hello,
I am writing to see whether or not it is time to switch doctors. I have type 2 diabetes. I asked my nephrologist about some of the new diabetes medication that is helpful in stopping the progression of ckd and the answer I received is I don’t handle diabetes meds. I called the office when I got Covid and was told that he doesn’t get involved with that. Call the primary doctor. Is this typical of a kidney doctor? Thanks
Only you can answer that, but my experience is that no, a specialist won't get involved with Covid or other conditions out of their specialty. Now having said that with diabetes it's a bit different, maybe. I've had 2 nephs and both didn't treat diabetes but they both would prescribe diabetic meds if they helped CKD. It's too bad that there aren't doctors who treated both beings many, most?, CKD patients have both.
My neph won't prescribe diabetic meds either. They stay in their lane. But my GP did. So seek from your regular doctor.
To be honest, he should have told you that. And what does her doesn't get involved with COVID mean? Maybe it means a new doctor for you?
Usually nephrologists won't get involved with issues unrelated to kidneys, but they woukd talk to you about these issues and advise you about them. The replies that your kudhey doctor gave seemed harsh and uncaring and because of that. I would consider finding a more involved doctor. Its scary that he offered no advice about covid.
I HAD AN ISSUE WITH MY NEPHROLOGIST AND I FIRED HER. I WAS AN ER RN FOR 25 YEARS AND I HAD NEVER DONE THAT BUT YOUR DR HAS TO BE YOUR ADVOCATE AND IF HE OR SHE ISN'T LOOK FOR ANOTHER. NO DR KNOWS EVERYTHING BUT THEY SHOULD BE ABLE TO GUIDE YOU IN THE RIGHT DIRECTION. REMEMBER YOU ARE YOUR BEST ADVOCATE. EDUCATE YOURSELF THE BEST THAT YOU CAN. SO MANY THINGS ONLINE ABOUT DIET AND ANY ISSUE YOU MAY HAVE TO GIVE YOU SOME INFORMATION AND QUESTIONS YOU CAN ASK YOUR DR.
Talk to your PCP, I have ESRD and most times my Nephrologist won’t make changes in medication until she discusses it with my PCP. Good luck
To your last question: NO! SGLT2 is most recently drug developed for dyabets which shows good cababilities to delay CKD progression. This is commonly used and prescribed also by nephrologiest. The point is that dyabets is multidishiplinary desease and should be treated using team working approach. In short and if you can change phisytian.
maybe switch. My nephrologist has taken into consideration that I don’t have diabetes and has put me on prescription drugs accordingly. If I did, he would manage that too. As for COVID, I was just told by a NP in my nephrologist’s office to contact them immediately if I do get covid so they can prescribe a safe drug regime for me.
Sounds like your current doc is a bit curt and unwelcoming. As for Covid when I got it in July I went to my PCP who knows of my kidney disease. She gave me monoclonal antibodies which I would not have gotten at the neph's office. When I first developed thyroid issues I went to my PCP who then referred me to a specialist in that area. My PCP is wonderful and quite willing to refer me out to specialists as needed. I'm not going to my neph for my thyroid or for heart problems. I'll keep him informed but other body parts aren't his specialty. If I had you doc and he talked to me that way I'd be getting a new one but that's me.
I have switched nephrologist twice. My newest one i trust very much. She is also licenced as an internist. She will not see me or prescribe anyrhing for me other than for kidney issues. I have a feeling its a liability issue. If you dont trust your current doc change, but if its because they wont help with other issues you will be hard pressed to find a nephrologist that will do more.
I had to find a PCP to handle anything not related to my kidneys. In my case, my Nephrologist just handles the kidney situation.
Every nephrologist I've had over my 40+ years of CKD has stayed in their own specialty. They're happy to refer me to podiatrist, endocrinologist or any other specialist. Choose one you feel comfortable with. Blessings
Agree with everything said in this thread. Basically, my hubby's primary doctor assembled a team of specialist to treat specific issues - heart, diabetes, kidneys, etc. And he's always happy to refer him to another specialist when the "fit" with someone isn't good or a ball is dropped. So I'd check with your primary for his recommendation not only for another nephrologist but also for a great diabetes endocrinologist (although some primary doctors also like working in that field). Please make sure that the person keeping an eye on your diabetes has an interest in it and will track that situation very closely. (Diabetes is often the monster responsible for one's kidney damage among other issues.) Anyway, my hubby has probably 5 or 6 specialists on his team and all their reports are shared with our primary. He's our "coach" in essence. Sending positivity your way for a great outcome!
Yep gwt a new dr.. so many with both your conditions should not be hard to find a specialist to 5ake that on.
I know with my husband, gp prefers if nephrologist decides which medication suits his diabetes. At the moment, no Ozempic, gp wants nephrologist to decide what is best. Fortunately, here, very easy to get appointment. I've been able to msg nephrologist with a question, he answered in 5min. When he saw my husbands blood test results on the Fri, we saw him the next Monday. But ultimately, it is your choice, hard to find ones that care. Take care. Moni
He should be referring you to a endocrinologist for the diabetes. The diseases are related and both an endocrinologist and nephrologist and gp should be on your team, working together. The COVID comment is really telling to me. Your nephrologist should be informed about the COVID impacts for people with CKD. For example, there are two antiviral drugs used minimize the COVID effects. Paxlovid™ (Pfizer) and Lagevrio (molnupiravir) (Merck) have different kidney impact. Paxlovid is a better antiviral for most - but should NOT be taken by people with CKD. I had to take molnupiravir. My GP and Nephrologist worked together to make sure I got the right drug. That your nephrologist simply said call your GP is NOT a good sign. They should have shared this information with you.
My thoughts; a competent GP who is conscientious and listens well to your needs as they will serve as the quarter back of your team; communicating and consulting with all of the specialists on your medical team. If they feel that a specialist is needed, they'll refer you.
My brother is an insulin diabetic who also has Polycythemia vera ; a form of blood cancer. Our PCP treats the diabetes and his Hematologist, the other. They communicate.
If you feel that your nephrologist is not communicating with you or meeting your needs then perhaps its time for another opinion. It took three tries to findt my present nephrologist. He is wonderful and happily willing to communicate with my PCP and me; forget with my other specialists.
Don't hesitate to look!
Let us know how you are doing.
Bet
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