Case Managers???

[rocky282]

So I, much like many of you I"m sure, am seeing multiple doctors for my symptoms. My PCP, Neuro, sleep doctor, and Psychologist, I am running into situations where each one is saything that the other should be taking care of certain symptoms. Do any of you have a case manager, or something like that that helps you know who to ask about what problems?

[gomer]

Multiple Doctors..........WHAT?

Joking aside, I have multiple-multiple docs, a laundry list of specialist. Being diabetic as well as having MS, cardio issues, kidney disease..ya I have more than a couple extra docs on my calendar.

When I started having day to day foot problems, what a mess. Fam doc, no help, walk-in got some help, podiatrist, little help, but when it got worse, he considered steroids but did NOT want to go that route since i am diabetic.

Lucky for me,the office where I saw my shoulder surgeon (2 falls 2 surgeries in one year) had an ankle ortho. He took charge and Rx'd AFOs and that kept me walking for several years. I still walk some but am limited, largely thanks to my ankle ortho.

My FamDoc, does help some with coordination, but too often they each expect another doc to pick up the ball, aka tend to pass the buck.

Doc Gomer Doctor of, Been There, Done That

[heliotrope]

No such luck... Wish there was such a thing offered here. I usually end up guessing, calling the doctor's office and asking if that's where I should be. They're usually able to send me in the right direction. I do make sure I keep copies of everyone's notes. There's always stuff they don't tell me (or sometimes they don't read their own files) and it's helped me avoid having to visit four or five extra people.

[amandarianne28]

So, I go to an IHS hospital that runs similarly to a regular facility and this is what I learned through ALOT of trial and error:

PCP: She and her case manager coordinate my day to day needs. I have nerve pain and several medications to manage migraines, shaking and muscle pain as well as the pain medications I use. Once a medication is prescribed by any Dr she will refill and consult with them to adjust any dosing issues we come accross. All PCP's have RN Case Managers to oversee their patient loads so this is a very viable option.

Neuro: He handles things solely for the MS. He orders all MRI, VEP, and any other tests he feels are needed in regards to seeing how my progression is. He also orders all DMDs for me, although once he orders them again my PCP will consult and refill since getting in to see him is sometimes difficult.

ER Doc's have filled in when Ive gone in for sudden emergencies, though once for a flare the internist on call said that Steroids were NOT effective treatments and I had to voice my knowledge of it until the Dr looked at past flare Rx's and agreed with me they were needed.

I hope this helps you some. As I see my PCP the most it seems to work the best.

Amanda

[rocky282]

Very Helpful

So, I go to an IHS hospital that runs similarly to a regular facility and this is what I learned through ALOT of trial and error:

PCP: She and her case manager coordinate my day to day needs. I have nerve pain and several medications to manage migraines, shaking and muscle pain as well as the pain medications I use. Once a medication is prescribed by any Dr she will refill and consult with them to adjust any dosing issues we come accross. All PCP's have RN Case Managers to oversee their patient loads so this is a very viable option.

Neuro: He handles things solely for the MS. He orders all MRI, VEP, and any other tests he feels are needed in regards to seeing how my progression is. He also orders all DMDs for me, although once he orders them again my PCP will consult and refill since getting in to see him is sometimes difficult.

ER Doc's have filled in when Ive gone in for sudden emergencies, though once for a flare the internist on call said that Steroids were NOT effective treatments and I had to voice my knowledge of it until the Dr looked at past flare Rx's and agreed with me they were needed.

I hope this helps you some. As I see my PCP the most it seems to work the best.

Amanda

Thank you Amanda, this is all very helpful, I currently see my Neuro the most, but that is because the DMD's aren't working for me. We are now trying the last of the 4 and I am beginning to notice some problems after 18 days of injections. I will talk to my PCP during my visit next week and use your example to see if she will be ok with it. That would make my life alot easier when I have questions, to know who to turn to.

[bigfoot14]

My wife has 3 Dr's: PCP, Pain Dr, & Neuro

The PCP & Pain Dr share an office, and as the DMD's were such failures for her, at this time the neuro is not prescribing anything (at one point he was writing the scrips for her migraines, but turned that over to the pain Dr so all meds are coming out of the same office)

She hasn't ever gone to a sleep Dr, but I think she should as she takes two ambien at bedtime and still wakes up 3-4 hours later...I can't remember the last time she slept through the night

[rocky282]

sleep

Big Foot,

I highly recomend seeing a sleep doctor, it will hopefully get me beyond the sleeping only 5 hours per night that I am right now. My husband is now sleeping a great 8 hours continuous after getting his C-pap, and if we can get my legs under control the doctors think I may sleep better too. Tell your wife that it is not a huge deal, and really one of the easiest doctors I have ever seen.

[Tawanda]

Hi Rocky!
I'm not sure how long you've had M.S., but when I was diagnosed, the single best piece of advice I got was to, "be (my) own health advocate". I have been through the doctors passing the buck thing, as they come from the school of "Covering Your A**" which turns out to be just a big fat waste of time, money, and let's not forget energy. As far as a case manager goes, unless he or she has M.S., that's just one more person to add to the 3-ring circus. I just do the basics.

I have learned to take the minimum meds, go to the minimum number of doctor appoints and do plenty of my own research. It can't hurt to eat right and exercise (KEEP MOVING!!), either. Just my 2 cents. Chin up, friend.