@tntwo99

I don't know how easily it is for you to choose which doctor you want to see and I am not a doctor. But--it sounds like your health is at least complicated as mine and my hematologist told me I need an MD to be my PCP. Just saying.

Also, I was sent to rheumatology after my first "likely gout" flare which in the HMO I use, is where decisions about gout are made. I had been sent to a Foot and Ankle Specialist after having an x-ray at Same Day Care which was said to be difficult to read. The F&A said the same thing about a new set of x-rays weeks later. A few days later I saw my nephrologist for my quarterly appt. He apparently saw the F&A's conclusion and had ordered a uric acid test. It was 9.2 so he started colchicine. The toe in question had been inflamed for months by then but eventually the pain went down. The swelling and redness stuck around for perhaps a year during which he had me tested for allergy to the uric acid lowering med, allopurinol. (People with East Asian heritage are more likely to be allergic. I have wondered if he was on top of that since his family is Taiwanese. You never know what experience your doctor brings to the table.) When that allergy test was negative, he started me on a low dose of allopurinol. Of course, a few months later, I developed an itchy spot on my hand which was never diagnosed but allopurinol was paused and re-started when he got back from a family vacation in Iceland. This time, no itchy spot. Eventually the dose was increased and uric acid fell to within the normal range. At the same time he put me on what we call the gout diet--no red meat (including beef, pork, game), no avocadoes, no almonds, and as we say, nothing fun to eat and sent me to rheumatology for more care.

I don't know if I got the bottom of the barrel in that dept or a typical rheumatologist but she wouldn't see me because I hadn't had a tophus (swollen joint filled with sodium urate) aspirated. A picture of the crystals is attached and while they are beautiful, they look like they'd do a fabulous job lacerating kidneys. My current PCP just referred me back to Rheumatology now that I've had another presumed gout flare (that was put out in just hours after a dose of colchicine I took when I thought another toe was in pain from gout.) The first rheumatologist left and I am hoping the second one will at least let me in the door. I'd like a referral to an informed dietician about the gout diet. The other one I saw probably googled it just before seeing me.

All this to say, knowing the little bit I know, I am glad that my "presumed gout" is getting attention.

BTW, my husband confirmed that the $2000 limit came into effect this year for Medicare Advantage plans. He topped out in January and has not paid a co-pay on meds since.

Do you use an insurance broker? Ours has been very helpful keeping us informed of changes like this. If you're in MN, I can ask ours if he'd take you on.

Dinner time. Back later.