I've been having increasing amounts of anxiety as my  routine nephrology appts approach on Jan 27th.

When I lived in AZ, there were a variety of neohrologists to choose from and I received excellent care. But I moved to a much smaller city in CO, and there is only one nephrologist office in the city, and the care I receive there is extremely sub par compared to the experiences I had living in AZ.

Calling the office with questions or concerns is nearly useless. In one experiences I played phone tag for nearly 3 weeks, even after I asked my question and requested multiple times they please leave a detailed message on my phone. I work during the day, and they seem incapable of answering questions or returning calls in a timely manner.

I eventually gave up calling and have resorted to using their patient portal, but there are times I've received no response at all!

They've called me multiple times to reschedule appointments, and once they called me the day of( after having this appointment scheduled for 3 months) to cancel and reschedule for another month out.

My BK virus was up, they reduced my antirejection meds, and rather than following up in 2 weeks--like nearly every nephrologist I've ever had would do-- they handed me lab work and said to get it done again in 3 months. I was worried, so I ended up using that lab work in 2 weeks time to check my bk levels. They were down, but not enough to up my antirejection meds.

I haven't even seen the same doctor for the last year. Every appt has been with a diff doctor because the doctor I was assigned to has been out on medical leave for nearly a year now. Rather than providing some consistency my appointment have been rescheduled with whoever is available.

I feel very frustrated about all this, and have been worring about my kidney and kidney function nearly all the time now. Im diligent about watching for signs of rejection or infection, but as my doctor appointments  approach I find myself nearly crippled with anxiety. Constantly worrying that I'm rejecting and don't know it. Im tired if having to explain my situation and health to a new doctor every visit, and am very afraid that--due to the lack of follow up and good care-- I will lose this kidney.

The idea of going back on dialysis makes me sick with dread.

I know I am my best advocate, but trying to advocate for myself seems like a moot point when I can't even get the office to answer my questions, follow up on what I view as important, or provide consistent care...

In this upcoming appointment I'm going to be very aggressive about my care-- be sure to ask the doctor all the questions I can think of, and request that I be transfered to a  different doctor--the same doctor-- so that I can at least try to establish some kind of consistency. Im going to ask for multiple lab orders so I can check my bk levels myself, and request a direct extension to this doctors medical assistant. Im not going to let this subpar care jeopardize my kidney. I'm just so afraid it already has...