5 Month Doctor Vists Now

[Jerry71]

Went to see my Doctor yesterday and now I don't have to go back and see her until 5 months. Still on the same regiment. Numbers are staying in the 200 range guess it is better since the economy is hurting like it is. Anyone else having there appointments lengthen out like this?

[Sweet_C]

Congratulations!!!  I can't wait until I can go longer between visits.  I swear I've been to the doc's office more in the past two months than in my whole life.

[Robert]

geez...jerry...if only...

I've been trying for the last year to go every 4 months.  I would simply love 2X/year.  I'm not sure what the problem is.  My numbers are good .  Compliance is so-so.  I'm honest with her about it and she doesn't like it so maybe that's why she makes me keep coming back.

robt

[Texan38]

Hey, Congrats Jerry!

Unfortunately, I was given the same news. It saddened me so....on my last Doctors visit, he informed me that I have been doing excellent and he no longer needed to see me every three months. He broke the bad news to me and said every five months would be just fine. Um, just in case you weren't aware, I find my doctor very attractive, BUT I guess every five months is alright but, boy, was I looking forward to seeing my Doctor, er, having my Doctors visits every three months! LOL!   

[Miss Philicia]

I go every 4 months and have done so for the past year.  Last year I went every 3 months.  Previous to that it was generally every month -- yeah, that's every month for 13 years.

I'm not sure but I get the feeling that my doctor doesn't do anything less than every 4 months and that's fine with me, but then I'm a bit conservative with such things.  Plus it only takes me 15 minutes to get to his office so it's not an inconvenience.

[jgs]

Jerry...
Almost the same here...every six months...been this way for years; I miss the trips down to SF and dim sum palaces.  That said, have developed very bad hearing loss which is a pain, the guidelines for maintaining my hearing aids is more stringent than the blood work, always something.
                                                                                                           john

[J.R.E.]

Anyone else having there appointments lengthen out like this?

Not yet. But it's been mentioned, about possibly every 4 months.  My appointments are still scheduled once every three months. My numbers are similar to yours, except my t-cells seem to be lingering in the low to mid 300's.

Take care----Ray

[Moffie65]

Jerry, good for you.  I know we all hope that this kind of news will enter our lives, and last visit I  made to the doctor, he siad he would be glad to see me in six months.  After 25 years, I finally graduated to twice a year.  Somehow, I never really thought about it, but I guess this means things are really good with my immune system for a change.

Glad for your news.

[gardner]

Jerry, After 6 years my numbers are about the same as you now.  I was seeing my Doc every 3 mths but when I told him my insurance wasn't paying for the visits, or the lab work, I asked to go 3 times per year. He put me on a twice yearly schedule.   
The only thing I miss is seeing my numbers more often.

[Peter Staley]

I've waited as along as six months, and this new study put my mind to rest about waiting that long:

http://www.aidsmeds.com/articles/hiv_less_monitoring_1667_15569.shtml

This isn't for everyone, though (read the article) -- 3 months is still the safest option.

[Assurbanipal]

My docs moved me to every 4 months back in the spring ... but it only lasted for one session because some other stuff came up (cholesterol  and osteoporosis).  Back on three months for now -- but hoping to get back to a 4 month or 6 month schedule eventually.

[Ric Wilke]

Hey Jerry,

Babe you are doing fantastic!  Those numbers look great.  You are doing things right.

I've been on 3/year visits for the past year without any problem.  However, the last two time I did have to go back to the lab for another CBC because of low WBC and RBC.

I'd say just keep keeping on.  You are on the right track, bud.

Love and hugs, R

[BT65]

I go every 3 months, but I think some of that reasoning has to do with my diabetes.  It hasn't always been well-controlled.  Maybe when it's been adequate for awhile, we'll go to more stretched-out visits.

[Oceanbeach]

During one of the Care Act funding meetings, Dr. Bromer, Director of Russian River Health Clinic suggested cutting patient visits to 3 times per year as opposed to 4 times as most patients get.

I was sitting with the HIV Section Manager from the Center for HIV Prevention and Care, we heard the same announcement, she later denied hearing that and felt most patients should remain on a 4 times yearly visit program.

Between the two clinics, both in Sonoma County, there are over 500 HIV Patients.  The Center for HIV Prevention and Care had just lost their Title I funding.  The Russian River Health Clinic never had Title I funding.  From having been on all the committees, it is my opinion the reduced number of times a patient see his/her doctor is based on doctors choice and continued response to treatment over insurance and funding issues.  I would like to reduce my doctor visits and labs to twice per year    Have the best day
Michael

[Ann]

There's a distinction here that I think needs to be pointed out.

For someone who is on meds and is compliant with the meds, having an undetectable viral load, and a CD4 count of over 200, there really shouldn't be a problem going more than three months for check-ups.

However, it's a different case with those of us not on meds. My clinic recently tried to get me to go in for four monthly checks, but fuck that, to put it mildly.

My virus is unchecked by any medicinal means. I've seen too many times where a  non-medicated person's stats went to hell in a short period of time. There's no way in hell I'll have my blood checked at less than three-monthly intervals (while not on meds). I've been poz for over eleven years now and I'm waiting for the other shoe to drop.

Just sayin...

[Miss Philicia]

Please honey -- you just like those free shopping trips on the airplane.

[Ann]

Please honey -- you just like those free shopping trips on the airplane.

Please, Barbara, kiss my pink pahtootie. I've already conceded six weekly for three monthly. ~rolls eyes~

Oh dear me, I forgot we have a ~rolls eyes~ visual here.



Love you too, hun.

I mean that in the nicest possible way.

Yes, I do. 

xxx

[emeraldize]

There's a distinction here that I think needs to be pointed out.

For someone who is on meds and is compliant with the meds, having an undetectable viral load, and a CD4 count of over 200, there really shouldn't be a problem going more than three months for check-ups.

However, it's a different case with those of us not on meds. My clinic recently tried to get me to go in for four monthly checks, but fuck that, to put it mildly.

I think there's one more distinction to be added for those not on meds. In a setting where you can get your labs done independent of having a doc visit to accomplish that, if the quarterly labs are done, and numbers are stable, two of my docs allow every six months for visits. I can't stand the idea of tying up my schedule, a doc and an exam room when many others need the latter two.

[aliveinla]

I wish I can do that: getting the labs mailed to my home address, maybe a copy to doc, then we decide whether I need to go in. Somehow I got the impression that my ID doc wants me to come in as often as possible (6 weeks was the original suggestion but i always try to "reschedule" it to 8-10 weeks), and somehow I think they make money from each visit. Doc actually only spends 5-10 mins with me, repeating the numbers, and after 4-5 visits, he still doesn't know my name, he wasn't even sure whether i was on meds or not. I drove all the way there, get half day from work, wait in line, pay my co-pay, then just 10 minutes face time with him and he never told me anything I haven't read on this board.

I seriously think their profit is based on how many visits they get. And I seriously need a good ID doc referal in Los Angeles.

I think there's one more distinction to be added for those not on meds. In a setting where you can get your labs done independent of having a doc visit to accomplish that, if the quarterly labs are done, and numbers are stable, two of my docs allow every six months for visits. I can't stand the idea of tying up my schedule, a doc and an exam room when many others need the latter two.

[Ann]

I think there's one more distinction to be added for those not on meds. In a setting where you can get your labs done independent of having a doc visit to accomplish that, if the quarterly labs are done, and numbers are stable, two of my docs allow every six months for visits. I can't stand the idea of tying up my schedule, a doc and an exam room when many others need the latter two.

Hell, direct me to the place that will do that in the UK and I'm there. As long as I'm stable, I don't really give a flying shit. (pun intended, my Philodendron sweetheart) As it is right now, I wait THREE MONTHS to hear my last results. I love me my NHS, but in the past year or so there are restrictions cropping up that are, frankly, restricting.

You know what? I blame you Yanks. Yes, I do. American Insurance companies have been whispering in too many British ears in the past few years. Go away, will you?

Don't like what I just said? Sue me.

Gee, I seem to be saying that a lot lately. Oh well. Tough poopie.

xxx

[Ann]

Yeah, yeah, yeah, ok, so there's more to this story than I alluded to in my previous rant.

One big fact is that the clinic I go to in Liverpool is being stretched beyond capacity. Because I look good "on paper" they're trying to fob me off with sub-optimal surveillance. I'm not having it, sorry. Been poz for too long now.

At least part of the problem is the fact that in the UK, as in the US, hiv awareness is inadequate. When I first started attending the clinic at Liverpool, I'd be one of maybe three other patients in the waiting room. Nowadays I'm just a number amongst many, and many of those people are women who didn't fit into the myth of "risk groups".

I just don't know what to say. To stop the increase in infections is to safe-guard our treatment in the health care setting. In today's political climate, in today's blame someone else culture, how are we ever going to achieve that?

Fuck.

[emeraldize]

Ann and Alive...

This has turned into a very interesting thread. Thanks Jerry.

I've read of and talked with a number of people who get their labs done, as you do Ann, at the time of an appointment, then three months later get the results. That would drive me fuckin' nuts! But, only because I'm accustomed to a different way. If I didn't know something else was possible, I wouldn't question it.

It seems silly to me to wait three months to learn if you got something to serious to address or nothing to worry about. If there's something serious, three months is a long time to wait.

Until this thread, I've never looked at giving up an appointment as possibly loosening up the attention I/we might getting in the whole scheme of HIV healthcare. Causes me to pause to think about this. I've only ever looked at it as giving up a busy ID doc and precious exam room time to someone who needs it more than I do. I've figured it will likely be there if/when I do. The docs pretty much won't let you go without being see face-to-face for any span greater than six months.

I do, frankly, look at it secondarily from an economic/insurance perspective. Why should that money be spent if it is unnecessary? The labs are costly enough without adding a visit. I have an ecological take on it...why waste the resources? My gas, time, parking money, the doc, the nurse, the room, the billing and on and on.

Hell, direct me to the place that will do that in the UK and I'm there.

 I love me my NHS, but in the past year or so there are restrictions cropping up that are, frankly, restricting.

You know what? I blame you Yanks. Yes, I do. American Insurance companies have been whispering in too many British ears in the past few years. Go away, will you?

Ann -- I figured with the distance you travel for your visits, you don't have choices and can't do labs first then later a visit (or not, depending upon results). Can you clarify how the NHS has become more restrictive and do you believe our US insurance policies are rubbing off on the Brits? If you were being serious, and I sense you were, in what ways are the Brits imitating or changing?

Alive -- There's probably someone within the forums who would give you a name or two of ID docs in the LA area who are worth their salt. Sometimes people post that kind of question in Living With and then, people respond via PM.

Em

[BUZZCUTT]

I have to go every 4 weeks for doctor vist and lab work - it kind of makes me feel better to see him as i feel someone cares

[RapidRod]

Mine are done every four months and if they find something abnormal they will contact you. Other than that I don't know my results for 4 months. No big deal..

[Oceanbeach]

I seriously think their profit is based on how many visits they get. And I seriously need a good ID doc referal in Los Angeles.

I don't know if this is done everywhere but at one of the clinics, I have used (Mendocino Community Health Clinic) for three years, the docs pay is based on how many patients they see.  I know this because I was on the Board of Directors, the finance Committee for a short time and chaired Community Advisory Board for a year.

If you don't mind the drive, the Care Clinic at St. Mary's in Long Beach was the first non-profit treating HIV patients, I was a patient there for 5 years and I highly recommend them.  The Director of Medicine was my doc and I have heard he and his wife moved to Africa and opened an HIV clinic there, I do not know any of the current doctors but the staff has been there for 12 years that I know and still there.  They are all very incredible.  Labs are in the St. Mary's main building, a short walk away and the pharmacy is also on premises.  The Care Program is the ASO and is located by the front gate, there is a dental clinic, specific for HIV patients.  They all validate parking, the Blue Line is on Long Beach Blvd., a block away and the bus stops at the front door.  It doesn't get any better than that    Have the best day
Michael

[Assurbanipal]

Huh, guess we all just assume that the way it works for us is universal.  It's puzzling that folks would have to wait for the doctor to call them with results or to see them in person as more and more systems move to an electronic basis.

My experience is very different -- one or the other of my docs writes a prescription for a blood draw and tests then I take it to a local Labcorp.  They fax/electronically send copies to both doctors and mail me a copy.  I usually know what the labs say in a week.

It hasn't always worked this way; it started when they forgot to fax the results to one of the doctors one time (I have separate ID and GP docs).  So at the next blood draw I demanded they mail me a copy in case one of the docs didn't get it and now they just do it each time.  It's kinda convenient because the docs and I can have a discussion as opposed to them controlling all the info til the last minute and telling.

So, if you are currently waiting on the results you might want to ask the place that draws your blood if they can mail you a copy of the results.  At worst they would tell you "no"?

Sorry if this is extending a hijack Jerry

[Jerry71]

Well with having the 5 month visit to see the doctor is great for me since every time I go it is the same routine. Check in wait sign in wait get called to get vitals taken sent to another waiting room. Then wait some more till they call me to the exam room. After all of that finally I get a 10-30 minutes with doctor and then go and get my blood work done. All in all it takes about three hours and after that I am tired as hell and am glad I am on the 5 month visit.  As for the blood work results I just call them on the next week and have my counts given to me over the phone or they will send me a copy of my results.

[randym431]

I kinda pulled my own strings.
I was on a three-er, then after over and over my cd4 raised and vl was
undetectable, I asked to go to 4 month. They said ok.
But even that seemed kinda too much, so what I do is cancel my
4-month appointment as it nears, and re schedule for the following month
(month 5). They ask no questions and just re schedule. So I basically go
every 5 months. If I were to have any issues sooner, I'd just make an
appointment. But have not had to, so far.
It does save on co-pays and labs.

[aliveinla]

Thank you Michael. You've recommended them before but I have to yet check them out since I live in downtown LA work in the valley so LB is quite a drive but I will surely recommend them to any of my friends in OC or LB.

I have blue cross HMO through work and I see a billing sheet in my file each time I went in to see my ID doc. They bill the insurance company several hundred dollars each visit I make (it was more for first time patient). There is a seperate sheet from my lab (another hospital) billing the insurance another several hundred. I guess that's why their incentive is to have me come in as often as possible and do as many tests as possible (my ID doc orders full spetrum STD, Hep ABC... tests every visit, thus they draw 10-11 tubes each time).

I don't know if this is done everywhere but at one of the clinics, I have used (Mendocino Community Health Clinic) for three years, the docs pay is based on how many patients they see.  I know this because I was on the Board of Directors, the finance Committee for a short time and chaired Community Advisory Board for a year.

If you don't mind the drive, the Care Clinic at St. Mary's in Long Beach

[aliveinla]

Good idea I will try that. Currently mine is like what yours was like before: the PCP doctor office who gets the test report always "forget" to fax over to the ID doc, who is in another hospital system. Last couple times ID doc nurse wasn't too happy to call PCP for the result so I had to get on the phone and beg them to fax over while I sat in ID doc office to wait. Once it's faxed (after 1-2 hours) ID doc office put me in a room then put my file on the door, since I always had to wait for another 20-30 minutes, I usually grab the file and read, that's when I get my numbers. My ID doc then came in, glances at the numbers, then tells me what I have already seen, then I would be out of there in 10 minutes...

My experience is very different -- one or the other of my docs writes a prescription for a blood draw and tests then I take it to a local Labcorp.  They fax/electronically send copies to both doctors and mail me a copy.  I usually know what the labs say in a week.

It hasn't always worked this way; it started when they forgot to fax the results to one of the doctors one time (I have separate ID and GP docs).  So at the next blood draw I demanded they mail me a copy in case one of the docs didn't get it and now they just do it each time.  It's kinda convenient because the docs and I can have a discussion as opposed to them controlling all the info til the last minute and telling.

So, if you are currently waiting on the results you might want to ask the place that draws your blood if they can mail you a copy of the results.  At worst they would tell you "no"?

Sorry if this is extending a hijack Jerry

[aztecan]

First Jerry, I think your news is fantastic!

I think I am supposed to go every six months for labs. I have gone more often recently for lipids because I started another new med to fight the dreaded blood sludge.

But I can't remember when I last did my labs. I don't think it was that long ago -  June or July.

I can wait till after the holidays.

HUGS,

Mark

[BUZZCUTT]

hi aztecan - what is blodd sludge?

[leatherman]

My numbers are good .  Compliance is so-so.  I'm honest with her about it and she doesn't like it so maybe that's why she makes me keep coming back.

compliance has always been an issue for me, so my doc flat out told me once that he has scheduled my visits every 6 to 8 weeks to keep me on the straight and narrow; and if I stumble, he gets to at least pile on some guilt about me skipping my meds. 

Though I was a good boy this year and made my appts, even while my partner was in the hospital and home with hospice (just 3 days before he passed away), as we went through Summer and Fall, my next appointment was rescheduled twice because my doctor had some sick days of his own.  I ended up going almost 5 months (!!) between appointments. The only other time I've ever gone that long without seeing a doc was when I went on and off meds with my previous doctor (and that was back in 98 when the meds were really icky)

my ID doc orders full spetrum STD, Hep ABC... tests every visit, thus they draw 10-11 tubes each time

I would suggest that you might be a bit more "pro-active" with you health and your doctor and bring this up, maybe even refuse some of those tests, if you think they are unnecessary. I've been dealing with AIDS for 16 yrs, and the only time they've taken that much blood from me was when I was in the hospital "almost dying" from PCP. My regular blood drawn is 4-6 vials. Right now, they're drawing nearly twice the blood from you as they do from me (you have almost double the tcells I do), and you're not even on meds yet. If you're not still out having unprotected sex, you probably ought to refuse those extra STD tests as they waste resources, your time, the labs time, and somebody's $$$ (if it's insurance money, then it could go towards paying another insurance holder's medical needs).

[michaelman333]

My doctor gave me the 4month speech and i was like seriously ... wow i have been going so often the past three years it feels so nice and odd LOL ...

I feel i have been scheduling my life around dr. appts for so long now it is strecthed out and I plan to enjoy it

[hades01]

lol!!!!!! 

Hey, Congrats Jerry!

Unfortunately, I was given the same news. It saddened me so....on my last Doctors visit, he informed me that I have been doing excellent and he no longer needed to see me every three months. He broke the bad news to me and said every five months would be just fine. Um, just in case you weren't aware, I find my doctor very attractive, BUT I guess every five months is alright but, boy, was I looking forward to seeing my Doctor, er, having my Doctors visits every three months! LOL!