Trust Your Gut

Getting the Best Care - August 31, 2015

Recently a client of mine* received a diagnosis of breast cancer. This was, of course, upsetting news but compared to many other people who receive that news her prognosis is very good. The cancer was caught at a very early stage and she was able to start treatment quickly. Her odds of survival are extremely high and the type of treatment she is receiving is much shorter and easier than it would have been if it had been diagnosed at a later stage. While cancer is never good news, in her case it is manageable and that is primarily due to the early detection.

What is unusual about this particular case is that the patient pushed for the testing that lead to the diagnosis, not her doctors.  A few months before the diagnosis she had a mammogram with a clean result. Then a few weeks later she discovered a lump in her breast. Her primary care physician ordered an ultrasound of that lump and the result of that test was clear. Soon after, she saw her gynecologist for an annual exam which included a breast exam and that doctor did not find anything concerning during that exam. A month later when she saw the gynecologist for a follow up appointment related to another issue she let the doctor know she was still concerned about the lump in her breast. The gynecologist referred her to a breast specialist who did a simple biopsy during the initial exam. The results of that biopsy were inclusive so a complete lumpectomy was done which allowed for a more thorough biopsy of the mass.  That was when the cancer was diagnosed. The specific type of breast cancer she has is extremely rare and because of that it did not present the way that most other cancers do. This is likely why the standard tests did not catch it.  To be honest I was surprised when the diagnosis was made, I expected it to be negative because all the other tests were negative. I don't think it was a surprise to the patient because she knew something was wrong with her body.  She knew in her gut that something wasn't right so she insisted on tests until it was confirmed.

Medical professionals use the scientific method to diagnose and treat patients. That means they work in the world of probability.  Based on research of past cases they use that information to predict the probability of the same being true for another patient's case. This method is the most effective for the most number of people and typically it works quite well. The problem is that sometimes there are outliers to the data that gives us probable outcomes. There are individuals who simply do not fit the profile for the expected results.  If you feel strongly that you might be one of those people it is important to speak up and request more information.  Also remember that medical errors do sometimes happen. Hospitals and labs are run by human beings and like in all areas of life those human beings sometimes make mistakes.

Of course there is a delicate balance to requesting further testing or more information when you feel something is wrong.  First, it is important to understand the test results you have and why the doctor believes them to be valid.  If the doctor tells you the result is negative and you feel this isn't right, ask further questions about it. Ask about the rate of false negatives for that test. Explain to the doctor why you feel something is wrong and ask how those specific symptoms or feelings could be explained with the test result. You may find that with further probing and more information that your "gut" was telling you something else is wrong and the test results are valid. You may also find that a different test or a referral to a specialist is appropriate.  If the doctor's explanation does not satisfy your concerns and further testing is not recommended then you may want to consider getting a second opinion.   As I've written before, second opinions are an important part of the medical process.  Doctors are almost always receptive of referring patients for second opinions and if they are offended by the request I would consider that a stronger indication of why one is warranted.

Most of the time when you have a test result and a recommendation from your physician regarding that result you can be assured that you are getting accurate information.  It really is wise to trust your medical professionals, generally they know what they are doing. The time to be most skeptical is when what you are being told really doesn't feel correct to you. A doctor has medical training and years of experience but they are not living in your body and can't understand your experience.  It is important to advocate for yourself and speak up and question things when your gut is telling you something isn't right.

Story shared with permission.