Time to Change Nephrologist

Posted by fiesty76 @fiesty76, Aug 9 6:17am

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.

Liked by lioness, kamama94

@fiesty76, wish I sisn't have to put "like"for your post because it sounds as if there's no rapport between you and your neph and this peeves me.

I'm not as nice as you are, I would've run (ok, LOL, rolled in my wheelchair) out of that lab so fast their heads would've swum. And would've gotten out of neph ofc ASAP because of my Irish and Cherokee temper – bad combo.

Not everyone looks at things the way I do but to my mind, my neph works for me, not the other way around. I (or insurance) pay her to take care of me at standard of care or better.

This is the third time this doc has seen you, plenty of contact for her to "get acquainted" with you. My neph was very reserved with me at first, I guess she wasn't prepared to treat another medical professional, now I have her laughing out loud. I was on the verge of asking for another neph when we broke the ice.

This isn't advice, just my experience.

As a patient you have every right to know everything possible about your condition and the disease process and certainly every right for medical professionals to protect you from COVID.

I'm not telling you what to do here, just what I would do, and that's call pcp immediately and ask for a referral to a different neph.

OK, I'll hush up now. Good luck, my friend! Keep us posted. And congrats on the GFR!

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@fiesty76 I'm sorry that you had such a bad experience with your nephrologist. Like @kamama94, I have some serious questions about the way you were treated. I would definitely let your PCP know about your experience. If your nephrologist is part of a group you want to go to that administrator and let them know how you were treated. They all need to know. Go to your lab and ask for your own copies of the bloodwork. It is well past the period of waiting that most labs do [mine waits a week and then they send me the results].

As a patient, you have the right to be treated well. You also have the right to have your questions answered and not pushed to the side. If you do not understand what is being reviewed you have the right to question and ask for further explanation. Beyond that, there are people who listen and learn by audio, others who do best by seeing something in writing. And many of us do things in a combination of that.
Ginger

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@fiesty76 Shame on that person for talking to you like that and you should get a report as soon as you ask for it . I think I would find another Dr who will send you your lab results instead of you asking for one this should be done without you asking .

Liked by cehunt57, fiesty76

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@kamama94

@fiesty76, wish I sisn't have to put "like"for your post because it sounds as if there's no rapport between you and your neph and this peeves me.

I'm not as nice as you are, I would've run (ok, LOL, rolled in my wheelchair) out of that lab so fast their heads would've swum. And would've gotten out of neph ofc ASAP because of my Irish and Cherokee temper – bad combo.

Not everyone looks at things the way I do but to my mind, my neph works for me, not the other way around. I (or insurance) pay her to take care of me at standard of care or better.

This is the third time this doc has seen you, plenty of contact for her to "get acquainted" with you. My neph was very reserved with me at first, I guess she wasn't prepared to treat another medical professional, now I have her laughing out loud. I was on the verge of asking for another neph when we broke the ice.

This isn't advice, just my experience.

As a patient you have every right to know everything possible about your condition and the disease process and certainly every right for medical professionals to protect you from COVID.

I'm not telling you what to do here, just what I would do, and that's call pcp immediately and ask for a referral to a different neph.

OK, I'll hush up now. Good luck, my friend! Keep us posted. And congrats on the GFR!

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@kamamamma, Thank you for your response. I just assume the "like" button is that someone is acknowledging a post so appreciate your response. I had some concerns from the get go with this nephrologist because she offered so little information from the start but needed those lab values.

I also have a dose of Irish but usually it is reserved for "injustices to others" and while I'm not sure of any direct Indian dna figure I have a bit of "everything". Do know for sure that both a former (not illustrious U.S. President and also the last person hung in the Tower of London were of my direct lineage…with a lot of who knows what else tossed in? lol

I didn't go with a list of 57 prepared questions and absolutely Know that you aren't attempting advice but appreciate what you wrote. I did want to know some basic information. In retrospect, I wish I had called the local health dept to report the actions at the lab. I still can and may give them the date and time of that appointment.

What I have learned about better managing my CKD has come from Mayo, this Connect forum and other highly trusted kidney sites. I am celebrating my gfr and bun values but the report did address my diabetes, which said wasn't reported, and high levels of protein from the creatitine urine tests. I can work on those but not because of the specialist's input.

Changing docs is not easy for me but a change from one cardiologist to another made a wonderful difference with two new dianoses i wouldn't have received from the one i'd been seeing for a long time. Sometimes, a change needs to be made and I appreciate your support. Hugs to you and all others who are working to improve and maintain the best kidney function we can!

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@gingerw

@fiesty76 I'm sorry that you had such a bad experience with your nephrologist. Like @kamama94, I have some serious questions about the way you were treated. I would definitely let your PCP know about your experience. If your nephrologist is part of a group you want to go to that administrator and let them know how you were treated. They all need to know. Go to your lab and ask for your own copies of the bloodwork. It is well past the period of waiting that most labs do [mine waits a week and then they send me the results].

As a patient, you have the right to be treated well. You also have the right to have your questions answered and not pushed to the side. If you do not understand what is being reviewed you have the right to question and ask for further explanation. Beyond that, there are people who listen and learn by audio, others who do best by seeing something in writing. And many of us do things in a combination of that.
Ginger

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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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@lioness

@fiesty76 Shame on that person for talking to you like that and you should get a report as soon as you ask for it . I think I would find another Dr who will send you your lab results instead of you asking for one this should be done without you asking .

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@lioness, Thanks, Linda, for your reply and also good to hear from you! I was beginning to worry about you because i'd not seen a post from you in a few days. Hope you are doing ok? Was tempted (but managed to resist,ahh), to take a "bonus" walk this morning. Instead, watched a favorite Sunday Morning program and then went on to other things. Hope you and all are staying well and safe.

Liked by cehunt57, fiesty76

REPLY
@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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@fiesty76 Cause waves! Appear to be a troublemaker! You have to advocate for yourself, because noone else will do it if you don't! Push for the information you need to make informed decisions about your health! [Yep, I proudly have "DP" for difficult patient on my charts in many offices]
Ginger

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@gingerw, Thank you! Your response of pride at being a "DP" brought an always welcomed laugh! Smiles to all.

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@kamama94

@fiesty76, wish I sisn't have to put "like"for your post because it sounds as if there's no rapport between you and your neph and this peeves me.

I'm not as nice as you are, I would've run (ok, LOL, rolled in my wheelchair) out of that lab so fast their heads would've swum. And would've gotten out of neph ofc ASAP because of my Irish and Cherokee temper – bad combo.

Not everyone looks at things the way I do but to my mind, my neph works for me, not the other way around. I (or insurance) pay her to take care of me at standard of care or better.

This is the third time this doc has seen you, plenty of contact for her to "get acquainted" with you. My neph was very reserved with me at first, I guess she wasn't prepared to treat another medical professional, now I have her laughing out loud. I was on the verge of asking for another neph when we broke the ice.

This isn't advice, just my experience.

As a patient you have every right to know everything possible about your condition and the disease process and certainly every right for medical professionals to protect you from COVID.

I'm not telling you what to do here, just what I would do, and that's call pcp immediately and ask for a referral to a different neph.

OK, I'll hush up now. Good luck, my friend! Keep us posted. And congrats on the GFR!

Jump to this post

I love your post. We all need to be our own advocate for our health. Thanks for your affirming post.

Liked by cehunt57, fiesty76

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

Liked by cehunt57

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@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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