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Infectious Disease doctor visit

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Posted 1/25/2007 10:03 PM (GMT 0)
I have been in training for my job all week, so I haven't had access to a computer. In any case, last week I just about had it with this low grade fever thing. Went back to my primary (dumb move), once again registered normal with their temporal thermometer, and was pretty much blown off again because of that. So I decided to take my rheumy's suggestion and follow-up with an ID doc. Called one local to me, and got the ball rolling. Got calls from my primary, once again within 24 hours, asking me if I was sure I really wanted to go to an ID doc. I'm like ***! Why do you care if I go see an ID doc? Also got calls from the ID doc's office because the records that were faxed over from my primary's office did not contain any info. regarding a fever. They didn't even bother to write down the reason for my two visits in the past 3 months. Neither did they bother to note that they treated me for a sinus infection (with a sucky antibiotic, by the way--Omnicef). So the ID doc wanted my rheumy's number. I told them that my rheumy doesn't really treat fevers--he's not a primary, but then I realized that he also treated me for the same sinus infection with ceftin (which worked much better than Omnicef). I got the the appointment with the ID doc, I was told the report very early in the morning (7:30am is early for a doctor anyway), go up the back stairs, and pay my co-pay in cash only?!?! It sounds like I'm getting an illegal abortion or something :) In any case, I don't have high hopes that this visit will be productive--my primary clearly didn't support me seeing an ID doc. My rheumy did, though, so perhaps his opinion will carry more weight.

Eve--I can appreciate your low grade fever situation. I think it can go on and on forever if it's not looked into. Any my rheumy reminded me that most primarys are too busy to take something like a low grade fever seriously. He was right so far, unfortunately.

One more thing--I am DONE with my primary care practice. Must find another one, hopefully one that is a bit more conscientious and less money hungry. End of vent.

El
Posted 1/26/2007 12:10 AM (GMT 0)

elcamino -

Many doctors blow off having a low grade fever of unknown origin. However, if you have this on a chronic basis it means something is going on somewhere in your body. I have heard that infectious disease doctors can be somewhat arrogant, so be prepared. I hope you get a good one. Please forgive me if I sound like a broken record - but it would be a good idea to have a careful dental evaluation if you don't find another cause. My dentist let me walk around with an absess for YEARS.  The University of Maryland School of Dentistry discovered the abcess, and then my dentist ADMITTED that he didn't tell me. After I had the wisdom tooth pulled this past December, the fever went away, and I feel much better all around.

If you don't get satisfaction with this doctor let me know. There is a woman in the Silver Spring area who has a reputation for being formidable in helping patients track down and deal with tough problems. I think she could also take over as your primary. She will send you to Johns Hopkins if she can't find the problem. I can send you her contact information. You know where to find me.

Hang tough. Be strong. Don't let anyone intimidate you. Sometimes it takes a while to get to the bottom of "hidden" health issues.


Posted 1/26/2007 4:15 AM (GMT 0)
hey el glad to hear things are rollin and yes get a new pcp for certain. miss u hope the training is going good and keep us posted as u can..... good luck yalinda
Posted 1/26/2007 6:53 PM (GMT 0)
Thanks guys. I saw the ID doc this morning and I thought she was wonderful. She didn't strike me as arrogant, although she did seem to know a lot. She was a bit pissed because she requested specific information from my primary and my primary didn't bother to send it. Why? Because she didn't want to go through my chart and pull out the relevant information. After talking to her, though, she made connections to other things that have happened to me this past year (i.e., the whole lung issue) and she feels that is very relevant and was wondering why my primary didn't bother to tell her about that, but my rheumy did.

Eve, I realize that a low grade fever is dismissable, but when you're taking a biologic like enbrel, I don't think you should ignore it. This ID doctor, when she found out be the lung issue, was immediately put on alert to a latent tb infection that had been reactivated by the enbrel (which has happened to others and has been documented by the FDA). I had a negative tb test, but in addition to strange findings on my chest x-ray, I had apical scarring and pleural thickening show up on the ct scan, a pattern that is typical of an old tb infection. In fact, pulmonologist asked me twice if I had ever had tb or been exposed to tb. Interestingly enough, my mother (according to my father) had 'strange' things show up in her chest x-ray too. Doctors repetitively asked her if she had ever had tb. She hadn't either. But it makes me wonder if we were both exposed to something unknowingly. I did live in Spain as a kid for a while.

My rheumy, when he suggested I go to an ID doc, actually recommended a doctor in Silver Spring--I wonder if it is the same one? Yes, please email me the info. I am definitely looking for a new primary who is board certified in internal medicine and the listings in Frederick are rather scarce.

Elcamino
Posted 1/26/2007 8:00 PM (GMT 0)
Hi Elcamino,

I'm glad the ID visit went well. I've been lurking and reading what you've been going through with your primary and I'm so glad you're ditching her/them. The office is probably so money hungry because they can't hold onto patients! Did the ID doc have speculations about the fever?
Posted 1/26/2007 10:19 PM (GMT 0)
Hey Rocky,

She mentioned obvious things, like tb, lymphoma, fungal infections, etc..., but she didn't get real specific. I think she mentioned the tb only because I had lung issues earlier this year.

Elcamino
Posted 1/26/2007 11:03 PM (GMT 0)
elcamino -

Sorry if I miscommunicated. I totally AGREE with you that it is critical to find out why you have the low grade fever. My point was that some doctors do dismiss it, but I don't think we should accept that. You are right that anything abnormal should be investigated, especially because you are taking enbrel. I wish I had been more aggressive in finding out why I had the fever. It only took me about five years to find out it was from the abcess. I am glad that you found an ID doctor that you like. Maybe they are only arrogant when it comes to lyme patients (the stories I have heard all deal with their dismissing lyme symptoms). I will see if I can locate the information on the internal medicine doctor in Silver Spring.

I hope that you get to the bottom of the problem soon.

Eve
Posted 1/27/2007 11:02 AM (GMT 0)
hi el glad u went and got the ball rolling with the id doctor. keep us posted on how everythng goes. lets pray it is not lymphoma.... fungal not pretty sounding but better choice. hopefully it is nothing but then again i know how frustrating it is to have something and no one knows why. good luck! yalinda
Posted 1/27/2007 11:56 AM (GMT 0)
Interestingly enough, Eve, ID doc specifically asked me about dental work in the past year.

Yalinda, I hope it's nothing as well. But then again, after launching this new, aggressive investigation I hope they find something so I don't look like a complete hypochondriac :)

Elcamino
Posted 1/27/2007 9:38 PM (GMT 0)
Hey el.. hang in there.. we know you're not a hypochondriac, and soon, they will too.. {{{{{hugs}}}}}
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