Moderator ventana Posted February 13, 2011 Moderator Share Posted February 13, 2011 Well, I discussed with my SP and ultimately he is making the decision. Do you really think another US of the LE would do anything? The ultrasound tech has 30 years experience...not saying she is perfect - she could have missed something. The major issue here is we are trying to cover our azzes. Or at least my SP is trying to. He just gave a deposition yesterday. And every time I turn around, there is another legal matter. Not sure how many cases he's had proof of fault or just involvement in care. We could employ a "wait and see" plan, but that could bite us in the butt if it ends up being something and we delayed imaging. It's sad that we have to practice "defensive" medicine :( Yes I think it makes sense to repeat the US I have worked in US departments when I was in IR and a bakers cyst is seen many times but if the US order is R/O DVT the tech does not even make note of it - yet I have also seen a lot of unilateral edema created by these. I am not saying to not get the CT - but instead try to find the answer with out exposing to hig dose radiation. Also - a very frank discussion with the patient about the risk/benefits of a CT 'hey we are likely not going to find anything' and very careful documentation that this was explained to the patient and the patient and the provider together decided to forgo the CT is certainly defensible medical practices. Sorry if I came across as bossy/preaching - just have seen too many people that have had numerous CT's for very weak reasons and we are going to be giving cancers to our patients if we continue to practice this way - but as you point out we can't get sued for a cancer 30 years from now and the trial lawyers will all think of new boats or property if we missed even a single Dx...... Try to minimize the rad's while doing an exhaustive work up - also, the Abd U/S did you order a full ABD survey ? This is a TON-o-Images and the techs used to hate getting them - and if this was negative I have a hard time justifying in a thin (body size makes a HUGE difference in US sensitivity - no pun intended) female the risk of radiation for a Abd/Pel with and without for left LLE edema - but then again I did not just give a deposition. This is one of the times it is great to be a PA - good thoughts - presented to doc -then let them shoulder the final decision and not have to fret it! Link to comment Share on other sites More sharing options...
deborah212 Posted February 23, 2011 Share Posted February 23, 2011 Any updates? Link to comment Share on other sites More sharing options...
macadamia813 Posted February 25, 2011 Author Share Posted February 25, 2011 Update: Well, as some of you suspected before, no findings on the CT scan. I'm going to leave it up to my SP to make the next move... Link to comment Share on other sites More sharing options...
kyboynp Posted March 5, 2011 Share Posted March 5, 2011 Wow. This is a really interesting case. Definitely keep uq updated. I'm interested in finding out what this thing is.... Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 5, 2011 Moderator Share Posted March 5, 2011 Update: Well, as some of you suspected before, no findings on the CT scan. I'm going to leave it up to my SP to make the next move... ugh, about 300 xrays to the pelvic organs of a female for no findings..... one or two more of these studies and you can almost say we gave her the cancer she is going to get in 30 years...... :sad: Link to comment Share on other sites More sharing options...
marilynpac Posted March 6, 2011 Share Posted March 6, 2011 With stem cell research hopefully cancer will just be an inconvenience in 30yrs.... Link to comment Share on other sites More sharing options...
mcneesejd Posted April 24, 2011 Share Posted April 24, 2011 Positive ANA coincidental. How many find pos ANA but no further findings? Alot. Sounds like peroneal neuropathy from habitual leg crossing. Could do NCT or EM but since early, most like will be negative. I suggest monitor. Link to comment Share on other sites More sharing options...
SocialMedicine Posted April 25, 2011 Share Posted April 25, 2011 what did this turn out to be? Link to comment Share on other sites More sharing options...
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