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Author Topic: what do you discuss with your ID Doc  (Read 3551 times)

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Offline pinkadam

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  • Posts: 76
what do you discuss with your ID Doc
« on: August 21, 2007, 09:28:15 AM »
Hi Guys

My meeting with my doc will be over in 15 minutes. We only discuss about my mental health as i have been going through depression issues. Some times iam happy with my doctor and some times  i am not.

When I started my treatment  in sep2006 my T cell was 57 and Viral load of 76000. Now i have undetectable viral load and my T cell count is 185. My doctor thinks i am healthy physically.

I see my ID doc  once every 3 months. I am not sure if i am asking my doc the right questions about my treatment.When you meet your id doc , what are the issues that should be discussed with the doc. How can i make sure my doctor is not missing anything.

I have a friend who is HIV+ve . His appointment session lasts for one hour. His doctor discusses everything about his blood work. I would love to hear your opinions on
"What one should discuss with doc when they see their ID doc when they go for blood work"

Pink

Offline Iggy

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  • Posts: 2,435
Re: what do you discuss with your ID Doc
« Reply #1 on: August 21, 2007, 10:45:29 AM »
Pink,

I've had two different doctors since I've been poz and both extremely knowledgable, compentant and personable.  However my first doctor always had a slightly rushed feel to him and if I didn't bring something up - he wouldn't either - much more straight business of bloodwork and results and things of that nature.

My second doctor however has a more broader range of items she prods me about from mental to specific physical issues and is constantly asking me if I have any questions about anything.  What I realize is that gentle prodding by her to be involved in our sessions vs. just a body for her to examine has made these appointments more signifacnt to me than what I had with my first doctor.

I guess what I'm trying to say is that you need to go to your doctor with an agenda that you want to discuss and not rely on him/her to volunteer things to talk about becuase most tiems they are stressed and swamped and not all are going to be able to prod you into bringing up issues.

Offline J.R.E.

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  • Posts: 7,099
  • Joined Dec-2003 Living positive, since 1985.
Re: what do you discuss with your ID Doc
« Reply #2 on: August 21, 2007, 01:27:27 PM »
Hello ,

I guess I spend about 20-25 minutes with my doctor. ( face to face) He usually begins asking the questions, after we discuss the latest numbers, and some of the blood work, but not all it, only items that may be of concern. If there is something in the bloodwork that needs to be discussed, he does bring it up, more often than not, it's just the viral load, tcell count, percentage, and the issues with cholesterol / triglycerides.When he's through asking the questions, then it's my turn to ask, or have some concerns addressed.

Everything is usually discussed, My appetite, bowell movements ( whether or not I am constipated or have diarrhea. He questions whether or not I have had any persistant headaches, or cough, or if I have shortness of breath. He ask how well, and how much I sleep. My doctor ask, if I am having any issues with depression, or if I have episodes of forgetfullness, or if I am having any issues of not being able to  concentrate. We talk about the PN, and if it has increased or remained about the same, since the previous visit. He ask me if I am having any issues with muscle cramps. He looks into my ears, he looks down my throat, he listens to my lungs, He probes around my armpits, and around the stomach area. He ask me if I am having any kind of vision problems, or any change in eyesight. He ask me if I am having or had any problems with rashes. I go to the dermatologist quite a lot, so I usually let my doctor know  what is going on, in that area. If/when I have a vision exam, I make him aware that it was done and let him know the results of that. He ask me if there has been any change to my vitamin or supplements, since the last visit. He ask if I am being consistant on taking the meds on time, and that I am not missing doses ( I do have a little bit of trouble at times in that area.)



If you have any problems with some of the above issues that I mentioned, Don't hesitate to ask your doctor about it.

Like you, I also started off with a very low t-cell count in 2003, of 16. and a viral load over 500,000. I think your making great improvements in your numbers. And, you are UNDETECTABLE !! That's great! You should feel good about that !

Just be open and honest with your doctor, and if you have questions or concerns, write them down, before your appointment, then ask him/her those questions or those concerns. Bring the list right out in front of him/her !!

I am not sure, if anything I stated here may help you out, or if I am just rambling ! :P


Take care of yourself-----Ray





Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline BT65

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  • Vegas baby!
Re: what do you discuss with your ID Doc
« Reply #3 on: August 21, 2007, 01:34:05 PM »
Pink:
  I discuss everything with him, related to my physical and mental well-being.  I try to think of anything I want to ask him about prior to the appointment and write it down.  Also, anytime I think of anything I immediately write it down or I'll forget.  We discuss the bloodwork, the care of my diabetes, meds etc.  I see him every three months. 
   Just be open and honest with your doctor and don't hesitate to bring up anything you want to talk about with him.  I think Ray gave you a pretty good answer.  Take care.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline AustinWesley

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    • HIV Discussion Group on Myspace!
Re: what do you discuss with your ID Doc
« Reply #4 on: August 21, 2007, 02:29:16 PM »
Today I discussed a LOT.   My prior two doctors were apathetic and horrible and I fired the 2nd one today and have a new guy who seems quite amiable and with the program.   The prior ones were both burnt out and I had finally hit my limit with bullshit.

Thus far, I'm rather impressed with the new guy who's up to date on the latest information and quite thorough and pleasant.   

As far as general information we discuss anything and everything.   He was appauled by the incompetence of my prior two doctors and offered me a fresh start with him today and I was happy to take him up on that.   

Good topic though and perfect timing! ; )
Diag. 3/06  Infected aprx. 2 mo. Prior
Date        CD4   %      VL
4/6/06     627    32    36,500     NO MEDS YET!
6/7/06     409    27    36,100
8/23/06   408    25     22,300
1/2/07     354    23     28,700
2/9/07     139    30     23,000  Hep A Vaccine same day???
2/21/07   274    26     18,500 
3/3/07    RX of Truvada/Sustiva Started.
4/5/07    321     27      Undectable 1st mo.  
5/16/07  383     28    Undectable 2nd mo.
8/10/07  422     32   UD <48 on new scale!

Offline RapidRod

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  • Posts: 15,277
Re: what do you discuss with your ID Doc
« Reply #5 on: August 21, 2007, 02:30:32 PM »
I get a complete going over each and every time I visit my ID doctor. All the normal stuff first, weight, bp, temp and then I go and sit on the bed to begin the works. Ears, eyes, mouth, reflexes, heart, breathing etc and then the lay down and probing begins. After all that is over with, we talk about labs A thru Z, meds, prescriptions needed and general chat. Then from there, I go to the lab and give my usual 11 to 18 vials of blood and some urine and I'm on my way home. It usually lasts from 1.5-2 hrs. that is if she doesn't send me for an X-ray or to the CT,MRI, or Cardiology Depts.  Tack on another 1-2 hours if she does that. She is never in a rush. Now she may be late once in a great while due to a patient emergency, but it's rare. At least she quit calling me Mr. Haines.  :D

Offline jack

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  • fomerly the loser known as Jake
Re: what do you discuss with your ID Doc
« Reply #6 on: August 21, 2007, 03:04:23 PM »
I have learned to make a list of every question and I take it with me and whip it out,otherwise I forget.

Offline StrongGuy

  • Member
  • Posts: 492
Re: what do you discuss with your ID Doc
« Reply #7 on: August 21, 2007, 05:49:57 PM »
My doc gives me a half hour to 45 minutes appointment sssion and we spend at least a half hour just sitting in his office talking about my health, outlooks, new treatments, and any questions I have. My doc is my trusted source when it comes to HIV and i always run anything by him.

Unfortunately I'm going on the 6 month visit plan which I'm not happy about (well, I should be happy but I like to chat it up with my doc). I'll have to annoy him with e-mail instead.

:)
"Get your medical advice from Doctors or medical professionals who you trust and know your history."

"Beware of the fortune teller doom and gloomers who seek to bring you down and are only looking for company, purpose and validation - not your best physical/mental interests."

"You know you all are saying that this is incurable. When the real thing you should be saying is it's not curable at the present time' because as we know, the great strides we've made in medicine." - Elizabeth Edwards

Offline Oceanbeach

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  • Posts: 3,565
Re: what do you discuss with your ID Doc
« Reply #8 on: August 21, 2007, 08:34:13 PM »
Hey Pink,

I also see my ID doc once every three months.  He is one of the best and works in 5 HIV clinics in 3 counties.  When I have questions or concerns, I email the Staff Nurse.  I hear some of his patients write their questions on their hands so they don't forget to ask... Any health related topic is open for discussion because there was a day when medical science hoped to keep us alive for maybe 5 years.  Now as we are receiving better medications and have the plans to reach "old age", everything from heart to long term health is discussed.  I did have a sort of off again, on again relationship with a member of his staff.  We never discussed that but he did suggest I spend less time as an activist and more time in socialization.  Have the best day
Michael 

Offline Bucko

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  • Posts: 1,947
  • You need a shine, missy!
    • The Spin Cycle
Re: what do you discuss with your ID Doc
« Reply #9 on: August 21, 2007, 09:16:47 PM »
If his office has vertical blinds, I always mention them. I hate vertical blinds.

Seriously, you aren't clear here, but if you have an ID doc, then chances are you also have a PCP. My experience is that PCPs are for the warm fuzzies and ID docs are numbers wonks. I don't expect much from ID docs and am therefore never disappointed.

Jack was quite right about a list. I always bring one or will forget everything.

Blessed with brains, talent and gorgeous tits.

The revolutionary smart set reads The Spin Cycle at least once every day.

Blathering on AIDSmeds since 2005, provocative from birth

Offline Queen Tokelove

  • Member
  • Posts: 6,033
  • Smokey the Smurf
Re: what do you discuss with your ID Doc
« Reply #10 on: August 22, 2007, 02:23:07 AM »
I swear the wait for my ID doc is usually what kills me. After being weighed in etc and tossed in a room, I usually have to wait 30 minutes to see him. He gets chatty w/ the other patients. It gets on my nerves at times but I figure they have questions like I have questions.

My doc follows along the lines of Rod and Ray's, they go over results and compare from the last visit. If I have any questions I usually ask them then.
Started Atripla/Ziagen on 9/13/07.
10/31/07 CD4-265 VL- undetectable
2/6/08 CD4- 401 VL- undetectable
5/7/08 CD4- 705 VL- undetectable
6/4/08 CD4- 775 VL- undetectable
8/6/08 CD4- 805 VL- undetectable
11/13/08 CD4- 774 VL--undetectable
2/4/09  CD4- 484  VL- 18,000 (2 months off meds)
3/3/09---Starting Back on Meds---
4/27/09 CD4- 664 VL-- undetectable
6/17/09 CD4- 438 VL- 439
8/09 CD4- 404 VL- 1,600
01-22-10-- CD4- 525 VL- 59,000
Cherish the simple things life has to offer

The Royal Blog

Offline bocker3

  • Member
  • Posts: 3,358
  • You gotta enjoy life......
Re: what do you discuss with your ID Doc
« Reply #11 on: August 22, 2007, 07:26:30 AM »
My ID doc spends as much time as I need -- sometimes 15 mins, sometimes 30.  He calls me back from the waiting room himself, he weighs me, takes my temp, BP, etc.  He gives me a physical exam, asks me how I'm doing, if I'm taking my meds (he always goes over everything I take, including over the counter stuff, to make sure nothing has been added that shouldn't).  We then discuss my lab results.  Over the 2 years I've been seeing him, I've started to discuss more and more stuff with him.  Last visit we talked about my disclosing to my mother and how that all went as well as my concerns with disclosing to my daughter.  He gave me some very good counsel.  I sometimes have to wait for him, but I know it's because he does not rush his patients.  I enjoy getting all my questions answered, so I can't complain about waiting while someone gets theirs answered.

Hugs,
Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline BT65

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  • Vegas baby!
Re: what do you discuss with your ID Doc
« Reply #12 on: August 22, 2007, 07:38:04 AM »
My doctor is also getting ready to start a clinical trial he would like me to participate in.  It is for PN.  It involves wearing a Capsaicin patch for two hours, then seeing what the result is.  I wonder if anyone knows anything about this.  I take Neurontin for the PN, but would like it if the patch works as I really detest the Neurontin because it starts disolving immediately in my mouth. *yuk*
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline J.R.E.

  • Member
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  • Joined Dec-2003 Living positive, since 1985.
Re: what do you discuss with your ID Doc
« Reply #13 on: August 22, 2007, 07:51:19 AM »
My doctor is also getting ready to start a clinical trial he would like me to participate in.  It is for PN.  It involves wearing a Capsaicin patch for two hours, then seeing what the result is.  I wonder if anyone knows anything about this.  I take Neurontin for the PN, but would like it if the patch works as I really detest the Neurontin because it starts disolving immediately in my mouth. *yuk*


Betty,

I've already been involved in that study. You can read about it here If you decide, I wish you the best !:

http://forums.poz.com/index.php?topic=8243.0


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline emeraldize

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  • Posts: 3,335
Re: what do you discuss with your ID Doc
« Reply #14 on: August 22, 2007, 09:04:11 AM »
I hate vertical blinds.

I totally hate vertical blinds, too.

I requested to be on the six-month plan because our clinic is growing and I figure it's better to give up face time to someone who really needs it. My stats have been static for a while.

I have access to my doc and nurse by e-mail if I ever need to ask a question. Rod's answer reflects what goes on in my typical appointment, the only difference is, labs are done in advance of the appointment. The draws aren't done in the doc's office.

No matter what doctor, for what health issue, I always write down items of concern on a list. And, usually, if a doc sees that, they'll address it by asking if there are any more questions.

Em

Offline Cerrid

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  • only as good as your last haircut
Re: what do you discuss with your ID Doc
« Reply #15 on: August 22, 2007, 09:17:58 AM »
My appointments usually last an hour. For the first 20 minutes, we talk about my present well-being or not-so-well-being, her family and my current boyfriends, some of which are her patients too (she always tries to hook me up with some of her other patients but I dont mind). Next, there's 20 minutes of discussion about the latest numbers and any issues I have on my check list. The last 20 minutes are spent with physical examination, blood draw and preparing the prescriptions. She does it all by herself, even the blood draw. She's my first HIV doc at the local university hospital, we're the same age and get along very well.

Oh, and there are no vertical blinds in her office. In fact, there are no blinds at all. Not even windows.
"Boredom is always counterrevolutionary. Always." (Guy Debord)

Offline buca45

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Re: what do you discuss with your ID Doc
« Reply #16 on: August 24, 2007, 01:02:00 AM »
I usually start off with a pleasant conversation with the nurses on duty and we cover topics other than my ailment de jour. after 20 or so minutes the doctor interrupts us and allows me to discuss whatever is on my mind and what has happened to me over the past 6 weeks since i last seen him. After we discuss and he notes everything, he will go through each item to give me his point of view and then allows me to direct where we will go next.
I usually do research on his recommendations and speak with his nurses before we go (usually in his direction) and i do as im directed.
fortunate to have had good, understanding and very educated docs in the past 15+ years.
For me, the most important thing is an open, no holds barred dialogue with agreement between the both of us on the course of action.
"Love and Laughter and Happiness Ever After"

Offline Jena

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  • To God Be The Glory!
Re: what do you discuss with your ID Doc
« Reply #17 on: August 24, 2007, 05:05:58 PM »
Rod and I go to the same clinic although we see different docs. The routine is the same though except I have my labs about two weeks before my appointment with the Doc so she has the results when I get there.
 She acts like I am her only patient and  can spend the whole day with me if I need her to. She never acts like shes in a hurry and wants to know EVERYTHING that is going on with me and with my boyfriend, Joseph because he is her patient also.
 We talk about life, job, kids, fears, plans, and that is about  both myself and her. Shes told me a few personal things about herself that sort of surprised me, but then she knows I'm a social worker so maybe she  felt like it was ok to do so.. who knows, maybe she was trying to get some free mental health care   :D
 I dont have a Primary Doc, just my GYN and this ID doc.

Jena

Offline SouthSam7

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Re: what do you discuss with your ID Doc
« Reply #18 on: August 25, 2007, 10:23:59 PM »
First, let me concur with the others about the importance of the list.  I have to bring one or I walk out pissed at myself for not taking advantage of the doctor.

Second, the care I receive is completely dictated by if I have good insurance, private doctor or public (crowded) clinic.  I go to a small clinic now, so I get more one on one.  I did, however go to a big-ass clinic in b-ham and they were so crowded and so much red tape I felt like cattle.  I hated it.  Turns out that same clinic is now in the news for dosing people's meds wrong with kidney problems!

Anyway, I still feel like the only thing the clinic wants to be bothered with is cd4 count and viral load.  Last year they forgot to give me my flu shot and I got the flu.  I had asked for it for weeks.  In January they said they didn't have enough which I know was a lie.  They had a surplus and had to destroy them because they didn't use them. 

I had some spots on my skin I was worried about, and also a small blemish that wouldn't heal.  She said don't worry about it; as long as you go to a dermatologist within the year you'll be ok.  That didn't make me feel better, but it's better than the treatment I got in Birmingham at the mega-clinic. 

Good luck.

Sam

Offline ChaplinGuy

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Re: what do you discuss with your ID Doc
« Reply #19 on: August 26, 2007, 02:17:51 PM »

I think that this is such an important question, and am glad to see it asked here. I recently switched docs when I moved from the east coast to the west coast, and was concerned about finding someone that I liked quickly without having to go through several test runs with different people.

The truth is, I've been lucky both times. My first doctor in D.C. was excellent, and while I think she was pressed for time during some appointments I always got the sense that she was taking more time when I needed it to talk about specific things.

Here out west, my new doctor is awesome. In a way, he has a laid back style that makes me feel a bit more "normal", and we often just shoot the breeze for several minutes without it being all HIV talk. He also makes a point to make me realize that everything is going to be okay, which I know a lot of docs don't do. It's easy to get into clinical analyses of the condition trends, which can often be too much to take in every 3 months.

I know every one is different, but I talk to my doc about everything from the weather to politics!


Offline solar

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  • No gods or kings. Only man.
Re: Neurontin
« Reply #20 on: August 29, 2007, 09:26:54 PM »
I take Neurontin for the PN, but would like it if the patch works as I really detest the Neurontin because it starts disolving immediately in my mouth. *yuk*

I'm on 600mg TID for post-herpetic neuralgia.  These tablets are a pearl color, and quite solid.  Are you referring to the yellow gelatin capsules (which I used to have with the lower dose)?

You may find a different manufacturer's product is not as disagreeable.  Because gabapentin is generic, and with its tremendous off-label prescribing, a great many companies make it:  Actavis Elizabeth, Apotex, Cobalt Pharma, GenPharm, Greenstone, Ivax, Mutual, Pfizer (the original patent holder), Ranbaxy, Sandoz, Sun Pharm, Teva, Watson, and others.

Just like your generic Paxil may come as an oblong white pill or a round green tablet, there could be an alternate version of Neurontin more palatable to you.  That said, I wouldn't discount other treatments such as capsaicin, or perhaps lidocaine patches (although the latter has not worked for me).

Offline aztecan

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  • 29 years positive, 56 years a pain in the butt
Re: what do you discuss with your ID Doc
« Reply #21 on: August 29, 2007, 10:53:37 PM »
It is a bit different here in the hinterland. We have one doctor - period. Love him or hate him, he's it.

Luckily, I like him.

I see him at least once each week, often two to three times in a week. Of course, I am there to talk about someone else, but I digress.

He is partially retired, so he can focus a bit more on the HIV and geriatric patients. He doesn't have a problem spending more time on a person than the usual 20 minutes.

On a personal level, I usually have to take a list with me because I forget to ask about things. Then, once I get in there, sometimes it is hard to concentrate on me without getting side tracked on someone else's needs.

Again, that is why I take a list.

There are times when he points things out to me, other times I point things out to him regarding treatment, etc.

One thing I do like is he is an old-fashioned doctor. He does the physical exam himelf, thumps the old abdomen to check the liver, listens to the lungs, etc., checks for edema in the legs and arms, you get the idea.

Of course, he does all the lab tests needed to make sure the plumbing is in order, but the hands on approach is so refreshing these days.

If I have a special problem, such as, say, a hump growning in between my shoulder blades, I point it out, he checks it out and then we talk about what to do next.

All in all, a very agreeable doctor/patient relationship. I don't feel like a steer being herded along and he does his very best to stay on top of things related to HIV.

So, what's not to like?

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

 


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