new pdoc
 

You mean he pretended to know but you could tell he didn't? Hmmm. Verapamil is unusual as a mood stabilizer, sure enough - it is understandable someone might not know of it. It is a good sign that he seemed to accept it. I would have preferred his showing thoughtful interest over feigning knowledge but many people in many walks of life - not just doctors - might have behaved the same way, in comparable situations.

My reply is an acronym, so I get away with it! ;)
O! M! G!
No doubt! :eek::Noooo:
That sounds pretty scrupulous - a decent first interview.
I hope the Lamictal is helpful. Are you allowed to get brand name Lamictal, or do you have to get generic lamotrigine?

T6? Are you sure it doesn't say T4?

I am glad he is checking your B12 and your folic acid. I would advise you to suspend any supplements, until you do the labs.

Awesome! :):):) Did he also write scripts for your other meds or did you tell him you were ok for a month?

----------------------------------------

This sounds hopeful.

How do you feel about this pdoc and the whole situation?

Did he say if the med students would be there every time? I am concerned for you there, mostly because it I personally would be uncomfortable if they were always present.

waves

about the thyroid tests - T6
 

I haven't found much to go on thus far but, from what I can glean, T6 would be an uncommon thyroid hormone variant. It might be measured to assess hypothyroidism. I am still confused as to why he wouldn't check T4 too - in fact, FT4 (Free T4) is usually preferred as it measures only "usable" T4. Typically, thyroid function testing measures TSH and FT4; FT3 is sometimes included also. More extensive thyroid or endo panels would include all of these, plus other things.

Not saying he did something wrong - just am very, very curious indeed as to what he is looking for, assuming your test does indeed say T6.

waves

Waves,


Thank you. You are helpful.

I will look at the script for the lab and get back to you on the thyroid test.

Mari

Mari

If you have to get a generic, please try to make sure its always the
same one. They don't work the same. And even at the small
dosage of 25mg, it would make a difference.

Derrick took lamictal many years ago, so I hope its helpful for you.

Donna :hug::grouphug::grouphug:

I had a med student sit in on one of my pdocs visits.....not a new one though I have been with her for years.my pdoc got all authoritative on me...I had been drinking a lot and she made me feel bad. anyway. I think you probably could have refused their presence...not sure about that.

Yes, you can refuse to have them present.

They are supposed to request that they be allowed to sit in.

I have had many request that they be allowed to either sit in on Derrick's
case when we were with Riley, or as when I was doing my Cancer treatment
I was asked that two students be allowed to observe the treatment for the
radiation.

I allowed it because how else are they going to learn to use the equipment.

I have had them sit in on my doctor's appts. also. But they have always
been nice.

Donna :hug::grouphug:

Residents in the room
 

Hi, Waves, Donna, Bizi,

They were probably residents and he named the hospital program but the name went past me.
We have a shortage of spots for medical residents in the U.S. and I was pretending that they were two of the lucky ones to be there to listen to me. :D
Maybe they learned something.
I found myself talking to them a little --pointing out things that I might not have needed to emphasize to him.

It was more like when I first said "Verapamil," he had a very brief blank look as if he had never heard of it and then in less than a second his face changed and showed that he remembered that he had heard of it.
He recovered quickly and he seemed to accept Verapamil. I can tell because he was not asking dumb questions like the GP's and other specialists do. He accepted it.

Regarding the two residents:
Twenty plus years ago, my then pdoc asked if the medical school could pay me $100.00 to be the patient while he was giving a test to a student who was completing her program.
The student asked me normal pdoc questions for 40 mins and I made sure that I told her things that she seemed to forget to ask.
After I left, she was supposed to talk to him: dx me, come up with a possible treatment plan . . .. things like that.
I left there after my 40 mins crying hard and the pdoc apologized that it had been difficult and thanked me.
The pdoc saw me in a different light and from that point on the two of us made headway in establishing good meds.

====
Today, the pdoc asked questions from my childhood and about who else in my family has gotten help for psychiatric issues.
Near the end of the session, after we had covered work and family, he asked how I am doing with my husband.
I said, "We have been together long enough that we are used to each other and stay in our own space" --- or something pretty close to that. :cool:

Upon double checking, the handwriting still looks like T3 andn T6 but I suppose that the people doing the paperwork for the blood draw at the lab could / will read it as T4.

I probably have to take the generic.
I do remember reading things about the generic Lamictal being lousy for some people. I hope it works for me.
He instructed me not to put any new creams on my skin.-- apparently so that we would know if the Lamictal is the cause of anything going on.

I dropped off the scripts (Tuesday) and was told that they do not have Gabapentin in 200 mgs capsules and that they would try to call the pdoc the next day. DUH. I do not care. I will pick up the other meds Wed whether the Gabapentin is ready or not.

Bizi, I am sorry that you had to deal with that. You needed her to be extra sensitive during that session and instead she put on a show for the visitor.

I do not care that much.
I can charm all three of them if I have to by G_d.

(Yes, I am cracking stupid jokes at 4:30 am).


Scripts:
He asked if I needed new scripts. I said yes.
He wrote brand new scripts for me. We sill see if the insurance covers them.
M

pdoc visit - sounds good!
 

Hi Mari!

It sounds as though it was a really positive experience for you - or at least a satisfactory one.

I am very happy about this. :):):)

I am glad that the residents were not a problem for you - that makes things easier. I do kind of hope you get to meet with him one-on-one at least sometimes though, because his behavior and, consequently, the feel you get from him would not be conditioned by these other interactions. I think it makes a difference in establishing a rapport too. But mostly, I am glad it is "ok" with you, one way or another.

Telling you not to apply new creams to your skin was very thorough. I am pleased about that, too. :)

--------------------

I hope the generic lamotrigine is ok for you. I agree with Donna that it is important to ask who the manufacturer is, then, insist your refills be ordered from that specific manufacturer. This is relevant to drug strength and can also make a difference in terms of s/e's. (Should you have minor/quirky issues, you could then try changing manufacturer.)

I took brand for a while, and was fine. I ditched the drug when I was forced to switch to generic because I got odd side effects. Since it wasn't clear whether it had been doing anything for me anyway, I ditched the drug completely. I hope whatever generic you land first is ok.

waves

Thyroid testing
 

I have looked again and I can't find much AT ALL regarding T6 in humans (lots about dogs). I cannot even find the site where I'd read it was an unusual variant implicated in hypothyroidism. I did find a post by someone who said theirs was slightly high - with no replies. That person could well have been confused.

Change of strategy: I went to the website of a private lab and searched their thyroid tests. They did not offer a "T6" test. :rolleyes::D

At this point, I must agree that the lab will almost certainly read it as T4. :cool::o

-----------
I am still perplexed as to the fact he didn't ask for FT4 (Free T4), even though T4 is most likely adequate. Some physicians would not even test anything other than TSH. As far as I know, T4 used to be used before FT4 detection was possible.

FT4 tells you the amount your body has available for use: if that is outside reference range, you have a problem. T4 gives the total amount in your bloodstream, and if it is normal, you are usually ok. Occasionally, T4 will be normal (or high) but FT4 will be inadequate. Systemic candida infection is an example where T4 can become excessively bound: even though your thyroid is producing enough hormone, your body cannot use it.

waves

I have used the generic and different manufacturers for some time, switch back and forth and have never had a problem with side effects. I wish you well and good luck from your insurance companies to cover them.
bizi