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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 2592
Experience:  Emergency Medicine and Family Practice for over 26 years
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I closed the initial question so that you can get paid. I

Customer Question

Hi,
I closed the initial question so that you can get paid for it. I thought you would get back to my reply so that we could talk about what is a fair price for examining the CT-scans and X-ray.
In any event, here is what I want: I would like someone to look at these scans from this stand point:
Patient has lymphoproliferative disorder, periodic difficulty in taking in breath (lungs don't seem to expand enough 50% of time when trying to catch deep breath - every 5 minutes on average). ...
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Phil, MD replied 1 year ago.

are they obese?

Customer: replied 1 year ago.

No. Last weight taken at time of second scan was about 187lbs. Weight loss – one-and-a-half to two belt notches in 6 months. (Sorry, have ordered bathroom scales, but not yet arrived.)

Forgot to mention that the patient (i.e. I) has arthritis. Most of last knuckles of fingers, big knuckle of large right toe, third toe left foot and periodic arthritic pain in various muscles at various times.

Did you want the links to the scans? Regards,

WMT

Expert:  Dr. Phil, MD replied 1 year ago.

can I have reports on them?

not the images

Customer: replied 1 year ago.

There were three diagnoses from two diagnosticians – one for the X-ray and one diagnosis for each of the CT Scans. The second CT Scan diagnosis differs so greatly from the first two diagnoses (to be put bluntly – one completely contradicts the other) that I would prefer that someone with experience in diagnosing scans look at these with fresh eyes.

Expert:  Dr. Phil, MD replied 1 year ago.

can I get the reports?

Customer: replied 1 year ago.

Can, yes. May, no. I don't want the reports to taint a proper reading of these scans.

Dear Doctor.

I have to leave this terminal for a few hours. To be clear, in my question I requested a reading of CT-scans, not a differential diagnosis based on someone else’s reading of these scans. If you are not qualified to do this, then please send this back to the pool.

If the amount set aside for this is not sufficient, the respondent can negotiate a different price with me. My wife and I are missionaries and the medical services here are a tad limited. I need this reading. I already have a differential diagnosis based on the readings in hand. But because these readings are so diametrically different, I want an expert to read these scans based solely on the patient’s history and the actual images.

Kind wishes,

WMT

Expert:  Dr. Phil, MD replied 1 year ago.

I will have to opt out for another expert then. Sorry

Expert:  khagihara replied 1 year ago.

Can you attach the results here?

Expert:  khagihara replied 1 year ago.

I will try to read them.

Customer: replied 1 year ago.

I will send them after this paragraph.

I just now received my Lymphoma Immunohistochemical Analysis. Here is what it says: "Interpretation: Spongiotic Dermatitis, consistent with a chronic eczematous process such as contact deratitis. Negative for cutaneous lymphoma. Lymphocytes have a mixed B and T cell phenotype (CD3 +/CD20+) iwthout T-cell subset restriction (CD4+/CD8+) or pan T-cell antigen deletion (CD2+/CD3+/CD5+/CD7+). These results together with the morphological findings support this impression."

The dermatologist feels that there is more likely an internal cause for the external manifestation of this exema, since there has been no contact with heavy metals or other alergens that could trigger this.

Maybe this report will give you some idea where to look on the scans, or what you might be looking for. Here are the scans:

https://www.dropbox.com/s/i2ykjrnv3laeujq/2015%2011%2025%20X-Ray.zip?dl=0 (X-Ray)

https://www.dropbox.com/s/x2frhemrhlxlskh/2015%2012%2007%20cat%20scan.zip?dl=0 (Normal + High contrast. You need to expand, copy to CD and then run the program in order to read this. Unless you have a better reader than the one included here.)

https://www.dropbox.com/s/4cyz5ulbaorxss6/2015%2012%2018%20cat%20scan.zip?dl=0 (Normal + Medium contrast. The reader will read from your disk.)

All supplied readers will allow you to adjust brighness and contrast. Let me know if you have any questions. If you need more money to give this a proper look, please do not hesitate to negotiate. We are self-supporting missionaries and medical service here, although adequate, is not great. We need some external help. Thank you for taking this on. Cheers,

WMT

Customer: replied 1 year ago.

Any success?

Expert:  khagihara replied 1 year ago.

no success. I read the CT description which is written in Spanish.

Customer: replied 1 year ago.

Hi, Dr. Khagihara.

I don't need someone to read the description (diagnosis). I speak sufficcient Spanish to understand that. What I need is someone who can interpret the scans themselves and who can produce their own diagnosis or diagnoses. The scan readers are provided with the scans.

There are about 100 slides or more, so if you need more money, let me know and we can strike a deal.

Cheers,

WMT

Expert:  khagihara replied 1 year ago.

I can't open the images.

Customer: replied 1 year ago.

Do you mean that you can't open the ZIP files? Or that you can't open the images?

If the former, I will upload them to DropBox. If the latter, make sure that you decompress the files to your disk or to a memory stick.

For the X-ray, use the enclosed viewer.exe program to open the X-ray image. It will allow you to adjust the image brightness and contrast.

For the file marked https://www.dropbox.com/s/x2frhemrhlxlskh/2015%2012%2007%20cat%20scan.zip?dl=0 you will need to burn it to CD and then use the enclosed edgeviewer_lite.exe to view. This program allows you to adjust contrast and brightness. Or, without burning to CD you can use the program (free download) MicroDicom (http://www.microdicom.com/). But it won’t allow you to adjust the image as you might like.

The last file needs to be decompressed to disk and then run Autorun.exe. You may need to change the folder in the upper left corner so that it displays the slides.

Hope this helps,

WMT