Questionable decision

[mysticalmoonray]

I'm an LPN have have approx 3 years of medical experience in my background. I don't know everything and am still learning something new everytime I'm on the floor. I went with my mother to the hospital today to get bone marrow drawn for testing. After nearly 3 months of contant exhaustion during ADLS, always cold, and poor appetite she went to the ER last week for dehydration. After some IV fluids she was okay except for one thing, her blood levels were extremely low. The docs said she's either not making enough or losing some blood somewhere in her body. During several days of work I thought they did an Occult blood test, and I knew they drew over 7 vials of blood for routine work. However today, she has a bone marrow test. Very painful. I was allowed to watch the procedure since I'm a nurse and wish I did not. However after bringing her home, the original doctor calls and states he wants an occult blood test and her old blood results came in showing Vitamin B12 deficent anemia.

Isn't it a point for doctors to rule out every possible blood test, occult blood, and other tests PRIOR to something as drastic as a bone marrow test? Like I've said I'm not saying that I know better than a doctor but this really got me questioning their ethics and decisions. Why would a doctor make a drastic call when not all of the 'lesser evils' are figured out?

Looking forward to other perspectives on this. Thank you in advance.

[ZippyGBR, BSN, RN]

not in the USA becasue if Doctors and adminstrators waited for simple test results they wouldn't bew able to deliver 'the standard of care' required to line their pockets from unnecessary investigations and procedures.

[MillieT]

It's very hard to say without being in the doctor's shoes. I would guess it's very possible that he was ruling out a more serious disease with the bone marrow asp that once was negative, proved that your mom had Vit B12 deficient anemia. The bone marrow bx probably proved that the marrow was producing enough RBCs and that a more insiduous process was not in play.

[psu_213, BSN, RN]

not in the USA becasue if Doctors and adminstrators waited for simple test results they wouldn't bew able to deliver 'the standard of care' required to line their pockets from unnecessary investigations and procedures.

For the most part, those days are long since gone is the country....if not 'deemed' necessary by insurace companies, medicare, etc., docs are wasting their time and will not get paid at all.

[psu_213, BSN, RN]

Isn't it a point for doctors to rule out every possible blood test, occult blood, and other tests PRIOR to something as drastic as a bone marrow test? Like I've said I'm not saying that I know better than a doctor but this really got me questioning their ethics and decisions. Why would a doctor make a drastic call when not all of the 'lesser evils' are figured out?

I am not going to defend the doctor in this senario, but I also think it is a very bad idea to question the ethics of that doctor.

Also, if she went to the ED for blood work and a bolus, I'm pretty sure the ED doc would not order/perform the bone marrow bx. Just wanted to clarify which doctor you we calling unethical.

Finally, I hope your mother and you are able to get the bottom of this and can do so without more painful tests.

[canesdukegirl, BSN, RN]

Oh honey, I am sorry that you had to watch that. It is one of the most painful procedures. That being said, I am glad that the doc ordered it because he was probably screening for something far more dangerous (like lymphoma) by doing the test...which in the big scheme of things, was the right thing to do. It sounds like he called you with the results of the blood tests AFTER your mom had the BMBx. So that means that he could not find the cause of her dwindling H&H and the last resort was to bx the bone marrow.

When do you expect results from the BMBx?

My prayers are with you and your Mom.

[traumaRUs, MSN, APRN]

We can't provide medical advice here at AN. We ask that you discuss your concerns with your mothers doctor.

[NRSKarenRN, BSN, RN]

why do an invasive test--- should have been explained to your mother at time of physican visit and/or when consent signed for procedure. most often performed rule out more serrious blood disorders due to abnormality on complete blood count --including cancers.

bone marrow biopsy: medlineplus medical encyclopedia

mayo clinic: why it's done

use these resources for discussion with your mother and her pcp.