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Validity of CT scan results

Posted by barbaraaw @barbaraaw, Jun 12, 2023

Hello~ I am new to this group and hope I am posting a question that is acceptable. I was diagnosed with papillary thyroid cancer in '98. Thyroidectomy, two doses of radiation. For the last 2 years or so, I've had a cough and fullness in my throat. Endocrinologist says no chance of recurrance being out so far and labs are normal. However, upon visiting my dentist, hygentist and dentist felt a lump and so did I. Upon speaking with my new PCP, she suggested a CT scan without contrast {I'm allergic} since she, too, could see a lump. Long story short, the CT scan came back fairly normal except for "tortous vessels" in my neck and "thyroid is normal and intact"! I am questioning the validity of the radiologists interpretation of the scan or is it possible that there is something growing back even tho labs are normal? I have reached out to the patient advocacy group at the hospital and they have not called back yet, but, somehow, the radiologist has made an addendum to the original report and now says, "Thyroidectomy. No residual thyroid tissue or surgical clips present." What should I do? What would you do? TIA

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koh | @koh | Jun 13, 2023

That’s concerning!! Thyroid intact when you don’t have a thyroid?! I am curious if you can go through your insurance company and have a repeat CT scan at another place for a second opinion. Since radiologist added addendum, they obviously got your call and are following up but instead of trying to “ make an error appear right,” maybe a second scan would be in order ( at another location).
Good luck!

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1 reply
cocha | @cocha | Jun 13, 2023

"thyroid intact" when you have had a thyroidectomy - definitely sounds strange. A second scan sounds very reasonable.

Also, a long shot - about the cough and lump - have you had acid reflux/GERD by any chance? That could also cause these symptoms.

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1 reply
barbaraaw | @barbaraaw | Jun 13, 2023
In reply to @koh "That’s concerning!! Thyroid intact when you don’t have a thyroid?! I am curious if you can..." + (show)
@koh

That’s concerning!! Thyroid intact when you don’t have a thyroid?! I am curious if you can go through your insurance company and have a repeat CT scan at another place for a second opinion. Since radiologist added addendum, they obviously got your call and are following up but instead of trying to “ make an error appear right,” maybe a second scan would be in order ( at another location).
Good luck!

Jump to this post

Thank you for replying ~ after speaking with the patient advocate at the hospital, she is putting my bill on hold until their investigation is made more clear. In the meantime, it is more confusing as my pcp said the US (?!) looked reassuring. I reminded her that she ordered a CT scan. She said that my insurance denied it and she went ahead and ordered an US, which was approved. Nobody informed me of this when I called to schedule the CT scan. It’s possible it was denied because my thyroid cancer has a workers comp claim attached to it. I think I might give this some time to settle as I have company coming next week. It’s all too consuming right now. Thank you again ~

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1 reply
barbaraaw | @barbaraaw | Jun 13, 2023
In reply to @cocha ""thyroid intact" when you have had a thyroidectomy - definitely sounds strange. A second scan sounds..." + (show)
@cocha

"thyroid intact" when you have had a thyroidectomy - definitely sounds strange. A second scan sounds very reasonable.

Also, a long shot - about the cough and lump - have you had acid reflux/GERD by any chance? That could also cause these symptoms.

Jump to this post

Thank you… yes, I have had acid reflux in the past and treated. Doing well with that now. Cough better but still present~

REPLY
koh | @koh | Jun 14, 2023
In reply to @barbaraaw "Thank you for replying ~ after speaking with the patient advocate at the hospital, she is..." + (show)
@barbaraaw

Thank you for replying ~ after speaking with the patient advocate at the hospital, she is putting my bill on hold until their investigation is made more clear. In the meantime, it is more confusing as my pcp said the US (?!) looked reassuring. I reminded her that she ordered a CT scan. She said that my insurance denied it and she went ahead and ordered an US, which was approved. Nobody informed me of this when I called to schedule the CT scan. It’s possible it was denied because my thyroid cancer has a workers comp claim attached to it. I think I might give this some time to settle as I have company coming next week. It’s all too consuming right now. Thank you again ~

Jump to this post

I had a car accident once and my doctor recommended a CT or MRI (I just don’t recall which one he ordered) and my insurance wanted me to go to PT first; so I went to PT. When I went back to my doctor to get a new script for the CT or MRI and he was furious! He informed me about the damage that the therapy could have done by not having the studies done first. My doctor’s comment was, “The next time your insurance company decides to direct what needs to be done for your condition, have THEIR doctor, contact the doctor who is actually treating you.” He told me that a person in an insurance office should not be the person determining what you need …..your doctor does that. I always remember how mad he was. I have not run into this situation again so I am curious if my doctor followed up with the insurance company.
I figured I would share this with you because it does seem odd that an insurance company changed the direction of the doctor’s recommendation for a CT scan. Good Luck!

REPLY
1 reply
barbaraaw | @barbaraaw | Jun 14, 2023
In reply to @koh "I had a car accident once and my doctor recommended a CT or MRI (I just..." + (show)
@koh

I had a car accident once and my doctor recommended a CT or MRI (I just don’t recall which one he ordered) and my insurance wanted me to go to PT first; so I went to PT. When I went back to my doctor to get a new script for the CT or MRI and he was furious! He informed me about the damage that the therapy could have done by not having the studies done first. My doctor’s comment was, “The next time your insurance company decides to direct what needs to be done for your condition, have THEIR doctor, contact the doctor who is actually treating you.” He told me that a person in an insurance office should not be the person determining what you need …..your doctor does that. I always remember how mad he was. I have not run into this situation again so I am curious if my doctor followed up with the insurance company.
I figured I would share this with you because it does seem odd that an insurance company changed the direction of the doctor’s recommendation for a CT scan. Good Luck!

Jump to this post

Wow~ it really is amazing how much of our lives that are controlled by insurance companies! I’m glad that worked out for you. Thanks for your reply ~

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bevr | @bevr | Jun 14, 2023

Would an ultrasound be possible? I was under the impression that ultrasound scans of the thyroid area give better results, and maybe insurance would be more amenable.

So sorry about the insurance situation. It's criminal how much suffering it causes.

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barbaraaw | @barbaraaw | Jun 14, 2023

Thank you ~ I was wondering the same thing. However, if it isn’t thyroid cancer, since thyroglobulin is undetectable, would US still be the best way to see what’s going on in there?

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