it done.

    Why was no one ordering them?
    It goes both ways.
    Dee Dee
     
  7. In article <[email protected]>,
    "Dee Randall" <[email protected]> wrote:

    > "OmManiPadmeOmelet" <[email protected]> wrote in message
    > news:[email protected]
    > > In article <[email protected]>,
    > > "Dee Randall" <[email protected]> wrote:
    > >
    > >> At my doctor's last visit, regarding two different tests in the same
    > >> day -
    > >> he had his nurse call me and tell me to take calcium (Dexascan -
    > >> osteopenia)
    > >> and on the other test results, he had her call me and tell me to stop
    > >> calcium altogether. When I questioned this with some other nurse who
    > >> called
    > >> to see what the trouble was with my thinking, I never got a return call
    > >> when
    > >> she said she would look into it. There have been other things along
    > >> these
    > >> lines, too. Time to look for ANOTHER doctor.
    > >> I say, Bullshit, too.
    > >> Dee Dee
    > >>
    > >>

    > >
    > > <lol> Sounds like someone too busy to correlate results...
    > >
    > > Why did they want you to stop taking Calcium?
    > >
    > > And for the record, Calcium by itself is not really utilized properly
    > > anyway.
    > >
    > > Short story here:
    > >
    > > When I first started weight lifting and eating a high protein diet
    > > wayyyyy back when when I was about 30, I started developing leg cramps.
    > >
    > > Not just ANY leg cramps, but Quadricep cramping that would wake me up at
    > > 2 am and have me nearly passing out with the pain. :-( I have a very
    > > high pain tolerance but this was about a 12 on a scale of 1 to 10!
    > >
    > > Turns out that eating more protein tends to cause the kidneys to dump
    > > more calcium, so you need a higher supplementation rate. One good reason
    > > to eat yogurt and cottage cheese. <G>
    > >
    > > Anyhoo, I tried 4 different types of calcium supplements over time with
    > > varying results, but none of them were adequate for stopping those early
    > > morning episodes of sheer hell. :-(
    > >
    > > I spoke with one of or ER docs about it, (one that I knew had a side
    > > practice of "complementary medicine" where he used nutritional and
    > > herbal therapies in combination with standard medical practices).
    > >
    > > He told me that the problem was that I was taking CALCIUM, by itself!!!
    > > He said that calcium works together in balance with Magnesium and
    > > Phosphorous to keep blood levels stable.
    > >

    >
    > Thanks for the information. Yes, I know about the balance. DH gets legs
    > cramps awful and he pops about 5 sublingual magnesium pills under his tongue
    > when this happens (he does take calcium & phosphorous supplements.)
    >
    > I am not a big believer in calcium supplements. I do believe in eating
    > cheese and yogurt and not necessarily milk. I've read the stastics on the
    > Bantu who do not drink milk and don't get osteoporosis. When I stopped
    > supplementing and stopped drinking milk, but eating cheese, I acutally
    > gained 6% bone. (I do take a regimen of vitamins, but basically they are at
    > the rates that are mostly recommended and I don't overdo any of them.)
    >
    > However, my blood test results have always showed a couple of .points (as
    > in .3) points over the calcium level of around 10. I've been told that it is
    > nothing to worry about this smaller .point number above normal; and I've
    > also been told that the reason for a higher level of calcium in the blood
    > backs up the fact that you are leaching calcium from the bone and it is
    > showing up in the blood.
    >
    > The doctor said to take more calcium because I was still a little under the
    > numbers on the Dexascan and still considered having osteopenia. That was
    > the first call. Then the second call he related to the 'blood test' being a
    > few .points over and he said to not take calcium. I had discussed the above
    > average calcium level previously and he said there was nothing to worry
    > about. Now all of a sudden he tells me to stop taking calcium. It was the
    > nurse who relayed this information to me, but his notes on the report
    > confirm that these were his recommendations in both instances.
    >
    > A day before the above relaying of information, the nurse wrote me a note
    > and said that my spine showed better improvement and my hips less; when
    > actually any person could read the chart and see that it was actually the
    > opposite. She said she got this information from the doctor's words.
    >
    > This is not a matter of great importance in the great scheme of things, but
    > if and when something greater does happen I don't want anything to do with
    > these rattled people. There have been a few things that I consider more
    > crucial to my health that has happened. This has just been the straw that
    > broke the camel's back.
    > Thanks for listening.
    > Dee Dee


    Understood. :)

    The brand I take is "Now", sort of a generic vitamin. Their "full
    spectrum minerals". They are quite affordable and it's 2 pills per day
    with food.

    Cheese is going to be higher in Calcium as it's sorta condensed and
    concentrated.

    I'm glad things are working for ya!
    --
    Peace, Om.

    "My mother never saw the irony in calling me a son-of-a-bitch." -Jack Nicholson
     
  8. Goomba38

    Goomba38 Guest

    Dee Randall wrote:

    > OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read the
    > fine print (on the front page) that this CT would NOT be done without the
    > submission of proof of blood test level of one particular thing, which I do
    > not remember at the moment.
    > This was an imaging facility/office where people come and go all day, but I
    > was not asked if I had had this blood test as a requirement for getting the
    > CT.
    >
    > In my case I should be asking the doctors at that facility why in the h....
    > absolutely no one had ordered this test prior, or reception personnel didn't
    > required that I had the papers to prove that I had had it done.
    >
    > Why was no one ordering them?
    > It goes both ways.
    > Dee Dee
    >

    Generally for a CT scan with contrast, they want those renal functions
    cleared by a current BUN, Creatinine. They want to know you'll be able
    to clear the contrast material quickly.
    Often the person who orders the "cat scan" just forgets to order that
    lab test in advance. Or perhaps you did have one on file from a recent
    visit? It is part of the common chemistry panel drawn.
    Goomba
     
  9. Boron Elgar

    Boron Elgar Guest

    On Thu, 23 Feb 2006 15:14:12 -0500, "Dee Randall"
    <[email protected]> wrote:

    >>
    >> Why not go talk to some of these docs who are ordering these tests in
    >> your hospital and find out why they are ordering them?
    >>
    >> Boron

    >
    >OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read the
    >fine print (on the front page) that this CT would NOT be done without the
    >submission of proof of blood test level of one particular thing, which I do
    >not remember at the moment.
    >This was an imaging facility/office where people come and go all day, but I
    >was not asked if I had had this blood test as a requirement for getting the
    >CT.
    >
    >In my case I should be asking the doctors at that facility why in the h....
    >absolutely no one had ordered this test prior, or reception personnel didn't
    >required that I had the papers to prove that I had had it done.
    >
    >Why was no one ordering them?
    >It goes both ways.
    >Dee Dee
    >
    >


    That is one of three things...one, that the Xray facility/doc screwed
    up, two, that you had the test previously and the results had been
    faxed over to the facilty by your doc, three, the test was not really
    needed as a pre-req or perhaps not in your particular case and the
    line was just not crossed out on the form.

    Give me a few minutes and I can probably come up with several more
    reasons.

    Why didn't you question this at the facility and call your doc's
    office right away? If you saw something that seemed untoward, you
    should have been proactive and followed up. Better safe than sorry. A
    patient who reads carefully and questions things might avoid an error.

    Boron
     
  10. In article <[email protected]>,
    "Dee Randall" <[email protected]> wrote:

    > >
    > > Why not go talk to some of these docs who are ordering these tests in
    > > your hospital and find out why they are ordering them?
    > >
    > > Boron

    >
    > OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read the
    > fine print (on the front page) that this CT would NOT be done without the
    > submission of proof of blood test level of one particular thing, which I do
    > not remember at the moment.
    > This was an imaging facility/office where people come and go all day, but I
    > was not asked if I had had this blood test as a requirement for getting the
    > CT.
    >
    > In my case I should be asking the doctors at that facility why in the h....
    > absolutely no one had ordered this test prior, or reception personnel didn't
    > required that I had the papers to prove that I had had it done.
    >
    > Why was no one ordering them?
    > It goes both ways.
    > Dee Dee
    >
    >
    >


    Creatinine... It's a kidney function test.
    If the CT was being done using x-ray contrast media, that stuff is
    eliminated by the kidneys and they dose it based on whether or not you
    have normal renal function.

    If they were not injecting you with dye, you did not need that blood
    test.

    HTH? :)
    --
    Peace, Om.

    "My mother never saw the irony in calling me a son-of-a-bitch." -Jack Nicholson
     
  11. Dee Randall

    Dee Randall Guest

    "Goomba38" <[email protected]> wrote in message
    news:[email protected]
    > Dee Randall wrote:
    >
    >> OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read
    >> the fine print (on the front page) that this CT would NOT be done without
    >> the submission of proof of blood test level of one particular thing,
    >> which I do not remember at the moment.
    >> This was an imaging facility/office where people come and go all day, but
    >> I was not asked if I had had this blood test as a requirement for getting
    >> the CT.
    >>
    >> In my case I should be asking the doctors at that facility why in the
    >> h.... absolutely no one had ordered this test prior, or reception
    >> personnel didn't required that I had the papers to prove that I had had
    >> it done.
    >>
    >> Why was no one ordering them?
    >> It goes both ways.
    >> Dee Dee
    >>

    > Generally for a CT scan with contrast, they want those renal functions
    > cleared by a current BUN, Creatinine. They want to know you'll be able to
    > clear the contrast material quickly.
    > Often the person who orders the "cat scan" just forgets to order that lab
    > test in advance. Or perhaps you did have one on file from a recent visit?
    > It is part of the common chemistry panel drawn.
    > Goomba


    The doctor did not order it; nor did the receptionist or technician have any
    clue as to what I was speaking about when I brought it up and showed it to
    them on the paper I was signing. Luckily I keep a file of my medical
    history with me when I go to any doctor's office. I had a recent BUN, but
    actually not recent enough according to their rules -- but they were
    satisfied. However, they were satisfied without it, too - heh?

    The same type of thing happened with my Dexascan, telling me that it would
    be compared to the previous scans - about 5 of them, but there was no
    comparison made. Too much of an effort, I guess.
    Thanks for your response, Goomba.
    Dee Dee
     
  12. Goomba38

    Goomba38 Guest

    Dee Randall wrote:

    > The doctor did not order it; nor did the receptionist or technician have any
    > clue as to what I was speaking about when I brought it up and showed it to
    > them on the paper I was signing. Luckily I keep a file of my medical
    > history with me when I go to any doctor's office. I had a recent BUN, but
    > actually not recent enough according to their rules -- but they were
    > satisfied. However, they were satisfied without it, too - heh?
    >
    > The same type of thing happened with my Dexascan, telling me that it would
    > be compared to the previous scans - about 5 of them, but there was no
    > comparison made. Too much of an effort, I guess.
    > Thanks for your response, Goomba.
    > Dee Dee


    But the question that needs answering is: Did they inject contrast at
    all or was it a CT without contrast? If they weren't going to inject
    contrast, no lab test was necessary and it was just mentioned in a
    standard consent form.
    How do you know no comparison was made with the previous dexascan?
    Goomba
     
  13. Dee Randall

    Dee Randall Guest

    "Boron Elgar" <[email protected]> wrote in message
    news:[email protected]
    > On Thu, 23 Feb 2006 15:14:12 -0500, "Dee Randall"
    > <[email protected]> wrote:
    >
    >>>
    >>> Why not go talk to some of these docs who are ordering these tests in
    >>> your hospital and find out why they are ordering them?
    >>>
    >>> Boron

    >>
    >>OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read
    >>the
    >>fine print (on the front page) that this CT would NOT be done without the
    >>submission of proof of blood test level of one particular thing, which I
    >>do
    >>not remember at the moment.
    >>This was an imaging facility/office where people come and go all day, but
    >>I
    >>was not asked if I had had this blood test as a requirement for getting
    >>the
    >>CT.
    >>
    >>In my case I should be asking the doctors at that facility why in the
    >>h....
    >>absolutely no one had ordered this test prior, or reception personnel
    >>didn't
    >>required that I had the papers to prove that I had had it done.
    >>
    >>Why was no one ordering them?
    >>It goes both ways.
    >>Dee Dee
    >>
    >>

    >
    > That is one of three things...one, that the Xray facility/doc screwed
    > up, two, that you had the test previously and the results had been
    > faxed over to the facilty by your doc, three, the test was not really
    > needed as a pre-req or perhaps not in your particular case and the
    > line was just not crossed out on the form.
    >
    > Give me a few minutes and I can probably come up with several more
    > reasons.
    >
    > Why didn't you question this at the facility and call your doc's
    > office right away? If you saw something that seemed untoward, you
    > should have been proactive and followed up. Better safe than sorry. A
    > patient who reads carefully and questions things might avoid an error.
    >
    > Boron


    Boron, I was the one that was proactive about the whole thing. I was the
    one that read it carefully and brought it to their attention. The imaging
    facility was the one who was dragging their heels, not knowing what I was
    speaking about. This is a requirement for everyone age 70 and over, and my
    age was on the application, but there were two requirements which I met, age
    being just one of them. I was not asked for a report of my blood test. They
    acted like it wasn't important, and actually they acted like they'd never
    heard of it before. Yes, I would've called my doctor's office to get a
    faxed order to take the test, but I had recent blood test reports in the car
    with me which they accepted but according to the rules on the form, they
    weren't current enough -- I went with it because an MD there said, it's OK.
    Actually just sick of this type of thing happening almost everytime I have
    anything to do with the medical field. I'm so glad that I have my husband
    as my advocate with me at all times.
    Dee Dee
     
  14. Dee Randall

    Dee Randall Guest

    "OmManiPadmeOmelet" <[email protected]> wrote in message
    news:[email protected]
    > In article <1[email protected]>,
    > "Dee Randall" <[email protected]> wrote:
    >
    >> >
    >> > Why not go talk to some of these docs who are ordering these tests in
    >> > your hospital and find out why they are ordering them?
    >> >
    >> > Boron

    >>
    >> OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read
    >> the
    >> fine print (on the front page) that this CT would NOT be done without the
    >> submission of proof of blood test level of one particular thing, which I
    >> do
    >> not remember at the moment.
    >> This was an imaging facility/office where people come and go all day, but
    >> I
    >> was not asked if I had had this blood test as a requirement for getting
    >> the
    >> CT.
    >>
    >> In my case I should be asking the doctors at that facility why in the
    >> h....
    >> absolutely no one had ordered this test prior, or reception personnel
    >> didn't
    >> required that I had the papers to prove that I had had it done.
    >>
    >> Why was no one ordering them?
    >> It goes both ways.
    >> Dee Dee
    >>
    >>
    >>

    >
    > Creatinine... It's a kidney function test.
    > If the CT was being done using x-ray contrast media, that stuff is
    > eliminated by the kidneys and they dose it based on whether or not you
    > have normal renal function.
    >
    > If they were not injecting you with dye, you did not need that blood
    > test.
    >


    Yes, this was another one of the screw-ups. When I emailed them the
    prescription they said I didn't need a contrast; but when I got there, they
    said the prescription called for contrast. This is another time my
    attention to detail helped, I had a copy of my prescription and it did not
    call for contrast, but he said, we do contrast in cases like yours. The
    nurse reading the prescription when I emailed it, if it had called for a
    contrast, could have alerted me to getting a current BUN.

    I used to be a court-reporter and this is the type of thing gets more
    complicated the more you discuss it and question what happened-- AARRGH.
    Dee Dee
     
  15. Dee Randall

    Dee Randall Guest

    "Goomba38" <[email protected]> wrote in message
    news:[email protected]
    > Dee Randall wrote:
    >
    >> The doctor did not order it; nor did the receptionist or technician have
    >> any clue as to what I was speaking about when I brought it up and showed
    >> it to them on the paper I was signing. Luckily I keep a file of my
    >> medical history with me when I go to any doctor's office. I had a recent
    >> BUN, but actually not recent enough according to their rules -- but they
    >> were satisfied. However, they were satisfied without it, too - heh?
    >>
    >> The same type of thing happened with my Dexascan, telling me that it
    >> would be compared to the previous scans - about 5 of them, but there was
    >> no comparison made. Too much of an effort, I guess.
    >> Thanks for your response, Goomba.
    >> Dee Dee

    >
    > But the question that needs answering is: Did they inject contrast at all
    > or was it a CT without contrast? If they weren't going to inject contrast,
    > no lab test was necessary and it was just mentioned in a standard consent
    > form.
    > How do you know no comparison was made with the previous dexascan?
    > Goomba


    Nt previous dexascan reports have always compared by graph to my previous
    scans. There was no comparison to previous years in this report, nor any
    graph substantiation to previous years as preivously done -- enough
    "previous" words? tee hee.

    Yes, they did inject.
    Although in my previous posting, I said that they gave me conflicting
    interpretations of my actual prescription as to whether it was contrast or
    not contrast. That was really encouraging, too.
    Dee Dee
     
  16. In article <[email protected]>,
    "Dee Randall" <[email protected]> wrote:

    > "Boron Elgar" <[email protected]> wrote in message
    > news:[email protected]
    > > On Thu, 23 Feb 2006 15:14:12 -0500, "Dee Randall"
    > > <[email protected]> wrote:
    > >
    > >>>
    > >>> Why not go talk to some of these docs who are ordering these tests in
    > >>> your hospital and find out why they are ordering them?
    > >>>
    > >>> Boron
    > >>
    > >>OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read
    > >>the
    > >>fine print (on the front page) that this CT would NOT be done without the
    > >>submission of proof of blood test level of one particular thing, which I
    > >>do
    > >>not remember at the moment.
    > >>This was an imaging facility/office where people come and go all day, but
    > >>I
    > >>was not asked if I had had this blood test as a requirement for getting
    > >>the
    > >>CT.
    > >>
    > >>In my case I should be asking the doctors at that facility why in the
    > >>h....
    > >>absolutely no one had ordered this test prior, or reception personnel
    > >>didn't
    > >>required that I had the papers to prove that I had had it done.
    > >>
    > >>Why was no one ordering them?
    > >>It goes both ways.
    > >>Dee Dee
    > >>
    > >>

    > >
    > > That is one of three things...one, that the Xray facility/doc screwed
    > > up, two, that you had the test previously and the results had been
    > > faxed over to the facilty by your doc, three, the test was not really
    > > needed as a pre-req or perhaps not in your particular case and the
    > > line was just not crossed out on the form.
    > >
    > > Give me a few minutes and I can probably come up with several more
    > > reasons.
    > >
    > > Why didn't you question this at the facility and call your doc's
    > > office right away? If you saw something that seemed untoward, you
    > > should have been proactive and followed up. Better safe than sorry. A
    > > patient who reads carefully and questions things might avoid an error.
    > >
    > > Boron

    >
    > Boron, I was the one that was proactive about the whole thing. I was the
    > one that read it carefully and brought it to their attention. The imaging
    > facility was the one who was dragging their heels, not knowing what I was
    > speaking about. This is a requirement for everyone age 70 and over, and my
    > age was on the application, but there were two requirements which I met, age
    > being just one of them. I was not asked for a report of my blood test. They
    > acted like it wasn't important, and actually they acted like they'd never
    > heard of it before. Yes, I would've called my doctor's office to get a
    > faxed order to take the test, but I had recent blood test reports in the car
    > with me which they accepted but according to the rules on the form, they
    > weren't current enough -- I went with it because an MD there said, it's OK.
    > Actually just sick of this type of thing happening almost everytime I have
    > anything to do with the medical field. I'm so glad that I have my husband
    > as my advocate with me at all times.
    > Dee Dee
    >
    >
    >


    That's the problem with some big facilities. :-( It's almost like you
    are nothing but a number on an assembly line....

    I'm glad the place I work at is still small enough to treat our
    customers like individual humans!

    Our CT/Radiology people call the lab themselves to ask for and wait for
    the renal function testing prior to starting the procedure! I get those
    calls all the time when I'm working Chemistry.
    --
    Peace, Om.

    "My mother never saw the irony in calling me a son-of-a-bitch." -Jack Nicholson
     
  17. In article <[email protected]>,
    "Dee Randall" <[email protected]> wrote:

    > "OmManiPadmeOmelet" <[email protected]> wrote in message
    > news:[email protected]
    > > In article <[email protected]>,
    > > "Dee Randall" <[email protected]> wrote:
    > >
    > >> >
    > >> > Why not go talk to some of these docs who are ordering these tests in
    > >> > your hospital and find out why they are ordering them?
    > >> >
    > >> > Boron
    > >>
    > >> OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I read
    > >> the
    > >> fine print (on the front page) that this CT would NOT be done without the
    > >> submission of proof of blood test level of one particular thing, which I
    > >> do
    > >> not remember at the moment.
    > >> This was an imaging facility/office where people come and go all day, but
    > >> I
    > >> was not asked if I had had this blood test as a requirement for getting
    > >> the
    > >> CT.
    > >>
    > >> In my case I should be asking the doctors at that facility why in the
    > >> h....
    > >> absolutely no one had ordered this test prior, or reception personnel
    > >> didn't
    > >> required that I had the papers to prove that I had had it done.
    > >>
    > >> Why was no one ordering them?
    > >> It goes both ways.
    > >> Dee Dee
    > >>
    > >>
    > >>

    > >
    > > Creatinine... It's a kidney function test.
    > > If the CT was being done using x-ray contrast media, that stuff is
    > > eliminated by the kidneys and they dose it based on whether or not you
    > > have normal renal function.
    > >
    > > If they were not injecting you with dye, you did not need that blood
    > > test.
    > >

    >
    > Yes, this was another one of the screw-ups. When I emailed them the
    > prescription they said I didn't need a contrast; but when I got there, they
    > said the prescription called for contrast. This is another time my
    > attention to detail helped, I had a copy of my prescription and it did not
    > call for contrast, but he said, we do contrast in cases like yours. The
    > nurse reading the prescription when I emailed it, if it had called for a
    > contrast, could have alerted me to getting a current BUN.
    >
    > I used to be a court-reporter and this is the type of thing gets more
    > complicated the more you discuss it and question what happened-- AARRGH.
    > Dee Dee
    >


    You need to send a formal complaint to the facility's CEO.

    Seriously.
    --
    Peace, Om.

    "My mother never saw the irony in calling me a son-of-a-bitch." -Jack Nicholson
     
  18. Dee Randall

    Dee Randall Guest

    "OmManiPadmeOmelet" <[email protected]> wrote in message
    news:[email protected]
    > In article <[email protected]>,
    > "Dee Randall" <[email protected]> wrote:
    >
    >> "OmManiPadmeOmelet" <[email protected]> wrote in message
    >> news:[email protected]
    >> > In article <[email protected]>,
    >> > "Dee Randall" <[email protected]> wrote:
    >> >
    >> >> >
    >> >> > Why not go talk to some of these docs who are ordering these tests
    >> >> > in
    >> >> > your hospital and find out why they are ordering them?
    >> >> >
    >> >> > Boron
    >> >>
    >> >> OTOH, I had a CT a few weeks ago, signed papers for it, etc. when I
    >> >> read
    >> >> the
    >> >> fine print (on the front page) that this CT would NOT be done without
    >> >> the
    >> >> submission of proof of blood test level of one particular thing,
    >> >> which I
    >> >> do
    >> >> not remember at the moment.
    >> >> This was an imaging facility/office where people come and go all day,
    >> >> but
    >> >> I
    >> >> was not asked if I had had this blood test as a requirement for
    >> >> getting
    >> >> the
    >> >> CT.
    >> >>
    >> >> In my case I should be asking the doctors at that facility why in the
    >> >> h....
    >> >> absolutely no one had ordered this test prior, or reception personnel
    >> >> didn't
    >> >> required that I had the papers to prove that I had had it done.
    >> >>
    >> >> Why was no one ordering them?
    >> >> It goes both ways.
    >> >> Dee Dee
    >> >>
    >> >>
    >> >>
    >> >
    >> > Creatinine... It's a kidney function test.
    >> > If the CT was being done using x-ray contrast media, that stuff is
    >> > eliminated by the kidneys and they dose it based on whether or not you
    >> > have normal renal function.
    >> >
    >> > If they were not injecting you with dye, you did not need that blood
    >> > test.
    >> >

    >>
    >> Yes, this was another one of the screw-ups. When I emailed them the
    >> prescription they said I didn't need a contrast; but when I got there,
    >> they
    >> said the prescription called for contrast. This is another time my
    >> attention to detail helped, I had a copy of my prescription and it did
    >> not
    >> call for contrast, but he said, we do contrast in cases like yours. The
    >> nurse reading the prescription when I emailed it, if it had called for a
    >> contrast, could have alerted me to getting a current BUN.
    >>
    >> I used to be a court-reporter and this is the type of thing gets more
    >> complicated the more you discuss it and question what happened-- AARRGH.
    >> Dee Dee
    >>

    >
    > You need to send a formal complaint to the facility's CEO.
    >
    > Seriously.
    > --


    To get involved further with any people at the medical facility takes
    moments/hours/days off my life that would not be worth it to me. My skin is
    not thick enough for it. I think there is a time in life when we all feel a
    little fragile even though we still have a tiger inside. This is that time
    for me.
    Thanks for your support.
    Dee Dee
     
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