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Posted 6/25/2010 7:32 PM (GMT 0)
I missed my appointment with the hepatologist last Tues as I was in hospital with a flare up of my pancreatitis. My hepatologist has said he doesn't need to see me before September and any questions I have should be asked of my GP. However, my GP is new as I have just moved and she doesn't know my history. She thought I had alcoholic hepatitis which is about the only thing that has been ruled out as I don't drink. nono I am getting very frustrated as I don't know what to expect or how good or bad things are. My GP said I should take comfort in the fact that the hepatologist doesn't feel that he needs to see me before September.

When I was in hospital my lft's had come down abit from 600's to 500's but don't really know what this means for me because before they were in the 400's but then went back up to 1000's. I have beeen told that the pancreatitis flare ups could be responsible for the elevated lft's. I have not been jaundiced although my urine is very dark, my periods have stopped and I feel very sick and itchy. shakehead

Can anyone help relieve my anxiety. I am from the UK and our medical system is different from yours if we need to see a specialist our GP's have to refer us. smilewinkgrin

Thanks

 

Posted 6/25/2010 7:40 PM (GMT 0)

Gymbug, I'm sorry that your pancreatitis landed you in the hospital.  I tend to agree with your GP, that it's affecting your liver enzyme levels.  I also think it's a good sign that the hepatologist doesn't feel the need to see you until Sept.  However, I know that you are frustrated and just want to find out for sure what is going on.  You might want to find out if the hep doc can get you in sooner.  Other than that, concentrate on diet and rest.

Hugs,

Connie

Posted 6/25/2010 11:23 PM (GMT 0)
I can't speak for everywhere in the US, but here in Massachusetts, in order to see a specialist, you must be referred by your PCP. Once you're set up with them, you deal with them for some things and your PCP for others. It sounds as if you need to find a new PCP and get them to get you into a hepetologist sooner than September. Is there anyway to get in touch with your old PCP and get a recommendation from where they are now. Good luck.
Posted 6/25/2010 11:54 PM (GMT 0)
David, I thought that depended on insurance.  However, Mayo does not require a PCP referral.  A patient can self-refer, as I did.

Posted 6/26/2010 12:34 AM (GMT 0)
If you're on HMO you still need PCP referral...PPO doesn't.  I would agree that either finding another PCP would be good or if you're comfortable with your PCP, maybe ask if they can refer you to a different hepatologist.  It would be like getting a 2nd opinion.  In the States, you have every right to have a 2nd opinion but I don't know about the UK.  Who's taking care of your pancreatitis flare ups?  Do you have a GI doc for that?  If not, maybe you can get a referral for a GI and maybe that GI might have some hepatology experience.

I checked online and acute pancreatitis can cause all those symptoms so that might be the problem.  Have they been able to get it under control?  Are you taking and medications (prescribed or OTC)?

Posted 6/26/2010 1:10 AM (GMT 0)
Hi Everyone, According to what I remember UK with the social medicine you do have to be referred from your PCP/GP to all specialties and sometimes the wait to see someone can depend on the availability more than anything. Alot of Drs here in the US leave small openings to squeeze in a patient if they need to be seen sooner. My mom always said that was an issue back home that was not like the US. My sister was born in the house because the Dr was booked up and she wasnt sure if she really needed to go to the hospital. So our family Dr actually stopped over to check on her and ended out doing a delivery while I played in the garden! I thought Dr Blackburn was pretty cool to bring his black bag over and all of a sudden there was a baby......took along time to figure out how the baby came out of that bag...... thought maybe he was a magician! LOL
Sue
Posted 6/26/2010 2:38 AM (GMT 0)
My insurance is a PPO. I tried years ago to see a orthopedic doctor for a shoulder problem and was told I needed to have my PCP refer me. When my liver began to fail (combination Hep C/cerebral hemorrhage), a hepetologist was assigned to me in the hospital. But then, I was assigned a neurologist at the same time.
Posted 6/26/2010 4:09 AM (GMT 0)
PPO, CMM, HMO - It really does not matter the type of plan you have or the state you live in. What does matter is the plan design. This is what will determine if you need a referral to a specialist. This model is very outdated and ineffective. Progressive smart plans don't use a "gatekeeper" anymore - why? It actually costs more. Going to the GP to get a referral adds a few hundred dollars to the entire cost. So, what to do? I would say this... if you don't like your GP or s/he is not taking the time to understand your condition(s), dump the doc and get a new one. A smart GP who does their homework is worth their weight in gold. One who does not, is a menace to your health. Call your health plan carrier and find out if referrals are required. If they are, make sure you find a GP who realizes they are not specialists and is willing to provide you with ample referrals given your complex medical conditions. Hope this is helpful!
Posted 6/30/2010 10:01 AM (GMT 0)
thank you all for your advice, I am in the mddle of trying to find a new GP as I have moved area and my old GP cannot continue with my care. I see a pancreatic surgeon for my pancreatitis, I am due to see him in September as well. Half the prblem is that for my last two liver check ups with the hepatologist I have been in hospital and he doesn't come and see me when I'm in hospital even though he works in the same hospital he just sends me another routine appointment for 3 months time. I know that everytime I'm in hospital they check my lft's etc so he knows whats going on but it still means I can't ask any questions of him. Have just spent another 2 days in hospital where I asked the A+E Dr how bad the liver damage was and he said my bloods are 6x's what they should be but they aren't as bad as they were a year ago so I guess that's good.

Thank you again.
Posted 7/3/2010 11:18 AM (GMT 0)
Hi gymbug

I am from the uk too. Have you actually seen a hep yet? what have they tested you for and have you had a liver biopsy or a scan?

 They don't seem to be doing very much considering how poorly you are. You have got to ring the consultants secretary and see if you can get in sooner. It is your body and you are worried at whats going on and you have a right to answers. £ months is far to long and the hep should see you sooner with LFTs in the thousands.

Best of luck

 

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