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Author Topic: My doctor only cares about blood results  (Read 4232 times)

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Offline JesseLY

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My doctor only cares about blood results
« on: January 18, 2009, 11:00:44 PM »
I've been HIV+ for over 20 years now and doing well. In the early 90's I had pneumocystis and a few other things. But since 1996 I've generally done well. I live in Seattle and am fortunate to have one of the best HIV specialists in the region.  Yet I get more and more frustrated by the lack of care feel I get.

My doctor has rarely touched me in the last 3 years. I see him every three months or so, sometimes more. Our appointments are about 15 minutes long and the only thing he is ever concerned about are my blood results. My t-cells are about 300, VL is always 2000-6000. My results have been like this since the mid 1990's.

My doctor doesn't do the usual examination stuff of listening to my breathing, or poking and prodding. We just sit and talk about blood test results. If I have something specific that I'm concerned about he'll examine me. But otherwise, it's strictly a talking appointment. This really frustrates me.

A year ago I had a lump in my chest and had to have a biopsy. It turned out to be nothing. But it bothered me that if I hadn't found that he never would have, since he doesn't examine me.

Anyway, this whole thing really frustrates me and I don't know if I'm expecting too much from my doctor or what. I had a previous doctor who did the same thing - after the first few visits simply stopped touching me and focused instead on blood results.

Am I expecting too much by thinking that my doctor should examine me, at least in an perfunctory manner? Has anyone else had this experience?

I awkwardly mentioned to him after the chest lump incident that I would like him to examine me more often. He did it once and never again.

My partner thinks the whole thing is really odd, too. But he also knows that my doc is considered one of the best in the city.


Offline Dachshund

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Re: My doctor only cares about blood results
« Reply #1 on: January 19, 2009, 06:04:11 AM »
You're the only one that can advocate for you and unless you share your concerns with your doc I suspect your doctor visits will continue to frustrate you.

Offline BT65

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Re: My doctor only cares about blood results
« Reply #2 on: January 19, 2009, 09:39:27 AM »
Jesse, I totally agree with Dachs.  If you never mention it to your doc, he's not going to change.
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Offline JesseLY

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Re: My doctor only cares about blood results
« Reply #3 on: January 19, 2009, 09:57:55 AM »
You're the only one that can advocate for you and unless you share your concerns with your doc I suspect your doctor visits will continue to frustrate you.

I agree. And I did mention it once about a year ago. He said "why do you want me to examine you -  are you having trouble breathing or something?" I said, no, but I would just like to make sure we integrate these types of things into my appointments. He checked me that one time, but never again.

It's not only the issue of physically touching. My partner tells me how he's had all these booster shots, for things like tetanus, pneumonia, etc...I've never had any of that. Again, it's all limited to my other blood test results.

I guess I feel I shouldn't have to ask my doctor to do what doctors are "supposed" to do. It seems ridiculous for me to have to say "OK, now I'd like you to check my breathing. And now I'd like you to see if my shots are up-to-date. And now I'd like you to tap around on my belly..."

Maybe I'm expecting too much. But it just seems like there should be more and I shouldn't have to ask for proper treatment.


Offline mewithu

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  • mewithu
Re: My doctor only cares about blood results
« Reply #4 on: January 19, 2009, 12:18:15 PM »
The Doctors do have a heavier patient load now days and unless they see an abnormal reading on your test results and you have been their patient a long time they sometimes feel no need to explore your body unless you have a complaint. You may ask him though why he is not checking your body more efficiently as you expect.

much care, Jerry
1997 is when I found out, being deathly ill. I had to go to the hospital due to extreme headache and fever. I fell coma like,  two months later weighing 95 pounds and in extreme pain and awoke to knowledge of Pancreatis, Cryptococcal Meningitis, Thrush,Severe Diarea,  Wasting, PCP pneumonia. No eating, only through tpn. Very sick, I was lucky I had good insurance with the company I worked for. I was in the hospital for three months that time. 
(2010 Now doing OK cd4=210  VL= < 75)
I have become resistant to many nukes and non nukes, Now on Reyataz, , Combivir. Working well for me not too many side effects.  I have the wasting syndrome, Fatigue  . Hard to deal with but believe it or not I have been through worse. Three Pulmonary Embolism's in my life. 2012 520 t's <20 V load

Offline aztecan

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Re: My doctor only cares about blood results
« Reply #5 on: January 19, 2009, 06:42:37 PM »
When I see my doctor with an appointment, (I see him all the time without one), he always does the once-over.

He listens to my breathing, my heart, checks my liver (that's why they thump around on your abdomen) and also checks my ankles and wrists for signs of swelling. He also thumps around my back to make sure there isn't any fluid build up in the lungs.

He is an old-fashioned doctor, which I rather like.

As for the immunizations, they are standard of care and you shouldn't have to ask for them. There is a new combo of serums, including one for tetanus, I think, aimed at those of us who are older than 50.

The pneumovax, etc., should be done routinely, just as should tests for syphilis and tuberculosis.

If that isn't being done, you had better as your doctor about them.

My doc also regularly attends conferences. He is looking forward to the next conference he plans on attending because they are going to have someone there speak about lipodystrophy and what is new and exciting in the treatment thereof.

Did I mention he just celebrated his 69th birthday a week ago?

I am lucky to have him. If he weren't here, I would be driving 400 miles round trip to see a doctor, or go to Colorado to see the doctor in Durango.

Ah, life in the hinterland.



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

Offline RapidRod

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Re: My doctor only cares about blood results
« Reply #6 on: January 19, 2009, 07:03:20 PM »
I have to concur with Mark, my doctor is very efficient. I get the same going over as the first time I was seen by her. I can't ask for a better doctor or service. Yes, she is still trying to fix me up with any single guy that works there.


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Re: My doctor only cares about blood results
« Reply #7 on: January 19, 2009, 07:21:16 PM »
My Doctor has specialized in the treatment of HIV since the epidemic came about, and I feel very fortunate to have him as my doctor. His working relationship with his patients is about as good as one could have with a doctor. He has given me his personal cell number, and has instructed me to call him if I ever have a question or concerns. When I do visit every 4 months we review my blood work, and he asks me about my general health, and if I have any concerns. Other than that I have not had any major problem for him to be challenged with at this point (knock on wood) but I am very confident he will be able to help me with any health issues that may come about.
Atheist don't believe in GOD, but GOD believes in them and loves them. Never let the failure of man conflict with your love of GOD.

Offline Robert

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Re: My doctor only cares about blood results
« Reply #8 on: January 19, 2009, 10:39:58 PM »

Hi Jesse.

I've come to realize some people here have 2 Drs: their ID (Infectious Disease) Dr and their PCP (Personal Care Physician.)  For all things HIV, they see their ID doc.  Everthing else falls under the aupices of the PCP.  Perhaps your Dr thinks you have another Dr to perform those routine procedures like thumping your chest and poking the liver and coughing.  If I were you I would make it clear to him that you don't have another PCP doc for those normal check-up routines and that you expect him to do them. If he declines, then keep him for your HIV concerns and find yourself a PCP for the chest thumping


Offline AndyArrow

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Re: My doctor only cares about blood results
« Reply #9 on: January 20, 2009, 11:58:24 AM »

I think Robert hit the nail on the head.  My ID doc gets reports from my GI doc whenever I have something done so he doesn't really see the need go into details about my esophageal problems unless I bring something to his attention.  Since doctors specialize so much now they are often only focused on the area of their practice.  Let him know he's your only doctor all your routine checkups.

Good luck!
It is not the arrival that matters.  It is the journey along the way. -- Michel Montaigne

Offline pozhealthy

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Re: My doctor only cares about blood results
« Reply #10 on: January 24, 2009, 11:38:35 PM »
you know your body best and when something is out of whack. My old doc used to make me strip and look me over from head to toe. He was not afraid to prescibe serostim, oxandrin and testosterone when i needed them. He sees the value in looking good and having good numbers. My new doc only cares about my lab values and has flat out told me that he is not concerned about how my body looks.
The HIV docs don't know everything. I went undiagnosed for years with an umbilical hernia. My HIV docs told me it was probably just an infection when my belly button popped out and to push it in and cover it with neosporin
This worked for a while but i finally went to a surgeon who took one look and told me what i had and that it was pretty bad so I had surgery and it was MUCH worse when they got inside me to check it out. So now I have a mesh inside that holds the hernia  in and i feel great but it took months to heal and was very very painful.
So check around with other doctors and get second and third opinions. I think a really good doc looks at the total body and will give you prescriptions to help you maintain your body and your self esteem.

Offline SoSadTooBad

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Re: My doctor only cares about blood results
« Reply #11 on: January 25, 2009, 12:57:17 PM »
My ID doc does all of the poking and prodding that azetecan mentioned, but on the other hand, he also sometimes checks off the less sensitive VL test on the lab request - I have to remind him to ask for the ultra sensitive test.  He is very well regarded, but it freaks me out that he is so casual about it. 

I guess they all have their blind spots, and as Dachshund mentioned, you need to bring up issues that you'd like to see handled differently.


  • Guest
Re: My doctor only cares about blood results
« Reply #12 on: January 26, 2009, 07:44:17 AM »
I live in Seattle and I would bet good money I know who you are talking about:))  Three years of going to the guy and never once did he even put a stethoscope to my lungs or give me a physical.  Every visit was 15 minutes long, tops.  I switched IDs and was surprised that other IDs spent an hour with me and actually poked and prodded me.  I now go to Dr. Aboulafia at Virginia Mason and am really glad that I switched.  What a difference.

Offline rondrond

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  • 22 years HIV+ yet a yard could be the death of me
Re: My doctor only cares about blood results
« Reply #13 on: January 26, 2009, 01:52:50 PM »
My ID doctor checks everything. I am usually with her for at least 30 minutes as she will go down my list that I bring, even checking them off.

My other doctor//eghh, not so much. There is a Nurse that checks my vitals.
"I'm not done yet"....Glen Campbell

"I may not be exactly where I want to be, but I sure as Hell am not where I was"
Wynnona Judd

No Meds for 7 Years

04jul07/DVT-right leg/Bi Lateral PE's     
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Offline bufguy

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Re: My doctor only cares about blood results
« Reply #14 on: January 31, 2009, 06:43:42 PM »
I'm pretty new to this, just diagnosed positive in May after a mail order home test. My PCP had died over a year previously and I had not had a full physical in 13 years. Shameful, but I was always healthy.
When diagnosed I sought a new PCP and found one who is also the top ID doc here in Buffalo.
He gave me a thorough physical on my initial visit. Every time I go in a nurse does all the routine blood pressure, weight, pulse etc, but he listens to my heart and prescribes everything he thinks a 48 yo guy needs. I have the best of both worlds.
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .9


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