Who is in charge

I’ve been comtemplating that question for some time, not who is in total charge, but because of my heart stopping I see 6 different specialists.

I tried to get my GP to take charge of the drugs, but he shrugged it off.  He said he couldn’t be responsible for what the cardio doc gave me or what my thyroid doc gave me. And I certainly can NOT go off any drug. So who knows if any of them even look to see whats going on. Pulimonary doc put me on oxygen, but I haven’t used it.  I breathe just fine as my heart is pumping again.

GP said I should use it because the Pulmonary doc said I should. Just wondered if anyone had this going on? Any suggestions?

Jean

P.S.   I know it is said we are in charge and we can stop taking anything, but now that I’m here again I don’t want to mess up whatever the plan is.

7 Comments

hi:)

by Pookie - 2012-10-12 06:10:12

Right to the point....

1) you didn't say why your pulmonary doc put you on oxygen

2) you didn't say why you don't want to take it

3) unfortunately it boils down (in most cases) to the patient being in charge - you have to be the leader and one way in which you can get that done (and it can feel like a full-time job) is to get copies of ALL your medical records...that way you can make sure that all of your doctors have copies of everything.

4) as far as drugs go - always go to just one pharmacy to get all your meds - that way the pharmacist gets to know you & what meds you are on. What Tracey mentioned above is so true - they know a lot more about a particular med than most doctors.

Now, if you can find a GP who is willing to do #3, then it will be a lot easier on you, but don't you want to know what is in your medical file? I certainly did. It was an eye-opener for sure AND once all my doctors knew what I was doing they really pulled up their socks because they knew just how much I was interested in my health and health care and there was NO way they could ever "pull one over" on me.

Take care,
Pookie

Our Veterinarian told us...

by donr - 2012-10-12 08:10:13

...you've got to be your own gatekeeper!

Especially when you get answers from medics that just plain don't sound correct.

Back to something Ian wrote about some brilliant GP's & some dumb hospital consultants. Our #2 Son & I got what I believed was an exposure to rabies - a not very nice disease. I went to our vet first & outlined what had happened & she confirmed that we had, indeed, been exposed. She loaned me her copy of the US CDC Rabies exposure/treatment protocols. I had to go to three different places to find an MD who understood all the ramifications of the disease - including the chief of infectious diseases at a major hospital (who said he "...didn't THINK we'd been exposed.") You don't deal w/ "Think" when you deal w/ rabies. I finally found an ER MD at a local hosp who fully understood all the issues involved & insisted that I come see her immediately for treatment.

As far as meds are concerned, I have yet to find an MD we go to who has objected to discussing the reasons for prescribing drugs or listening when asked about interactions among them. When I pick up a Px for either Wife or me, I always ask for the "Roll of toilet paper" that comes with it & the pharmacist dutifully hands over the bedsheet sized page w/ all the safety & prescribing data on it. If there are potential problems, like a side effect that lengthens QT time in TWO drugs to be taken simultaneously (Happened to me) it has NOT been a problem getting one changed.

I would not leave that to my PCP - I do it for myself, in conjunction w/ advice from our pharmacist. Which brings up another point - always buy your drugs from the same pharmacy & get to know all the people who work there.

Don

GP

by Tracey_E - 2012-10-12 10:10:28

If your gp isn't willing to at least keep an eye on what the other specialists are putting you on, I'd get a new gp. While it's important to be informed and to look out for ourselves, most of us have not been to med school. A good pharmacist can be a wonderful resource, too. They can look at everything you're on and tell you if there are interaction risks.

Having been born with a rare heart condition, I learned young that I need to know what's going on and be able to explain my condition. A gp has an ok idea what it is, for specialists in other fields it was just an afternoon lecture in med school and they're clueless. I've stopped more than one specialist from giving me meds I shouldn't have. When in doubt, I ask the pharmacist. But really, I depend on my gp to be the one in charge.

You are...

by jenny97 - 2012-10-12 10:10:49

but be careful stopping medications without talking to your dr. Going off some medications cold turkey or without working with a doctor can be dangerous or even life-threatening.

It sounds like you need a new gp who will communicate with all your specialists and look at the whole picture.

I'm similar in that I have about 10 different specialists for various manifestations of an autoimmune disease I suffer from and no one ever seems to look at me as a whole person. They don't seem to realize that what we do with one system actually does affect the other systems. For about 10 years I had a fantastic internal medicine dr who kept herself up to speed on the whole picture. I had records from all my drs sent to her and she kept and reviewed everything. When new or weird symptoms appeared, she was able to point me in the right direction of which specialist I needed to see (when warranted), what medication could be contributing to the problem, or help me out herself. She periodically got on the phone with the drs directly, when the case became particularly confusing and complicated. I'm currently looking for her replacement since she moved away.

Anyway, I think it really boils down to you finding the right drs who are willing to communicate with one another, keeping complete records that you can take to your dr appointments, and making sure that at least one dr has access to all the records.

It's hard work and frustrating, but hopefully you'll be lucky like I was and find one dr who's willing to take the lead.

Jenny

PS My internal medicine dr never changed another dr's prescriptions for me or stopped medicine. But if there was an issue, she would discuss it with them to get a better understanding of the situation (and provide more information on my medical history) and then would help me make an educated decision. Ultimately, I was the one who had to tell the other dr if I didn't want to take a particular med.

Very good question Jean

by IAN MC - 2012-10-12 10:10:52

I've often wondered that myself when different specialists are looking after different bits of your body. As a rough guide I would tend to always believe a hospital consultant ahead of the GP but there are some less well-informed consultants around and some brilliant GPs so it is difficult.

You said it all in your last paragraph , the person who really should be in charge is YOU especially when lots of different Drs are throwing drugs at you . With all the info on the web on drug interactions, for example , you can easily acquire more knowledge than the Drs have.

It would be a good question to ask them .. '" Who is actually in charge of my health ? " It would be interesting to know how they would answer it !

Best wishes

Ian

thank you

by jeanlancour - 2012-10-13 12:10:14

All of your comments make sense, thank you. I get my meds from mail order as that way my insurance pays for them, but I do check on the net to make sure I know what their funtion is. Pookie I just don't want to drag an oxygen tank (however small) when I walk the dog. The dog and I like to walk off road, and I don't get out of breath or feel any stress. I live in northern Mn. I live in a very small town and we have 1 Dr, and a P A for this town and 5 towns down the line. So Ian what I need to do is go to the place where the cardio and other specialist are to get a GP, but it is a far peice when you just need something for a sore throat it's a 2 hr. drive...whine whine, Anyway thank you food for thought. Jean

advantage of big city

by JustKrs - 2012-10-22 08:10:59

I have the advantage of living in Chicago... so i have all 7 of my specialists and my GP all in the actual hospital. That means all the records and all the tests are in one database that they all have access to.
Each of my specialists prescribes things themselves, BUT i have one spreadsheet that i keep up to date and bring a copy to hand to the doc at EVERY appointment or ER visit i go to.
It has Meds (name, condition for, dosage, frequency, date started), and Procedures (name & date), Conditions (just a list), and Docs (name, speciality, phone & fax)

and at every appt i make each doc go over the whole sheet with me. So that each of my specialists knows each condition I have an each medication I'm on - so they can weigh in on their concerns.

For example, my cardiologist had us adjust the date of my annual brain MRI to be further in time because we had to do a pacemaker lead revision and he doesnt want to take risks.
Or for example my GP understands my syncope and pacemaker situation so we discussed why the first two "options" of migraine preventative drugs wouldn't work for me because of my cardiac history.


I've fired docs because they won't listen and won't go over the spreadsheet with me and talk through my concerns with me! You are in control so don't forget that you are also doing the hiring and firing here!


Also, if you dont TOTALLY TRUST your mail pharmacy to be checking for things...
A) make sure any prescription changes are only done with a doc that has seen your spreadsheet and knows what you are on and why

B) use an online resource to check the potential interactions yourself: such as http://www.drugs.com/drug_interactions.html

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