Sunday, November 3, 2013

The day I lost all trust in my PCP

There is a possibility I could have seen this coming, and maybe you will be thinking the same thing in the coming posts (the metfor.min debate!) but the day came... the day I lost all trust in my primary care physician.

A few weeks ago I went in to have my thyroid tested. I've had some trouble keeping it in range ever since the boys were born, or really, since they were conceived. I've gone in somewhere between monthly and once every three months to have it tested and to have my medication changed either slightly up or down dependent on my TSH level. No biggy.  Well, no biggy until this last appointment.

I went in, had my blood drawn, and chatted with her a bit about how I was feeling. I expressed to her that I was somewhat tired, but I wasn't sure if that had to do with swinging hypo, or if it was because I had two teething babies at home. We talked a bit more and she sent me on my way saying they'd call once my results had been read and at that time they would refill my prescription with any changes. A few days passed and the medical assistant called me. She let me know my results had come back a little high (4.54) and that they would like to change my dose. I said ok, with the understanding that I was obviously being UNDERTREATED and then she said 'we'll be LOWERING your dose to 75mcg (from 100mcg)'. I quickly said that didn't seem right and she responded with, 'that is how the thyroid works, it can be confusing.' I expressed my concern again and asked that she have my PCP look over it again and then call me back. I was sure she'd call back quickly with an apology and a different dose that was higher than my previous instead of TWO steps lower.

She did call back. It was about an hour later, and when she called she let me know that my PCP was adamant this was her plan of care and would like me to be on 75mcg instead of the 100mcg I was currently taking. At this point I made sure I'd heard correctly during the first conversation that my level was 4.54 and went to work on the computer to make sure I wasn't the one who was all wet. It was clear within seconds that I was correct.

I texted hubs asking what the heck I was supposed to do, even though I knew I needed to call the practice and ask for another doctor to read my chart, or promptly change practices all together and be rechecked. So, because I knew it would take some time to get in with a new doctor, I called the practice and spoke with the receptionist. I made it clear there was a problem, explained my issue and she told me 'its uncomfortable to have other doctors checking over another's charts.' While I can appreciate this, I told her I didn't much care how uncomfortable it made my doctor, because I was FAR more uncomfortable with the fact that I was being prescribed the exact opposite of what I should have been. A short time later the other PA in the practice called and assured me that I was most surely correct, and without totally throwing her peer under the bus she told me that she was really unsure how this mistake could have been made.... twice. She then sent in the proper dose to the pharmacy and we hung up.

We haven't really loved our primary care physician or the clinic, ever, but we ended up with them a few years ago when we needed one to refer us to the fertility clinic. I was able to get in with them quickest, so that who we chose. Until now, we've never had a real problem, but now, now it is time to take a little initiative and change providers. I hate this part. I really, really hate finding a new doctor!


Michele said...

Have you been referred to an endocrinologist for your thyroid? After I went up and down and back and forth, I called the local endocrinologist, and I didn't need a referral to see him. It turned out that my thyroid med was binding to milk protein at breakfast (I have a protein shake almost everyday) as well as my prenatal. He advised me to take my med last thing at night, right before bed to avoid reactions. This solved my fluctuating TSH.

I'm glad that you are worried enough to change docs because I don't thing that your pcp should be handling it anymore and should have referred you out already.

E and R said...

Finding a new dr is the worst...we went through 3 pediatrician so here until we finally found one we like, I have to drive 30 min to get to them but it is so worth it! Good luck on the dr hunt.

Jules said...

Ugh, what a hot mess. If I were you I'd take it to Facebook. Ask your local friends for recommendations for new doctors. You gotta find someone you love -- it really makes a difference!

Stephanie said...

One good thing to come of dealing with IF is becoming more of an advocate for yourself. It would be interesting to call your doctor out on the error and see what she says. Glad you caught it and can hopefully find a better fit for a PCP for you and your family soon.