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Choosing the right nephrologist
I am one year in with a nephrologist and find the specialty to be all over the board relative to what I am looking for. Are my expectations unrealistic? The first nephrologist only scheduled video visits and was “assigned” to me by my Rheumatologist (I have Lupus), then after my renal biopsy he never contacted me to discuss the results. When I contacted the office to ask when he would be contacting me, they said his first face to face appt was 8 months away. So I switched to another practice and to a wonderful doctor who left a month later to go to Pharma as a Medical Director. So I switched to another doctor in the same practice. He was OK and when I followed up and made my next appt I asked for the NP of the first doctor who left since I liked him so much. A few days before that appt I got a confirmation that I was seeing someone else, another NP I never heard of. So now I have an upcoming appt with the Nephrologist who was “OK” and I just had some bloodwork done. The practice would not release my lab results to my portal until it was reviewed by a provider. Mind you, my undergraduate BS degree is in Medical Technology (lab interpretation and analysis) I contacted the office to have them release the block on my lab results (going on 3 days after the test was done)and they said no it was an administrative policy. It was just a renal panel and urinalysis. Is this unusual to find these issues in a nephrology practice? Somehow I thought this specialty would be different than a PCP type office. Should I switch again? I have some names of a couple other practices but is it going to be the same situation? And how do I know whether it will be better or worse? Does anyone have a good list of questions to ask before you commit to another practice? About me: I am a T2 diabetic since my second pregnancy at 41. I am 66 now and have diabetic nephropathy stage 3b CKD. I worked 34 years in the medical industry both Pharma and laboratory. Right now I’m doing well, eat only plant based food and exercise. I know this doctor is going to be the most important provider in my lifetime. How do I end up with the perfect match?
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You may be correct about the approved mycotoxin tests. My functional medicine physician ordered the Mycotox screen from Mosaic Diagnostics. I had a high result on two mold species, Ochratoxin A and Gliotoxin. My nephrologist was not familiar with any treatments nor had he heard from any other patient about mold toxicity. He did thank me for bringing it to his attention and said maybe it is something he should be paying more attention to.
There are very few or no controlled studies for treatment of mold exposure, nor are there any clear cut guidelines on levels and who should be treated. There is a physician who has done some research on mold toxicity and treatment. Her name is Dr. Jill Crista. I read her book and she does have a detox protocol. I am going to another functional medicine physician in mid-May who has been through Dr. Crista’s professional mold training course. The nephrologist pretty much left it up to me to let him know what I find out.
I did find another Nephrologist but had to wait 8 months to get in as a new patient. October will be the appointment.
I would like to rule out any variables that may cause my kidney function to be compromised over and above diabetic nephropathy, which I know I have. I am being extra cautious so that I maintain or improve current kidney function. I have not started any detox program and anything I do take I always talk to my nephrologist first.