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Pharmacy Links

AFTER CANCER: VACCINATIONS. MEDICAL RECORDS

12th March 2009

Do I Need a Hepatitis Vaccine?

The hepatitis vaccine is recommended to people at increased risk of exposure to hepatitis B. Transfused blood undergoes extensive sensitive testing for hepatitis В prior to approval for transfusion, so the risk of transfusion-associated hepatitis В is very low. It is an expensive, three-shot regimen, usually given over six months. An optional regimen is given over two months. This type of vaccination can be discussed if there is a reasonable concern that you will need blood products in the future. For example, if you had a type of cancer that is treated with bone marrow transplantation if it recurs, then you might consider having this vaccine given to you while you are in remission.

Can My Children Proceed with Their Routine Vaccinations?

Some of the routine vaccines that children receive are “live” vaccines, namely, weakened but alive viruses. Check with your oncologist whether and when it is safe for you to be exposed to someone who has received a live vaccine.

Who Owns Ну Medical Records? My Scans and X Rays?

Medical records belong to your doctor, but you have a right to a copy of the records. Your scans and X rays belong to the doctor who ordered them or the radiography center where they were taken. You have a right to a copy of your X rays, but oftentimes you will be charged a copying fee.

Is It a Good Idea to Read My Own Medical Records?

For most people the disadvantages outweigh the advantages. The main reason people want to read their records is to find out about their condition. In general, if you feel you are not getting accurate or enough information about your medical condition from your oncologist, ask him or her to discuss your case with you in greater detail. If you still feel that you are not getting answers to your satisfaction, it is time to find a doctor with whom you communicate better, and not depend on self-interpretation of your records. The advantages of reading your own medical records include

• finding out details you missed during the discussions

• verifying your understanding of your condition

A major disadvantage of reading your own medical records is the enormous potential for misinterpretation of symbols, phrases, and medical conclusions. Once you read these things, it can be difficult for you to dismiss them from your mind even if subsequent discussion clarifies your misunderstanding. Some misunderstandings are easily corrected, and even amusing (“male, c/o SOB” is a man who is complaining of shortness of breath). Other misreadings are subtle but dangerous. Your doctor’s notes may indicate that “there is no evidence of metastases at this time,” which is a standard phrase to document a thorough exam. You may be left with a disquieting sense that your doctor is anticipating you developing metastases, when in fact your doctor is not.

You may read things that you really did not want or need to know and that cause you unnecessary anxiety. When evaluating a patient, doctors commonly write a list of different conditions that could be causing a symptom or problem. They may be unconcerned about most of the possibilities but include them for completeness. You, on the other hand, may be left worrying about problems you had not even thought of before.