Paul's Heart

$.04 – Two Cents For Each Opinion

We do it when we look for auto loan rates.  When we go shopping, we compare prices and quality.  Even if there is a movie that we want to see so badly, but the critics said it stinks, we seek out and value the opinion of someone else, because they might feel differently.

Then why would we not do it for a medical opinion?  Two of the most common reasons are passivity and the belief that our lack of knowledge does not qualify us to question the doctors and technicians who clearly should know, right?

When the decision is more radical than simply selecting a medication, you have the right, check that, you have the obligation to ask questions, to get a second opinion.  When time allows you, and in most cases it probably will, you need to ask the question, what else can be done.

A pregnant woman who is five months into her term is recently diagnosed with Lymphoma.  This particular situation occurs quite often (not to be confused with “because of the pregnancy she developed Lymphoma).  The mother is faced with so many decisions,  can treatment wait until after the birth or  what effects will occur to the unborn child?  The mother will not be concerned with hurting the doctor’s feelings by requesting or demanding a second opinion.  She needs to know and understand all of her options, and the possible outcomes of those decisions.

One of the first young men that I counseled had been diagnosed with a cancer that would have left him with a urine bag, not to mention affect the possibility of fatherhood.  Clearly upset, shaken, and defeated, he was surprised when I had asked him, “what did the second doctor say?”  A second opinion took him out of state, but to another research institution that gave him an option of remaining completely intact, functional, and cured.

I have to stress, sometimes you do not have this luxury.  My heart surgery was one of those moments.  A stress test had discovered a blockage.  Its severity had not been known, but the cardiologist was certain it could be taken care of with simple catherterization and stinting.  Only when they got in there, did they realize the opposite, and far worse.  It was a common condition for this hospital to see, but not the cause.  The doctors felt that they could save my life, and while I was coming out of the anesthesia from the earlier procedure, my wife gave the authorization to schedule the emergency bypass surgery for early the next morning.  In that case, time was not an option.

But when you have the time, and face it, other than your heart beat stopping you will have the time, consider a second opinion, especially when it comes to something radical like a mastectomy or the removal of a lung.  You have to understand, if you go to see a surgeon for a diagnosis, their specialty is going to be surgery.  If you go to a radiation oncologist for a cancer diagnosis, chances are likely, the doctor will push radiation.

I am not a doctor, nor do I play one on television.  But when it came to my Hodgin’s Disease diagnosis and treatments, there were a total of eight doctors involved.  For my late effect issues, I have more than a dozen.  I am certain that my insurance carrier is not happywith all of the bills, but I am alive, and my quality of life is as best as it can be, and would have been far worse had I closed the door on the other options made available to me.

I honestly believe, that even 23 years later, if my radiation oncologist were to bump into me on the street, he would probably still swear that he wants me to undergo preventive radiation therapy.  I believe this because he chased me for the first five years of my remission.

There is the chance that a doctor may get annoyed with a delay for a second opinion, but if the doctor is worth anything, they will welcome a second opinion, a chance to discover something that might have been overlooked, some newer option available.  Just as it only took a decade to come up with a better and safer treatment for Hodgkin’s, unless my oncologist was kept well-informed of the progress, I would not have had the options. 

I am blessed to have a great team of doctors who work with each other, in spite of the geographical distance.  Time is rarely wasted as they consult with each other, which has become my second opinion.  They know that if they did not do it themselves, then I would do it for them.   Doctors know time is important, but so is the sanity of a patient that all efforts to minimize the effect to quality of life have been exhausted.