Re: Question for Simon/care after surgery

[Guest guest]

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Aldyth Rae wrote:

>

> Hi Simon, I was just out walking the dogs and thinking..like you

> do...

I have no dog

> about who takes care of your health after surgery or RAI.

> ...snip...

> When I was first diagnosed with Graves my GP said that in the case

> of an underactive thyroid the GP monitors the disease and the

> medication, but in the case of Graves they are referred to an Endo.

You'd be surprised how many GP's don't know this.

> So if a person is rendered hypo after having surgery or RAI does the

> GP take over the care or does the Endo continue to do it? Hope you

> are well,keep taking the tablets.

First surgery doesn't always render people hypo, in fact most aren't

hypo after partial thyroidectomy.

Who continues treatment varies. I continued to get routine care from my

local thyroid clinic (so under the endo's care), but since I only needed

a blood test every 6 months, and felt fine on no medication, it didn't

really matter much.

I got one surgical follow up with a surgical underling to make sure they

they had done a good job, and a couple of endo appointments to make sure

the levels stabilised before the blood testing regime settled in.

Knowing what I know now, and that the course of this disease isn't

always as smooth as my first time through, I'd say see an

endocrinologist until you are stabilised, then exercise your judgement

as to who will provide the most appropriate care.

I don't think currently the endo, and local thyroid clinic add

sufficiently over my GP's care (even if I have to educate him a little

in some matters Graves' related) to justify the inconvenience.

My GP will do Saturday morning appointments, run blood tests when I

request them (even if the labs won't run them all), and let me walk in

and grab a prescription if it hasn't made it to the pharmacy on time,

answers email enquiries, and can provide some sort of continuity, he

recognises me and knows who I am and what I do.

My endo is involved in molecular medicine research, diabetes research,

doesn't answer his email, and works the thyroid clinic half a day a

week. He may know more about thyroids, he may be doing more to advance

humanities understanding of disease, but he isn't able to be " my doctor " .

In contrast my previous endo always seemed to have time for me, and was

generally more approachable, with a better organised Thyroid clinic.

As to who takes care of your health? You do.

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[Guest guest]

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Aldyth Rae wrote:

>

> The reason I was asking is that I

> wondered how many Endo's followed up a patients care if (only if!)

> they became hypo after surgery or RAI. The Consultant Endo I saw

> first was quite happy to let me choose the method of treatment, but

> his reg whom I saw last time was pushing RAI, and after reading

> everything here I wondered if the Endo's here in the UK just passed

> you over to the care of the GP and just got text book/statistics as a

> basis to judge how people got on afterwards instead of seeing for

> themselves.

I've wondered the same.

I think there is a degree of ignorance on the part of doctors with how

patients fare, although I think it is mainly that patients will run

quickly from any doctor whose treatment makes them worse, or who clearly

isn't reasonably competent, or who doesn't take them seriously enough.

Thus doctors opinions on severity, if not details, are likely to an

extent to be self reinforcing.

Unless you specifically sue, or tell the doctor why you are leaving, he

or she probably can't distinguish it from the regular turnover of

patients due to people moving in and out of the area, unless you happen

to live nextdoor to him, or some such.

> I know from my sons Consultant, he gives us advice direct

> from the text book and has no idea what 'real life' is like with a

> problem like my sons ~ though he is learning alongside us now!

I wonder if the relative frequency of the disorders is the issue, no

endo has an excuse for not having met many tens of Graves disease

sufferers before they have qualified, where as I believe Addison's is

significantly rarer?

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[Guest guest]

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Aldyth Rae wrote:

>

> That's true, I hadn't really thought about that. My sons consultant

> has never had an Addisonian to treat before. But his Endo definitely

> has, but we only see him annually now.

I'm assured Bearded Collie breeders are the experts, but I can't

guarantee they won't say get him neutered ;-)

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