Question for a friend

[Whyte Noise]

What is the name of your state? Pennsylvania is where he lives and where the treatments and treating physician are.

A friend was diagnosed with liver cancer 4 months ago, and has been going for treatments since then. The treatment used was alcohol injection into his liver to try to dry up the cancer cells. Maybe you guys know the correct medical name for this, but I don't. He's had 4 treatments.

He's also been in and out of the hospital because of having internal bleeding from his liver. They'd treat him, get him stabilized, and then send him home.

Yesterday, he was back in the hospital again. Again, his liver was bleeding out. They got the bleeding stopped and were going to send him home again. He refused, and told the doctor to find out what the hell was causing his bleeding in the first place, that he was tired of being sent home only to have to return again and again.

The doctor ran tests.... and has determined that he does not have cancer, never did have cancer, and that the bleeding was being caused from 2 lacerations on his liver that he got when in an accident around the same time he was diagnosed with the cancer.

This doctor never did a liver biospy, never ran a blood test, simply diagnosed cancer 4 months ago by looking at an X-ray when what he was really looking at was scar tissue from the lacerations on the liver. There was no MRI, US nor CT done on him, only the X-ray.

He's pissed to say the least. One, because he's had to endure that "big ass f***ing needle" every month. Two, because he's lost over $700,000 in income over the past 4 months because he had to cancel 2 overseas tours (he's a musician) due to being hospitalized so much because of the internal bleeding. Three, because the doctor didn't even make SURE he had cancer before starting treatments, just saw what he saw on the X-ray and began the injections. Four, because he doesn't know if these alcohol injections may have caused him damage to his liver that he didn't have to begin with.

The doctor that diagnosed the cancer in the first place is the same doctor that discovered he doesn't have cancer after all. He told my friend that there was a surgery they could do to repair the liver lacerations and staunch the bleeding, and he flat out told him that he'd rather someone else do the surgery. Can't say that I blame him. After being mis-diagnosed with cancer from just reading an X-ray, I wouldn't want the man to touch me either.

I don't know if this is malpractice or not, but said I'd ask around and see what opinions are. It's not about money to him, as he has more than he'll ever spend in a lifetime anyways. It's about being subjected to a procedure he shouldn't have had to undergo, being told he had a potentially fatal disease based on nothing more than an X-ray, and going through repeated hospitalizations over the past 4 months because of the internal bleeding he was having when a simple procedure could have fixed that problem.

OK, let me have it.

 

[rmet4nzkx]

If your musician friend has so much money, perhaps he should consult an attorney and get a second opinion from a specialist to review his medical record, together they should be able to answer those questions and since loss of employment is involved with some big bucks. It does seem strange to proceed with such treatment without further diagnostic tests. On the other hand, it should be a wake up call for your friend to count each day as something special and to comit to a healthy lifestyle.

 

[Whyte Noise]

Rmet, I didn't ask for snide remarks.

The amount of money he has has nothing to do with whether it's a valid concern or not. I simply said that I, as a friend, would ask since I know some people that work in this field (meaning the board members here). He just found all the test results out late yesterday (Thursday) afternoon. I should have just sent it to EC in a PM like I normally do when I have medical questions about my daughter.

And as an FYI, he does have a healthy lifestyle. Not all "musicians" are coked-out, drunken, falling off the stage idiots. He's a vegetarian, doesn't do drugs, and didn't drink until a doctor shot Ethanol into his liver.

 

[panzertanker]

I think ellen is going to agree with me:

Tell him to gather his records and RUN to a medmal attorney for review.
It is NOT standard care to dx cancer by an xray.
A needle bx or CT or PET scan should have been performed.

Something is not right with this MD's treatment, based on your post.

good luck, and tell your buddy that I DO NOT have enough money, so to send some my way....

 

[rmet4nzkx]

Rmet, I didn't ask for snide remarks.

The amount of money he has has nothing to do with whether it's a valid concern or not. I simply said that I, as a friend, would ask since I know some people that work in this field (meaning the board members here). He just found all the test results out late yesterday (Thursday) afternoon. I should have just sent it to EC in a PM like I normally do when I have medical questions about my daughter.

And as an FYI, he does have a healthy lifestyle. Not all "musicians" are coked-out, drunken, falling off the stage idiots. He's a vegetarian, doesn't do drugs, and didn't drink until a doctor shot Ethanol into his liver.

MG,
The remarks were not meant to be snide, but objective. Each person has some responsibility for their health and their actions which always come up in litigation. People in the music industry even if they don't smoke, drink alcohol or do drugs and still exposed to them and being a vegetarian is not in and of it's self the most healthy lifestyle either, it is still a time to reassess all aspects of his health and lifestyle, Including diet and use of supplements which may increase the likelyhood of bleeding. Was your friend anemic? All this will be looked at in litigaiton and now is the time to look at all aspects of potential litigation.

You, as a friend, were only able to provide a few facts and you know we need facts to advise no matter who is answering them. So far I am the only one who has responded. Did your friend advise the doctor of the accident when he went for treatment? Were the treatments administered in a hospital? How do you know there was only the Xray? These treatents are usually administered with the assistance of CT or Ultrasound so the alcohol goes to the tumor. If your friend met the criteria for Percutaneous Ethanol (Alcohol) Injection of Liver, which has a valid use in certain types of tumors, he is fortunate and an XRay may have been enough to initially justify the treatment and the damage may be limited to the areas already damaged by the accident. The unique thing about this type of treatment is that it targets only the tumor/s and is not systemic like other forms of chemo, so in an otherwise healthy liver the only thing that may be damaged is the already damaged portion of the liver and your friend may be ok. That is why a second opinion should be sought. Also if this treatment took place in a hospital, they may have some responsibility.

If your friend was indigent it would be one thing, but your friend has means and it seems strange to move forward with reatment for treatment for cancer without seeking more specialized treatment unless he and his doctor were confident, did he sign informed consent somewhere? There should be no question, if he believes that he was misdiagnosed to see an attorney promptly, as soon as he discovered the error, especially considering the profound effect and to get a second medical opinion. On the other hand, Cancer of the liver is an urgent matter because by the time it is diagnosed, it is requently beyond hope, so there may have been some urgency so one can see where both doctor and patient might be anxious to begin treatment. Especially if it appeared to be of the type known to respond to this form of therapy.

The ideal patient for alcohol injection has fewer than three Hepatocellular Carcinoma (HCC) tumors, each of which is:

* well defined (distinct margins)
* less than 3cm in diameter
* surrounded by a shell consisting of scar tissue (fibrous encapsulation)
* not near the surface of the liver

A single injection or a series of injections may be required, again, until your friend gets a second opinion he doesn't really know the extent of damage or if it is really malpractice, yet.
There may be some other concerns regarding his response as some clotting factors, which are acute reactants, meaning that the body produces them in response to trauma or exposure to toxins, may have been deficient leading to the bleeding, so seeking a second opinion by a onocologist/hematologist would seem to be a wise idea, some people have bleeding disorders and don't know it.

Please update us as this story unfolds.

 

[ellencee]

At last, I'm here!...

First, the friend with the lacerated liver wasn't going anywhere for eight weeks or more, at least not with medical approval; so deduct a minimum of eight weeks from lost wages due to any potential claim of negligence.

Secondly, lacerations do not appear on x-ray the same as scar tissue. Scar tissue takes time to form and would not have formed until the lacerations were repaired and sufficient time had allowed for scar tissue formation. If scar tissue on the liver was present at the time of the post-accident x-ray(s), it was present before the accident.

Thirdly, percutaneous alcohol injections into the liver are ultrasound guided or CT guided. That would mean one or more radiologist also believe the scar tissue to be well-encapsulated tumors consistent with tumors of liver cancer.

Lastly, I recommend seeking diagnosis and treatment at another hospital and with another set of physicians who treat liver injury. If there is to be a medmal claim, continuing treatment with the same providers is not recommended.

My opinion is: Until the patient receives a thorough evaluation of his liver injuries (from the accident and from the injections), there is not enough information available from which to make a determination on the merits of the claim.

EC

What is the name of your state? Pennsylvania is where he lives and where the treatments and treating physician are.

A friend was diagnosed with liver cancer 4 months ago, and has been going for treatments since then. The treatment used was alcohol injection into his liver to try to dry up the cancer cells. Maybe you guys know the correct medical name for this, but I don't. He's had 4 treatments.

He's also been in and out of the hospital because of having internal bleeding from his liver. They'd treat him, get him stabilized, and then send him home.

Yesterday, he was back in the hospital again. Again, his liver was bleeding out. They got the bleeding stopped and were going to send him home again. He refused, and told the doctor to find out what the hell was causing his bleeding in the first place, that he was tired of being sent home only to have to return again and again.

The doctor ran tests.... and has determined that he does not have cancer, never did have cancer, and that the bleeding was being caused from 2 lacerations on his liver that he got when in an accident around the same time he was diagnosed with the cancer.

This doctor never did a liver biospy, never ran a blood test, simply diagnosed cancer 4 months ago by looking at an X-ray when what he was really looking at was scar tissue from the lacerations on the liver. There was no MRI, US nor CT done on him, only the X-ray.

He's pissed to say the least. One, because he's had to endure that "big ass f***ing needle" every month. Two, because he's lost over $700,000 in income over the past 4 months because he had to cancel 2 overseas tours (he's a musician) due to being hospitalized so much because of the internal bleeding. Three, because the doctor didn't even make SURE he had cancer before starting treatments, just saw what he saw on the X-ray and began the injections. Four, because he doesn't know if these alcohol injections may have caused him damage to his liver that he didn't have to begin with.

The doctor that diagnosed the cancer in the first place is the same doctor that discovered he doesn't have cancer after all. He told my friend that there was a surgery they could do to repair the liver lacerations and staunch the bleeding, and he flat out told him that he'd rather someone else do the surgery. Can't say that I blame him. After being mis-diagnosed with cancer from just reading an X-ray, I wouldn't want the man to touch me either.

I don't know if this is malpractice or not, but said I'd ask around and see what opinions are. It's not about money to him, as he has more than he'll ever spend in a lifetime anyways. It's about being subjected to a procedure he shouldn't have had to undergo, being told he had a potentially fatal disease based on nothing more than an X-ray, and going through repeated hospitalizations over the past 4 months because of the internal bleeding he was having when a simple procedure could have fixed that problem.

OK, let me have it.

 

[panzertanker]

At last, I'm here!...

First, the friend with the lacerated liver wasn't going anywhere for eight weeks or more, at least not with medical approval; so deduct a minimum of eight weeks from lost wages due to any potential claim of negligence.

Secondly, lacerations do not appear on x-ray the same as scar tissue. Scar tissue takes time to form and would not have formed until the lacerations were repaired and sufficient time had allowed for scar tissue formation. If scar tissue on the liver was present at the time of the post-accident x-ray(s), it was present before the accident.

Thirdly, percutaneous alcohol injections into the liver are ultrasound guided or CT guided. That would mean one or more radiologist also believe the scar tissue to be well-encapsulated tumors consistent with tumors of liver cancer.

Lastly, I recommend seeking diagnosis and treatment at another hospital and with another set of physicians who treat liver injury. If there is to be a medmal claim, continuing treatment with the same providers is not recommended.

My opinion is: Until the patient receives a thorough evaluation of his liver injuries (from the accident and from the injections), there is not enough information available from which to make a determination on the merits of the claim.

EC

You were SUPPOSED to just agree with me ellen!!!

Jeesh, I can't catch a break....

 

[ellencee]

I SHOULD have agreed with pz on this one or at least acknowledged that his information on diagnosing cancer is accurate! (I had no way of knowing pz didn't have enough money...)

EC

 

[panzertanker]

(I had no way of knowing pz didn't have enough money...)

EC

I disagree with MissouriGal, If I had the money, I could always find a way to spend it...I don't believe in "more money than you could ever spend".
Haven't you guys watched infomercials???
Think of all the gadgets I could buy.......

 

[rmet4nzkx]

Can we all agree that things are not always as they first seem?
I can also use any spare money.

 

[panzertanker]

I can also use any spare money.

I asked first!
Plus, I think MissouriGal is miffed at you, so you are out of the will....

 

[rmet4nzkx]

I asked first!
Plus, I think MissouriGal is miffed at you, so you are out of the will....

But I answered first even though I knew that anything I would say she wouldn't be happy with because she is already miffed with me.

 

[panzertanker]

But I answered first even though I knew that anything I would say she wouldn't be happy with because she is already miffed with me.

That's why I will get some money from the rock star, and you won't!!!

 

[rmet4nzkx]

That's why I will get some money from the rock star, and you won't!!!

Then you have to share

 

[Whyte Noise]

Actually Rmet, contrary to popular belief I'm not in a constant state of "miffiness" with you at all. I only get miffed when you tell me I have no clue what I'm talking about, insinuate that you're better than me, and make snide remarks like you did above. The very first line of your first response to me was "If your musician friend has so much money,...." which is condescending in tone. Then, you finish with saying he should commit to a healthy lifestyle without knowing what kind of lifestyle he already leads. If you'd answered my post with your second response, I'd have simply answered your questions, just like I'm going to do now.

1.) Was your friend anemic? - No, he was not, and is not.

2.) Did your friend advise the doctor of the accident when he went for treatment? - Yes, the doctor knew of the accident.

3.) Were the treatments administered in a hospital? - Yes, they were.

4.) How do you know there was only the Xray? - He went in with rib and chest pain. The doctor ordered X-rays on him. After the X-rays were taken, the doctor interpreted them as liver cancer, and the first treatment was 3 days later. I "know" this because this is how the facts were related to me. He would have known if the doctor did a CT, an US, an MRI or a biopsy. The doctor did none of those. The treatments were US guided, yes. He laid on his stomach, the needle was inserted through his back into his liver. Again, I know this because this is what was related to me. I wasn't there in the procedure room so I can't say for certain this is how it went, but when I was told how it was done my first reponse was "That was how they did my daughter's kidney biopsy".

5.) did he sign informed consent somewhere? - Yes, he signed informed consent to have the procedures done. After all, his physician had diagnosed him with cancer and these injections were the course of treatment recommended. He trusted his doctor to know what he was talking about. He consented to the procedures thinking he had cancer. If the doctor was the one misinformed I don't see how my friend signing an informed consent in any way negates the doctors responsibility though. When we go to a doctor, get diagnosed, and treatment is recommended (whether it's for cancer or tonsilitis) we follow the doctors instructions because they're the professionals. Some just do it more blindly than others I suppose and don't seek a second opinion. This was a doctor that has treated him for years, and he had no reason to doubt the truthfulness of the diagnosis.

And to respond to EC:

1.) First, the friend with the lacerated liver wasn't going anywhere for eight weeks or more, at least not with medical approval; so deduct a minimum of eight weeks from lost wages due to any potential claim of negligence. - The accident was 3 months prior to the cancer diagnosis. I stated "around the same time" because I wasn't sure on that, but now I have clarification.

2.) Secondly, lacerations do not appear on x-ray the same as scar tissue. Scar tissue takes time to form and would not have formed until the lacerations were repaired and sufficient time had allowed for scar tissue formation. If scar tissue on the liver was present at the time of the post-accident x-ray(s), it was present before the accident. - I don't know how long it takes scar tissue to form, but it had been 3 months since the accident and the time the X-ray that diagnosed cancer was taken.

3.) Thirdly, percutaneous alcohol injections into the liver are ultrasound guided or CT guided. That would mean one or more radiologist also believe the scar tissue to be well-encapsulated tumors consistent with tumors of liver cancer. - His doctor is the one that performed the injections and yes, they were US guided. When I was told this it was kind of a shock. My daughter's PCP is a good man who tests her very thoroughly, but when he wanted the kidney biopsy done he sent her to a Nephrologist at Vanderbilt, he didn't just do that procedure himself. And as much as I like him, if he'd have said he was doing the biopsy, I would have objected and wanted someone that did this on a regular basis to do it. I'm not as trusting as my friend though I guess, hence why I always PM you with any new findings or test results on my daughter to get a "second opinion". LOL

4.) Lastly, I recommend seeking diagnosis and treatment at another hospital and with another set of physicians who treat liver injury. If there is to be a medmal claim, continuing treatment with the same providers is not recommended. - He will be doing this.

The accident was a motorcycle accident. The lacerations have apparently went unnoticed and/or undiagnosed until yesterday. When the doctor gave him the alcohol injections, they were directly into the laceration sites because he believed those sites to be cancerous tumors. Apparently, doing the injections into those sites irritated them and caused the bleeding since they weren't tumors after all. There were X-rays done over the past 4 months, yes, and those sites showed up on the X-rays. Again, the doctor saw cancerous tumors instead of investigating further and finding out that it was lacerations. He wasn't looking for anything other than cancer, and that's all he saw, even though it was incorrect. Yes, I know he followed proper protocol as far as the injections go.. that they are injected directly into the tumors and this is what kills the cancerous cells of the tumor. The doctor did that, and injected the alcohol into what he thought were tumors. The point is that they weren't tumors at all and the doctor only did an X-ray, saw these sites on the liver, diagnosed cancer, started treatments, and went on the assumption that they were cancer without doing definitive tests to verify that is was cancer in the first place.

As for whether anyone believes he's who I say he is... meh. If I were going to make up an imaginary friend it would be Joe Elliot or Rick Allen from Def Leppard (since that's my favorite band of all time) instead of someone from a band I never listened to because I didn't like their music. Oh, BTW... he's no longer in that band and hasn't been for a number of years. He's a solo artist now although he does tour with one person in particular. Let's suppose he's just a regular Joe Schmoe that works at Microsoft or some other Fortune 500 company and he still has money, though not as much. I only listed his profession and money lost due to the fact that I thought it would show that he'd suffered some major monetary damage as a result of undergoing unnecessary treatments which may have caused the lacerations to bleed and kept him from performing his job, not because I wanted to impress anyone or give myself an ego boost. I know that everyone here always says you have to have suffered damages to even have an inkling of a chance, so I was trying to let you all know he'd suffered the monetary damages at least. Whether there's enough physical damage, who knows?

Today, he said that he was thinking about not even pursuing any type of medmal claim, and just wants to let the appropriate authorities know about him so that someone else doesn't undego what he has. I told him that the first place he would need to go was the licensing board in PA. I think he's still in shock and dumbfounded actually and doesn't know what he wants to do. Can't say that I wouldn't be the same way.

Oh... I don't know him well enough to be in the will, so if I get no money, neither do any of you! *Neenerneenerneener*