The New Nephrologist
If you are just coming on board and HAVE NOT read my previous posts, then let me tell you that I have been wanting to change Nephrologists for quite a while. I believe Terry and I started talking about it in August 2012. No, there isn't anything wrong with Dr. Asshole per se, but we were sort of "assigned" to each other.
If you HAVE read my previous posts, then you will vaguely remember in "My First Hospital Visit" when I went to the E.R. in March 2012. The E.R. Attending, "Dr. Arrogant" came in to the exam room and said he didn't know if he could help me or not. He said I needed to see a Nephrologist immediately. Hence the product of that visit was a referral to a Nephrologist, who turned out to be Dr. Asshole.
Dr. Asshole is the one who admitted me into the hospital again two days later in "My Second Hospital Visit." He's also responsible for the kidney biopsy, the diagnosis and beginning my treatment. Out of respect for him, I have been staying month after month.
Why switch, you ask? Well, in the beginning, it was little things that bugged me. Everything I know about this disease, I learned online or through the Support Group. I'd go to his office, pay a $50 copay, for him to tell me that my levels went up or down, not what my levels were. He'd tell me that I need to reduce my sodium intake. Exercise. Then we'd discuss my medication levels and he'd say things like "play with the dosage until you feel comfortable." If I were comfortable, I wouldn't take medication. Dumb ass. The fact that he never offered to give me a copy of my labs unless I specifically requested it.
Soon, those little things turned a bit larger. He would tell me he understood that I couldn't work, but from a "kidney standpoint," I'm not disabled. And right after saying that he would give me a list of things I'm limited in doing. He balked at filling out FMLA, Short Term Disability or DLA or Daily Living Activity documents. And when he did fill out the papers, he charged me $20 for each set. $20 for the FMLA. $20 for the Short Term Disability. And $20 for the DLA every time I needed them completed. And that is on top of the office visit copayment.
It wasn't until I decided to switch doctors and I went to get my medical records that I found out he wasn't disclosing everything about my condition to me and my husband. Oh, and by the way, I had to pay $119 for my own damned medical records.
Now in meeting with the New Nephrologist today, he immediately pointed out the following items that Dr. Asshole didn't tell me about:
In March 2012, my blood labs, specifically the ANA aka Antinuclear Antibodies tested a strong positive which could be indicative of Lupus.
In March 2012, my kidney biopsy indicated FSGS with Tip Variant
My Liver Enzymes are elevated indicating Liver Damage
I have hematuria or blood in my urine.
And even though Dr. Asshole refused to fill out my FMLA and Short Term Disability paperwork on the grounds that "from a kidney standpoint, you are not disabled" he wrote in his notes of my care that "he didn't know how much longer I would be able to work in my condition."
One meeting with a new Nephrologist, who reviewed my prior medical records before even meeting me, and on initial exam and discussion suspects possible Lupus as a primary cause of the FSGS making my FSGS secondary, not primary. Now, we still have to confirm it. You can get a false positive on the ANA test. He also told me that with consistently HIGH liver enzymes, I probably has liver damage but we have to determine to what extent.
On our initial greeting with the new Neph doctor.... I say "our" in reference to the fact that Terry and I were both at the appointment.... I think we were blown away. He walked in and got right down to business. No small talk. He began asking very decisive questions. He reviewed my own medical records with me. And then he asked that all important question...."Why was I here and not at Dr. Asshole's office?"
I have worried about this line of questioning.... I've worked with enough doctors that you don't want to "trash talk" your old doctor in the face of your new doctor. A lot of docs tend to frown on this, thinking if you would trash your old doc, you'll trash them as well. Besides, I didn't want to tarnish Dr. A's reputation. He is a good doctor, just not the right doctor for me. So I answered it the best I could. Spur of the moment.... "I'd like a new perspective. And I want full disclosure about my illness." I didn't get a reaction to this answer.... I only hope that I passed the test.
On leaving the office, we got my labs orders, my next appointment card, and I was going to pay our $50 copay. Unfortunately, whoever set up the appointment for me forgot to mention they only accept cash or check. (Huh? That's new) So the lady said it would be fine if we paid the next time. Terry asked the lady if they charged for medical records. She said No. She told us that those records belong to the patient, so they don't charge for them. Terry then asked if they charged to fill out documentation. Again, she said No.
Terry and I couldn't wait to leave so we could discuss our appointment. Initial reports are good. We both like the "No nonsense" approach. The fact that they don't nickel and dime people to death. The fact that my appointment was for 5:20 p.m. moved up from 5:40 p.m. so they are open after hours for people who work.
So now you have been introduced to my newest doctor.... and since all of my doctor's have nice nicknames, Terry and I have dubbed him "Dr. Straight Laced."