@gingerw I apologize for the delay.

I think the comment my Mayo nephrologist made at an early appt might work for our t-shirt. He called me his "one in a million patient." : )

I make separate quarterly appointments, usually within the space of a two weeks, with the "team" who are each able to communicate with each other as well as view each other's visit summaries, including lab results (which are not always in complete agreement--currently my HMO lab says my eGFR is normal while the Mayo Lab says it's low and has a different result) at both the HMO and at Mayo. I don't know if they are able to read all messages sent to me. My PCP _can_ read my HMO nephrologist's messages.

My Mayo nephrologist doesn't write prescriptions for me but instead makes recommendations that my HMO nephrologist has, I think, always concurred with. I suppose it's possible that I would have to make the 90 minute trip to Rochester to retrieve a medication otherwise.

I forgot to mention that only the Mayo nephrologist had heard of ITG when the pathologist report landed. I was impressed that my HMO doctors have revealed that they had never heard of ITG. Initially, I searched the literature for information and read the authors' conclusions as I have no experience with medical research design. As a chemist I have only meager experience with statistics. I should probably renew my search efforts now that I think more treatment is likely (soon).

This pattern was established in 2022. I occasionally ask for re-tests which are approved. I think I may be granted this privilege because, one time, the total volume of a 24 urine sample was off in the report by almost a factor of two. I had to re-do that one the next day which is too often for me. (The head of the HMO's lab and I had a conversation about the "hardship." I now put a magic marker line at the top of the liquid level and write the total volume on the container. The lab reports now agree with my volumes.) The HMO lab is willing to send a portion of the collected urine to Mayo as well as the tubes that Mayo sends to me to be filled at the HMO lab. ) I am a retired organic chemistry professor so I have taken analytical chemistry.

I tell my doctors about my educational background and assure them that if I don't understand, I will ask questions. (Not to bias or impress but to not be talked down to as I have read commonly happens to women.)