What are the chances of that, then?

[DaveUK]

Hi Karen,

He introduced himself as "Dr", and I'm certain I've found him on the register. He's an "MB ChB" (medical degree, bachelor of surgery), and is also on the 'clinical radiology' specialist register.

He said there are all manner of "soft tissue structures" in the testicles that might feel hard "to you" but don't show up on the ultrasound, and are definitely not cancer.

He squirted the gunge, told me to put my legs together, and held the probe quite firmly on the inside of the one being done. Almost as soon as he put it there, he said there's a cyst - which was right at the top. He did then move it slightly up but basically held it firmly against the inside of the one being done. After my continued disbelief, I remember now him putting it back down and moving it up and across to about the middle-front area and pressing quite hard. He said, 'look there's nothing here - what can I tell you?'. I expected it to be like a shaver covering the whole area, but it seemed to be more a technique of holding it firmly against the testicle to get a good contact. Perhaps it's the way some devices work?

Well, anyway, I'm seeing the GP on tuesday.

Thanks for looking into it for me, Karen!

[Karen]

Dave,
Googled a bit and the ultrasound man should have done many passes over the testicles with the transducer. A soft tissue structure....of what??? Ultrasounds can detect if a mass is solid ot fluid filled but can't diagnose cancer or not. Also, I noticed he said there was fluid (which can be nothing more than a hydrocele). I'd call the GP, tell him that you have concerns about the performance of the US and the fluid in the testicle and request another one with a different technician. This is your body and your life and if you do not believe you were properly diagnosed and are still concerned then make a fuss. Can you go to a urologist instead of a GP? If you have another US and it shows nothing then relax.

[Karen]

Hi Dave,
I didn't abandon you ....I've have lots of ultrasounds but obviously none on testicles . I was waiting for the guys to chime in.

An ultrasound, properly done and read by an experienced radiologist should put your mind at ease. If you are not happy with it you can get your films and have another radiologist look at them. Was the ultrasound man a radiologist or technician? My husbands US technician told him there was something there but nothing to worry about......the urologist was the one who looked at the films and knew.

[DaveUK]

Er, no thoughts on my ultrasound man's technique??
Do they not normally move it around a bit more. And is the ultrasound's all clear sufficient?

[DaveUK]

Well, ultrasound man gives me a commentary and says there is a small cyst at the top of each testicle. The large "hard" area lower down on the inside of one - that the female GP thought was a hard lump - was just another "soft tissue structure" (he said there are lots of these which may feel hard but they ain't cancer on the ultrasound). There's also some fluid around the testicles. He said definitely no cancer.

I was unprepared for this, and he said I didn't look like I believed him. When I started saying 'what about this and that' he said 'you're the first person I've ever had disappointed not to have cancer!'. He didn't seem interested in discussing my perception of lumps, it was simple case of 'ultrasound says no'; there's no cancer there. He was very pleasant and Jovial, and ended up exclaiming at the top of his voice (easily audible in the waiting room next door) "Mr xxxx, I assure you, there's is definitely nothing wrong with your testicles!". Results to GP, who I should see next week. No blood test.

I'm sort of elated but still concerned. I think it's the fact that tried to plug the wrong end of the probe into the machine/display at the start. How can a radiologist not know one end from the other? On the other hand, I got the impression he'd done it plenty of times before once he started. But he didn't move the probe about much, just pressed it against the inside of each testicle; I expected he'd cover the whole surface. Is that sufficient? He also didn't turn the lights down, which I thought they do.

Pretty certain I've found him on the medical register and he's a specialist clinical radiologist registered since '96 and qualified in Cape Town SA in '79, so he ought to know what he's doing.

Sorry for too much detail, but just composing thoughts. Anyway, any chance he's wrong?

[DaveUK]

Thanks Karen ..just about to go.

[Karen]

Hope the US went well for you today...please let us know when you get some results...hoping for only good news!

[DaveUK]

Ultrasound tomorrow. That's eight days from referral, so phone call from GP did speed up original estimate of 2 weeks.

Worried but want to know.

[DaveUK]

"Wow.....I hear the NHS is great as far as financial aspects go,..."

Well, 'free at the point of use'. Hope it's worth more than you pay for it.

"Anything show up with the urine sample?"

Couldn't see anything. . No, haven't heard anything yet.

Thanks.

[Karen]

Wow.....I hear the NHS is great as far as financial aspects go, but I would go crazy dealing with all the waiting you guys must do across the pond. Anything show up with the urine sample? Good luck!!!!

[DaveUK]

Recap: GP arranged "urgent" ultrasound on Monday.

I've just phoned the hospital ultrasound dept. They've got my form and it does say "urgent". But the radiologist won't vet the forms until next week to decide the priority! They said it's up to the GP to phone through and make a case if something is urgent. I phoned the GP surgery, and the receptionist said, 'that's funny, our system has always been to just fax through as "urgent" and my form says "urgent" in capitals right across it. Receptionist spoke to another doctor (the one I saw is off for a few days) and phoned me back to say the other GP phoned the hospital, and the hospital had told him that I'd hear about it in "a couple of days" - as though that was going to happen anyway. I reiterated what the hospital had told me, and she said "well, that's what they told the doctor".

It's bad enough if the hospital system is slow or perhaps inefficient, or even incompetently run. But dishonesty like that p1sses me off. I'm sure the GP receptionist thinks all was in order and I was just being paranoid/pushy. I am mindful of the ethical dilemma around pushing ones own case up the queue by just kicking up a fuss. But the hospital seems to have just been trying to cover themselves while only really looking at the official 2-week max target.

Looks like a good job you lot gave me kick up the backside to do something more about it. Cheers.

[dave25285]

dave25285, I phoned NHS-direct (for non-Brits that's an official health advice line). They said that 2 weeks is the target in urgent cancer referrals to the first outpatient appointment - which they reckoned the scan probably counted as, however, that that was a bit unclear. I think Pilgrim (who may know better) reckoned in his blog that the scan didn't count as that. Anyway, they suggested I phone the hospital and ask what their wait is. Wouldn't surprise me if there's no one there that knows the first thing about TC.

Well when my GP was referring me, he seemed to suggest that he could select an urgent referral on the referral form. This is what he did for me, and I guess most other patients (this took two weeks).

However he said that if he had been more suspicious of my lump he could have phoned the hospital to get a next day appointment, maybe you should see if a resident GP at your practice can do that.

[DaveUK]

dave25285, I phoned NHS-direct (for non-Brits that's an official health advice line). They said that 2 weeks is the target in urgent cancer referrals to the first outpatient appointment - which they reckoned the scan probably counted as, however, that that was a bit unclear. I think Pilgrim (who may know better) reckoned in his blog that the scan didn't count as that. Anyway, they suggested I phone the hospital and ask what their wait is. Wouldn't surprise me if there's no one there that knows the first thing about TC.

[dave25285]

That’s odd I live in the UK and was told by my Dr that because he was fairly certain all I had was a cyst he wouldn't rush to get me an ultrasound. My appointment finally came through as being two weeks after my initial GP referral (incidentally it is this afternoon!).

The Dr said that if he had been more concerned he would have phoned the hospital straight up and got me in within a couple of days. Maybe you should check back with your surgery and see if another Dr who knows the area etc can get you in sooner.

[DaveUK]

"The urine test is for infection. I had an ultrasound before I had blood tests."

OK, thanks for that.

I suspect that two weeks is some kind of general target here in the 'third world' (UK). Our government has been micromanaging, re-organizing and setting targets like it's going out of fashion. Not sure what I can do really. If I don't hear anything in a week, suppose I should do something. Dunno what though.