How to go about organising your medical tests?


Following a medical consultation, getting investigations done is part of assessment of one's health or disease. Investigations can be as simple as giving an urine sample to be checked or complex having to stay in the hospital overnight to get certain conditions assessed (sleep study). This article gives an insight into how to go about basics investigations related to blood tests, x-rays etc.

Introduction


Going to hospitals for investigations can be an uphill task especially, if we are not familiar with the hospital, the instructions to be followed, payments etc. But these are important in health and illness. Prior knowledge of basic factors that are related to investigations will help to ensure that the whole process goes on smoothly without needing to re-visit the hospital numerous times.
  1. Degree of Urgency: If the test is urgent or important to arrive at a diagnosis or in emergency situations, then we do not have time to think about other ways of getting it done. It would be better to get the urgent tests done in the same hospital without wasting time. If it is elective or non-urgent, then we have time to get things done in between our regular work and daily life.

  2. Sample collections: Home visits(for sample collection) are often offered by good reputed diagnostic centers and major hospitals for elderly citizens, people who live far off from the centers. This service is offered at a little extra cost or at no added cost depending on the firm and geographic location. At times, a major hospital brand has many small peripheral units (franchise units) around the city which are linked and act like the hub and spoke model. If we have this option nearby, we can utilize this service.

  3. Basic knowledge of tests: One has to ask the doctor about the needs and implications of the tests. For instance, people tend to over eat at parties, festivals or at holidays, if blood tests like lipid profile etc are done at such times, the values are bound to be high and hence the interpretation and treatment also may be exaggerated. Similarly, given liver function tests after a weekend party with plenty of alcohol would show higher values of some components (GGT).
    Many people go for treadmill test as part of cardiac assessment, here the test involves running at higher speeds at an incline, if people have joint pains, not used to the treadmill, they are forced to stop early due to lack of familiarization rather than cardiac inefficiency. People with joint pains that hamper brisk walking should clearly tell the doctors/cardiologists so that they can do alternative tests, rather than waste time and money.

  4. Life style and Investigations: Most of the tests done as a routine without any illness would mean to be on a healthy diet, following our regular routine and exercises. At very stressful phases, routine tests can be postponed as it often adds on to the anxiety and may not reflect the true health. People doing tests for chronic illness states should continue their regular medications and not stop it, for instance patients who are diabetics or have hypo or hyper thyroid issues, they should take their standards medications unless advised otherwise by the doctors.

  5. Hematological tests: The common blood tests done for checking hemoglobin, platelet count etc can be influenced by blood donation, excessive menstruation, iron supplementary injections, lead exposure and smoking. One needs to inform the doctor about these so that he or she can bear it in mind while interpreting the results. Most of the tests are give early in the morning. Many cardiac patients are on blood thinners, the names of the tablets have to be informed clearly to the doctor and while the blood sample is being drawn so that they can take the adequate precautions.

  6. Bio-chemical tests: Here state of fasting, use of antibiotics, steroid use etc need to be mentioned. It's common knowledge that sugar levels are important based on the last meal ingested, likewise prolonged use of antibiotics like Co-amoxiclav can alert liver function tests, Linezolid can reduce platelet counts.

  7. Microbiological tests: Commonly urine culture or throat culture etc are take to assess the kind of infection, if you are already on antibiotics, please inform the doctor as the results can be negative. Similarly sample give for culture should not be contaminated by hand or external sources to avoid getting a false report.

  8. Radiological tests: Most of the investigations involve exposure to radiation. Women in the reproductive age group or when there is a possibility of being pregnant, women should inform the doctor before X-ray, CT scans etc. Some centers do a pregnancy test prior to these investigations. If you are being administered any injections or tablets at the X-ray department, please mention your allergy and status of kidney function tests ( before receiving intravenous contrast for CT scans).
    MRI scans are performed using high power magnets, these produce an intense magnetic force so that metal chairs or oxygen cylinders all can be sucked on to the machine. So, it is very important for the patient and family to remember to tell the doctor about all the metal implants in the body including the head and pacemakers. Relatives accompanying the patients should also be careful about having any metal objects in their clothing and also surgical implants. Anyone going for an MRI scan.Please be careful.

  9. Radio nuclear tests: some specific investigations will need exposure to radio nuclear tagged medications or compounds, at such times, please enquire about the precautions take like breast feeding the baby, discarding urine etc. In general, it's good practice not to take little children to radiology departments.

  10. Pathological tests: Some tests like needle aspiration or a biopsy for diagnosis would be requested. Here again, enquire and follow the advice given, any tablets to be stopped before the biopsy (Asprin, Clopilet, Acitorm all are blood thinners) what to be expected during and after the tests, when the reports would be ready etc.

  11. Booking appointments: Some patients turn up at the hospitals expecting that everything will happen soon only to find that there is already a long queue. So, as far as possible it's wiser to book the appointment slots. You can combined many tests on a single day, if we organize properly. Please allow yourself extra time while visiting major hospitals for investigations as there will be delays due to various reasons.

  12. Specific Instructions: Most tests would have simple instructions to be followed to ensure that the results are appropriate and valid. Please enquire about the hours of fasting, drinking water, diet etc. For instance, if an ultrasound is being performed to assess gallstones, it would be ideal to be done after overnight fasting. Some scan would require a full bladder etc. So, it's prudent to seek clarifications the previous evening or when the test has been requested by the doctor.

  13. Payments and tokens: Many hospitals will collect the payment and at the sample collection center or the radiological reception desk, you would have to enter the name or hospital number. In busy units at the point of blood sample collection, there would be an automatic token vending machine, you need to collect a sticker or a label and go in when you number is being announced. Some centers have an automated number display board that keeps flashing the next token number. If payments are being made, do it for all the tests so that you don't need to keep running back and forth.

  14. Waiting lounge: Major hospitals will have a waiting room, it is wiser to keep following up with the reception staff about when your turn would be coming because, often there would be multiple types of investigations being done in the same department and the staff can forget that you are still waiting for your turn. Many new units are children friendly, have a small play area for kids, if you do have to use this option, inform the nurses around the area to keep an eye on the child.

  15. Special circumstances: There are certain tests that would mandate the patient to be in the hospital overnight just for the sake of these investigations. For instance, a patient who is very obese or has snoring issues etc would need a sleep study done for further management. Such tests are expensive and time consuming, so, all the more reason for the patient and family to double check on the do's and don'ts.

  16. Follow-up: Most labs and hospitals now have the option of sending the results by soft copy to the registered e-mail i.d. Just before leaving the hospital, please approach the appropriate staff or the results section, give the proper email ID and if needed arrange a follow-up visit with the doctor.

  17. Self-analysis: Often we see the results; especially the values printed in bold fonts and get worried. It is prudent to wait until the doctor interprets it because; most of the automated reports would flag up any minor or even a little deviation from the range. This may not be relevant clinically. So let the doctor decide on it.

Conclusions


Although a visit to the hospital is something we do not look forward to, we need to be prepared about the medical consultation and how to go about to get the investigations done. If we know our way around these tests and the basic details, we can get the tests done efficiently, avoiding time being wasted between tests and also making the test results more meaningful.


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