'complex' diagnosis at St. Louis

[lifemagic]

I just volunteered for a three month semester in a phnom pehn ngo (loved it) and volunteered the next one starting December 15. Came here (Bangkok) for a break and my shin was a bit swollen when I got here so I went to St. Louis yesterday.

First guy said it's normal because it's a bit varcoise, but there's a gap between my legs, the muscle is shrunk. Sent me to Orthopedics. He said there's atrophe, sent me to neurology. He said the same, but not sure why. Could be a lot of things. First, go back Thursday for some kind of electrical test (5000b), and hormone blood test (1500) to find out what kind of wasting it is. He told me it's going to be complex as I don't have any other symptoms, it will take a long time, am I insured (yes) and next we will start looking for a malignancy.

Mind went blank/numb at that point. I've been in a bit of a daze since actually. Before this, I asked if I would be back at school for the 15th and he said it would be ongoing, best case scenario would be continuing the diagnosis there, though he seems to want me here.

The question I'm asking here is... I've been warned it's complex and will take a long time to diagnose. So the procedure seems to be, they look at you, decide the test (I had to wait three days), then you will have to wait again until that particular doctor is back in the hospital to see them again, rather than just seeing anyone who is there straight away. Is that right?

Like the first ortho guy, made another appointment for me in a weeks time, in case I get sent back from neurology, if I don't get sent back, then cancel it. Now I'll have this next test and perhaps have to wait until this same guy is back. That's another reason it's going to drag on.

Is it different at a bigger hospital, i.e. everything done one thing after another, or you just have to flow with it. This waitings doing me in.

[lopburi3]

This is actually one of the large hospitals. But if you are consulting specialists as it appears they may be working primarily in other (often government teaching) hospitals. This would be true at any hospital as none have a lock on the best of everything.

[Sheryl]

Certainly with something like this you need some continuity (same doctor) at least until diagnosis is made. Waiting may be a function of the hours of the doctor in question (which should be easy enough to verify) in which case switching to someone with more frequent hours may help. Things will still need to be done in order, though but waits may be shorter.

I'd suggest waiting until you have the test results at which point the nature of the problem may be clearer and, if it is something comparatively rare/specialized, that in itself might be reason to change to a different doctor, one with relevant sub-specialty.

[lifemagic]

Thank you. That is really, really helpful. Yes, I'll go back and get this first thing done, and see what this guys hours are. The thing is, I didn't know if I'd been 'claimed'. Probably irrational, but it's a stressful time; I'm not thinking straight.

Thanks again.

[Sheryl]

If by "claimed" you mean by the doctor, as a private patient you have absolute right to change doctors at any time, and can and should be proactive in ensuring you benefit from the very best expertise available.

You also have, by law, and absolute right to obtain all hospital records including originals of scans etc should you decide to change to a doctor at another facility.

I'm happy to help advice on this once your test results are in. Until more is known about what the underlying problem may be, not possible to say if a change of doctors/hospitals would be advantageous but if so, no need to hesitate in doing so. It's your body and your money!

[lifemagic]

Thanks again for the support. The test came back normal, i.e. my muscles are atrophied but electrical stimulation is normal, so nervous system OK, but actually, that makes diagnosis more complex.

I had blood drawn too, not sure for what overall, I think white cells, thyroid and something else. I'm going back tomorrow.

I asked this guys times. Actually, it's the guy who did the scan who is rarely in, the specialist is in all days except saturday (though took the kings birthday off). I'll go and see him tomorrow, and see what the next steps might be. As far as I can work out from my policy document, I'm insured.