Who wants to help a medical newbie?

Parent Cafe
1

<p>These are honest questions - perhaps “no brainers” to some of you, so if you don’t mind, allow me to learn from your knowledge.</p>

<p>Say you were in your mid 40s and hadn’t had a true physical since you were senior in high school (general belief that the body tends to take care of itself + being raised incredibly independently). The only times you’ve gone to anyone medically related since then was for pregnancy and childbirth (youngest is now almost 18), updating a tetanus vacc (we live on a farm), twice getting antibiotics (pneumonia + tick bite), and a work physical (yeah, if you actually call it a physical - I suppose he did make sure I was alive).</p>

<p>Then you have a vision issue that lasts for a good year and a half and finally decide to get that looked at as you’ve given up on the body healing itself in this case. You go from basic ophthalmologist to vision specialist to finding out you have a brain tumor (expected to be benign) that is inoperable due to location (risks of surgery vs symptoms not being bad) and will be treated with radiation - but that’s ALL you know at this point - no clue even on the timing.</p>

<p>So… your brain starts telling you that MAYBE (ok, probably) you should check out the rest of “everything.” Both heart disease and diabetes run in your family line to where you kind of know you are doomed for either or both (you do know your BP has always been fine). You were also told you have asthma (by a dr) about 25 years ago, but have always wondered if it’s true or not due to not being like others you know who have it - but the machine said there was lower lung capacity… so who knows? You start to wonder if the “different” things you are feeling are related to the BT or are they symptoms of something else - or are they even made up by the brain due to the new situation.</p>

<p>Do you:</p>

<p>1) Find a primary care physician and go from there not knowing just how quickly you can get an appt? This person would not even remotely be related to where the BT issue is going on (I prefer close to a 1 1/2 hour drive). Is this even possible?</p>

<p>or</p>

<p>2) Talk it over with the radiation specialist when you actually end up seeing them and see what they say?</p>

<p>or </p>

<p>3) Something else? (If so, what?)</p>

<p>I, literally, have no idea. Either option seems like it could be the “correct” way. I guess I’m basically looking to know that neither the diabetes nor the heart disease is an issue in my life at this point (perhaps some sort of asthma (?) explanation too.</p>

<p>FWIW - no “sympathy” needed over the BT. Such is life - it’ll be dealt with.</p>

<p>And… if you don’t mind sparing the scolding over not keeping up on health issues it’d be nice. I’ll freely give you that point.</p>

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<p>I’m not a medical professional, but I would talk to friends to find out who they use/like/recommend as a primary care physician and make an appointment. If you have any friends who work in the medical profession that can be helpful! When you call to make an appointment, let the receptionist know that you’d like to get in as soon as possible, and that you’ll take a cancellation if one comes up.</p>

<p>It is really handy to have an established relationship with a good primary care physician.</p>

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<p>Always start with a primary care physician who is affiliated with the hospital you would choose. This closes the loop in your care and provides a middle person to coordinate all of your healthcare needs.</p>

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<p>No scolding here–there are lots of people who feel as you do about doctors. I’m one and I’m in a medical field.<br>
Confused on why you prefer a long drive? The closer the doctors the better as long as they are good.
Get an appointment with a primary and get a complete physical. Tell him your concerns about family background so you get tests for those. Tell them about the brain tumor and upcoming radiation–don’t keep it a secret. If you have specific symptoms that concern you that you think are coming from the tumor then say so–find out if there is any relation at all. If the primary wants more tests than you think necessary then ask for his reasoning for requesting the test–you can refuse whatever tests you want if you feel really strongly about it.
And yes, talk over your concerns with the radiologist also.
And hugs and good luck!</p>

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<p>Good advice from frugaldoctor–get someone affiliated with your chosen hospital.</p>

6

<p>See, and I would say choose a primary care doctor close to home, so he/she can take care of your every day stuff. It’s okay that your specialist for the brain tumor is far, but you’re not going to want to travel that far for the every day issues. Any doctor worth anything will communicate with your specialist. I say this from experience. We travelled 4 hours for my daughter’s bone tumor doctor, but her PMD is in town.</p>

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<p>Agree with a primary physician and getting recs from friends. Not just “my doc is good” - you want the right combo of highly competent, responsive to your concerns and caring. (Plus the hospital affiliation and covered by your insurance.) When you call for an apt, you can explain the need for a quick fit-in (sometimes, even for a new patient, they can give you a slot someone else cancelled.) </p>

<p>But, once you have a few names, you can also run them by the radiation doc and then ask his/her office to help you get a sooner (rather than later) appt. I wouldn’t wait til your next visit for this- you can call in. </p>

<p>In general, a specialist will like you having a primary care doc. He/she needs to know your general health is being tended to and that there is another professional to compare notes with, if needed. Things can come up that are not in the specialist’s arena- not just the cardio or diabetes. </p>

<p>And, get a gynecologist, as well.</p>

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<p>You might ask your ophthalmologist for a reference, if he or she is nearby.</p>

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<p>I’d go see an internist for the diabetes and heart disease questions. Ask friends, and if you have an Angie’s list type review service, look there, too. Go get evaluated and get some baseline numbers. If you live in a small town, the same names of good docs may keep coming up. </p>

<p>I have seen an internist twice, once at forty and once at fifty. My numbers were good and I feel good, so that was enough. I do see my gyn annually because of a history of reproductive cancers in the family.</p>

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<p>There’s actually some evidence that only seeing a doctor if you have a problem is a good idea, so no castigation from me.</p>

<p>My husband had not seen a doctor in years when he developed his lymphoma (13 years in remission now). We found that having a personal physician was invaluable, as he was the person to consult for all the minor issues that came up during treatment. His office was quick with prescriptions as needed. I would ask the office of the doctor who’s supervising your radiation who they find easy tp deal with–the nurses there can tell you–and start with that person. You want to find someone you’ll feel okay calling in the middle of the night when you don’t understand what’s happening. (In my husband’s case, it turned out to be appendicitis. Yes, he developed appendicitis while in chemo.)</p>

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<p>My primary care doctor does routine pelvic exams and Pap smears, which means I don’t have to go to a gynecologist unless I have a problem. I like this.</p>

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<p>My family practice Dr & my naturopath can provide pelvic exams, so I haven’t been to an ob/gyn since my youngest was born.</p>

<p>Oftimes younger drs who are still building their practice are much easier to get in to see.( they also seems to book longer appts) My ortho surgeon falls into this category & he is excellent.</p>

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<p>Both heart disease and diabetes are easy to identify. You get a chest x-ray and some blood work. Who orders that isn’t particularly important as long as the doctor knows they need tests for those conditions (which would generally be picked up anyway). </p>

<p>Every woman should add in pap smears and the like because ovarian cancer is pretty darned awful. Mammograms are also necessary starting at like age 40. </p>

<p>If you have no history for colon cancer, you don’t need a colonoscopy until you’re 50. </p>

<p>There really isn’t that much to do. I bet they’ve already checked your BP and done basic lab work. Make sure you know what the labs say.</p>

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<p>Ok, appt scheduled (locally) for next week. It’s good to know it’s not really a conflict. I wasn’t sure how all that worked together - esp with one issue being an hour and a half away and the other not. (We live rural, so it’s common for folks with “issues” to travel to one of two teaching hospitals further out. I really didn’t want to do that for “everyday” issues.)</p>

<p>It’s also good to know it’s not super awful to not have been going for regular check ups. Being totally honest, I never suspected anything was wrong - except for the vision - then the hearing… and neither were painful nor terribly life disrupting. We eat (mostly) healthy. We’re fairly active for our age. Now I just need to find out if the “new” things are connected to the BT, something hereditary, or all a figment of my newfound imagination of “what ifs.” Today is a “good” day where I actually don’t think anything (else) is wrong. Yesterday was a different story - leading to actually doing something about it today. I kind of wish it were all one way or the other (preferably good), but whatever.</p>

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<p>It may be easier to find a primary physician in a large multi-specialty medical group. These groups may also have physician profiles on their web sites, so you may be able to choose one with a particular interest in medical issues most relevant to you.</p>

<p>Here are some recommendations for or against various types of medical screenings for adults by the USPSTF:
[Recommendations</a> for Adults (USPSTF)](<a href=“http://www.uspreventiveservicestaskforce.org/adultrec.htm]Recommendations”>http://www.uspreventiveservicestaskforce.org/adultrec.htm)</p>

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<p>Actually no… I’ve only seen eye specialists to this point - no one checked the BP at all, but it should be fine because I regularly donate blood and they always check it (never high). They did labs testing for other potential causes (thyroid, autoimmune, etc), but nothing related to diabetes.</p>

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<p>Pap smears are for detection of cervical cancer, not ovarian cancer.
[Screening</a> for Cervical Cancer](<a href=“http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm]Screening”>http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm)</p>

<p>Mammograms every two years are recommended starting at age 50, though some individuals (presumably those with high risk factors otherwise) may wish to start earlier, in consultation with their physicians.
[Breast</a> Cancer: Screening](<a href=“http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm]Breast”>http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm)</p>

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<p>Pap smears aren’t needed very often if you test negative for HPV, since it is known to cause “virtually all cervical cancer cases in the US” (WebMD site).</p>

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<p>I hope the local doc brings some reassurance. Good step. Don’t hesitate to share your concerns and let him or her talk it through with you.</p>

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<p>Unless the dr insists… I plan on waiting on any “other” issues until after this one has been resolved. I just really want to know if everything I’m feeling is coming from the BT - or something else. I’m all of one year younger than my dad was when he had his first heart attack… then there’s the diabetes… and possibly/supposedly asthma. Carpal tunnel types of things have been part of my life since my last youngster. The OBGYN said it would go away after he was born. It never did, but wasn’t terribly bothersome. She said that happens sometimes, so I didn’t worry. It is, however, getting worse now - IF it’s even carpal tunnel (never actually tested anything - just diagnosed from symptoms).</p>

<p>My diet/lifestyle is a heck of a lot “better” than any of my relatives, and has been for years, so no, I wasn’t too concerned about things before - esp while still relatively young. Now I’m wondering if genetics plays more of a role than I wanted to believe (though the BT most certainly isn’t genetic - I just got “lucky” there and diet/lifestyle didn’t seem to matter).</p>