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A scare, an unnecessary fright and bad behavior, all over potassium

Posted Mar 13 2009 3:39pm

I had my blood drawn two weeks ago to check out my vitals and all were in target range except my potassium. Potassium?! Who even knew they tested your potassium? But I was told it was out of range, high, a "6" and needed to be retested to see whether the test result was accurate.  How important can it be that it might be a little high? [ Normal range is 3.5-5.3 mEq/L. ] O.K., no sweat. After all how important can potassium be? Certainly not up there with my A1c, cholesterol, triglycerides, microalbumin and thyroid activity.   

Now is when it gets interesting. First, I had to instruct my endocrinologist's office to send the test results to my general practitioner. Isn't that what an HMO is all about? Your GP sends you out to specialists who report back? Apparently not. When my GP got the results a day later his assistant called me to say, and I might add sounded a little worried, "Riva, do you know your potassium is high?! The doctor wants you to get it tested again." "No problem," I said nonchalantly. I already have an appointment next week to have it retested. I hung up the phone wondering what's all the fuss about my potassium? 

I suppose my comfort came mostly from the fact that this very thing happened to me once before several years ago, and I'm basically healthy: I eat a Mediterranean-like diet, high in healthy fats, whole grains, low in fats and sugars, plenty of veggies, my weight is in range, I walk every day…But the idea that something might be wrong began to pray on me so I looked up on the internet foods high in potassium to see if that could have caused the spike. If so, I'll cut down on those foods I decided. In my search naturally I started reading about potassium. The Mayo Clinic site reports, the most common cause of high potassium is impaired kidney function, such as due to acute or chronic kidney failure. High potassium is a life-threatening disorder that can cause muscle fatigue, paralysis, abnormal heart rhythms, nausea and require kidney dialysis.

Whoa, stop the train! Now I'm a little freaked out to be honest. I still believe my number must be wrong but....what if it was right? What if my potassium is now a problem and I'm headed for kidney failure or am already in the early stages? How I will fare with such a fate? Of course I also did read sometimes a report of high blood potassium isn't accurate. It may be caused by the rupture of red blood cells in the blood sample during or shortly after drawing the sample. The ruptured cells leak their potassium into the serum. This falsely elevates the amount of potassium in the blood sample, even though the potassium level in your body is actually normal. But, achem, I wasn’t quite so confident anymore.

The conclusion to my retest is the first test result was an error and I’m in range. But here’s my real beef. I was retested on a Wednesday, first thing in the morning and called my endo Friday morning to get the results. His assistant told me he wasn’t in but would be in in the afternoon and yes she had the results. I was very clear that I wanted to know the results that day as I didn't want to go the whole weekend fearing the worst. He didn’t call me back.

I called again Monday morning. I was told my endo was busy all day with patients and the assistant said fleetingly as a throw-away, "He doesn't call you if your test result is O.K." But I had no assurance of this. I repeated to her that it wasn’t O.K. before and I’d like to know for sure if that was a mistake. Please ask him to call me." She said she would leave him the message. He didn’t call.

I called Tuesday morning and she told me, "I gave him the message yesterday. I'll tell him that you called again." No return phone call. I called again at 5 PM to find the office closed and so I left this message, more or less. “I can’t understand why after having an abnormal value for my potassium and getting it retested and not knowing whether or not it's still abnormal and calling Friday, Monday and today, no one has bothered to call me back and let me know if I'm O.K!" It took five days to get me to that point. My husband was already there the first day.

My doctor called the following morning. “What can I do for you,” he said. No apology, very matter of fact, and he told me my potassium is in range. As he was about to get off the phone he said, “I don’t call patients when the results are normal.” I said, “After getting an initial result that wasn’t, it only makes sense I would want to know whether this result was also abnormal or not.” He muttered something that was hard to make out and we hung up.

I began to think about what this policy of only call a patient when there's a problem creates. It means you don't even hear from your doctor when there’s a resolution to a problem. Further, don't you think if your doctor called and said when your test results were all in range, “Your labs are all good, all normal, good work! Keep it up, you’re doing something right and that’s great!” Yes, it will cost him another half hour a day. It will likely cost a lot of mental stress for patients, and money for our healthcare system. Because frankly, wouldn't it encourage continued good behavior if you were called and congratulated when you did well? How perverse is our system that hard work and effort goes unappreciated and unacknowledged and we're only told about problems? 

O.K., I've ranted, it’s out of my system now, but just between you and me, I’m changing endos.

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