["Starr"]

The family doc that is technically mine, is close to retirement and is not helpful for anything ever. Especially concussion related.

So I started seeing another doc at our clinic regarding my rash (has occurred since my concussion and I think it is related somehow, I just don't know how... that's what I expect my doc to help with!!)

Saw him today, and spoke to him about the possibility of hormone levels being out of whack since my fall and he doesn't believe that a concussion could cause any change to hormone levels. He didn't laugh when I said it, but he was certainly poo pooing the idea.

I was planning to go get some routine blood work done after my appointment and asked if he would add some tests to check hormone levels and he said no, there was no reason to test anything. That he wasn't just going to shoot around in the dark and hope to come up with something.

He did question why I did not have a cat scan or mri when I was at the ER after my accident and I told him I did not know why. The ER doc sent me home once I could remember my birthday, that was his only requirement.

And I did end up reading it off my hospital bracelet, cheating, not true remembering, because I did not want to be there. (I don't remember much of the hospital visit, I have some very foggy, vague memories of leaving, but still not really understanding why we were there in the first place.)

But he did not order any imaging... probably ok, from what I've seen, they rarely show anything.

I told him I was having a hard time recovering from the concussion. He was very focused on me being depressed. I've been depressed in the past and I would not say this is the same. Frustrated that I can't do the things I want to do when I want to do them, yes.

Tired and miserable when I don't get enough sleep, for sure. Impatient with myself and the world around me, definitely. But at the same time, I feel I am moving forward and getting stuff done.

He is going to refer me to a dermatologist re: my rash, but that will take 5-6 months, unless there's a cancellation. Until then, his idea is to just keep prescribing prednisone on and off until the appointment. (Prednisone makes me feel more energetic, but increases the headaches.)

I don't really understand what to do next. Do I try to pursue the hormone imbalance thing? Do I just sit tight and wait this out? Do I just try to keep on and pretend I was not injured?

I guess I am just venting... having a frustrated day. Hard to navigate the system... heck, it took me more than 8 weeks to figure out how to register for THIS site (finally had to get admin to do it for me, as the captchas snagged me up) ... navigating doctors feels impossible.

Will take my own advice and go to sleep now.
Starr

[camyam73]

you need to be specific. Tell him that you need a referral to a physiatrist in order to better manage your concussion. Also, tell him that there is hard and fast up to date evidence that concussions mess with hormones because it messes with the pituitary gland...

i would start calling around if no action on that front and find a GP who has had some experience with PCS, and knows what referrals to make.

[EsthersDoll]

How weird!

I get a blood panel done every year; My PCP orders it as a part of my annual physical. The blood panel I get shows all my hormone levels. I don't understand your Dr.'s reluctance to give you that - it seems simple enough to me.

I do understand his reluctance to start to "shooting in the dark", but c'mon.

What about a referral to an allergist? Rashes can be caused by allergies too.

I, took, think you need to be referred to a better PCP, one who does understand the complexity of a concussion.

Have you been referred to a neurologist? I think you need to be referred to a neurologist if you haven't already seen one. A good neuro who understands concussions should be able to help you more than this PCP you just posted about.

[Mark in Idaho]

One of the problems "Starr" has is the limitations of the Canadian Health care system. Doctors can be very reluctant to refer and prescribe. PLus there can be quite a delay in seeing a specialist.

Check out www.onf.org to see if there is any additional help or direction.

Maybe someone else in Canada can read this and give you some advice to get the blood work done. I know that hormones can create havoc with skin condition.

My best to you.

["Starr"]

Originally Posted by Mark in Idaho

One of the problems "Starr" has is the limitations of the Canadian Health care system. Doctors can be very reluctant to refer and prescribe. PLus there can be quite a delay in seeing a specialist.

Check out www.onf.org to see if there is any additional help or direction.

Maybe someone else in Canada can read this and give you some advice to get the blood work done. I know that hormones can create havoc with skin condition.

My best to you.

Mark, you have lots of good info to offer, however, your knowledge of Canada doesn't seem part of it.

Doctors here are not reluctant to refer and prescribe. Doctors are not the gatekeepers of the health care budget, they make referrals and prescribe to the best of their ability with no thought as to cost. (Its one of the downfalls of the system). It can be a long wait to see specialists though, that is true, but that is BECAUSE too many unnecessary referrals are being made.

The issue I am actually having is a group of doctors in one clinic who are obviously not well educated about concussions and pcs and the various possible complications.

What I am trying to do is gather information from CREDIBLE sources to try to educate my doctor and get what I need. Obviously I am not explaining my circumstances well enough to him on my own.

Starr

[greenfrog]

Starr, is there another clinic with concussion expertise that you can get a referral to? My doc is one of the top specialists in Toronto, and he offered to refer me to the Sunnybrook TBI clinic if depression became an issue (Sunnybrook has a team approach to dealing with mild-to-moderate brain injuries - among other docs, they have a neuropsychiatrist on staff). I didn't end up needing the referral, but the clinic has a very good reputation (I know of one person with a TBI who spoke very highly of them) - perhaps there is a similar clinic in Ottawa?

["Starr"]

Originally Posted by greenfrog

Starr, is there another clinic with concussion expertise that you can get a referral to? My doc is one of the top specialists in Toronto, and he offered to refer me to the Sunnybrook TBI clinic if depression became an issue (Sunnybrook has a team approach to dealing with mild-to-moderate brain injuries - among other docs, they have a neuropsychiatrist on staff). I didn't end up needing the referral, but the clinic has a very good reputation (I know of one person with a TBI who spoke very highly of them) - perhaps there is a similar clinic in Ottawa?

Greenfrog, thanks for your suggestion. The Ottawa Hospital does have an Acquired Brain Injury Program and when I mentioned it to my doc, he seemed to think I would not qualify, for the outpatient program, because in his words "You are not injured enough. It is intended for patients that had prolonged hospital stays and serious accidents. There is nothing wrong with you that time won't fix."

They do accept some self referrals, so I will try contacting them next week and see if I qualify for that. It would be good to at least be assessed by them and see if THEY seem to think they would have anything to offer me.

Starr

[EsthersDoll]

I wish your doctor realized that even though time might fix all your impairments, getting some therapy would fix them faster and that would reduce any depression or anxiety that they are causing you and allow you to return to being a productive citizen again.

Please keep us posted.

What kinds of articles from reputable sources do you need? Are you having trouble conducting research online and finding articles that your Dr. would take into consideration?

[greenfrog]

Originally Posted by Mark in Idaho

One of the problems "Starr" has is the limitations of the Canadian Health care system. Doctors can be very reluctant to refer and prescribe. PLus there can be quite a delay in seeing a specialist.

Check out www.onf.org to see if there is any additional help or direction.

Maybe someone else in Canada can read this and give you some advice to get the blood work done. I know that hormones can create havoc with skin condition.

My best to you.

The issue of willingness to prescribe seems like a complex one to me, as it's not always obvious whether meds are warranted (and if they are, which one(s) should be tried and at which dosage).

Sometimes the hardest thing for doctors to do is *not* prescribe. This is what my doctor did - no SSRIs, no tricyclics, no prednisone, no sleep meds, etc. Just time and rest. I can't say whether this was a good choice or not, as I have no baseline for comparison, but as I gradually improve I'm glad that I don't have to deal with the side effects and/or unintended consequences of meds, withdrawal symptoms as I try to wean myself off, etc.