Time to Change Nephrologist

Posted by fiesty76 @fiesty76, Aug 9, 2020

I had a very unsuccessful third visit with the nephrologist. I again asked when I signed in if I could have a copy of my lab report. The receptionist said "I'll tell the nurse". No copy given me. When I told the doc about my experience at the lab, she said, "that was irresponsible behavior for tech not to be wearing a mask the whole time nor asking you questions about covid or taking your temp." When I asked if this was her "preferred lab", she said "Yes. We have an arrangement with them." Should have asked what that meant??? Should have asked instead, What other labs do you use???

When I asked which lab values I needed to be most concerned about, she said, "your lab values all look good....what does that tell me?" What do I need to do differently or pay most attention to until next appt? Her response: You are doing well and then talked about how we could do a Zoom or Facebook appt if needed down the road. I am so frustrated.

I told her about asking for but not getting a copy of my lab to follow along as she went over my labs. "That is not customary." Said: I have hearing loss, you speak softly, (and wanted to say: you are hard to understand anyway because you are from the Phillipines) and I need to read or be shown how to do something to learn. I am not a good listener for learning things.

Could you please see that I have a copy of my labs beforehand for my next appt? Response: I will tell the nurse. Can I please get a copy of my labs today before I leave? Yes, I will have one printed for you. What did I learn about my kidney function from her? Nothing. The wait in lobby and exam room plus additional wait for lab printout resulted in 2hrs and 40 minutes. Time with her? Maybe 10-15 minutes.

Because I have learned to read and understand more about the lab results, I am very happy that my original Gfr values that showed Stage 3a CKD have stayed at 62, a high Stage 2 for the second report in a row. My Bun value was also normal range. However, when I asked what my A1c showed for diabetes, she said that value wasn't reported. It was the time before.

When I got home to go over the report, it showed that my HGB, MCV, and MCH were each High. The report didn't give a number value for the diabetes but these three values have to do with protein and creatine ratio...the normal range for the latter showed normal range 0.021 - 0.161; mine reported 0. 278mg.

I feel like my last lab visit exposed me to a tech who didn't wear a mask or gloves until she began to draw blood and that the doc visit was a waste of time except for getting a copy of the lab report. I will be asking my PCP for a different referral at my next annual appointment.

Interested in more discussions like this? Go to the Kidney & Bladder Support Group.

@fiesty76

@kamama94, Hoping your procedure yesterday went well and that today you are resting confortably. Update us when you can,ok? Hugs to you.

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@rosemarya, Ginger can update e veryone. Just got out of hosp yesterday so too tired to post much - ambulance ride back to hosp, ufgent dialysis d.t. incr uremia, soft tissue injury to right leg making transfer from bed to wheelchair impossible. Ginger will share more info later. So glad all of you are in my corner!

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@kamama94 has asked I send out an update. After last week's permacatheter procedure on Tues she was readmitted to the hospital with complications. She had dialysis in-hospital Wed and Fri, and is home now. She will be having in-center dialysis, and has been approved for two weeks [I hope more!] of home health. Her family stepped up to help modify her living space to accommodate her new-to-her lifestyle. She will post when she has more energy. I know we all wish the best for her.
Ginger

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Yes, tie to change doctors. Also, I should mention, Quest Diagnostics will email a lab report to the patient if requested. I'm not sure about Lab Corp.

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@veteran1950 I use Labcorb and get results mailed to me from my Dr

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@kamama94

@rosemarya, Ginger can update e veryone. Just got out of hosp yesterday so too tired to post much - ambulance ride back to hosp, ufgent dialysis d.t. incr uremia, soft tissue injury to right leg making transfer from bed to wheelchair impossible. Ginger will share more info later. So glad all of you are in my corner!

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@kamama94, Just glad to hear from you! Your many friends here were becoming concerned so happy that Ginger will be sharing more info. In the meantime, rest and hang tight. Hoping your days will become smoother and you'll be feeling stronger soon. Hugs and prayers coming your way.

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@fiesty76

I truly appreciate your response, @gingerw. All other docs, who require labs for me, are part of one large hospital extended complex. The nephrologist is independent from this group and is the only doc I see who uses this particular, different lab. Other labs are connected to the large hospital complex.

This lab told me at my first visit that lab results would be much faster to obtain from my doc's office. When I signed in the previous visit with the doc, I asked for and was given a copy of my lab report. The doc asked to see my copy of the lab and then went over the results with me. I had nothing to follow and many values were given which was very confusing for a newbie to kidney problems.

This second visit to the lab, I didn't ask to pick up lab results from them. So was very happily surprised to see an e-mail from the lab a couple of days later. However, when I opened it, it gave only two values: a calcium which showed normal and a thyroid, also normal. I sent a request online to the lab for clarification noting that the doc prescribed Kidney tests. I didn't hear back from the lab before my doc visit and have yet to receive an online "corrected lab report" from them.

This nephrologist expects the labs to be completed a week in advance. This second go around, I scheduled the labs two weeks in advance hoping I could pick up a copy from doc's office and making a 2nd copy ...one for neph to review and one for me to follow. That proved very lucky for me as it turned out. My neph. office called to tell me my scheduled appt. had been cancelled could I come a week earlier if labs had been completed? I just got under the timeline and could make the new appt.

Thank you, Ginger, for reading and listening. I felt troubled and discouraged by both the lab and by the doc's visit. I know that my pcp puts in requests to some third party who makes the actual referral decisions...don't know how that works exactly because in the past, a doc could request a specific specialist. I'm not sure if any of my docs or specialists can now even request a specific specialist but will ask my pcp. Everything medical is changing so rapidly; I am older and do not want to cause waves or appear to be a troublemaker.

And yes, I have long known, years before my hearing loss that i am not an audio learner so this is another obstacle for me. I know that others in this forum have established really strong, positive relationships with their specialists and i am happy that can happen. Thanks again, Ginger.

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Thinking good thoughts for you

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@kamama94

@rosemarya, Ginger can update e veryone. Just got out of hosp yesterday so too tired to post much - ambulance ride back to hosp, ufgent dialysis d.t. incr uremia, soft tissue injury to right leg making transfer from bed to wheelchair impossible. Ginger will share more info later. So glad all of you are in my corner!

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Hello @kamama94

It is good to hear from you and have @gingerw provide an update on your behalf. I'm glad to hear that you have been approved for home health care and that your home is now modified for your new health needs.

Yes, here at Connect we are all in your corner and wishing you well. I will gladly pray for you as you adjust to these new circumstances.

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GFR values for years have been around 60. My age is 77. My Doctor says this is not a problem.

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@murmur

GFR values for years have been around 60. My age is 77. My Doctor says this is not a problem.

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@murmur Welcome to Mayo Clinic Connect! Good for you, keeping a steady eGFR! As research has shown time and again, our values for eGFR declines a bit as we age, naturally. I would be interested to hear what kind of a lifestyle you keep [diet, exercise] that helps keep you healthy?

What brought you to Mayo Connect?
Ginger

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