Can I self refer to come from out of state?

Posted by lovesblues @lovesblues, Apr 12 11:27pm

Hi,
I’ve been under a doctors care (5 doctors) and that’s been 4 years now. I finally went to the VA ER last Saturday. I was admitted, I suffered through several painful “blown IVs” and blood tests that left me so bruised I appear to be a crime victim!

I was such a nervous wreck that my blood pressure climbed, it was 189/123 when I finally had enough and signed out, AMA. This due to the MRI not being available until at least 5 days from yesterday, when I left.

I’m now needing a mass removed from my chest cavity, the mass was hidden behind my breastplate, it’s 3 cm long. I don’t know how long it has been hiding there, but I think they believe that I have systemic cancer. I have a surgical growth in my throat that is causing my voice to change and be unreliable.

So I want to be cared for by doctors and not interns all day. I only saw a few. Residents and 2 full MDs that I’m aware of.

I want the mass removed as soon as possible without having a biopsy, that seems to be the push back. But I assert there’s no room in my chest cavity for space sharing and so there’s no reason not to fully remove it before pathology.

Can you please have someone call me?
Sincerely,
Lovesblues

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@lovesblues Welcome to Connect. I am a Mayo patient and self-referred for a spine condition. Connect is a patient forum where you can discuss and learn from other patients through shared experiences. Connect doesn't take appointment requests for Mayo Clinic and is not staffed by doctors.

You can self-refer to Mayo and get started with this link. http://mayocl.in/1mtmR63

You will need to have insurance that is accepted by Mayo, and you can check that on this web page.
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance

If you have imaging related to your appointment request, you will be asked to send a copy of it for review. There is no cost for the review, and this determines if your appointment request can be fulfilled. After contacting Mayo through this link, someone will call you to set up an account and take your information.

I do understand your frustration, however, I think most likely a biopsy will be required before surgery to remove a mass no matter where you go for treatment. In order to get insurance coverage and payment for services, the need for surgery must be justified, and there are specific treatment guidelines that are standard practice that must be followed, and a diagnosis must be made. When you have a diagnosis, a treatment plan is recommended that may be surgery or something else. That is a call made by the specialist, and I do know that Mayo is very thorough with testing before any surgery is offered.

This isn't unique to Mayo, and this is how a cancer specialist works. My husband is a skin cancer patient, and recently had an ultrasound on a skin lump, then a needle biopsy with image guidance. We followed up with his surgeon and he will remove this lump and that decision was made because he is high risk for a cancer reoccurrence because of genetic testing, and he already had surgical removal of melanoma which is deadly skin cancer unless you can find it and remove it before it spreads.

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@lovesblues, It is difficult when we don't get the answers that we want and deserve. When we know there is something foreign growing in us, it's normal to just 'want it out'. We don't know what the mass is, and if cancer is causing it. A biopsy is one step in answering those questions.
In the case of cancer spread, or metastatic disease, surgery may not be an option.
The biopsy can drive the treatment plan. With advancements in specialized medicine, treatment options for many cancers have drastically changed. Four years ago, I had a primary mass in my lung, and the lymph nodes in the center of my chest were enlarged to the point where my breathing was down to a wheeze. I could hardly get food down as my esophagus was being compressed. The biopsy of that lymph fluid showed lung cancer, and a biopsy of the liver showed that the lung cancer had metastasized to my liver. That information drove the treatment plan. No surgery for me, and luckily no chemo or radiation. I was put on a targeted therapy treatment that matches my specific type of cancer (ALK positive lung cancer). A few days after starting treatment I began to breathe better. Four years later, I'm still on the same treatment, and I can breathe.
With today's treatment advancements, surgery isn't always the first or best option. There are many people in the lung cancer group that have had surgery, and the recovery is not easy. They are often left with nerve pain for years, but those surgeries save lives too.
The bronchoscopy biopsy procedure is generally well tolerated, with some minor coughing after the procedure. Recently I had a new nodule show up on a CT scan and my oncologist started talking about changing my treatment. A biopsy showed that the new nodules were fungal (histoplasmosis). I'm taking an anti-fungal med now, we aren't doing surgery to remove the nodules. The biopsy can tell us so much. I will always go to a biopsy for information prior to changing or adding any treatment.
Can I help answer any questions related to the biopsy procedure?

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@lovesblues, just checking in. Were you able to submit your self-referral to Mayo Clinic? How are you doing?

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I just tried to self refer the day before yesterday. Whatever you put in the online form triggers an automated response such as "hip adductors" in my case. Then the scheduler can only place you in certain departments.
This is my understanding of how their system works based only on my own experience. So now I'm having my doctor refer me.

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@shark37

I just tried to self refer the day before yesterday. Whatever you put in the online form triggers an automated response such as "hip adductors" in my case. Then the scheduler can only place you in certain departments.
This is my understanding of how their system works based only on my own experience. So now I'm having my doctor refer me.

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@shark37, I'm glad you're able to get your physician to make a referral for you. If you have any questions or categorization about the request you submitted, you can call Mayo Clinic at the location to which you submitted the referral.

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