I recently received copies of my husbands last 6 months of doctor visits and labs and found one documentation puzzling. How would you interrupt this.

"I did not appreciate a focal abnormality to account for uptake in the right piriform sinus on his June PET. We will continue to monitor the are closely."

My question is the doctor saying she did not like the focal abnormality or am I taking it personal because I did question the uptake of 4.7 that I learned about weeks after the PET scan when I read his mychart report. (we had been told by the doctors there was no uptake so that is why I questioned her. (I am known more being a little too peristant and have had many one to one visits with the doctors without my husband present. He has the no need to know anything attitude!!)

Anyway, I still think that is a strange way to write something!!!!

Hi Terrib

I think the phrase "I did not appreciate ..." means she hadn't considered that whatever the abnormality was around the piriform sinus was responsible for the increased uptake reading on the PET.

It is possibly she either doesn't think the increased uptake is anything to do with the piriform sinus OR someone explained it to her and she is now saying "oh I hadn't realised ..."

Whatever she means, you will have to ask her but I really don't think it is anything you said

PS things get stuck in the piriform sinus all the time (that sensation of something being stuck in your throat?), so maybe there is infection, left over food or even scarring from a previous lodgement of food that set the PET off??? Just a guess... and may be completely off ...

Alex often described his food/mucous/formula getting stuck on a "platform" at the back of his throat which made him feel he was choking. I certainly saw (via endoscope) a lot of pooling of gunk in that area .

I agree with Karen. Sounds like medical lingo. Who is this doctor, an RO or MO, and where was this statement included in the PET report or follow-up visit report? The words focal and diffuse, are terms used for positive visual findings in the FDG uptake in PET scans, and did not agree as the cause, as Karen mentioned, and to ask the doctor. Good luck.

This was a summary written up after his monthly check-up that includes a scope each time. I had questioned her about the uptake and asked her if she could see how the piraform sinus looked during the examination. This doctor is one that works with our ENT who thankfully arrived the day before our first visit with her. We at first were very apprehensive, thinking we had a trainee that was going to do the laser surgery on his vocal cord. (She looked like she was 20 and weighed under 100 pounds.) We switch off seeing her and the ENT every month and our ENT told us that if he had done the surgery my husband would not have had near the voice that he has now. She is considered the "Voice Doctor" so we are very fortunate for the team of doctor we have had.

After reading this I was afraid I offended her but my husband thought I took it the wrong way also. I still think it is a strange way to word things!!!

4.7 is an elevated uptake however it's like Karen pointed out, it's in an area that would have several reasons for this, which is why monitoring it is important.

All of this is foreign to you so your initial reaction is to be expected, don't take "anything" personal while in the emotional state that only cancer, or potential cancer can cause. Keep breathing and seeking clarification and answers my friend and allow us to do what we do best...which is help.

Keep your chin up!

Eric

Terib

Give yourself a break. Your earlier word by word analysis of the Petscan report, this concern over whether your doctor's report meant she did not appreciate your remarks, etc gives far too much significance to the routine medical boilerplate that they are all written in. Klo's interpretation sounds spot on: the doctor now realizes that a high SUV on a petscan could be caused by non cancer (something we on OCF all know all too well).
So yes, you are taking this too personally. I cross examine all my doctors unmercifully and have never seen any write up in their notes about it. I'm pretty sure I'm more caustic about it then you are, especially when I demand citations to studies for their opinions and email them the latest studies.
You are being a diligent caregiver but relax
Charm

Also remember that Doctors see patients/caregivers all day, and that you would have to do or say something REALLY epic for them to remember it as snippy.

I asked a lot of questions, too, and complained as needed. But I think my husband's doctors were glad he had an involved spouse.

Hey Lady,
I didn't realize you were still worrying. Write me!
Kathy