Worried about keeping an upcoming CKD lab and nephrologist appointment

Posted by fiesty76 @fiesty76, Jul 13 5:24am

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.

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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@fiesty76 I also use Quest Labs, and have since 2017, using locations in 4 different areas in two states. I like the fact there is a database that can be pulled from by my Dr's. My own personal experience with Quest, is that they have set their first hour of the day for seniors and health-compromised people. I make my appt to be their first of the day, and get there early to wait and be first in line. There are patients who walk-in, but if I am there first, I get in first. This minimizes my exposure. And, I am not above telling someone else waiting, they need to be masked and distanced ;)) I find the labs are keeping good sanitation protocol, as are my medical places.

I have labs pulled 2 weeks before my appt, so the lab will email me results before the appt.
Ginger

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@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, I do the same as you and agree whole heartedly with "better safe than sorry". Love it that you wipe down your dog, too! smiles

You are doing a better job than I of checking urine so thanks for that tip. Aware of big loss in usual energy since covid started and attribute most of it to just the upheaval of our usual routines and uncertainty about the future Covid waves I feel are coming…especially in Texas, now decreed a hotspot, where most people have ignored basic precautions from the get go. Why should this come as a surprise??

Even after our gov f i n a l l y mandated all must wear masks starting July 4th, a friend told me yesterday that she and a friend had lunch Sat (July 11th) and their waitress, water boy and check out clerk were Not wearing masks…they should have gotten up and left before being served but didn't. Both she and her friend individually called to report them to our Health Dept. yesterday. No idea if any action will be taken. Think fines of $200 can be assessed to individuals but no idea about businesses and don't know if all have to be "caught in the act" for any penalties to apply.

Dentists love to see me coming! And why not? I've sent their children to college and built their private tennis courts and swimming pools over the years…vbg Have been hoping against hope for the past 2 months that a troublesome tooth would "magically heal" without seeing my dentist. Called yesterday and after 3 back and forth conversations with receptionist/off mgr, dentist prescribed an antibiotic and oral rinse to try first for a few days. I am confident that my dentist is taking every conceivable precaution with her staff, equipment and office but still, what closer contact can there be than dentist and asst. hovering right over one's open mouth???

Luckily, my Walgreens has a drive through and I'll pick up the scripts to start today. I truly appreciate the dentist trying to determine if there may be an infection but I'm thinking the problem may be a crack between teeth because it isn't the constant aching of a tooth infection. We'll see.

Thanks for your response! One medical decision at a time, yes?

Glad you will continue taking best care and hope all of our other health compromised friends on Connect will be too.

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@gingerw

@fiesty76 I also use Quest Labs, and have since 2017, using locations in 4 different areas in two states. I like the fact there is a database that can be pulled from by my Dr's. My own personal experience with Quest, is that they have set their first hour of the day for seniors and health-compromised people. I make my appt to be their first of the day, and get there early to wait and be first in line. There are patients who walk-in, but if I am there first, I get in first. This minimizes my exposure. And, I am not above telling someone else waiting, they need to be masked and distanced ;)) I find the labs are keeping good sanitation protocol, as are my medical places.

I have labs pulled 2 weeks before my appt, so the lab will email me results before the appt.
Ginger

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Thank you, @gingerw, for your helpful response. Like you, I've been scheduling first of the day medical appts and earliest possible lab trips for some time. An early waker, I find less wait time with earliest appointments across the board.

However, the one exception is my current neph. who follows a different procedure and sends a letter notifying of the appointment date and time. She is one of three nephs at her location and the waiting room is small. My appt. in Aug. is for 3:45 p.m.

I appreciate that Quest Diagnostics if setting aside their first hour of the day for srs, etc. now in your area and hope that is the same here. I need to stay on the phone next call to get a receptionist to tell me what procedures our local Quest is following. The lab here is small and the waiting both visits before were crowded. That was before covid so I am hoping for a different outcome if I decide to go. Will also ask if they will e-mail results. Was upset when I asked earlier and was told it might take up to 6 weeks for mine to show up on internet.

Ten months for labs is too long to wait for lab reports for a stage 3 ckd patient. I'll probably keep this appt and lab but because so little info. was shared, despite my written questions, on my earlier 2 appts, I'll probably be asking for a referral to a neph within our hospital system. Had decided to give her a third try but doubt I'll continue with her if a different referral can be given by my pcp.

Hugs, Ginger, for sharing your Quest experiences.

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@fiesty76

@kamama94, I do the same as you and agree whole heartedly with "better safe than sorry". Love it that you wipe down your dog, too! smiles

You are doing a better job than I of checking urine so thanks for that tip. Aware of big loss in usual energy since covid started and attribute most of it to just the upheaval of our usual routines and uncertainty about the future Covid waves I feel are coming…especially in Texas, now decreed a hotspot, where most people have ignored basic precautions from the get go. Why should this come as a surprise??

Even after our gov f i n a l l y mandated all must wear masks starting July 4th, a friend told me yesterday that she and a friend had lunch Sat (July 11th) and their waitress, water boy and check out clerk were Not wearing masks…they should have gotten up and left before being served but didn't. Both she and her friend individually called to report them to our Health Dept. yesterday. No idea if any action will be taken. Think fines of $200 can be assessed to individuals but no idea about businesses and don't know if all have to be "caught in the act" for any penalties to apply.

Dentists love to see me coming! And why not? I've sent their children to college and built their private tennis courts and swimming pools over the years…vbg Have been hoping against hope for the past 2 months that a troublesome tooth would "magically heal" without seeing my dentist. Called yesterday and after 3 back and forth conversations with receptionist/off mgr, dentist prescribed an antibiotic and oral rinse to try first for a few days. I am confident that my dentist is taking every conceivable precaution with her staff, equipment and office but still, what closer contact can there be than dentist and asst. hovering right over one's open mouth???

Luckily, my Walgreens has a drive through and I'll pick up the scripts to start today. I truly appreciate the dentist trying to determine if there may be an infection but I'm thinking the problem may be a crack between teeth because it isn't the constant aching of a tooth infection. We'll see.

Thanks for your response! One medical decision at a time, yes?

Glad you will continue taking best care and hope all of our other health compromised friends on Connect will be too.

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@fiesty76, And I thought I was the only one supporting a dentist! <big wink> Am so glad my pharmacy and grocer deliver! I don't mind staying home at all. COVID makes me nervous, especially frustrated with non-maskers. I agree with you, it's going to get worse because we opened up too soon and too fast nearly everywhere.

Neph appointments make me nervous, too. I'm always scared I have gone back into stage 4. Usually I know what's going on with my body but in the past I've had eGFRs in the 20s and felt just fine but eGFRs in the high 30s and been exhausted and chilly. Go figure.

You take care of yoursel, too and to all on Connect, love and hope live here.

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Thanks, @kamama94. Really like your saying and it is soo True!: "Take care of yourself, too and all on connect, love and hope live here". Wonderful to remember; wonderful to live by! Hugs

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@fiesty76

Thanks, @kamama94. Really like your saying and it is soo True!: "Take care of yourself, too and all on connect, love and hope live here". Wonderful to remember; wonderful to live by! Hugs

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@fiesty76, @kamama94 – I have an appointment with my PCP this afternoon and if there are 4 people in the waiting area, I will be sent to wait in my car until my appointment. There is a large seating area that is shared with another provider. I am not a real happy camper, I do love this PCP but the regional hospital and insurance set the rules, so – Even though I was at Mayo a month ago for a thorough post kidney /liver transplant evaluation, I have to see him before I can get a refill on my BP meds which Mayo approved.
As for dentist, I went in early June to complete the COVID19 cancelled appointment. My dentist has a one man office and a small staff. I felt extremely safe in the dentist chair. I hope you are able be equally satisfied.
And for labs, I go at 7a.m. when they open. I am near enough to my lab, and so I drive back to the lab later in the day to pick up a copy of my labs. This way I know if they have been faxed to my transplant dept. and I can see the results immediately.

I'm with you – Wash hands, Wear mask, and Move away from others.

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@rosemarya

@fiesty76, @kamama94 – I have an appointment with my PCP this afternoon and if there are 4 people in the waiting area, I will be sent to wait in my car until my appointment. There is a large seating area that is shared with another provider. I am not a real happy camper, I do love this PCP but the regional hospital and insurance set the rules, so – Even though I was at Mayo a month ago for a thorough post kidney /liver transplant evaluation, I have to see him before I can get a refill on my BP meds which Mayo approved.
As for dentist, I went in early June to complete the COVID19 cancelled appointment. My dentist has a one man office and a small staff. I felt extremely safe in the dentist chair. I hope you are able be equally satisfied.
And for labs, I go at 7a.m. when they open. I am near enough to my lab, and so I drive back to the lab later in the day to pick up a copy of my labs. This way I know if they have been faxed to my transplant dept. and I can see the results immediately.

I'm with you – Wash hands, Wear mask, and Move away from others.

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@fiesty 76, @rosemarya, I'm very fortunate with my neph and pcp.

Neph office is actually IN the hospital and nobody gets farther than the front door without a temperature check, being given mask and gloves if needed, and being observed by staff to wash hands at a handwashing station by the door. Distances are marked on the floor and a gloved and masked staff member pushes the appropriate elevator button for me. Neph and nurses are masked and carry gloves (of course) and hand sanitizer.

PCP is across the street in an annex and follows the same protocols.

The only other places I go are from my apartment door to the lobby for mail every other day after everyone else has been gone for awhile and once a month to my bank for contactless transactions requiring only that I sanitize my card after using and put paperwork in a plastic bag. I am masked and gloved whenever I leave my apartment.

Not long ago I was approached by a policeman to see if I had witnessed something and when he started to get too close, without thinking I held up my hand and said, That's far enough! He apologized and I could tell he was grinning behind his mask. Maybe I should be named Fiesty, Jr. <wink, wink>

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@fiesty76 Im going to new Dentist today if they don't have mask on I won't stay . Why take a chance right ?

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@kamama94

@fiesty 76, @rosemarya, I'm very fortunate with my neph and pcp.

Neph office is actually IN the hospital and nobody gets farther than the front door without a temperature check, being given mask and gloves if needed, and being observed by staff to wash hands at a handwashing station by the door. Distances are marked on the floor and a gloved and masked staff member pushes the appropriate elevator button for me. Neph and nurses are masked and carry gloves (of course) and hand sanitizer.

PCP is across the street in an annex and follows the same protocols.

The only other places I go are from my apartment door to the lobby for mail every other day after everyone else has been gone for awhile and once a month to my bank for contactless transactions requiring only that I sanitize my card after using and put paperwork in a plastic bag. I am masked and gloved whenever I leave my apartment.

Not long ago I was approached by a policeman to see if I had witnessed something and when he started to get too close, without thinking I held up my hand and said, That's far enough! He apologized and I could tell he was grinning behind his mask. Maybe I should be named Fiesty, Jr. <wink, wink>

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@kamama94, You make me smile!

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@lioness

@fiesty76 Im going to new Dentist today if they don't have mask on I won't stay . Why take a chance right ?

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@lioness, Linda let us know how your visit with the new dentist goes. I'm with you; not staying if staff anywhere aren't wearing masks!

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@fiesty76 Couldn't get pass front person After I gave her my ins and d.l she gave me , of course ,paper to fill out I waited and waited went up to her and couldn't believe it she had to call Humana to verify the information finally it was getting late so I left with another appt on Thurs. with my paper work to bring back Did you ever hear of such a thing?

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@lioness, As though there wasn't a bit of anxiety beforehand about a first visit to a new dentist! I am so sorry about the bureaucratic paperwork and ins. verification, not to mention the incredibly long wait. Arrrrgh!!! Kudos to You for rescheduling!!!

Luckily for me, the last few new doc appts had their offices send me the paperwork to fill out ahead of time.

However, my decades long opthomalogist retired recently and I picked up a copy of my patient file from his office. I made an in-person appt with the new doc and was given the "new patient book" to fill out at home. Taking both my history file and new paperwork with me for the 1st appt. I was steamed because I had to wait over two hours for a 9 am appt and then "seen" by a new "assistant" who actually performed the eye test.

Neither she nor the doc even looked at either the history or new patient data. The doc didn't even look in my eyes and spent less than 10 minutes in the room with me before instructing me to make "next yr's appt" at the front desk. Hope he's not holding his breath or looking forward for a glance at me next year!

Can you count these two visits as your weekly walk??? Let us know how it goes tomorrow.

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@fiesty76

@lioness, As though there wasn't a bit of anxiety beforehand about a first visit to a new dentist! I am so sorry about the bureaucratic paperwork and ins. verification, not to mention the incredibly long wait. Arrrrgh!!! Kudos to You for rescheduling!!!

Luckily for me, the last few new doc appts had their offices send me the paperwork to fill out ahead of time.

However, my decades long opthomalogist retired recently and I picked up a copy of my patient file from his office. I made an in-person appt with the new doc and was given the "new patient book" to fill out at home. Taking both my history file and new paperwork with me for the 1st appt. I was steamed because I had to wait over two hours for a 9 am appt and then "seen" by a new "assistant" who actually performed the eye test.

Neither she nor the doc even looked at either the history or new patient data. The doc didn't even look in my eyes and spent less than 10 minutes in the room with me before instructing me to make "next yr's appt" at the front desk. Hope he's not holding his breath or looking forward for a glance at me next year!

Can you count these two visits as your weekly walk??? Let us know how it goes tomorrow.

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@fiestu76 I will so frustrating new way of doing things I guess

Liked by fiesty76

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I use Quest and have used that lab for many, many years. My last visit was April, 2020. and experienced limited number of people allowed in the waiting room, distance requirements were observed and everyone was required to wear a mask including the phlebotomist. I would think all Quest labs have similar operating conditions. I hope what I just stated allows you to complete your lab testing without fear and anxiety.

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