Haven't been to the doctor in way too long... can I go straight to a specialist?

[jil9270]

I haven't been to a doctor in about 20 years, not smart I know. I'm having some symptoms of not end, but later stage ckd and heart failure, I'm wondering if I should skip the appointment with a general practicioner and go straight to a nephrologist? Thank you for any suggestions.

[jodaer]

The 1st thing to consider is do you need a referral, per insurance, before you see a specialist. 2nd thing to consider is will the specialist take you without a referral from a GP. 3rd is why a neph and not cardio? My recommendation would be go to either urgent care, if having chest pains or the GP. Explain your symptoms and concerns. He can order tests based on what you tell him and then go to narrowing it down. You didn't say what your symptoms are or how old you are.

[jil9270 in reply to jodaer]

Thank you for the reply, I'm 51, normal weight. CKD symptoms are loss of appetite and back pain when I ate way too much a few times over the last couple years. A couple times a couple years ago Ive had leg weakness but that seemed to go away after starting consisent cardio. Belly edema as well though that seems to have gone away reducing water from 100oz a day to 70oz. Shortness of breath a couple times after eating not long after intense cardio.

[jil9270 in reply to jil9270]

Oh and it seemed like the kidney symptoms were stronger but I could be wrong. There are no chest pains thankfully (and thank you for the reply).

[Sophiebun11 in reply to jil9270]

I don't think of kidney trouble when I read any of your symptoms.

Please don't diagnose yourself unless you are a trained medical professional, which I doubt.

Find a good Internist and start there.

Good luck

[jodaer in reply to jil9270]

I would just go to the doctor, gp, and tell him your symptoms. AND stay away from doctor google. He's a dangerous guy. In the meantime, instead of cutting back on water, cut back on the sodium. Good luck

[jil9270 in reply to jodaer]

I think i will do that. And I've already drastically changed my diet the last week or so and feel even better, very little of the bad things like sodium. Thanks again for the feedback.

[jodaer]

Let us know how it goes.

[Tolmezzo]

Sorry have you had blood work at least? Symptoms can be very much generic before assuming it's CKD..

[Darlenia in reply to Tolmezzo]

Agree! There are a lot of assumptions here. The symptoms point to most anything - gastro issues, immune disorders, etc. Could be anything. One needs a full blood panel and a physical - something tangible to point one in the right direction. Thankfully, a blood panel is on the way. (One can generally order those up by oneself, too, if one goes directly to LabCorp, LabQuest, etc. But interpretation can then be an issue if it's just you looking at it.) Anyway, my greatest worry would be about seeing the wrong sort of specialist who might run all sorts of expensive tests only to tell me to see someone else.

[jil9270]

I have been lax in my annual physicals but have one next week. I am self employed and have HMO but will try to switch to PPO. As for heart failure, what i've seen is its a series of decline that doesnt necessarily happen all at once though I could be wrong. Thank you for the advice.

[Sophiebun11 in reply to jil9270]

That isn't what heart failure means. It's diagnosed by an echocardiogram.

[jil9270]

No, I have that in a week or so. I should probably wait before posting much until I get the blood work done. I appreciate your reply.

[Beachgirl32]

I hope you get check out soon. 20 years is a long time. I know a lot of nephrologist are internist too. I’m not sure if you need a referral for internist it. But any heart problems should be check ASAP. I don’t even know I had a heart problem whenN my ejection factor was low . I found that out from my transplant evaluation . But with medicince I was able to bring it up , I did have some shortness of breath with it. They said the cause was a virus that went in the heart I never knew such thing could happen. Yes they sent me to a cardiologist that is back to normal now. So please make your appointment soon and best of luck to you,

[Beachgirl32]

Ejection factor was 25 I was sent to a cardiologist he prescribe Carvedilol and Bidil. The Bidil was super expensive my husband call the manufacture we get it from them. I’m still on both . The bidil had decrease from three to two pills the carvedilol twice a day . My ejection faction is back up to 66 . I had to bring it up before they let me be listed for a transplant thank goodness it came up.

[Beachgirl32]

12.5 twice a day . I walk a lot and swimI am 66

[renegade70]

i would say have a complete physical with a specialist in internal medicine and go from there.

[Avenger]

sounds like you need a cardiologist also. I don’t know where you live. I’m in southern 🤤NJ.

Dr. Allen Kramer of penn medicine is a great Dr.🤗