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Experts Suggest Second Opinion in Crucial Diagnoses

by Gopalan on August 31, 2007 at 11:46 AM
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Experts Suggest Second Opinion in Crucial Diagnoses

Bypass or cancer, don't be in a hurry to follow your physician's directions. Rather wait and take a second opinion, experts suggest.

Pause especially when the diagnosis is tricky, the procedure is risky or has permanent consequences, or when there are less-invasive alternatives.


Heart bypass surgery first. 'Anytime you're considering a procedure that has a risk of dying, stroke and severe infection, you should get a second opinion,' says Dr. Richard Stein, director of preventive cardiology at Beth Israel Medical Center in New York.

Stein says alternatives such as angioplasty or medications with exercise are less risky and may be better for some patients.

So also sometimes doctors recommend surgical removal of the uterus for bleeding or pelvic pain when the uterus isn't the problem at all.

'Almost on a monthly basis, I will see a patient whose doctor told them to get a hysterectomy, and it turns out they have myofascial pain,' says Dr. Howard Sharp, vice chair of clinical affairs in the Department of Obstetrics and Gynecology at the University of Utah School of Medicine.

Myofascial pain is a type of musculoskeletal pain that can be treated with icing, stretching and anesthesia injections.

Even when the problem is in the uterus, there are alternatives to a hysterectomy. There are lots of less-invasive options these days, including hormone treatments.

Even where some fetal abnormality is detected, one doesn't have to opt for abortion.

Sometimes a fetus might be diagnosed with having a congenital cystic adenomatoid malformation -- an abnormal formation in the lungs -- but actually turns out to have a diaphragmatic hernia. Parents might make different decisions based on these diagnoses, Dr. Jessica Bienstock, associate professor of maternal-fetal medicine at Johns Hopkins Medical Institutions, points out.

Again the case of varicose veins, (the swollen veins, affecting women more), one doesn't have to rush to surgically remove the affected veins.

There are so many different treatment options for varicose veins, it's best to get a second opinion, according to Dr. Julie Fleishlag, chair of the department of surgery at Johns Hopkins.

Exercise, use of stockings, injections, surgery and laser treatments are all options, she says.

'Go to someone who does all these types of interventions,' she suggests, since a doctor who performs only one might be biased. 'If you get the wrong procedure, it won't last long.'

Finally in the case of a brain tumour, the diagnosis depends largely on the pathologist reading a slide -- and mistakes can happen.

Sometimes brain tumors are diagnosed when they aren't even tumors at all, says Evan Falchuk, president of Best Doctors, a company that helps patients get second opinions. 'You may not need brain surgery because what they told you was a tumor was in fact an inflammatory disease, treatable with medicines,' Falchuk says.

Bernard Shaw had warned against trusting doctors too much. May be his admonitions are still valid.

Source: Medindia

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