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Author Topic: Did you or have you?  (Read 1966 times)

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Offline PozJeepGuy

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Did you or have you?
« on: August 18, 2011, 03:25:51 AM »
So I was recently talking with a friend who has cancer. First she is doing fine, but as she was telling me about her medical things, and I found  myself asking her if she has ever went and received a second opion. She threw the question back at me if I ever have. So it got me thinking. How do you know when starting this journey if you are receiving the right medical care.  Since I found out I have gone to one doctor ( which I'm very happy with) and have done everything they have told me, but should you go to another doctor for a consolation? I mean everything is good but I just never thought of this one?  Not about being positive just about am I receiving the right advise and direction. Did anyone ever do this or just is this just another dumb thought. Thanks
Jacob Perry

I refuse to wear my HIV as a badge of shame any longer.

Offline spacebarsux

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Re: Did you or have you?
« Reply #1 on: August 18, 2011, 04:01:07 AM »
.Hey Jake. You don’t need to go to a doctor to know if you are being misdiagnosed or not. I just went to a testing centre and tested poz on WB and I knew I had HIV. There can be no difference in opinion on this point as this is a scientific FACT.

As far as initiation of treatment is concerned, it depends on your CD4 and VL counts, what your doctor thinks about when to commence therapy, what the Treatment Guidelines say and how you feel about making a lifetime commitment to ARVs (especially if starting therapy with a CD4 count > 500 as that can impact adherence). It should be your decision under the guidance of your doctor.

Some doctors and patients prefer the “Hit hard, hit early” approach (as there is evidence that viral replication can be harmful in the long-term regardless of CD4 levels) and some prefer to “Wait and See” until the CD4 drops to between 350 and 500 (to avoid potentially adverse side effects of ARVS as well as adherence/resistance issues).

The treatment guidelines state that one can wait until CD4 drops to 350-500 (in most places).  We do know for certain that one should definitely start treatment before CD4 drops below 350 and 18-19%.

The START (Strategic Timing of Anti-Retroviral Treatment) clinical study is currently underway and its objective is to ascertain the overall benefit or not/ impact on one’s health of commencing therapy with a CD4 higher than 500 as compare to lower CD4 counts.

Personally, I would change my doctor only if I feel he doesn't listen to my concerns and treats me like a robot
« Last Edit: August 18, 2011, 04:07:53 AM by spacebarsux »
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline buginme2

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Re: Did you or have you?
« Reply #2 on: August 18, 2011, 05:47:33 AM »
I have sought out second opinions before but not about HIV.   Few years ago I got in an accident and needed to have surgery on my back.  The neurosurgeon I saw said I needed surgery.  I went to another doctor to get a second opinion and he agreed so...I had the surgery. 

I havent sought a second opinion on HIV yet because my doctor hasn't recommended anything out of the ordinary.  My doctor also takes the time to explain things which I can later read up on. 

If you feel your doctor is steering you in a direction you feel isnt in your best interest a second opinion is warranted.
Don't be fancy, just get dancey

Offline mecch

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  • red pill? or blue pill?
Re: Did you or have you?
« Reply #3 on: August 18, 2011, 06:50:38 AM »
Lets see. The diagnositc process is usually done with two tests to make sure. 
So, once that is confirmed, we don't need more opinions about if we have HIV:

As for treatment, yes, I get second opinions. 

I also find it valuable to make my doctors call each other if I really am not happy with the way I feel.   I was surprised how resistant a few doctors were about this - i think because
some think they are the all powerful oz
some are afraid of all the other others, who are all powerful ozzes
some, the patient shouldn't be asking them to do something
some, its extra time and how do you bill it?
etc etc.

I switched HIV docs this spring and don't regret it. I went to him for a second opinion.  My old doc said he couldn't do anything about a problem because it wasn't in the covered treatment and the 2nd opinion said, oh that's not in the covered treatment list but we MUST do something about it.  Obviously I switched.
Nobody wants to be a number (emotionally) and nobody wants to suffer because some treatment can't be paid for.

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Theyer

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  • Current ambition. Walk the Dog .
Re: Did you or have you?
« Reply #4 on: August 18, 2011, 07:13:39 AM »
I have sacked a Doctor, but on the whole I have been very lucky with my Doc,s.I do wonder wether I would have the energy to hassle around getting to another Doc as when ill and recieving treatment  all energy is used up , and there is a committment between me and the Doc somehow without there agreeing to a second opinion it would feel wrong----I intend to think more about this.
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline surf18

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  • Posts: 525
Re: Did you or have you?
« Reply #5 on: August 18, 2011, 07:28:45 AM »
yea this is a good question. we not so much need one for dx but really for care. though when i was dx'd i didnt believe it and went and got a rapid test right after dx. well obviously the result was the same. did the treatment thing ,still had doubts i had this ha , and went and ordered and online test and did that too and again obviously the result was the same.
but, on treatement i was not happy with my dr or the office and did think about moving on, but we dont have another place here to go to so i weighed the benefits of going 3 hours away to the best place in my area and decided to try to work it out with my current dr.

Offline mecch

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  • red pill? or blue pill?
Re: Did you or have you?
« Reply #6 on: August 18, 2011, 07:34:16 AM »
and there is a committment between me and the Doc somehow without there agreeing to a second opinion it would feel wrong----I intend to think more about this.

Its not wrong to get a second opinion about some serious treatment advice or some serious health challenge that isn't going in the direction you want.  If your doctor thinks its wrong to get a second opinion, then 1) ask him/her to explain why its wrong.  And 2) no matter the doc's explanation, probably go get the second opinion anyway.

Im sure a lot of second opinions are wasted time and money but many are not, which is the whole point.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline surf18

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  • Posts: 525
Re: Did you or have you?
« Reply #7 on: August 18, 2011, 08:06:51 AM »
right. this is to serious a disease to worry about any doc's feelings. i could have cared less whos feelings i hurt.

Offline GSOgymrat

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  • Posts: 5,052
  • HIV+ since 1993. INTJ
Re: Did you or have you?
« Reply #8 on: August 18, 2011, 09:48:41 AM »
One reason I like my PCP is because he readily consults experts. If we run into a situation where there is any question what the best treatment should be he will call Dr. A at Duke or Dr. B at John Hopkins and get the latest info. I also research online, so I feel I have my bases covered.

Offline bocker3

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  • You gotta enjoy life......
Re: Did you or have you?
« Reply #9 on: August 18, 2011, 10:24:26 AM »
There is a big difference, IMO, between getting a second opinion and "firing" your doctor.  If you doctor isn't listening to you, or taking your thoughts into account, then it is time to fire.  If you think that your doctor is wedded to one course of action, but you think there may be other, reasonable or not, alternatives -- go get a second opinion and then discuss with your doctor.

I have not done either with my my Infectious Disease doc -- I try to stay well educated on HIV and we discuss things together -- in fact, my meds are NOT the ones he suggested, but are the ones that I wanted to be on.

I have fired PCP doctor though.

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 Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Did you or have you?
« Reply #10 on: August 18, 2011, 11:16:08 AM »
I suppose you could say that I've had a second opinion, and a third and fourth, fifth and sixth over the years. Not because I sought other opinions out, but because my clinic is at a teaching hospital and I've seen various doctors over the years. I do have a senior consultant who ultimately oversees my case (the highly respected and published Wizard of Poz), but I don't always see him. So far, all the doctors I've seen have been on the same page, so to speak.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

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