1. < Kidney & Bladder

Worried about keeping an upcoming CKD lab and nephrologist appointment

Posted by fiesty76 @fiesty76, Jul 13, 2020

My last lab and nephrologist appt was in Sept. With stage 3a ckd diagnosis, I was concerned that the next visit was scheduled 6 mos later and am
becoming increasingly worried about keeping an August appointment. I postponed an earlier "phone" consult because of worry about "walkins" at the lab the neph. uses exclusively.

With the exception of the nephrologist and opthamologist, all other physicians I see are connected to our large hospital and all labs and tests are administered through that system. The nephrologist, although referred through the referral service used by my pcp, uses an independent lab, Quest Diagnostics. My two visits there, before the Covid outbreak, found the lab crowded; I was told their online results might take up to 6 weeks and that the doc could provide a copy much faster. Welll, yes... Quest is a huge organization which has been very involved in Covid testing.

The 20 minute wait for an earlier phone inquiry about special precautions being taken now was so long, I finally hung up before the lab receptionist came on the line.

I can ask my pcp for another nephrologist referral specifically for one who uses the hospital complex but that will further delay specific lab results for the kidney. I can "take my chances" at Quest and see the current neph. and then make a request for a new neph. referral. I'm just writing my thoughts here. Wish I'd thought to ask pcp for a referral earlier but I didn't hoping that by August, the virus spread had lessened. Now, my state is one of the three "hotspots" for Covid spread and hospitalizations/capita.

Would appreciate thoughts from others here. I know we aren't docs but we know the importance of tracking ckd lab values. Upset with myself for being in this predicament but unsure which option to choose. Any other suggestions or opinions? Thank you.

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fiesty76 | @fiesty76 | Jul 16, 2020
In reply to @gingerw "@veteran1950 I have to go to Quest tomorrow morning, and anticipate their protocol will be at..." + (show)
@gingerw

@veteran1950 I have to go to Quest tomorrow morning, and anticipate their protocol will be at least as strict as last time I went, which is as you described. Our closest location is still 20 miles away after we reach the interstate, and appears to most people to be an afterthought, it is so tiny. An extra supply closet size, attached to a medical clinic/urgent care. Three waiting chairs, one phlebotomist.
Ginger

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Oh, my @gingerw, Your Quest lab sounds even smaller than the one here! Appreciate what you posted earlier too and feel better hearing from both of you and veteran1950 that you feel safe going.

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fiesty76 | @fiesty76 | Jul 25, 2020
In reply to @kamama94 "I hear ya, fiesty! I stay in lockdown except for quarterly neph and pcp visits and..." + (show)
@kamama94

I hear ya, fiesty! I stay in lockdown except for quarterly neph and pcp visits and bank ATM once a month. Even though others don't, I wear a mask all the time I'm out of my apartment to protect them and insert a coffee filter or a paper towel to protect myself, wear gloves or use paper-towel-touch, and carry hand sanitizer to use the moment I peel off the gloves. I sanitize the hand cleaner container also, then remove clothing to my washer, wipe my shoes, take a shower, and put on clean clothes. My service dog gets wiped down and the dog handler wipes off my wheelchair. It's a pain in the nether region but my motto is Better Safe Than Sorry. Non-maskers put other folks at risk, IMHO.

I get nervous if I have to delay quarterly labs for some reason so I check my urine for bubbles, which can be a sign of damage, assess for normal clarity, normal odor, normal amount, etc., note any increased fatigue, etc., etc. This is NOT medical advice, it's just what I do.

I hope you figure out what to do and be sure and keep me posted.

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@kamama94 @gingerw, Kamama, I am doing exactly as you do in taking extra precautions and although it makes me feel like a virtual pariah in my own "little kingdom", I'll continue for the foreseeable future. We only have one life and if it is compromised with chronic health issues, it seems prudent to walk on the safest side we know.

Ginger, I called Quest Lab to check on protocal. As you'd reported, the online site had listed the 1st hr of day for seniors. Was able to schedule an early appt for the 29th which was a relief. Then called the neph. to ask about protocals there. Could wait in car until my turn but it was "against doc's 'policy' to release a lab report until following the patient appointment with her.

Now I know why Quest had told me earlier that it would be faster to get a report from doc's office and also why the doc had me hand over the lab copy I'd requested the day of my appt. for her to review with me. Frustrated to say the least.

Late afternoon yesterday, a voice mail from doc's office saying my appt had been moved up to Aug. 7th and I would need to have completed my lab a week in advance before the appt. Barely under the wire for doc appt. Will keep it because I really need to know my lab values but I'll be asking my PCP for a new neph referral at my next annual. I may be overreacting but didn't feel good initially with this neph and this only serves to confirm my early intuition. Feeling overloaded by recent events and just needed to "vent". See what happens when you open the door kamama??? Smiles

REPLY
1 reply
kamama94 | @kamama94 | Jul 25, 2020
In reply to @fiesty76 "@kamama94 @gingerw, Kamama, I am doing exactly as you do in taking extra precautions and although..." + (show)
@fiesty76

@kamama94 @gingerw, Kamama, I am doing exactly as you do in taking extra precautions and although it makes me feel like a virtual pariah in my own "little kingdom", I'll continue for the foreseeable future. We only have one life and if it is compromised with chronic health issues, it seems prudent to walk on the safest side we know.

Ginger, I called Quest Lab to check on protocal. As you'd reported, the online site had listed the 1st hr of day for seniors. Was able to schedule an early appt for the 29th which was a relief. Then called the neph. to ask about protocals there. Could wait in car until my turn but it was "against doc's 'policy' to release a lab report until following the patient appointment with her.

Now I know why Quest had told me earlier that it would be faster to get a report from doc's office and also why the doc had me hand over the lab copy I'd requested the day of my appt. for her to review with me. Frustrated to say the least.

Late afternoon yesterday, a voice mail from doc's office saying my appt had been moved up to Aug. 7th and I would need to have completed my lab a week in advance before the appt. Barely under the wire for doc appt. Will keep it because I really need to know my lab values but I'll be asking my PCP for a new neph referral at my next annual. I may be overreacting but didn't feel good initially with this neph and this only serves to confirm my early intuition. Feeling overloaded by recent events and just needed to "vent". See what happens when you open the door kamama??? Smiles

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@fiesty78 Vent away! We're listening. Hope you find a great neph like mine. At 1st I almost asked pcp for new neph referral bc 1st 3 appointments I wasn't sure neph was as good as everyone said. Neph very reserved and gave quite simple answers to my questions, for one thing. But then she realized I was well-versed medically and got used to my twisted sense of humor. And I began to realize she not only knew her onions, she knew how to grow them. Now I'm crazy about her.

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2 replies
Mentor
Ginger, Volunteer Mentor | @gingerw | Jul 25, 2020
In reply to @kamama94 "@fiesty78 Vent away! We're listening. Hope you find a great neph like mine. At 1st I..." + (show)
@kamama94

@fiesty78 Vent away! We're listening. Hope you find a great neph like mine. At 1st I almost asked pcp for new neph referral bc 1st 3 appointments I wasn't sure neph was as good as everyone said. Neph very reserved and gave quite simple answers to my questions, for one thing. But then she realized I was well-versed medically and got used to my twisted sense of humor. And I began to realize she not only knew her onions, she knew how to grow them. Now I'm crazy about her.

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@kamama94 @fiesty76 Good-for-you-and-your-situation doctors are gems in a desert of the medical field. It's not one-size-fits-all, and shouldn't be. Finding the right combination can be frustrating. I like my nephrologist now, but a couple in the past weren't worth salt. Ya gotta advocate for yourself!

Also, I just got my lab results from Quest, that were done on 7/16, in an email. Haven't heard from Dr, yet.
Ginger

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1 reply
fiesty76 | @fiesty76 | Jul 25, 2020
In reply to @kamama94 "@fiesty78 Vent away! We're listening. Hope you find a great neph like mine. At 1st I..." + (show)
@kamama94

@fiesty78 Vent away! We're listening. Hope you find a great neph like mine. At 1st I almost asked pcp for new neph referral bc 1st 3 appointments I wasn't sure neph was as good as everyone said. Neph very reserved and gave quite simple answers to my questions, for one thing. But then she realized I was well-versed medically and got used to my twisted sense of humor. And I began to realize she not only knew her onions, she knew how to grow them. Now I'm crazy about her.

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@kamama94, Laughing at your sense of humor! and hoping maybe my third neph visit will be the charm that she too not only "knows her onions, (but also knows how to grow them). We can always hope!

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fiesty76 | @fiesty76 | Jul 25, 2020
In reply to @gingerw "@kamama94 @fiesty76 Good-for-you-and-your-situation doctors are gems in a desert of the medical field. It's not one-size-fits-all,..." + (show)
@gingerw

@kamama94 @fiesty76 Good-for-you-and-your-situation doctors are gems in a desert of the medical field. It's not one-size-fits-all, and shouldn't be. Finding the right combination can be frustrating. I like my nephrologist now, but a couple in the past weren't worth salt. Ya gotta advocate for yourself!

Also, I just got my lab results from Quest, that were done on 7/16, in an email. Haven't heard from Dr, yet.
Ginger

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@gingerw, I do agree and most of my docs are true gems! Think I have a distorted sense of loyalty that makes it more difficult for me than some to change docs but one of the many benefits gained from the Connect forums is learning to better advocate for myself...if we would do it for another, surely we can do it for ourselves as well, right?

Are you feeling good about your new lab results? Will you receive a written report from your doc or need an in-person appt to discuss labs?

My annual labs always ff my doc visit and she sends a snail mail report eventually. However, now there is a patient portal and since I've learned how to better decipher the lab results, I can get a faster reading and look for any med changes she may indicate in her letter.

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Mentor
Ginger, Volunteer Mentor | @gingerw | Jul 25, 2020
In reply to @kamama94 "@gingerw, hope your labs are great!" + (show)
@kamama94

@gingerw, hope your labs are great!

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@kamama94 @fiesty76 The one value has come down in to high normal range due to a change up of medication, so that is good. Additional labs to be pulled in 3 weeks for the oncologist, and I hope to see that another value that showed a significant decrease [my eGFR] has righted itself. Until then I will monitor myself closely, and see what the nephrologist says.
Ginger

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1 reply
kamama94 | @kamama94 | Jul 25, 2020
In reply to @gingerw "@kamama94 @fiesty76 The one value has come down in to high normal range due to a..." + (show)
@gingerw

@kamama94 @fiesty76 The one value has come down in to high normal range due to a change up of medication, so that is good. Additional labs to be pulled in 3 weeks for the oncologist, and I hope to see that another value that showed a significant decrease [my eGFR] has righted itself. Until then I will monitor myself closely, and see what the nephrologist says.
Ginger

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Keeping you in the Prayer Pipe! @gringerw

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lioness | @lioness | Jul 25, 2020

@gingerw Glad to hear this good news praying for some more for you .

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