› Forums › General Melanoma Community › incorrect records
- This topic has 14 replies, 4 voices, and was last updated 13 years, 11 months ago by
LynnLuc.
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- June 17, 2011 at 8:40 pm
i have posted a few times… first w questions, then the pathology for my initial biopsy. but now, i am as scared as my first post. i already knew i wasnt happy w my derm. i am seeking a second opinion w a oncologist, that appt is the 23rd. so today i had stitches removed from my reconstruction (after MOHS) at the original derm's office. i also picked up my records for the second opinion… and they have ALOT of incorrect info.
i have posted a few times… first w questions, then the pathology for my initial biopsy. but now, i am as scared as my first post. i already knew i wasnt happy w my derm. i am seeking a second opinion w a oncologist, that appt is the 23rd. so today i had stitches removed from my reconstruction (after MOHS) at the original derm's office. i also picked up my records for the second opinion… and they have ALOT of incorrect info.
the first thing i noticed was the antibiotic. the day the derm did MOHS (may 31st) he prescribed Cipro as my antibiotic, to be taken starting the morning of reconstruction (june 3rd). my records say he prescribed Keflex. i called the pharmacy they say usually keflex would be the more appropriate antibiotic, but call my derm. the pharmacy also stated the original prescription was always for cipro, that i took. i didnt call the derm… they already messed enough up.
but then i continued to check records… i had told the derm that lesion had scratched open a few times bc it was itching. i told him i wasnt sure if he would consider that ulceration, he said no. my pathology for biopsy, i think, says no ulceration. but in my records it says ulcer marked on the picture of the body where my lesion was… confusing.
then, im listed as a non smoker… which today i agree with. but i smoked my last cigarette on may 30th, the day before the MOHS. and the last time i spoke w derms office was june 3 for reconstruct… how did they know i actually quit? and i dont think that would have even bothered me if the other stuff was right… i probably would have assumed they just had faith in my quitting.
also, the records claim they gave me antibiotic ointment for wound care… i didnt. i assume that went to one of the staff for their personal use.
after the physician asst at derms office removed stitches he wanted to biopsy more, i refused… will wait for second opinion dr. but he also stated that he wasnt worried about the moles i pointed out that came up since my pregnancy w my daughter (3yrs ago) bc they were not dark enough. said they are only concern if dark pigment. but isnt it possible for melanoma to not always appear dark???
and after all this… im supposed to trust they really got it all??? has anyone ever heard of anything like this?
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- June 17, 2011 at 9:01 pm
You need to find another dermatologist and possible a surgeon who specializes in oncology to get this area resected properly. I'm not sure an oncologist will able to answer your questions. They don't do biopsies! Is it a melanoma oncologist?
I can't remember what your original path said as far as depth. I just don't think MOH's is considered a wide enough excision.
If there is a mole that you are concerned about then get to someone else. This derm is wasting his time and needs to go back to doing Botox shots!
Linda
Stage IV since 04 , 2 weeks NED
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- June 17, 2011 at 9:01 pm
You need to find another dermatologist and possible a surgeon who specializes in oncology to get this area resected properly. I'm not sure an oncologist will able to answer your questions. They don't do biopsies! Is it a melanoma oncologist?
I can't remember what your original path said as far as depth. I just don't think MOH's is considered a wide enough excision.
If there is a mole that you are concerned about then get to someone else. This derm is wasting his time and needs to go back to doing Botox shots!
Linda
Stage IV since 04 , 2 weeks NED
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- June 17, 2011 at 10:45 pm
my new dr is an oncologist special interest in melanoma. seriously, she wont biopsy??? i did NOT know oncologists dont biopsy. should i be trying to find another derm now instead?
the depth was 0.72mm breslow according to biopsy. the derm said it was deeper at removal but wouldnt say how much deeper. i found out from this bulletin board tha is bc MOHS makes that an unanswerable question. bc of the way the procedure is done there is no final depth measurement.
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- June 17, 2011 at 10:45 pm
my new dr is an oncologist special interest in melanoma. seriously, she wont biopsy??? i did NOT know oncologists dont biopsy. should i be trying to find another derm now instead?
the depth was 0.72mm breslow according to biopsy. the derm said it was deeper at removal but wouldnt say how much deeper. i found out from this bulletin board tha is bc MOHS makes that an unanswerable question. bc of the way the procedure is done there is no final depth measurement.
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- June 17, 2011 at 11:56 pm
I have a derm, a surgeon, a mel specialist(I travel to him), a local oncologist, now a radiologist that has experience with melanoma and a local radiologist! Quite a pain……. But, at least for me an oncologist hasnever done a biopsy. If your appointment is soon I would just get his advice, let him read all of the reports, then go from there. Meanwhile you can be looking for a new derm.
Now, many years ago went to Univ. of Penn's cutaneous center – I was stage 1A then, and I would see whoever was on rotation. I would usually tell them I would wait till I got the Dr I wanted. If there was something to biopsy they would send in someone else to do it. So if your going t a huge clinic that might be the case.
It's amazing how they each have their specialty!! That's why I like where I go because they have a team approach and the different specialists talk. Please realize I am stage IV and in a much different situation then your in.
Want you to know that even if they do an SNB now the path might have been changed and could end up inaccurate. There is also a good chance because of your Dr's lack of communication that things were done properly but not explained correctly to you. The oncologist will be able to tell by reading the reports.
Let us know how it goes!!!
Linda
NED 2 weeks, Stage IV since 06
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- June 17, 2011 at 11:56 pm
I have a derm, a surgeon, a mel specialist(I travel to him), a local oncologist, now a radiologist that has experience with melanoma and a local radiologist! Quite a pain……. But, at least for me an oncologist hasnever done a biopsy. If your appointment is soon I would just get his advice, let him read all of the reports, then go from there. Meanwhile you can be looking for a new derm.
Now, many years ago went to Univ. of Penn's cutaneous center – I was stage 1A then, and I would see whoever was on rotation. I would usually tell them I would wait till I got the Dr I wanted. If there was something to biopsy they would send in someone else to do it. So if your going t a huge clinic that might be the case.
It's amazing how they each have their specialty!! That's why I like where I go because they have a team approach and the different specialists talk. Please realize I am stage IV and in a much different situation then your in.
Want you to know that even if they do an SNB now the path might have been changed and could end up inaccurate. There is also a good chance because of your Dr's lack of communication that things were done properly but not explained correctly to you. The oncologist will be able to tell by reading the reports.
Let us know how it goes!!!
Linda
NED 2 weeks, Stage IV since 06
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- June 17, 2011 at 9:26 pm
If I remember correctly, you are waiting for your insurance to cover a second opinion. When approved, have all your records transferred. This derm is a nut case. If you are not approved, be the squeaky wheel and explanin what is going on.
Since you had MOHS for a .72 mm Breslow depth, discuss with the second derm about having adequate margins, especially the depth margin. MOHS never should have been done.
Concerning the ulceration. Your pathology report states no ulceration, so I would not worry about your scratching something open after the fact. The determination of Ulceration is made on the lesion itself by microscopic evaluation, not be you scratching it, either before of after surgery. Pathologists can tell if a tumor is ulcerated or not or has some other type of trauma instead.
Michael
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- June 17, 2011 at 9:26 pm
If I remember correctly, you are waiting for your insurance to cover a second opinion. When approved, have all your records transferred. This derm is a nut case. If you are not approved, be the squeaky wheel and explanin what is going on.
Since you had MOHS for a .72 mm Breslow depth, discuss with the second derm about having adequate margins, especially the depth margin. MOHS never should have been done.
Concerning the ulceration. Your pathology report states no ulceration, so I would not worry about your scratching something open after the fact. The determination of Ulceration is made on the lesion itself by microscopic evaluation, not be you scratching it, either before of after surgery. Pathologists can tell if a tumor is ulcerated or not or has some other type of trauma instead.
Michael
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- June 17, 2011 at 10:39 pm
thank you! i was hoping the ulceration was determined by pathologist. but i have been so confused bc of this derm being so uncommunicative. i have read MOHS was NOT a good option… but unfortunately, whats done is done. now i will see what the new dr says. and i think i will insist on further testing to ensure i am NED in that site as well as the other areas im concerned about. i have already contacted my insurance to file a complaint. and hope everything goes smoother w the new dr.
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- June 17, 2011 at 10:39 pm
thank you! i was hoping the ulceration was determined by pathologist. but i have been so confused bc of this derm being so uncommunicative. i have read MOHS was NOT a good option… but unfortunately, whats done is done. now i will see what the new dr says. and i think i will insist on further testing to ensure i am NED in that site as well as the other areas im concerned about. i have already contacted my insurance to file a complaint. and hope everything goes smoother w the new dr.
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- June 18, 2011 at 10:04 pm
it's not really a shock that they got your info wrong…I have found that true in my care as well. Med Center One in Bismarck ND did it every time I went for an appointment. The worse mistake I ever saw of documentation was when I took my records from Mayo Clinic ( which is first hand and correct) to Dr Rosenberg at the NIH for an assessment and evaluation. The final reports had me at stage 3 (instead of stage 4) had 3 more melanoma in lymph nodes ( I had one) and also mentioned my groin area was healing nicely from surgery….ummm..never had surgery there.I had a thoracotomy in it was a cut beside my breast around my side and up thru my should…no where close to my groin…wonder what else they got wrong and what patient was treated with my files! I am happy I am at Moffitt and so far all is very fine here!
=:o) Lynn
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- June 18, 2011 at 10:04 pm
it's not really a shock that they got your info wrong…I have found that true in my care as well. Med Center One in Bismarck ND did it every time I went for an appointment. The worse mistake I ever saw of documentation was when I took my records from Mayo Clinic ( which is first hand and correct) to Dr Rosenberg at the NIH for an assessment and evaluation. The final reports had me at stage 3 (instead of stage 4) had 3 more melanoma in lymph nodes ( I had one) and also mentioned my groin area was healing nicely from surgery….ummm..never had surgery there.I had a thoracotomy in it was a cut beside my breast around my side and up thru my should…no where close to my groin…wonder what else they got wrong and what patient was treated with my files! I am happy I am at Moffitt and so far all is very fine here!
=:o) Lynn
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Tagged: cutaneous melanoma
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