sing a song of sixpence...

December 23, 2005 7:04 AM

I found a lump in my underarm earlier in the week which has since disappeared, leaving me to believe the doctor was right and it was a cyst. My doctor (just to be on the safe side) ordered blood work and I had my blood drawn on Monday. Now it's Friday and I haven't heard my results.

I called the doctor's office this morning to see if I could get my results over the phone. The receptionist said sure and then put me on hold.

When she came back, she explained my doctor was on vacation and had not signed off on the test results so she couldn't release them over the phone and she would have him call me on Monday when he returned to the office.

My question for the doctors on the board is: is this normal office procedure or am I basically awaiting bad news?

My doctor did say he would have the test results to me next week, but as it was just before the holidays, I was hoping to have an answer so the results wouldn't be hanging over my head during the festivities this weekend.

Needless to say, now my imagination is going into overdrive, thinking the receptionist wouldn't give me the results because the news was bad.

Any advice would be greatly appreciated. Thanks.

posted by obeetaybee to Health & Fitness (20 answers total)

My experience has always been that doctor's offices don't usually contact you unless its bad news. I have had a battery of tests recently and none turned up anything negative. In all cases, the doctor's offices would drag their feet getting the results to me. I assume it was because it wasn't bad news. Also, my gyno only contacts patients in the event of bad news. I've never had the results of my pap and I'm told this means that everything is normal.

Hope this helps!
posted by LunaticFringe at 7:10 AM on December 23, 2005

I'm not a doctor, but I'd imagine if it was bad news your doc would have been sure to call before going on vacation. Surely that wouldn't be the type of thing you'd leave on your desk over Xmas? Best of luck.
posted by jamesonandwater at 7:10 AM on December 23, 2005

With my doctor, no news = good news is delivered via postcard.
posted by cribcage at 7:14 AM on December 23, 2005

I used to report medical results to doctors for a living, and the one thing that's pervasive in the culture of medical testing is that bad news is urgent and good news waits.
posted by jacquilynne at 7:24 AM on December 23, 2005

I think this is totally normal and you are wise to relax. But - here's my advice - it's extremely unusual for a doctor to not have a colleague cover while they are away, so I would call back, ask to speak to your doctor's nurse, or the nurse of whomever is on-call, and explain your situation. Tell them you understand there are limitations on what they can tell you, but would it be possible to at least have a doctor review your labs and tell whether or not anything is unusual? If they give you a hard time, ask to whom you would address a letter of complaint - NOT for the doctor (the staff will crucify you - they protect the doc, to the detriment of all, unfortunately) but for the nursing staff for not taking the time for a simple request. If they cannot appreciate your anxiety with Christmas weekend coming then they are idiots. This is a routine example of someone with a crapload of work making a reasonable attempt to pare down their workload, and your job is to be the squeaky wheel.

If your doc doesn't have anyone covering for these situations, consider changing your care.

Also, No news is either good news, or the test was lost. A recurring source of medical disasters, esp. in smaller clinics without a tracking system. Never, never, never, never assume anything.
posted by docpops at 7:26 AM on December 23, 2005

A good friend of mine recently felt ill and went to the hospital for a checkup and blood workup. He never heard back from the hospital in spite of feeling even worse. When he did call to ask about the test results they said, "oh, you have a staph infection" and he was rushed into surgery the same day. And this was in a "good" hospital. So you probably have to stay on top of things because there seems to be no guarantee any more that they will.
posted by gallois at 7:40 AM on December 23, 2005

jamesonandwater: "I'm not a doctor, but I'd imagine if it was bad news your doc would have been sure to call before going on vacation. Surely that wouldn't be the type of thing you'd leave on your desk over Xmas? Best of luck."

Very true. A year ago one of mine insisted I come in two days before Christmas, the day I was leaving on a road trip to see family, to have some scary moles removed - rather than waiting a week until I came back. bad news is not a laissez-faire situation with doctors.
posted by kcm at 7:43 AM on December 23, 2005

besides, a blood test with abnormal results would just indicate more tests to be done, so it's not like you'd know what cancer you were going to die from tomorrow if it was bad news. :) MRIs, CTs, FNAs, ultrasounds, you name it.

but you're fine.
posted by kcm at 7:46 AM on December 23, 2005

I'm no doctor, but you have lymph nodes under your arms, and some mild illnesses make your lymph nodes swell (as normal as a fever or headache). Could it not have been swollen lymph nodes? You also have them under your jawline, and near the hip bones. I once thought I had a double hernia since I had the characteristic swelling, but they turned out to be swollen lymph nodes instead. Did you check the other under-arm to see if the other side was swollen also, during the time the one had been?
posted by vanoakenfold at 8:01 AM on December 23, 2005

The differential diagnosis for a lump in the axilla (underarm) area is fairly limited:

Lymph node [reactive (inflammatory/infectious), primary lymphoma, or metastatic disease (i.e. breast ca)]
Cyst
Abscess
Vascular abnormality (AV fistula, AVM)
Other rare disorders (i.e. sarcoid)

Blood work doesn't usually exclude all of the above diagnoses (I would be bold enough to say: none of them).
How large is the node? and is it tender?

Are you at risk for any of the above mentioned?

The only "emergency" on that list is probably an abscess, which should be drained sooner, rather than later.

All the others will require an extensive workup. (Although in your mind they may seem like emergencies).

I hope this is helpful.
posted by erd0c at 8:07 AM on December 23, 2005

you have lymph nodes everywhere. having swollen lymph nodes that grow instead of disappearing in your axial or clavicular regions (esp. one-sided, esp. the left side) can be bad news since those are two places the rest of the body will drain to - i.e. it has metastisized from elsewhere. inguinal are more common to have a benign process cause

this isn't pertinent to the thread, since they went away, but just an FYI for anyone searching in the future to go get this kind of thing checked out. it's very common for children to have enlarged nodes from benign illnesses, but adults should pay more attention since it happens less as you age - at least by benign processes.

Here's a little more on lymph nodes, but it's from an NHL site so it could be scary if you think a node is enlarged. It's hard to find online information about them that's not from cancer sites. :)
posted by kcm at 8:10 AM on December 23, 2005

It's so weird that this topic came up...over the past week my sister developed severely swollen and painful lymph nodes in her armpits and a 101 fever. She ended up being sent to a rheumatologist, had a chest x-ray, CAT scan, lots of bloodwork...nobody could figure out what the problem was. They think it might be cat scratch disease.
posted by nekton at 8:14 AM on December 23, 2005

I'm no doctor...

Then keep your diagnoses to yourself. He's already consulted his physician, and even a careless reading of the question will tell you he's looking for opinions on office procedure, not amateur speculation from internet whackos.
posted by cribcage at 8:15 AM on December 23, 2005

Response by poster: Thanks to everyone who has answered so far.

The pea-sized lump is gone and it was not painful when it was there. Because my paternal grandmother died of breast cancer at a young age, I'm fairly good about doing routine breast exams on myself every few weeks or so. I'm relatively young, (33) but I do seem to have an imagination which like to catastrophize. No fever, no illness at the time, however I was just finishing my period.

In hind sight (which of course is always 20/20) I should have let it go a few days before calling the doctor as the lump is now gone.

I figured "no news is good news" but I was concerned if they honestly could not release the results without the doctor signing off on them or if I was just being fed a line with no procedural background.

Again, thanks everyone, I really appreciate all the great answers.
posted by obeetaybee at 8:25 AM on December 23, 2005

cribcage: The "amateur" speculation is offering possibilities from experience in such cases to calm the nerves of a wild imagination, an underlying (and expressed) reason to be asking the question -- having a genuine concern.

P.S. Posts naysaying off-topic replies are, in themselves, their own worst offender ;-P
posted by vanoakenfold at 9:44 AM on December 23, 2005

What docpops said. Call the office and ask to speak to which ever physician is on call. Explain your concerns and let them know that this is going to ruin your holiday and that you need someone to review the results and tell you something.

Remember, you're the doctor's employer - you're paying his salary! Don't settle for the old paternalistic model - become a pushy health care consumer!
posted by jasper411 at 10:35 AM on December 23, 2005

Remember, you're the doctor's employer - you're paying his salary! Don't settle for the old paternalistic model - become a pushy health care consumer!

Usually the ones that use this line of reasoning wind up terminated with prejudice. But you do have the right to expect a level of service that is not necessarily the norm in office settings.
posted by docpops at 10:47 AM on December 23, 2005

Response by poster: Moot point now.

Called the office, they closed at noon for the holiday, reopening on Monday morning. I'll just have to put this aside, which reading all your responses certainly have helped me to do and enjoy Christmas.

Thanks again, everyone.
posted by obeetaybee at 11:09 AM on December 23, 2005

don't let that distract you, have a nice christmas, obee :)
posted by suni at 2:53 PM on December 23, 2005

IANAD, but I have worked in a doctor's office. This is normal procedure, especially because of HIPAA (the Health Insurance Portability and Accountability Act). The office is probably just trying to be careful about what kind of information they release about you. It's privacy concerns, and all that.

I wouldn't be worried, in the office that I worked in, the doctor would call the patient on the same day that results were received, only if the lab tests were abnormal.
posted by hooray at 9:52 PM on December 23, 2005