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Old 02-28-2014, 03:43 PM   #41
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My interpretation of OP's story is simply another form of a second opinion. With most medical test, it is only an indicator. In this case especially, a blood test can be affected by other variables and even the testing lab. So a follow-up test is more than reasonable. Having a trend over several tests over period of time is probably the best method, not a single test result that could be an anomaly.
Not only will I need to get a second opinion on PSA testing, I think I will also demand a second opinion to determine if I am actually dead or not. This was in the news today.

Embalmers find man alive and kicking in body bag. Poor man in Mississippi ready to be embalmed and he was not ready to go. They think maybe his pacemaker quit and then kicked in again.

Embalmers find man alive and kicking in body bag
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Old 02-28-2014, 04:11 PM   #42
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Not only will I need to get a second opinion on PSA testing, I think I will also demand a second opinion to determine if I am actually dead or not. This was in the news today.

Embalmers find man alive and kicking in body bag. Poor man in Mississippi ready to be embalmed and he was not ready to go. They think maybe his pacemaker quit and then kicked in again.

Embalmers find man alive and kicking in body bag
OMG imagine the terror that man felt inside the body bag!
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Old 03-03-2014, 06:53 AM   #43
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My PSA has been elevated for many years. After my last physical PSA came back elevated and they gave me a second blood test, for the life of me I am not sure what it was, but it was not another PSA. Some people just have high numbers. I have had 2 biopsy's, but here is the problem so if PSA is always high, how often do these doctors want biopsy?

In my experience lately doctors are test crazy. Tests tests and more tests. I think I am over tested. By the way if you need a biopsy ask to be knocked out, completely painless, but still the test carries risks.
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Old 03-03-2014, 08:35 AM   #44
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My PSA has been elevated for many years. After my last physical PSA came back elevated and they gave me a second blood test, for the life of me I am not sure what it was, but it was not another PSA. Some people just have high numbers. I have had 2 biopsy's, but here is the problem so if PSA is always high, how often do these doctors want biopsy?

In my experience lately doctors are test crazy. Tests tests and more tests. I think I am over tested. By the way if you need a biopsy ask to be knocked out, completely painless, but still the test carries risks.
As I understand it, they're simply responding to how they get paid, which has changed over most of our lifetimes.

They're not paid to keep us healthy (as they are at least to some extent in many other developed countries), they're paid for testing, expensive procedures and volume. So they see as many patients as they can and order as many tests and procedures as they can. Like my example in post #1, a doctor spent 5 minutes with me and scheduled a fairly costly procedure, I am fairly certain he'd already decided what he would recommend before he ever saw me.

And malpractice has undoubtedly pushed doctors to test more often than they otherwise might have.

I suspect the health care our military folks receive may be one of the few models left in the US where doctors are paid to keep the troops healthy, not to order tests and procedures.
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Old 03-03-2014, 12:38 PM   #45
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I had always had a DRE and was OK. Then I got an elevated PSA. Doc said to watch and wait. Next year he died of a massive heart attack (a year younger than me). New doc advises that PSA cannot be done after a DRE so recommends just the PSA. It comes in well within range. So the following year, PSA is stable and DRE shows no concern.

My belief is to remain calm and seek another opinion in any diagnosis. One of my school buddies was an ace in marks and decided to go into meds. I asked him why he did not choose engineering (my choice) and he said he preferred an occupation that was easier.

So I have always viewed my docs as those that chose the easier path!
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Old 03-03-2014, 01:56 PM   #46
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They're not paid to keep us healthy (as they are at least to some extent in many other developed countries), they're paid for testing, expensive procedures and volume. So they see as many patients as they can and order as many tests and procedures as they can.
We should do what the primitive people do. They pay the Witch Doctor say one chicken a month as long as everybody is well. When somebody gets sick the chicken payment stops until the sick person gets well. If somebody dies (except for the very old and very young new bornes), the Witch Doctor gets no chickens for several months!
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Old 03-03-2014, 07:34 PM   #47
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We should do what the primitive people do. They pay the Witch Doctor say one chicken a month as long as everybody is well. When somebody gets sick the chicken payment stops until the sick person gets well. If somebody dies (except for the very old and very young new bornes), the Witch Doctor gets no chickens for several months!

Our healthcare system, OTOH is abused because no matter what the cost of the procedure we get off with a modest crowpay.
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Old 03-03-2014, 09:40 PM   #48
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Our healthcare system, OTOH is abused because no matter what the cost of the procedure we get off with a modest crowpay.
Written by someone who's obviously not on a Hen Savings Account eligible plan.
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Old 03-04-2014, 08:01 AM   #49
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And there lies the problem. I know an elderly lady who husband was an officer in the military. She pays nothing, not on cent for anything. Her Cardiologist has installed 9 stints in her over the last 10 years. Last week she was feeling a little bad and went into the hospital and same Cardiologist did a cauterization just to "look around" . Cardiologist has a three million dollar home.
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Old 03-04-2014, 08:05 AM   #50
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ISTR that the US has comparable death rates to other countries even though there are too many invasive surgeries and prescription drugs.
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Old 03-04-2014, 09:49 AM   #51
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Our healthcare system, OTOH is abused because no matter what the cost of the procedure we get off with a modest crowpay.
That may be true for many of those with employer HI coverage, but the rest of us usually have a deductible to meet.
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Old 03-04-2014, 08:55 PM   #52
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As I understand it, they're simply responding to how they get paid, which has changed over most of our lifetimes.

They're not paid to keep us healthy (as they are at least to some extent in many other developed countries), they're paid for testing, expensive procedures and volume. So they see as many patients as they can and order as many tests and procedures as they can. Like my example in post #1, a doctor spent 5 minutes with me and scheduled a fairly costly procedure, I am fairly certain he'd already decided what he would recommend before he ever saw me.

And malpractice has undoubtedly pushed doctors to test more often than they otherwise might have.

I suspect the health care our military folks receive may be one of the few models left in the US where doctors are paid to keep the troops healthy, not to order tests and procedures.

The payment issue is a important point, usually the MD that decides whether to biopsy is the one who will be paid to do the biopsy. He gets a lot more for a biopsy than he does for referring you to a different test. I'm not trying to say they are putting profit above care, but it does mean that they have incentive to set the bar very high for replacing biopsy.
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Old 03-06-2014, 11:16 AM   #53
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Stay off your bicycle for 5-7 days prior to PSA test. An hour on the saddle makes the number go up.
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Old 03-06-2014, 12:13 PM   #54
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Socal Tom... You can say "profit over care"......Its happens all the time.
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Old 03-07-2014, 12:24 PM   #55
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Stay off your bicycle for 5-7 days prior to PSA test. An hour on the saddle makes the number go up.
Yes it is odd that riding a bike and having sex are often overlooked as factors that raise PSA readings. Could it be that doctors are not getting enough of either?

(On a related subject, HIFU is a non-invasive procedure for prostate removal that is widely practiced worldwide. A friend here had it done in January after getting 7 positive biopsies.)
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Old 03-07-2014, 01:18 PM   #56
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Stay off your bicycle for 5-7 days prior to PSA test. An hour on the saddle makes the number go up.
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Yes it is odd that riding a bike and having sex are often overlooked as factors that raise PSA readings.
In addition to bike riding & sexual activity - repeating myself, but your doctor should NOT perform a DRE BEFORE the blood draw that will be used for PSA testing (which is the mistake my GP made, and still may not know better). The blood draw should come before the DRE, it can make a (big) difference.
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Old 03-08-2014, 09:12 AM   #57
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The blood draw should come before the DRE, it can make a (big) difference.
In my case, the reading was 60% higher after the DRE.
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Old 03-08-2014, 09:45 AM   #58
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The blood draw should come before the DRE, it can make a (big) difference.
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In my case, the reading was 60% higher after the DRE.
For me it was 219% higher after the DRE (4.38 vs 1.37), though I assume other factors may have contributed? I know that particular DRE 'took my breath away' - not always the case...
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