BS: Scan discrimination

22 Mar 16 - 10:57 AM (#3780391)
Subject: BS: Scan discrimination
From: Roger the Skiffler

Just had my third ultrasound in 6 months. When a pregnant woman goes for an ultrasound she is shown the screen, gets a copy (four prints and an enlargement please). When a man has one the screen is closely guarded and I'm afraid you won't be seeing a view of my prostate on Youtube! Not malignant thankfully.

RtS

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22 Mar 16 - 11:19 AM (#3780396)
Subject: RE: BS: Scan discrimination
From: GUEST,#

Congratulations on the good news. For future reference, tell them you're a pregnant woman and you too will get copies of the scan.

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22 Mar 16 - 11:28 AM (#3780398)
Subject: RE: BS: Scan discrimination
From: Steve Shaw

They might wonder what you're doing in the prostate clinic, mind. I've just had a letter calling me in for a scan for abdominal aortic aneurism under a national scheme I didn't know existed. The accompanying leaflet is apocalyptic. I think I'll go along!

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22 Mar 16 - 11:52 AM (#3780410)
Subject: RE: BS: Scan discrimination
From: GUEST,#

Steve, that is nothing to joke about. Make sure you get to the appointment.

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22 Mar 16 - 12:24 PM (#3780418)
Subject: RE: BS: Scan discrimination
From: Steve Shaw

Er, I wasn't really making a joke...

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22 Mar 16 - 12:44 PM (#3780425)
Subject: RE: BS: Scan discrimination
From: GUEST,Derrick

If you were pregnant Roger, you would not only get your photos you'd get a spot on the 6 o'clock news and a place in medical history.

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22 Mar 16 - 12:45 PM (#3780426)
Subject: RE: BS: Scan discrimination
From: Will Fly

I had an AAA scan about 7 years ago - all OK. It's worth having. A burst aneurism kills in minutes.

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22 Mar 16 - 12:49 PM (#3780428)
Subject: RE: BS: Scan discrimination
From: GUEST,Derrick

Well worth going Steve,it doesn't take long and you get the result straight away.

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22 Mar 16 - 12:57 PM (#3780430)
Subject: RE: BS: Scan discrimination
From: GUEST,#

Didn't think you were, Steve.

Translation: That's nothing to joke about = Holy sh*t Batman!

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22 Mar 16 - 01:00 PM (#3780432)
Subject: RE: BS: Scan discrimination
From: Steve Shaw

I'm going, I'm going! The leaflet scared me shitless!

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22 Mar 16 - 01:07 PM (#3780434)
Subject: RE: BS: Scan discrimination
From: olddude

Steve, I had my doc tell me to go for tests. I said fuck it, I am fine... Well after a open heart bypass I guess I should have listened earlier

Ok bro

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22 Mar 16 - 01:34 PM (#3780443)
Subject: RE: BS: Scan discrimination
From: fat B****rd

Great news, Thimbles.
Over the past few years I have had an AAA, two heart checks(one for a slow heart rate and one for an 'extra' beat), a chest x-ray, that one had me waiting anxiously, and,best of all, me 'enry Halls greased and ultras-canned!! The two nice men who did that also let me have a look at my kidneys for free!. Then there was the x-ray for arthritis of the knee. But I knew about that anyway.

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22 Mar 16 - 02:15 PM (#3780456)
Subject: RE: BS: Scan discrimination
From: Dave the Gnome

My 60th birthday photograph was taken with an endoscope. Honest! They said they don't usually but as it was a special occasion they turned the printer on and, voila!, a lovely picture of my lower intestine. A lot less wrinkled than my mush anyway :-)

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22 Mar 16 - 03:10 PM (#3780463)
Subject: RE: BS: Scan discrimination
From: Steve Shaw

Yes, I've had two of those. Nothing like being told by a beautiful nurse that it's absolutely fine to fart in her face!

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22 Mar 16 - 05:05 PM (#3780482)
Subject: RE: BS: Scan discrimination
From: Joe Offer

Since my stroke, I've had to get an ultrasound of my carotid arteries every 6 months. The technician doesn't tell me anything and doesn't show me the screen. A week or two later, I see the doctor and he'll show me whatever I want to see. I wonder if the technicians aren't authorized to provide information because they're not trained to interpret it.

-Joe-

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23 Mar 16 - 03:48 AM (#3780540)
Subject: RE: BS: Scan discrimination
From: Kampervan

It seems to vary as to whether or not the person doing the scanning gives you the results. I recently had ultrasound scans of my prostate and other delicate anatomical features and the scanner - a very nice lady - told me there and then that there were no problems and that I didn't need a follow up appointment with my doctor.

Very re-assuring although I didn't enquire about getting a print of the scan, probably not something I'd want to show anyone.

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23 Mar 16 - 05:51 AM (#3780561)
Subject: RE: BS: Scan discrimination
From: Roger the Skiffler

Thanks friends. I has a good night's sleep last night (couldn't get more than a few minutes at a time in the hospital overnighter, every time I dropped off they wanted blood, Bp or temperature). I'm on the waiting list to have my prostate "scraped" (too much information). It's been a long time since I've had so many young women near my private parts!
RtS

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23 Mar 16 - 09:09 AM (#3780595)
Subject: RE: BS: Scan discrimination
From: Charmion

With all that attention, Roger, can those parts of you still be described as "private"?

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23 Mar 16 - 09:28 AM (#3780596)
Subject: RE: BS: Scan discrimination
From: Backwoodsman

Since 21st December 2005, due to gall-bladder, pancreas and liver issues, I've had at least 6 CT scans, 4 MRI scans, 6 Ultrasounds, and 5 laparoscopic endoscopies (cameras and other surgical implements down my throat and into my hepatobiliary system)

Never been shown the images from any of them, only ever been given the result after the event, never at the time.

Oh, and for the benefit of our US friends, all the above provided by our Superb NHS, together with at least ten hospital stays ranging from one week to four weeks in duration, and two major 'open' abdominal surgeries, all free of charge at the point of delivery.

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23 Mar 16 - 09:47 AM (#3780597)
Subject: RE: BS: Scan discrimination
From: GUEST,Musket

Joe has noted correctly. The technicians, nurses and allied health professionals operating the equipment are well skilled in seeing how accurate the scan is in terms of what is required and of course know generally whether the scan reveals what is either suspected or being screened for.

However, other than in a small number of types, and pregnancy ultrasound is one example, only the doctor will have the rest of the medical history to hand to interpret the results. (One extreme example being certain small breast anomalies in a 80 year old isn't a problem as no matter how bad it could get, the patient will die with it not of it so surgery would be trauma for little benefit whereas a person in their 20s would be advised to nip it in the bud.)

Some technicians can interpret and share with patients, for instance there could be guidelines to say that if it shows no anomaly and nothing else of concern, a technician may be authorised to put a mind at rest there and then. Some technicians are competent at interpreting, we have "reader" radiographers in the same way as prescribing nurses and pharmacists.

I had an MRI scan after I passed a kidney stone. All clear but my better half got their hands on it, and being in the bloody trade used a small anomaly (nowhere near the kidney) to try and bully me into cutting down on beer... Mmm.🤔

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23 Mar 16 - 03:31 PM (#3780691)
Subject: RE: BS: Scan discrimination
From: GUEST, topsie

My doctor seems always to be encouraging me to get tested for this, that and the other, but has never suggested a scan for abdominal aortic aneurism.
I have had letters, however - scary 'apocalyptic' letters from a commercial organisation - offering me such scans at what they claim is a special 'low' price.
I haven't taken them up on it. Their 'low' price is more than I can afford.

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23 Mar 16 - 03:32 PM (#3780692)
Subject: RE: BS: Scan discrimination
From: Steve Shaw

A "small anomaly?" That they thought was exacerbated by excessive beer-drinking? The mind boggles...

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23 Mar 16 - 03:40 PM (#3780696)
Subject: RE: BS: Scan discrimination
From: Steve Shaw

The AAA scan is apparently offered just to men who are coming up 65.

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23 Mar 16 - 03:40 PM (#3780697)
Subject: RE: BS: Scan discrimination
From: GUEST,Musket

A sludgy pancreas if 'tha must know.

We have legislation around unnecessary imaging, under ionising and radiation criteria. Even a request for an X Ray by a doctor that turned out to be not needed in order to diagnose has to be classed as an incident and reported to the regulator. What it does do is cut down on exposure to potential issues (great, he stopped smoking years ago but four chest X Rays in short succession is as dangerous as smoking heavily for a month.)

This is why I and others spend time working out age range for screening. You make clinical decisions and get effectively overruled by politicians who don't want to see it as rationing...   Sorry, just getting it off my chest. 😡

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23 Mar 16 - 06:20 PM (#3780728)
Subject: RE: BS: Scan discrimination
From: Joe_F

The only ultrasound scan I have had so far was of my carotid artery. I forget why they did it. They didn't give me a print of it, but I got to see it on the screen, in real time. Nothing like seeing the velocity contours of your blood sloshing around in living color.

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24 Mar 16 - 04:57 AM (#3780787)
Subject: RE: BS: Scan discrimination
From: Roger the Skiffler

On a more serious note, I would encourage men who are experiencing the early symptoms of enlarged prostate (nocturnal trips to the loo etc) to get it checked out. Nowadays the PSA blood test can confirm or eliminate cancer and is non-invasive. If I had gone to the doctor earlier they may have been able to shrink it with drugs alone without the need for surgery.
RtS

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24 Mar 16 - 05:12 AM (#3780793)
Subject: RE: BS: Scan discrimination
From: Musket

Absolutely Roger. The publicity drive to encourage men to be prostate aware is lost in the fog of NHS v government so doesn't get the media attention it should.

Your GP is expecting you and meanwhile, the pros and cons of population profile or age screening is forever debated. (Not quite as clear cut as you think. Age and lifestyle aren't trigger factors in the same way other medical conditions can indicate.)

Basically, how often do you pee, compared with a couple of years ago? Sexual activity? Both with co pilot or flying solo. Without recourse to my usual crudeness, the more you stimulate the prostate to release fluid, the happier and less prone to issues it is. You can understand that screening a population would infer knowledge of sex life and toilet habits. Only we ourselves can answer that and present for GP consultation.

Awareness is the answer.. Nips issues in the bud. Also, an enlarged prostate is not necessarily a cancer, they tend to enlarge slightly with age anyway, a bit like ears.

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24 Mar 16 - 05:18 AM (#3780796)
Subject: RE: BS: Scan discrimination
From: GUEST,Ian

I had two scans at the end of last year after a leg operation. Once to check for DVT and once to check the area around my wound. On both occasions the lady doing the scan said everything was OK immediately after finishing the scan.

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24 Mar 16 - 08:39 AM (#3780819)
Subject: RE: BS: Scan discrimination
From: Charmion

I had a similar experience with the gastroenterologist who performed the delightful colonoscopy many residents of Ontario receive as a 55th birthday present from the Ministry of Health. The technicians dummy up; only the doc can pronounce.

I would like Musket to expand on his point about screening and rationing. As I understand it, the idea is to identify predictable problems in their earliest stages in the majority of people in the vulnerable age-group, thus reducing their suffering and making room in the treatment queue for those who find themselves in the dreaded class of Exceptions To The Rule.

Is this not what is happening in Britain?

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24 Mar 16 - 09:16 AM (#3780823)
Subject: RE: BS: Scan discrimination
From: Musket

Absolutely.

Rationing is what politicians are scared of people seeing limitations as, whereas screening is a public health function with the aim of prevention being better than cure, both for the patient and for the treasury. We are saying the same thing in that regard.

A good example of dilemma can be found in breast screening. There is no clinical evidence to support widening age range or frequency for general public screening via mammography whilst there is every political reason to do so. There is however a need to screen at risk groups and recall screen people with family history and test indicators putting them at high risk. You can't fill the clinic with the riskiest patients because the budget and the physical space is crammed with people arbitrarily sent for based on an ever politically increasing age range.

Screening is one of the best early intervention measures we have, not only for early excision of potential anomalies but also for encouraging healthy lifestyle. Both are good for the patient and the treasury. Increasing anxiety however doesn't help. Breast surgeons and oncologists spend time discussing options with elderly patients for whom the trauma and discomfort of surgery, chemotherapy and radiotherapy is worse than living with something that is so far off being a problem, it will sit there beyond potential life expectancy. Mammography picks these up too..

An interesting less acute example is about fifteen years ago, optometrists were allowed and encouraged to screen for glaucoma, cataracts etc. The cataract "star field" machines are so good they pick up cataracts years before they grow to a level you'd notice. Also difficult to remove properly when so small. People were being referred via their opticians for problems hospitals said weren't yet clinically appropriate to treat.

The best way to explain how a limited budget and rationing mean the same thing is to visit the website for NICE where clinical effectiveness vs cost is used for NHS funding decisions. It isn't about rationing, it's about the best clinical decisions being funded. However, by clinical decision, it's also about patients as opposed to the patient. Giving a drug that costs £500k to add a month of uncomfortable life as opposed to funding three hundred courses of a drug that will extend other lives less far down the line and the quality of them by a couple of years.

Notwithstanding the government's wish to screen more and encourage GPs to refer more (their indemnity insurance encourages that ever more too.) The same government then scratches its head when hospitals are on the verge of bankruptcy and everyone is running round with their hair on fire trying to deal with the workload. Expectation is a wonderful thing and encourages better ways of working but we have reached a genuine point where you can't just throw money at it. Over 19% of clinical posts in The NHS are vacant or short term locum. Over 20% of senior management posts are vacant or with interim. We used to have too many people with clipboards called managers. We now have a huge gap due to not enough management. Paying consultant doctors their time to do what a manager on far less can do better isn't the best way of financing. NHS trusts know this but in case we forget, the piggy bank is controlled centrally by a government ministry.

Still. Over a million clinical episodes every twenty four hours, with approx 97% of them not going wrong. Sounds good but could be better. If the airline industry was at 97%, a jumbo jet would fall out of the sky each and every week.

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24 Mar 16 - 11:20 AM (#3780838)
Subject: RE: BS: Scan discrimination
From: Charmion

Thanks for that, Musket.

Unlike jumbo jets, the human body doesn't come with a maintenance schedule or an operator's manual. What's more, there is no regulator standing over the owner to ensure close compliance with best life-cycle management practices. Drat that free will!

In that context, 97 percent looks pretty good.

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24 Mar 16 - 03:29 PM (#3780890)
Subject: RE: BS: Scan discrimination
From: keberoxu

For some reason this reminds me of Cahonas Scotland and their publicity campaigns.

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15 Apr 16 - 02:55 AM (#3785412)
Subject: RE: BS: Scan discrimination
From: Roger the Skiffler

PS Just home after 2 nights in hospital having the op. All seems well, no pain or discomfort, thanks for kind concerns. One interesting phenomenon, I was so late finally getting up to the ward because of bed blocking that I was too late to order meals for the following day. The person who'd had that bed had ordered but been discharged so I go what he'd ordered- food Russian Roulette! Anyone in yesterday in the same boat would have got what I ordered except I had to wait around till 8pm dressed and packed until the surgeon was free to sign me off.
RtS

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15 Apr 16 - 08:07 AM (#3785452)
Subject: RE: BS: Scan discrimination
From: fat B****rd

Take care, Thimbles and keep me posted. ATB from Charlie

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15 Apr 16 - 08:34 AM (#3785455)
Subject: RE: BS: Scan discrimination
From: Senoufou

Wishing you a fast recovery Roger.

I've blocked a bed for hours in hospital waiting for the wretched pharmacist to hurtle into the ward clutching my medication. The poor soul was rushed off her feet. I could easily have walked down to the Pharmacy myself to collect the stuff, but no. There I sat fully dressed and eager to be discharged, but the Ward Sister couldn't let me go without seeing I had my meds.

The next occupant of the bed was waiting in the Day Room for me to leave. I felt like offering her the bottom half of the bed with me at the top. We could have sat there having a nice chat.

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15 Apr 16 - 08:38 AM (#3785457)
Subject: RE: BS: Scan discrimination
From: Senoufou

Regarding scans, I once had a very vinegary technician (a lady) who announced abruptly, "Your ovaries are completely withered and you have several gallstones." I could think of nothing to say except a rather feeble, "Oh." (I wasn't there for either of those bits of my insides)

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15 Apr 16 - 11:44 AM (#3785488)
Subject: RE: BS: Scan discrimination
From: Charmion

At a certain age, most women don't need to be told that their ovaries have withered. As for the gallstone datum, I'd be glad to get that bit of news if it spared me a round of biliary colic -- I'm told that's even worse than kidney stones, a truly terrible prospect.

But "Oh" strikes me as an appropriate reaction.

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16 Apr 16 - 05:28 AM (#3785581)
Subject: RE: BS: Scan discrimination
From: Roger the Skiffler

One of my friends had the same experience as Senoufou, waiting for hours to get his own meds unlocked from bedside cabinet. I felt well enough to go back to reading for a Blues night (Bill Boazman and Michael Roach). To appease 'er indors I got a cab back from Ascot station avoiding usual half hour walk.
RtS

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16 Apr 16 - 12:08 PM (#3785623)
Subject: RE: BS: Scan discrimination
From: Senoufou

Glad to hear you're feeling better now Roger.

I know Charmion. At my age, nobody's ovaries are exactly blooming. My sister says she may have been having a quick look for ovarian cancer while she had me there, so to speak. Also, you're quite right, gallstones are Not Nice. But she did clarify that none of the little blighters was blocking the duct and all were 'floating free'. It was just her snippy attitude. Maybe she was fed up; her job must be rather boring and not well-paid.

When I had my brain scan the two young men in charge were delightful, and said I had no tumour, but some very distorted, twisted blood vessels which were something they'd not seen before! 'Loopy' they called them. My daft friend said,"Are you sure it wasn't you they were calling Loopy, 'cos that would make more sense?" I chopped her head off with an axe. (not true)

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17 Apr 16 - 07:48 AM (#3785712)
Subject: RE: BS: Scan discrimination
From: Thompson

I applied to have a DEXA (bone density) scan last October, and was given an appointment in either this month or next, not sure which. I thought I'd put the letter away safely but can't now find it… rang up and got a voicemail message saying "I only monitor this phone on Monday, Tuesday and Wednesday mornings" or some such. Obviously not much of a priority.

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08 Jul 16 - 05:34 AM (#3799440)
Subject: RE: BS: Scan discrimination
From: Roger the Skiffler

PS...and finally. I went for an outpatient's post-op check yesterday and was out of there in under a minute. I'm feeling fine, the op didn't throw up any unexpected issues and I'm now off one set of pills. Doc didn't even need to glove up.

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08 Jul 16 - 07:07 AM (#3799446)
Subject: RE: BS: Scan discrimination
From: Roger the Skiffler

...lost the rest of that post, meant to say: If you are getting symptoms, get checked out. Procedure sounds horrible but I had no post op soreness or pain and blood in urine soon cleared. I was lucky, not cancerous (nicest thing a young woman has said to me in years with a finger up my arse (ass): "Your prostate is nice and smooth, not knobbly, that's a good sign")but my kidneys were on the verge of shutting down because of the obstruction.

RtS

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08 Jul 16 - 07:45 AM (#3799454)
Subject: RE: BS: Scan discrimination
From: Senoufou

That's very good news Roger.

I keep nagging my husband to have a check-up for his prostate. He has no symptoms but it's always best to be proactive. Being African, he can't see the point in going to the doctor's unless you're half dead already.
I think if one actually asks the scanning staff to comment on what they see, they'll oblige, even if they won't provide a print-off. I had a ghastly endoscopy procedure (tube down gullet with sedation which didn't seem to help!) Four very nice nurses have to hold one down firmly while the thing is shoved in. After it was shoved out again, I croaked out some questions I'd prepared earlier. (Ever the teacher!) The chap was a bit reluctant but he told me all I wanted to know and showed me the pics on his screen. Only a hiatus hernia thank goodness.
It is rather annoying if they assume one is too daft or thick to understand the findings.

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