<b>Biopsies, Lab Tests, and Keeping Records.

Compiled by doctordee 
November 2002



Keeping Records

Interpretation of Laboratory Tests


<b>Keeping Records</b>



<b>Collect all reports:</b>  operation reports, biopsy reports, scan reports, Xray reports, lab reports, letters from doctors to other doctors...in short, all official medical records.  You are entitled to a copy of each.

Organize them in a looseleaf notebook.  

You may need a second notebook for <b>correspondence about bills and payments</b>.  Make sure you make notes of whom you spoke to, when, and what was said.

You may need a third notebook about <b>medical arrangements or treatment protocols</b>.  Make sure you make notes of whom you spoke to, when, and what was said.

You will also need a <b>weatherproof artists' portfolio for your scans</b>, so you can trundle them around safely.


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<b>Interpretation of Laboratory Tests</b>
 



A laboratory test is a medical procedure that involves testing a sample of blood, urine, or other tissues or substances in the body.  

Such tests have a variety of uses:  
1. They are often used as part of a routine checkup to identify possible changes in a person's health before any symptoms occur.  
2. Laboratory tests also play an important role in diagnosis when a person has symptoms.  
3. In addition, tests may be used to help plan a patient's treatment, 
4. Evaluate the response to treatment, 
5. Or monitor the course of the disease over time. 

Laboratory test samples are analyzed to determine whether the test results fall within normal ranges.  They also may be checked for changes from previous tests.  Normal test values are usually given as a range, rather than as a specific number, because normal values vary from person to person.  What is normal for one person may not be normal for another person.  Many factors (including the patient's sex, age, race, medical history, and general health) can affect test results.  Other factors that sometimes affect test results include specific foods, drugs the patient is taking, how closely the patient follows preparatory instructions, and variations in laboratory techniques.  It
is also common for normal ranges to vary somewhat from laboratory to laboratory. 

Some laboratory tests are precise, reliable indicators of specific health problems while others provide more general information.  Laboratory test results may help decide whether other tests or procedures are needed to make a diagnosis, or can be used to develop or revise a treatment plan.  All laboratory test results must be interpreted in the context of the overall health of the patient and are generally used along with other exams or tests.  The doctor who is familiar with the patient's medical history and current condition is in the best position to interpret that person's test results and explain their implications.  Discuss questions or concerns about laboratory test results with your doctor.



Reference ranges ("normal ranges")
Because reference ranges are usually defined as the range of values of the middle 95% of the healthy population, it is unlikely that a given specimen, even from a healthy patient, will show "normal" values for all the tests if a lot of tests are done.   Caution should be exercised to prevent overreaction to mild abnormalities unless they correspond to the clinical condition. 

Units of measurement: America against the world
American labs use a different version of the metric system than does most of the rest of the world, which uses the Système Internationale (SI). [The American system generally uses mass per unit volume, while SI uses moles per unit volume. Since mass per mole varies with the molecular weight of the analyte, conversion between American and SI units requires many different conversion factors. ] Dennis Jay, PhD, has kindly made available an online converter between SI and conventional units: http://dwjay.tripod.com/conversion.html


Liver Function Tests
Leiomyosarcoma tumors do not always cause symptoms.  Tumors may grow vigorously in the liver, but unless there is pressure in a confined space, there is no pain.  Until liver tissue has undergone major destruction, there will be no symptoms from the tumor.  However, liver function tests done on the blood may show high levels of liver enzymes.  These liver enzymes are actually proteins released from dying liver cells.  So the first indication of a liver metastasis might be a shadow on a scan, or elevated liver enzymes in a blood test.  

Blood Counts
Blood counts, the levels of the red cells, white cells, and platelets in the blood, are often done when treatment of radiation or chemotherapy is carried out.  Radiation and Chemo, and other targeted agents, as well as the tumor itself, can result in lowered numbers of these cells, causing symptoms of fatigue, infection or bleeding.

Organs that Share Enzymes
Alkaline phosphatase is present in bone, liver, and other organs.  If the alk phos is elevated, whether it is from liver or bone becomes important.  If one cannot tell clinically [no bone pain, no other liver functions elevated], then a special test that separates out and reports the levels of the different types of alkaline phosphatase can be done.  "Isoenzyme determination" may help determine the organ/tissue responsible for an alkaline phosphatase elevation. 
Likewise, SGOT is present in liver, but also in red blood cells.  If blood is drawn too quickly through a small needle, the red blood cells can break down, and create an artificially elevated SGOT level that has NO clinical significance.


Testing the Patient: Sites that describe and explain the significance of individual laboratory tests and abnormalities: 
Go to the URLs below and look up the names of each of the lab tests that you are concerned about.

http://www.neosoft.com/~uthman/lab_test.html 

Diagnostic Tests Information at: http://www.health.harvard.edu/fhg/diagnostics.shtml

http://www.labtestsonline.org/ 
http://www.labtestsonline.org/understanding/analytes 
