I think I’ve made it very clear in the past that I believe everyone should look at their own labs and watch for trends.  Occasionally, I get the question of “I can ask for my own records?”

YES.

You have the right to your own medical records.  In fact, if you have screwed up insides that many doctors don’t understand, not only do you have the right, you really have an obligation to have your records and to (I’m going to lose a few of you here) understand them.

Now I’m not saying that you understand surgical notes enough that you can go in and perform your own surgery on someone else.  That would just be silly.  But to know what a 1721 means for a B12 level, or a 30ml pouch created, or that you had a cholecystectomy during your RNY are all important things to know and to understand.

You’re going to ask why — and that’s good.  Cause asking “why” is always good – unless you are my almost two year old asking “why?” when I’ve told him not to hit his sister or to stop throwing blocks at the dog, and in that instance asking “why” is liable to make me want to pull my hair out.. but you get my point.  You need to know because you never know when you’re going to run across an idiot with a medical degree.  Please, please, PLEASE do not get blinded by the white coat.  We all want to think that our doctors are the smartest people on the planet, that they are the best surgeon in the world, and we are the most important patient on their roster for the day.  But let’s face facts — we are one of several patients your doctor sees every day, one of hundreds of prescriptions your pharmacist fills each day, one of thousands of people that will walk through a hospital a year.  Mistakes will happen, a degree of detail that you wish would happen will not always happen — and you are the only person that will really have to suffer through the consequences of any mistakes.

So let me concentrate for a moment on lab work.  When you have your labwork done, get copies of every single draw.  Get the interpretation by your doc and your nutritionist — fine, I don’t care.  But put your eyeballs upon it.  Even better, make a spreadsheet.  Be g33ky if you want and put it on the computer, put it on regular note paper, or just compare it time to time — whatever floats your boat.  But look at it.  And here’s what you want to look for — trends.

Are your numbers staying stable?  Are they going up?  Are they going down?  If they are going down, how quickly are they going down?  Why are they going down?  What can you do to make them stop going down?

Why is this important?  Here’s a scenario.

You have a blood draw done at 3 months, another at 6 months, and one planned at 9 months.  At 3 months, your B12 is 800, with a range of 200-900.  At 6 months, B12 is 500, which is still in range.  Because it is still in range, it is not flagged and is not even mentioned by the doctor or nutritionist.  Assuming nothing changes, and everything is equal, what do we guess the 9 month labs to be?  If no one is looking at trends, we are now at deficiency range, something that easily could have been avoided if trends had been watched and measures had been taken to avoid a deficiency in the first place.

It is your right, as a patient, to have access to your medical records.  Take advantage of this right.

It is the right of a hospital or medical facility to charge you for copies of these records.  Many hospitals will charge you $1 per page for copies.  Many doctor’s offices will not.

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