What Happens At A Follow-up Visit?

[Hummingbird4]

I was diagnosed celiac at the end of June, at which point my GI doc referred me to a dietician and said I should come back to see him in a month. I put off my follow-up appointment until August 20th because I didn't start the gluten-free diet until a few days ago, due to a planned European vacation and no symptoms.

I did meet with a dietician last week and frankly, I seemed to know more about gluten-free eating than she did. She mostly specializes in diabetes education.

What is this follow-up GI visit for exactly? Just to see how I'm doing and if I have any questions?

[Ursa Major]

What is this follow-up GI visit for exactly? Just to see how I'm doing and if I have any questions?

To help pay for the GI doctor's new yacht.

Seriously, at this point, the visit would likely be as useless as that visit to the dietician.

Have you noticed any positive changes since starting the gluten-free diet?

[Hummingbird4]

That's kind of what I was getting at. I'd rather not spend the time and a $20 copay if it's not necessary. I wasn't having symptoms, so I haven't noticed any positive dietary changes at this time. I don't know what I could possibly discuss with the doc that I can't just discuss with you wonderful people! And since you're living with it, you probably know more than he does! (no offense to him)

[kbtoyssni]

Some people like to do a followup visit to test their antibody levels. This can show how compliant you're being with the diet, especially when you don't have symptoms to "remind" you when you mess up! But I wouldn't do that for a year or so. Unless you're still having symptoms or want to ask a lot of questions, I don't see the need for a follow up.

[WW340]

It really depends on the doctor. My GI did lots of blood testing right after my endoscopy. He found I had B-12 deficiency and is treating that. He also requested my bone density scan at my second visit, which showed I had severe osteoporosis.

I see him every 6 mos with routine labs to watch for various problems and deficiencies. It is also an opportunity to ask questions. Sometimes I have questions, and sometimes I don't. I keep a good relationship with my doctor so that I can call him when I have problems.

Recently I had shingles for the 2nd time in 4 mos. I called my GI about it and he spent a lot of time with me on the phone. He also called out some medicine to help me with the pain. Personally, I like having him available.

He also discussed the seriousness of the diagnosis with my husband on our second visit, so I have no problems keeping a gluten free kitchen.

[jerseyangel]

After diagnosis, I had to go back in 2 months and again 6 months later. Both of those visits consisted of him asking me how my bowels were (his exact words) and telling me to keep doing what I was doing.

I switched GI's the next year, and at the 2 year mark, he did bloodwork to test for antibodies.

[mamabear]

As WW340 said, it depends on the doctor and what you need. We celiacs are not all alike. A smart doc will check mineral and vitamin levels and replace as indicated from the beginning. And then retest for successful results. She/he will also check bone density for baseline results. Antibody levels(if your body can generate them) should be followed in ~6 months. Not just for dietary compliance , but to also assess the need to keep looking for longterm complications of celiac disease(GI lymphoma being the most elusive and worrisome).

[mirabella]

URSA MAJOR is probably correct with the yacht!!

[Hummingbird4]

I'm thinking that a followup visit in 6 months is probably a better idea. Surely my antibody levels haven't changed much in 3 weeks of being gluten free. I wasn't anemic to begin with (hemoglobin was 12), and I did not have any iron studies or chemistry panels done.

[Meleficent]

I am so glad you asked this question! My GI was next to useless, like you the dietician was useless, and now I am swimming alone. I wonder if I need to have a bone density test or have my vitamin/mineral levels checked. But, I have been running into insurance issues as well, so I do not know what to do. I am almost 3 months into my diagnosis with some days better than others......

Thanks for asking and getting some thought out there for me to ponder!

[Hummingbird4]

I did end up helping my doc buy his yacht . Went to the followup appointment yesterday and didn't get much out of it. Well, I did get a copy of my lab & pathology reports, so that was useful.

He encouraged me to stick with foods specifically labeled as gluten-free to avoid CC from the manufacturing process, but when I asked him how careful I need to be when eating in a glutenous environment (other people's homes, restaurants, etc.), he said I should be fine so long as I eat gluten-free. In other words, not to worry too much about stray crumbs.

He wants me to have follow-up bloodwork in a few months, when I feel healed. Otherwise, there's no reason to go back unless things change.