How much do I share with possible new neuro?

[Fluffysmom]

I just called Quix's MS Clinic, and they want copies of chart notes from referring doctor, MRI reports, and a CD of my latest MRIs.

I told them that I could deliver the chart notes and CD, but there was a problem with the MRI reports; they had many mistakes and I was waiting for an addended version, but they still want the reports.

Do I send the previous ones as well, from the neuro-radiologist that said my lesions were "far and away most likely to be multiple sclerosis" and said it again when he reviewed my 3T MRIs with my PCP?

Do I wait for the addended reports and hope that they are at least somewhat better than the versions I have now?  I really think this doctor will make up his own mind, but a nurse needs to read all my reports and chart notes and decide if I should be seen.

As for the chart notes, there are some mistakes that I had my MS specialist correct via e-mail; for instance, she listed my second neuro as someone i had never heard of before.  Do I include our e-mail correspondence, or is that way too much information and I can correct any misinformation after I'm accepted at the clinic?

Should I fax the information, or make copies and hand deliver them with the CD when I get it back from the neuro-radiologist that just read it?

I could use a little help, please; nervous and wanting to do things right.  I chattered too much with person I talked to, though she didn't ask my name.  

There are several quesions in here; I'd appreciate some thoughts and ideas.

Kathy

[Fluffysmom]

Yes, it makes sense.

To clarify, though, should I include the lab results from the LP and bloodwork, as well as the most recent bloodwork by the rheumatologist?  How about the fax from the cardiologist, plus the results from the Bubble Echocardiogram ?

I don't want to overwhelm him with records, but I want to cover as much as I can that will really help.

I really like the cover letter idea; I may use pretty much the same wording.  Should I leave discussing the mistakes in the chart notes until I see him in person?

Thanks so much for your help.

Kathy

[Quixotic1]

This is a tough one  I suggest that you collect the MRIs, the reports and your PCPs notes and, even, the previous neuro's notes.   Write a cover letter telling him straight out that the previous neurologist was dismissive of you from the beginning.  She jumped immediately to the impression of small vessel ischemic disease, and was never open to any other diagnosis, despite the opposing views of your other specialists, especially the cardiologist and the neuro-ophthalmologist.  You wish for a fresh opinion, not biased by the neurologist.  (this appeals to the ego, asking him to be "better" than the previous doctor.)

He would need as much as possible of your rule-out work up.  Yes, I would have the reports stating that MS is by far the most likely answer for the appearance of your MRIs.

Does this make sense?

Quix

[Fluffysmom]

Thanks, thought that was the case, that a MS neuro would want to read the films.

I suggested to the person I talked to that Dr. M. would want to read the MRIs himself, but she insisted that they need the chart notes and MRI reports.

I also tried to convince her that he didn't want those chart notes, either, :o)

I'm all for saving the trees, doggone it, but if some nurse is going to read my reports and call me and let me know if I can make an appointment, then I guess I have to give them what they ask for.

I do want them to see the original neuro-radiologist's report, because the ones from OHSU say that everything is essentially unchanged from then.

I learned with this last neuro that one page with bullet points is an effective way to communicate with doctors, lol!

Kathy

[Lulu54]

Kathy,
All MS neuros basically discard the radiologist reports and read the films for themselves.  They know what they are looking for an trust only themselves to get it right!  


Actually that sounds harsh, which I don't mean for it to be - they hold themselves responsible for getting the dx right.

I would not drown the new doctor in paperwork - they are not going to read reams of print anyway.  

Save the trees,
Lulu

[Fluffysmom]

Thank you so much!  I was thinking about including my Timeline, but figured that could wait until after I got accepted.

Yes, the MS neuro that I'm filing the complaint about is considered my referring dr., doggone it.  I asked if my PCP could be, and was told that they needed the neuro's chart notes.  That's when I told them that I had the chart notes and could get copies of them to the clinic

I haven't had ON; my complete neuro-ophthalmological workup was pretty normal.

Other than that, the rest I can do!  I called and sent an e-mail to my current/ex MS neuro asking for the new MRI reports; I can still write an explanation about the mistakes in the chart notes.  The MRI reports, too, if they aren't any better.

I hope Dr.M. will see me!  I'll call my PCP's office and see when I can get my CD of my MRIs back, and start copying the chart notes to deliver with the CD and reports and all.  I just feel like it should be all in a package, not faxed notes and then deliver the CD.

I just bought new paper for the printer, and have extra ink cartridges, lol!

Hugs,

Kathy

[LLWB]

Which dr is considered your referring dr? The one who made all the mistakes? I would organize your reports, with the neuro-radiologist who said "far and away most likely ms" right on top!  Then the diagnosis of ON next.  Then I would put next an explanation  that the following reports/chart notes had a lot of incorrect information, and that you had requested the mistakes to be corrected. Then those reports. I have been to the neuro you are requesting to see. My reports were sent by my PCP, along with my MRI of brain, on 1.5T. I only showed ONE lesion. Yet he accepted me as a pt. After furthur MRI's on 3T, with no further lesions, and his physical exam, I was determined not to have MS. Dr. M was one of the best dr's I have ever seen, and very very thorough. His exam was over 2 hrs. I left feeling totally confident in his diagnosis.  I'm sure others will chime in today with their advice, just thought I would give you my opinion, as I have seen Dr. M..........Oh, he also read my timeline very completly, and questioned me about it. Good luck.

Maggie