When is it time to change care to a Gerontologist?

Posted by codered032 @codered032, Oct 24, 2021

I am 70yo. Have always been healthy with no chronic illness. Two years ago during my annual physical I was diagnosed with a rare kidney disease, MCD. Having never been on medication, I started taking high dose prednisone. The side effects were awful. I am now taking Tacrolimus with similar side effects. My PCP is 30 something and appears to think this is just the aging process. I am having trouble finding a gerontologist. I don’t want to keep changing doctors but don’t know how or where to start looking.

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Hi there ... now this is just MY experience, so don't take it as everyone is all the same. When I moved down here to (what I call) the "sticks" of VA, I first went to a Geriatric Internist. The first visit he was very nice (looked about my same age!); the second time it felt like a "conveyor belt" appt., if you know what I mean. So when I had to go back, I didn't ask for anyone in particular (there are 6 doctors in the practice) and I got a Physicians Assistant ... a probably 30-ish guy (or thereabouts) and he is excellent! He listens, asks questions, offers suggestions, and actually spends time with a patient. I'm sticking with him. I've wondered if they may be training their new doctors to also be "people persons" also, rather than just the "serious, stick to the facts" type. Just thinking.
Barb

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@amberpep

My daughter is a Nurse Practitioner and, like many PAs and ARNPs, they treat the person more holistically. My daughter works for herself and treats residents in the Assisted Living Facilities. She is essentially my doctor and I am lucky to have her next door.
My favorite providers in the past have been Nurse Practitioners and Physician Assistants. You’ll get more time and interest and patience from a PA and ARNP. Doctors are focused on diagnostic and specific treatments. ARNPs and PAs spend more time on assessment, prevention and wellness based treatments. I like to say Physicians are like Joe Friday of “Just the facts Ma’am”
fame.

FL Mary

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@amberpep

Hi there ... now this is just MY experience, so don't take it as everyone is all the same. When I moved down here to (what I call) the "sticks" of VA, I first went to a Geriatric Internist. The first visit he was very nice (looked about my same age!); the second time it felt like a "conveyor belt" appt., if you know what I mean. So when I had to go back, I didn't ask for anyone in particular (there are 6 doctors in the practice) and I got a Physicians Assistant ... a probably 30-ish guy (or thereabouts) and he is excellent! He listens, asks questions, offers suggestions, and actually spends time with a patient. I'm sticking with him. I've wondered if they may be training their new doctors to also be "people persons" also, rather than just the "serious, stick to the facts" type. Just thinking.
Barb

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It's been my experience that, regardless of the specialty, medical people who are women are more likely to be "people persons" than men. I think women are more likely to be good at communicating than me. I'm male and not a good communicator so I always choose a woman given the opportunity. I'm not being sexist, it's just been my experience.

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@imallears

@amberpep

My daughter is a Nurse Practitioner and, like many PAs and ARNPs, they treat the person more holistically. My daughter works for herself and treats residents in the Assisted Living Facilities. She is essentially my doctor and I am lucky to have her next door.
My favorite providers in the past have been Nurse Practitioners and Physician Assistants. You’ll get more time and interest and patience from a PA and ARNP. Doctors are focused on diagnostic and specific treatments. ARNPs and PAs spend more time on assessment, prevention and wellness based treatments. I like to say Physicians are like Joe Friday of “Just the facts Ma’am”
fame.

FL Mary

Jump to this post

In reply to @imallears …. I have been on the roller coaster of general practitioners and I lost another one. I just accepted a nurse practitioner in internal medicine this time and your comments sound very hopeful. Thx so much💕

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@migizii
I hope your experience with the Nurse Practitioner is a good one. You didn’t say whether the ARNP is a male or female. There seem to be more females who are. Keep in mind there are great ones and others not so great. If you feel rushed during an exam, let him or her know that.

Be a good historian about your medical history , medications etc . I find it helpful to jot down relevant facts and timelines( important). They will love you for doing that..it makes their job so much easier. One of my daughter’s big complaints is that so many of her patients don’t remember their medical history and are vague and rambling. Many times there is little documentation or help from families. It’s frustrating and time consuming.

I personally have always kept a journal of all significant happenings….medical, car, house etc. I’m that kind of personality and that’s what my dad did.

Let us know how things worked out.

FL Mary

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@loribmt

Hi, @codered032 I’m jumping into your conversation a little late. But the mention of Tacrolimus caught my attention. Does your PCP have you on this medication to use as an anti inflammatory drug for your kidneys?

From experience, this is an excellent drug but very strong. It also requires frequent Tacrolimus trough levels in your blood because it can cause serious damage to your kidneys and cause other serious side effect. Trembling and generally feeling ‘awful’ can be a good indication of too much in the blood stream. It’s also important to take magnesium with this as it can deplete the body of magnesium quickly. Instead of magnesium citrate you might consider a daily Magnesium Glycinate supplement. It’s easily absorbed and doesn’t cause intentional issues. The product is sold over the counter but you should check with your physician. I whole heartedly agree with @gingerw with looking for another provider.

If you don’t my asking, who put you on the Tacrolimus and the prednisone? Were you seen by a nephrologist? (Kidney specialist).

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Thank you for information on Magnesium.

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