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Need Advice On What To Ask A Potential New Pcp

Roda

By Roda
in Doctors

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Roda Rising Star
Roda
Posted

I have been wanting to change my PCP and just now got around to calling and setting up an "appointment" (more like a visit to feel the potential new doctor out) with a different family practice physician. I'm not sick and everthing is going well, but I need a good pcp that I can feel confident with. My current PCP I am not satisfied with and have not been since my symptoms started over 3 1/2 years ago. I know the obvious things like sick visits, rx, lab results, etc. but need advice on what to actually ask the doctor.

  • 2 weeks later...
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Roda Rising Star
Roda
Posted
  • Author

Well, I just winged it and went for an appointment this morning. I really liked this new doctor and her personality made me feel at ease. She was easy to talk to. I knew that she "got" celiac by a comment she made. She said something to the fact that I was lucky my blood work was positive and went on to say that there can be alot of false negatives, even in biopsy. I was impressed with that. I told her that I thought a good doctor was one who was humble enough to say they don't know everything and be willing and listen to their patients to help them figure it out. After alot more discussion, I feel like she is a good fit for me. I am going to try to get my husband to switch to her also. It will be nice to have a pcp that takes the time with you and listen, not just herd you in and out like cattle.

Wolicki Enthusiast
Wolicki
Posted

Roda, that's great! I had a similiar experience with a new PCP last week, an Osteopath. I simply asked how familiar he was with Celiac, and he only stopped citing examples when I told him "he passed." :D It is so comforting that my doc knows more about it than me! Yippeeee!

breavenewworld Apprentice
breavenewworld
Posted

hi Wolicki

who is your doc

what did you go in for??

i've been going it alone for the past year besides an endoscopy (obviously couldn't do that myself) and a visit or two to some non-helpful GI's

thanks!

Wolicki Enthusiast
Wolicki
Posted

His name is Andrew Mielnek. He's a D.O. in Huntington Beach, with Beach Family Doctors.

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I went in for my first patient visit. He looked at all my labs, was able to determine several issues and gave some good, no nonsense advice. My next visit I am going to ask about food intolerances. Haven't found a GI I like, but I think all they care about is endos, etc. The doctor I truly have faith in, who is very thorough and very caring is a Rheumatologist Kathy Karamalou in Newport Beach. She is amazing. Actuallu will say "I don't know" and then call one of her colleagues for an answer.

Janie

breavenewworld Apprentice
breavenewworld
Posted

janie-

thanks!! i'm an hour north but sounds like it might be worth the drive as i can't find anyone in my area. part of me is so resistant to going to more doctor visits. it's so draining to have to explain everything and catch someone up, plus it adds to my schedule which i'm trying to clear out so i can HEAL. plus, i've gotten so much conflicting info on supplements and herbal remedies that i don't even know where to start. anyway :) have you found it necessary/helpful to visit them? what kind of tests have been helpful for you- did you get a full metabolic? have you found deficiencies in certain vitamins? other issues?

i'm so curious about everything and i've been on this site for WAY too long today :)

thanks again

Wolicki Enthusiast
Wolicki
Posted

I've been tested for almost everything. Vitamins, electrolytes, metabolic, kidney, heart and liver funciton. Having some kidney issues, so everything has been checked. They found the following deficiencies/issues:

secondary hyperparathryoid caused by D deficiency

hypothyroid

iron deficient anemia

b12 deficiency

Most of it has been addressed. i take Caltrate + D and 50,000 IU (presciption) Vitamin D, got 6 b12 shots along with 8000 mcg sublingual daily, took Ferrex but it upset my stomach, so I had an iron infusion.

I also take Fish Oil, B complex, multi daily.

I was sick for 10 years before diagnosis. I have an appointment with a new nephrologist tomorrow. I've had terrible edema since going gluten-free. I also developed neuropathy and restless legs AFTER going gluten-free. But, no neuropathy in 3 days! yippee!! Getting better slowly but surely!

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breavenewworld Apprentice
breavenewworld
Posted

wow that's a lot to deal with! i admire you you for being diligent with all the right tests.

sometimes reading people's health struggles on here it seems like it goes from one thing to another. i'm not sure why the body does other things after going gluten-free?? do you think a lot of us are still getting microglutened? or does our immune system switch to doing other weird stuff? or maybe it's all just issues that were created when we were on gluten.

Wolicki Enthusiast
Wolicki
Posted

This is just my theory: I think that our bodies are so overloaded with fighting off the gluten that the other things lurk there until your body has time to deal with it. In other words, these issues were there all along, bod was just choosing its battles.

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    • knitty kitty
      Desperately need a vitamin D supplement. I've reacted to most brands I've tried.

      By knitty kitty · Posted

      @Jane02, I hear you about the kale and collard greens.  I don't do dairy and must eat green leafies, too, to get sufficient calcium.  I must be very careful because some calcium supplements are made from ground up crustacean shells.  When I was deficient in Vitamin D, I took high doses of Vitamin D to correct the deficiency quickly.  This is safe and nontoxic.  Vitamin D level should be above 70 nmol/L.  Lifeguards and indigenous Pacific Islanders typically have levels between 80-100 nmol/L.   Levels lower than this are based on amount needed to prevent disease like rickets and osteomalacia. We need more thiamine when we're physically ill, emotionally and mentally stressed, and if we exercise like an athlete or laborer.  We need more thiamine if we eat a diet high in simple carbohydrates.  For every 500 kcal of carbohydrates, we need 500-1000 mg more of thiamine to process the carbs into energy.  If there's insufficient thiamine the carbs get stored as fat.  Again, recommended levels set for thiamine are based on minimum amounts needed to prevent disease.  This is often not adequate for optimum health, nor sufficient for people with absorption problems such as Celiac disease.  Gluten free processed foods are not enriched with vitamins like their gluten containing counterparts.  Adding a B Complex and additional thiamine improves health for Celiacs.  Thiamine is safe and nontoxic even in high doses.  Thiamine helps the mitochondria in cells to function.  Thiamine interacts with each of the other B vitamins.  They are all water soluble and easily excreted if not needed. Interesting Reading: Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet https://pubmed.ncbi.nlm.nih.gov/19154566/ Safety and effectiveness of vitamin D mega-dose: A systematic review https://pubmed.ncbi.nlm.nih.gov/34857184/ High dose dietary vitamin D allocates surplus calories to muscle and growth instead of fat via modulation of myostatin and leptin signaling https://pubmed.ncbi.nlm.nih.gov/38766160/ Safety of High-Dose Vitamin D Supplementation: Secondary Analysis of a Randomized Controlled Trial https://pubmed.ncbi.nlm.nih.gov/31746327/ Vitamins and Celiac Disease: Beyond Vitamin D https://pmc.ncbi.nlm.nih.gov/articles/PMC11857425/ Investigating the therapeutic potential of tryptophan and vitamin A in modulating immune responses in celiac disease: an experimental study https://pubmed.ncbi.nlm.nih.gov/40178602/ Investigating the Impact of Vitamin A and Amino Acids on Immune Responses in Celiac Disease Patients https://pmc.ncbi.nlm.nih.gov/articles/PMC10814138/
    • Jane02
      Desperately need a vitamin D supplement. I've reacted to most brands I've tried.

      By Jane02 · Posted

      Thank you so much @knitty kitty for this insightful information! I would have never considered fractionated coconut oil to be a potential source of GI upset. I will consider all the info you shared. Very interesting about the Thiamine deficiency.  I've tracked daily averages of my intake in a nutrition software. The only nutrient I can't consistently meet from my diet is vitamin D. Calcium is a hit and miss as I rely on vegetables, dark leafy greens as a major source, for my calcium intake. I'm able to meet it when I either eat or juice a bundle of kale or collard greens daily haha. My thiamine intake is roughly 120% of my needs, although I do recognize that I may not be absorbing all of these nutrients consistently with intermittent unintentional exposures to gluten.  My vitamin A intake is roughly 900% (~6400 mcg/d) of my needs as I eat a lot of sweet potato, although since it's plant-derived vitamin A (beta-carotene) apparently it's not likely to cause toxicity.  Thanks again! 
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    • Scott Adams
      Desperately need a vitamin D supplement. I've reacted to most brands I've tried.

      By Scott Adams · Posted

      I do not know this, but since they are labelled gluten-free, and are not really a product that could easily be contaminated when making them (there would be not flour in the air of such a facility, for example), I don't really see contamination as something to be concerned about for this type of product. 
    • trents
      Desperately need a vitamin D supplement. I've reacted to most brands I've tried.

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      Contact them.
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