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Published August 27, 2019

THE VIEW FROM MY SEAT

Are doctors running too many tests and stressing out patients?

By Ernie Williamson / The Bulletin

Enough was enough.

I realize that as a paraplegic I require more medical tests than most 72-year-olds. But things were cascading out of control. I began to wonder if so many medical tests were actually unhealthy. Definitely too much anxiety. And maybe too much radiation.
Feeling as if I were in a medical maze with no way out, I questioned my urologist, who just happened to be the next doctor on my routine appointment schedule.

He wanted me to take my annual uroflow test, a test I had taken and passed every year since coming down with a spinal cord disorder seven years ago. The test requires drinking enough water to fill your bladder before going to the urologist’s office where you empty the bladder into a device that measures flow.

It’s tolerable, if the timing is right. But have you ever known a doctor’s office that operated on schedule? Too often I would sit in the office in my wheelchair with a full bladder, waiting to get called, hoping not to embarrass myself. I would fidget a lot.

I didn’t want to go through that again. So I rebelled and said I didn’t think I needed this test. To my surprise, the doctor let me off the hook ... for a year.

My new-found caution about some medical testing had been building as a result of two traumatic first-hand experiences several years earlier.

Right after becoming a paraplegic, I went to an emergency room with stomach pain. The doctor ordered a CT scan. A solitary nodule was found in a lung.

He reassured me that most lung nodules are not malignant and that was probably true in my case since I had never smoked. He told me; however, I should see a pulmonologist, just in case.

The pulmonologist agreed the nodule probably wasn’t malignant, but just in case (again) medical protocol called for me to get a CT scan every 6 months for two years. If the nodule didn’t grow, I was in the clear.

For two years I felt the stress millions of cancer patients feel. Sleepless nights before the test. Stress during the test. Anxiety waiting for results. Repeat.

I was cleared after two years but not before I had absorbed several doses of radiation. CT scans in some cases produce the equivalent to about 200 chest X-rays, or the amount most people would be exposed to from natural sources over 7 years.
Several months after being cleared by the pulmonologist, I went for my annual four-to-five hour MRI of the spinal cord and brain.

My wife and I were stunned when my neurologist told us that the MRI showed a brain anomaly. He explained this was either the result of me moving during the MRI or a rare brain cancer that claims lives in several months if not treated or 18 months if treated. He doubted it was a tumor, but just in case (again), we had to check it out.

More weeks of stress. More anxiety. More tests, including a lumbar puncture.

By the time my neurologist got the final results, I wasn’t too worried. After all, several months had gone by, and I was still alive and taking tests.

It turns out even doctors worry there is too much testing. Several years ago a group of medical specialty boards recommended that doctors perform 45 common tests and procedures less often. They also urged patients to question these services if offered.
But that is easier said than done. After my rebellion with my urologist, I had an appointment with a gastroenterologist because I battle heartburn. He recommended an endoscopy.

Reluctantly, I agreed. I am glad I did. This test actually found something needing attention.

So much for my rebellion against testing.

(Ernie Williamson welcomes reader input. Please contact Ernie at williamsonernie@gmail.com)