Author Topic: I am not pleased with my family doctor - any advice  (Read 6386 times)

Dragonfly

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I am not pleased with my family doctor - any advice
« on: January 27, 2017, 12:35:16 PM »
Hi everyone,
I am not at all happy with the treatment that my family doctor gives me nor the care she has given my daughter.

I suffer from bipolar II and other health problems. In hindsight I know that I suffered from bipolar mental illness since the age of 12. I was diagnosed at age 30. I am now 66. It has been a long journey. For the most part I am now stable. Some of the drugs I was on have left me with health problems. I see a psychiatrist. Due to my diabetes and having been on lithium for years I am now seeing a kidney specialist  for chronic kidney disease, an eye specialist, diabetes specialist . I have seen a neurologist to test my nerve function. I have had a heart stress test. Many other tests.

My family doctor has been good in referring me to specialists for my health problems. I have been sent to a kidney specialist a little late. She could have picked up on my creatinine (pardon my spelling) level much sooner. I had a physical done by her and she hardly did anything.

My daughter was in a car accident. She hurt her back, arms and her left knee very badly. My eldest daughter and I took her to emergency where she had x-rays done. The doctor told her she needed physiotherapy for her knee. My daughter followed up with the family doctor. She didn't even examine my daughter. The doctor just wrote down, whiplash, hurt knee, etc. My daughter went back to her and at urging from my daughter sent her for an aultra-sound of her knee. There was a problem and her doctor never got back to her and the physiotherapist had to fax for the results. My daughter went back to her GP and reguested an MRI which she is getting.

I feel that the family doctor is not treating my daughter and I properly. We have had her for 26 years. I think it is time to change doctors. Should my daughter do it after she has the MRI.

I am not sure if I should change doctors since I have so many specialists looking after me. If I changed I would have to go through my whole life history. Would I be able to keep the same specialists that I have? Finally I have found specialists that are very good.

Any advice would be helpful.

Dragonfly

Stenacron man

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Re: I am not pleased with my family doctor - any advice
« Reply #1 on: January 27, 2017, 02:50:34 PM »
Hi Dragonfly

I have one question for you regarding your lithium are you still on it ?

The reason I ask is I almost died this year from [ Lithium induced (NDI) Nephrogenic Diabetes Insipidus] that's Diabetes caused by taking Lithium. It sound to me like this has happened to you by the need for a kidney specialist and having Diabetes. Most mood stabilizers and antipsychotic are all listed as a medication that can cause or worsen Diabetes.  I am also suspecting you have had bladder problems as well.

Did you have Diabetes before taking lithium ?

Finding any kind of DR step 1.

I am going to presume you are in ontario and what you do is go to this website to find doctors in your area accepting new patients.
https://www.ontario.ca/page/find-family-doctor-or-nurse-practitioner

Once you have names you can go to this website called; Ratemds.com here is a link to the site and my doctor who help save my life from Lithium (NDI). Dr Lillian Narouz and you can see the rating I gave her on October 30th 2016 . She practises in Ontario now but the website hasn't updated her page yet

https://www.ratemds.com/doctor-ratings/4004526/Dr-L-Narouz-Weyburn-SK.html

On Ratemds you can see what others think of a GP or any specialist long before you waste you time making an appointment.

I very sorry to hear about your condition it is horrible like torture. Here is a link to one of  many articles about lithium (NDI) http://www.mdedge.com/currentpsychiatry/article/76062/somatic-disorders/lithium-induced-diabetes-insipidus-prevention-and


As long as you know the date and hospital where the MRI was done any doctor can access it off the database

Edit; OHIP does not cover physical examinations anymore they do not feel they are effective enough for the cost involved when blood testing is technically more effective. Make no sense to me but they are the big machine.

second edit; you can continue to see all your specialist under a new GP. The new Dr just needs to pull your file from your current Dr. In my opinion I would change doctors.

Buddy mack.



« Last Edit: January 27, 2017, 10:25:55 PM by Stenacron man »

paulm

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Re: I am not pleased with my family doctor - any advice
« Reply #2 on: January 28, 2017, 02:17:40 AM »
Hello Dragonfly. There are a couple of problems with changing doctors. Buddy mack has given you the website  https://www.ontario.ca/page/find-family-doctor-or-nurse-practitioner   and it is a pretty good site for info.

 However don't be surprised if when you go and see a potential new doctor if you have to fill out a form detailing your age and health and have an interview with the doc.  Don't be surprised if the potential new doc won't take you on as a patient. The new billing system is incredible complex and some docs will not take on patients with certain needs. 

 Ask the potential new doc what the wait times are to get an appt. Ask them if they will allow referrals to any doctor. A while ago the province encouraged the forming of Family Health Teams, a sort of one stop shopping and those docs in those teams prefer to refer you to other docs in their team. (and nurses and dietitians and physiotherapists.) 

 For example Hamilton Family Health Team https://www.hamiltonfht.ca/en/index.aspx represents about 1/2 of the G.P.s in Hamilton and they even have their own member psychiatrists. I'm not saying that you have to take their shrinks, dietitians, psychotherapists etc , but members of that Health team are going to push you that way.

 Should you change docs. I can't say. But what ever you do, don't drop your current doctor until you've investigated the availability of doctors in yr area. Take Care. paul P.S. sorry if I made your head ache without giving you an answer but evn my doc hates the new system.

 P. P.S. you can still get a physical, but now they are called a periodic health visit and a few yrs ago the province dropped the payment from $77 to $50 so some docs don't do them or limit severely the amount of time that they will spend on them. The billing code is K131A. Truck Drivers airline pilots etc who require a very full physical can still get one , but they have to pay extra.   

 
« Last Edit: January 28, 2017, 02:19:46 AM by paulm »

Dragonfly

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Re: I am not pleased with my family doctor - any advice
« Reply #3 on: January 28, 2017, 01:38:11 PM »
Hi Stenacron man,

No I am no longer on lithium. I had been on it for about 30 years. I started on lithium when I was 30 years old. They started me on 1700 mgs. per day but I developed diabetes insipidus. Then they lowered to 1500 mgs. per day. Over the years it kept being reduced. Before I stopped it I was on 600 mgs. per day. I guess as I got older the body processed it differently.

Before I had my three children I would become manic and depressed. When I was depressed I was not suicidal. That all changed with the birth of my three children. Hormones in a woman can cause mood swings. I became either manic or depressed to the point of suicide. After the birth of my third child the psychiatrist put me on lithium. That was a life saver for me. I had 12 very good years after that. If I hadn't taken lithium I probably wouldn't be here.

After I had my complete hysterectomy at the age of 43 I went into a very deep depression to the point of being suicidal sometimes. The psychiatrists tried me on many different drugs. Anti-depressants which were totally the wrong kind of drug. This took quite a few years.
My one psychiatrist introduced me to lamotrigne. This was a very good mood stabilizer for me. (still on lithium at this point). Finally the cocktail of psychiatric drugs seemed to make me stable. Not without side effects though.

No I was not diabetic before I took lithium. I don't think the lithium brought on diabetes. It only made my diabetes worse because of the weight I gained being on lithium. Diabetes runs very strongly in my family. Out of 8 of us already 5 of us have diabetes. I am the only one that is an insulin dependent diabetic. Diabetes is genetic.

Thank you Buddy mack for the websites. I have checked some of them out already.

Dragonfly

Dragonfly

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Re: I am not pleased with my family doctor - any advice
« Reply #4 on: January 28, 2017, 01:52:07 PM »
Hi Paul and Stenacron man,

Thank you for the advice on changing doctors. I think I will stick to my family doctor. She has referred me to some very good specialists and they do many tests. My kidney doctor is amazing. He checks me for everything and nothing and catches things that the other doctors don't. I only see my GP for one prescription drug. I didn't realize that doctors don't do physicals anymore.

I think it would be worth her while for my daughter to change doctors. She hasn't had many problems so far. However, this knee injury that she has sustained after the accident needs more attention than her family doctor (also mine) is willing to give. This doctor was good in the beginning. I looked up this family doctor and the reviews say she hardly addresses health concerns, makes you wait a long time, is not readily available when you really need her. Seems to go on a lot of holidays and cancels appointments.

Dragonfly

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Re: I am not pleased with my family doctor - any advice
« Reply #5 on: January 28, 2017, 02:41:44 PM »
I am so sorry to hear about you lithium induced diabetes insipidus I suspected that was the case. I almost became that this year I read many scientific paper on it to prove to my Psychiatrist that he was killing me. He didn't care at all. One of the worst parts for me was my stomach acids were so high I couldn't eat right.  So I became severely nutritionally and protein deficient. in July alone I have 4 infections at the same time, double tooth, sinus, bladder, and prostate infection with 2 antibiotics.  I had 2 more infection at the same time in October.

The new legal limit for lithium is technically 900 mg per day because of it's toxicity. But some doctors will ignore it and prescribe as they like. For you and me I think I will write an article here about Lithium NDI to warn others about this because it can and will eventually kill you.

I have read, seen on TV, and saw in the newspaper information that confirmed my previous thoughts. Female Doctor do make for better doctors. They tend to adhere to regulations and policies better, then tend to not over medicate, they are way more sympathetic, tend to have high levels of empathy, and most have low or zero ego.


Buddy Mack.
« Last Edit: January 28, 2017, 03:37:04 PM by Stenacron man »

paulm

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Re: I am not pleased with my family doctor - any advice
« Reply #6 on: January 28, 2017, 09:49:06 PM »
Hello Dragonfly. Doctors still do physical, but they are not as in depth and they are called periodic reviews and the doctor gets paid less than they used too.  They also don't recommend having an annual physical (or periodic review). It's pretty much the doctors call whether they do them or not, my G.P. still does them, but it's mostly blood work , looking over my skin for signs of skin cancer and a , well lets just say it involves a rubber glove. I'm in and out in 15 min max.  He send me to a tech to get the blood work done.  Take Care. paulm

 P.S. the amount of lithium a doc can prescibe is decided by the blood concentration level , usually between .8 and 1.2 mmo1/L . For a new comer to Lithium the doc's usually start with a low dosage. Depending on the person's clearance rate and weight that could go as high as 1800 or higher for heavy patients.

 The recommended maintenance dose is whatever keeps you between .8 and 1.2 mmo1/L  .There is no max or minimum that a doc can prescribe with lithium. Rough dosing is figured out at 15-20 mg per kg of weight.Thus a 100 kg person like myself may take 1500 and a 50 kg person only 750.  Slow works ups and blood tests are needed to confirm this.   Source Health Cda Drug Monographs https://pdf.hres.ca/dpd_pm/00023004.PDF   page 12

 Anyone wishing to look up side effects, dosage amounts, drug interacions etc can use Health Cda and access their drug product data base. http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index-eng.php  click on the button, enter the name of the medication, pick a company and you will see the drug product monograph, usually about 40-50 pages long.

Dragonfly

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Re: I am not pleased with my family doctor - any advice
« Reply #7 on: January 28, 2017, 11:12:49 PM »
Hi Paul,

Thank you for your support. I now realize from what you say that it is not that important to have an in depth physical especially with all the tests and blood work that my specialists do. Thank you for clearing that up for me. It is much appreciated and I am very serious about that.

When I was on lithium my psychiatrist would always order a lithium test over a twelve hour period and make sure that I was at the right level. For me .9 was fine but 1.2 mmo1/L was too much and I would have tremors. Like I said in a previous post lithium was a life saver for me when I was diagnosed with bipolar mental disorder (then called manic-depression). If the doctors hadn't put me on lithium I believe I would have committed suicide.  I never went off it in that point in time. I was very afraid about going into a deep depression again. My quality of life was so much better when I got on lithium.

I am not blaming my diabetes on taking lithium. It runs very strongly in my family and is genetic.

I hope I haven't hurt your feelings because of what I have written. I don't want to put words in your mouth. I think you and I have had a long journey with this mental illness. We have both learned a lot. I consider you as my friend.

Dragonfly

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Re: I am not pleased with my family doctor - any advice
« Reply #8 on: January 29, 2017, 12:05:55 AM »
I truly believe you, I have been suicidal since 1997 and I am also bipolar II. And when I was on lithium is was very clear headed and happy till I got sick. Even though diabetes runs in your genetic line Insipidus is only caused by lithium. According to the research I did this summer CDC, FDA, John Hopkins archival department and Scientific published literature, there are over 40 type of type 2 diabetes. When you get a GENERAL blood test it only looks for the most common one that millions have from genetics and or bad life habits.

Each type of Mood stabilizer medication like; lithium, quetiapine, chlorpromazine, olanzapine, risperdal. divalproex, Lamotrigine, valproic acid, and the list goes on, all can create their own specific diabetes through a unique DNA genetic pathway each having there own signature. Yes you were more prone to diabetes in general, but not insipidus that is only caused by lithium. Back in the day there wasn't the medication options we have today even Lamotrigine wasn't invented and released to the public till 1994. 

I am making an in depth post on this subject most people don't know and tend to just trust our doctors to make us better, or monitor or side effects and they typically  don't.

I am actually prosecuting my psychiatrist for criminal assault and battery. Lithium is a class (B) controlled medication that require blood monitoring and side effect intervention. By not doing the intervention monitoring he is criminally liable. Plus he never asked for my consent to put me on lithium he just did it cause he is old school and that's the way they use to do this. He is very old he graduated in 1963 and is not always or does not appear to have a great memory. I am not after money all I want is his practice closed and his license pulled forever. I can not in good faith allow him to hurt others with his negligence .


Buddy Mack.





« Last Edit: January 29, 2017, 10:03:45 AM by Stenacron man »

paulm

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Re: I am not pleased with my family doctor - any advice
« Reply #9 on: January 29, 2017, 04:45:47 PM »
Hello Dragonfly. I could never be upset with you .  You are right we have had long journies and we've both learned a lot from sharing experiences on the forums.  I consider you a friend too.

 Lithium has been a life saver for me as well. I know that it is probably not the most friendly substance in the world , but then I've tried all of the other mood stabilizers and most of the anti psychotics and tried a lot of alternative healing and CBT and DBT.   

 It all comes down to the same thing for me. If it wasn't for lithium I wouldn't be here today. So, while I know it's not good for my kidneys, neither is living under a bridge or over a subway vent, which is where I was headed due to un checked mania, not to mention numerous bouts of depression.

 Lithium certainly isn't for everyone, but no medication works for everyone. The psych medication that worked best for me was actually epival, but a rare side effect of it almost killed me. Penicillin works great for most people, I ended up in the ER when I took it and again it almost killed me, in that case due to a severe allergic reaction. 

 Anyways I've babbled enough. Every time I'm in a campground I'm always looking for a woman of my approx age, with a lot of family around and a couple of grand kids. However that describes a lot of people, but I still wonder if one of them is you. If you (or any one else) is ever in a campground and you come across a pop up camper with a beagle and a 60ish couple , please say hello.  The beagle is always friendly LOL.   Take Care. paul m

 

Dragonfly

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Re: I am not pleased with my family doctor - any advice
« Reply #10 on: January 30, 2017, 07:28:06 PM »
Hi Paul,

Thank you. I will be looking for you too.

Dragonfly