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Author Topic: How I think one should go about getting a 2nd opinion  (Read 1404 times)

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Offline sp7

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How I think one should go about getting a 2nd opinion
« on: August 01, 2008, 07:16:35 PM »
I've never gone from one doctor <who has told me X about my medical problem and how he'd treat it> to another one for a second opinion.

I have to do this now so here's what I think would be the way to do this. Tell me if this good or not. I know readers here must have experiences in getting a 2nd opinion.

Since one is paying another doctor to actually *think carefully* in considering some important and/or serious medical matter, I think you'd only want, in the case of an accident that caused bad bodily damage, to tell that doctor:

- what happened (i. e. the event of the accident) and when
- what's wrong now with the body
- what can be done and what can't be done with the body

You then present him with certain records and documents such as:

- hospital notes from the time you were brought in an ambulance to the emergency room (to prove that the damage happened to you on date ________ )
- the MRI scan and the radiologist's report on the scan
- X ray radiographs and the radiologist's report on these

Then you ask him "what's wrong with me, what's damaged?" and "what would you do for and to me". If you tell him everything that the first doctor told you, the second MD *might not think* but just parrot back to you the same diagnosis, treatment plan, etc., etc.

Does the above sound reasonable and thoughtful in considering how to go about getting a good, useful second opinion?
Once an avid bicyclist (since '71 but ended bicycling in Aug. 2009)
Late May '08: hit on L side by motorist-> L knee badly damaged--> all 4 ligaments torn, bone bruising, meniscal tears; no surgery, no arthroscopy, only X-rays & 2 MRI scans. P. t. and swimming greatly help LEFT knee.
7/14: lost 1ACL

Offline jathib

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Re: How I think one should go about getting a 2nd opinion
« Reply #1 on: August 02, 2008, 01:18:11 AM »
I think you're just overthinking the whole thing. Go to the doctor and tell him what hurts. Let him ask the questions. Bring all your records, test results, etc. If he asks you what the other doctor said then tell him. It's pretty simple really. He should offer his opinion based only on what's presented to him, not what another doctor said.

Offline sp7

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Re: How I think one should go about getting a 2nd opinion
« Reply #2 on: August 02, 2008, 07:28:15 PM »
I think you're just overthinking the whole thing. Go to the doctor and tell him what hurts. Let him ask the questions. Bring all your records, test results, etc. If he asks you what the other doctor said then tell him. It's pretty simple really. He should offer his opinion based only on what's presented to him, not what another doctor said.


Well it sounds as if you're basically agreeing with me. I suppose just hope the 2nd doc asks what the 1st one said *after* the 2nd one tells you what's wrong and what he'd do for you. Right?
Once an avid bicyclist (since '71 but ended bicycling in Aug. 2009)
Late May '08: hit on L side by motorist-> L knee badly damaged--> all 4 ligaments torn, bone bruising, meniscal tears; no surgery, no arthroscopy, only X-rays & 2 MRI scans. P. t. and swimming greatly help LEFT knee.
7/14: lost 1ACL

Offline jathib

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Re: How I think one should go about getting a 2nd opinion
« Reply #3 on: August 02, 2008, 08:35:00 PM »
He really shouldn't ask at all but it depends on the purpose of the second opinion. If you're looking for a diagnosis then you don't need to even tell him you're there for a second opinion. He should give you a diagnosis based on his exam and any test results you bring. Then he should offer a treatment plan based on his protocol. But I'm not really sure why you'd be looking for a diagnosis unless you don't trust what the first surgeon told you. If you've had an MRI and x-rays then you already have a diagnosis from the radiologist's report. That isn't going to change. The doctor may or may not even look at the films if he has a report in front of him. Some doctors will just show you the bad parts based on the report.

Most people get second opinions when they're told they need surgery or their first doctor's treatment plan isn't working or they want to know if they're doing the right thing, etc. In that case you're not wanting a diagnosis, you just want to find out if the second doctor has a different protocol or some other treatment option.

Offline sp7

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Re: How I think one should go about getting a 2nd opinion
« Reply #4 on: August 02, 2008, 08:58:53 PM »
.........or their first doctor's treatment plan isn't working or they want to know if they're doing the right thing, etc. In that case you're not wanting a diagnosis, you just want to find out if the second doctor has a different protocol or some other treatment option.

Thanks for this helpful info.

Yes, I'm keen on getting help with what I quoted above. I've been only to the VA where I've only seen two young, inexperienced orthopedists who didn't tell me much. I need some guidance and have not even had any physical therapy yet, and it's now 9 weeks and some days since a car hit me on my left side while I was on my bicycle. Since 1971, I've been an avid bicyclist and am worried I might never ride again. All 4 ligaments in my left knee were damaged to one degree or another. In the forum "General rehab issues and pain problems" (which is at this website), see my post "Is it OK to enter the pain zone in this simple ROM exercise?" for background info on my case.]

Yesterday I made an appointment with a sports med orthopedist who deals with knee injuries and is keen on using MRI to figure out what's best to do. [20 days after the accident, I had an MRI scan, and earlier X rays of the left knee. I have all this on a CD prepared for me by the VA's radiology department. I hope another orthopedist wants this kind of format so he can see what's happened to me.][I also made an appointment with a non-VA hand surgeon because two fingers on my left hand were badly sprained/jammed/stoved and are now permanently bowed/curved/arched and cannot be made flat with the other fingers when either side of the left hand is pressed on a flat surface.]

Thanks again jathib for your good advice.

 
« Last Edit: August 21, 2008, 02:34:53 AM by sp7 »
Once an avid bicyclist (since '71 but ended bicycling in Aug. 2009)
Late May '08: hit on L side by motorist-> L knee badly damaged--> all 4 ligaments torn, bone bruising, meniscal tears; no surgery, no arthroscopy, only X-rays & 2 MRI scans. P. t. and swimming greatly help LEFT knee.
7/14: lost 1ACL

Offline travel agent

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Re: How I think one should go about getting a 2nd opinion
« Reply #5 on: August 08, 2008, 02:48:11 AM »
Hello-I just received a 2nd opinion regarding my knee injury.  On May 24 my knee buckled. I went to an OS and was advised to have PT.  After 5 sessions I complained that SLR were extremely painful.  1st MRI showed a crack in the patella but all ligments and tendons intact.  He put me a brace for 4wk and then started PT again.  I still complained about pain in the patella tendon region.  A 2nd MRI showed a partial tear in the tendon.  He advised me to continue PT.  He never fully explained my injury to me.  I had to keep calling for answers to my  many questions, especially if I didn't understand the MRI info.  He told me I would know how the knee would behave until a year had past! I saw another OS yesterday (one who has treated a family member and a couple of friends) and I was pleased with his decisiveness.  I just asked him to review the MRI reports and to tell me what he would suggest.  He explained that I have lost the "groove" that the kneecap slides over, therefore, it will move out of place causing the knee to buckle.  He also felt the crack in the patella has been there for a long time.  He wants me to a have PT for 4wks at a different facility (more advanced) and then we will re-evaluate the situation.  No discussion was had regarding the first doctor. Since I felt comfortable with his plan, I decided to change.  This is the 1st time I've ever changed doctors.  I think if you have any doubts about anything, get a 2nd opinion or even a 3rd.  It's your body and you don't owe anyone an explanation.  Good luck!.

Offline Skinnycatz

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Re: How I think one should go about getting a 2nd opinion
« Reply #6 on: August 08, 2008, 04:20:11 AM »
If you want to hear all about how to get MANY opinions...go to my thread over on the Patello-femoral section: "Got a Second Opinion on my knee - should I seek a third?"  I am about to get an opinion from OS #4, referred to me by #3!  I am not about to give up...I feel like I am fighting a war.  It has taken a lot of determination to keep going!

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline step

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Re: How I think one should go about getting a 2nd opinion
« Reply #7 on: August 08, 2008, 11:10:54 PM »
I also took a second and third opinion, and stuck with the third OS, who I thought offered the best diagnostic and recovery plan.
I did not offer upfront the recommendations of the previous consultants, just the investigation results so far (X-ray, etc.) and the ER report.

Overall, I think it's good to seek as many opinions as one needs to trust the diagnostic and treatment plan.

Lennie


Offline K8te

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Re: How I think one should go about getting a 2nd opinion
« Reply #8 on: August 09, 2008, 12:30:52 PM »
Hi
I 'm new to this website and have the same concern about getting a differnent opinion.
I'm 6 months out from an injury to my rt knee. Finally had my ACL repaired 6 weeks ago. Still dealing with a significant joint contracture that I had pre op. I slipped the other day onto my right foot and the pain was worse than when I first injured it. I'm convinced I have a serious soft tissue injury on the lateral side of my knee that is not being addressed, contributing to my contracture and swelling and delayed recovery. I'm considering getting the opinion of a physiatrist. Has anyone sought this service before?  Will this type of physician focus on soft tissue injuries? Of course, I'm still working with my Ortho and I don't want to rock that boat. How do you "diplomatically" seek the opinion of one physcian while still working with another? Please advice. Thanks

Offline jathib

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Re: How I think one should go about getting a 2nd opinion
« Reply #9 on: August 09, 2008, 01:44:00 PM »
Hi
I'm considering getting the opinion of a physiatrist. Has anyone sought this service before?  Will this type of physician focus on soft tissue injuries? Of course, I'm still working with my Ortho and I don't want to rock that boat. How do you "diplomatically" seek the opinion of one physcian while still working with another? Please advice. Thanks

I see a Physiatrist (aka Physical Medicine & Rehab) for chronic pain. I don't think they'd be the best specialist to see in your case until you know what's causing your pain. They might be able to help you if your condition becomes chronic.

I think it's way too soon for you to even be worried about seeing another doctor. Six weeks out from an ACLr is not nearly enough time to heal. This is a surgery that takes a several months of healing, not weeks. Back when I had mine done the standard protocol was to be out of work for six weeks even if you had a desk job.















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