Dealing with two different clinics

Ratatosk

Administrator
Staff member
I've mentioned in other posts about trying to decide if we should continue going to the local CF clinic or just see a regular doctor in town and primarily see our CF doctor in the City. Getting close in time to yet another local CF clinic and get edgy -- cross contamination, lack of germ control practices, plus we seem to spend the majority of the time either cooling our heals for 4+ hours or listening to put downs about the care received by the CF doctor in the city.

Originally we thought it was great that there was a CF (nonaccredited) clinic in our city because one of our primary concerns what "what if DS got sick? Do we drive to the City? Will we get adequate care in town? What if DS needs to be admited?"
So we started going to the local clinic -- thought it was ideal to have blood work, cultures, xrays, etc done locally and then send the reports to our doctor in the city.

Last clinic appointment I mentioned a liver function test that our doctor in the City has started using -- factor something or other -- to determine early on if there's liver damage. The gastro doctor scoffed at me and refused to order the test. DS was having accidents this spring, our doctor in the city wanted to rule out diabetes or an infection so asked that the local clinic do a urine test, urine culture to see if anything is growing and a blood test to test for glucose. They REFUSED to do the culture.

Add to that the flu shot fiasco every year -- the tell me DS is top of the list 'cuz of his CF, then when it comes time for flu shot season -- they don't have any available for him. I recently found out at DS's well child exam last month that they had TONS left over in May. We had to get his flu shot in the City. Local doctor said there must've been a miscommunication. How can one misunderstand DS has CF, we were told he's a priority for receiving the vaccine and we called and emailed the clinic several times.

Add to that when DS does get sick -- I call the clinic and get told to go to urgent care or if I can get an appointment I'm told DS's cough is normal -- it's what cfers do. Over the past three years he's later been diagnosed with bronchitis twice, 3-4 sinus infections. Grrrr!

So we're toying with the idea of just seeing the regular peds doctor who is head of the CF clinic and skipping out on the whole CF clinic experience. Or another option is seeing a family practice doctor in our town who supposedly sees some other CFers and rumor has it has a couple of children who have CF. Just hate to get a bad rep -- get put on a double secret list and blackballed and have to take DS to the veterinarian like Elaine and Cramer on Seinfeld.

So basically I'm just venting. Trying to figure stuff out. Basically I'm terrified of the germy cf clinic, get angered when we ask for a test and are refused... We just want what is best for our son and are pretty sure we're not getting it where we're at -- but if we change will it be better or worse?
 

rcq925

New member
Personally I would stick with your peds doctor and skip the clinic! I would never want to be treated the way that clinic has treated you and your child. You sound like you would be in better hands with your doctor, he is the one being proactive and wanting to order tests, ect.

Cf clinics can be great, however, some of them from what I have read are horrible. I think you can get great care from private doctors as well as clinics. Are there any Pediatric Pulmos close to you familiar with CF that you could see? Good luck with whatever you decide.

Becky
 

Ratatosk

Administrator
Staff member
The clinic we go to has one peds pulmnologist and he's one of the doctors we see at the CF clinic and I've not been impressed. There may be another one in town at the other clinic. We're leaning toward just going to our regular peds doctor and the CF doctor in the City and skipping the CF clnic experience all together, although then we'll need to coordinate cultures and labs, but I'd almost prefer having it done in the City as I know our doctor down there will follow up on the results.

Currently CF clinic appointments last 4 hours and last time we arrived at 8 and didn't see anyone until 9:15 and pretty much waited half an our between doctors and other team members. At Noon DS was getting hungry, tired and hadn't had labs or xrays yet and the nurse forgot to come back and give him his emla for his bloodwork. I'd brought along snacks, lunch, juice and milk, as well as a bag with puzzles, games, books and dvds. But after a such a long wait in a confined space, DS was pretty cranky (as were we).
 

JRPandTJP

New member
Is this about your son's health or their egos? IMHO, it sounds like your non-accredited CF clinic is filled with some pretty insecure egos who don't like any outside opinions. From what you are saying the city doc seems thorough and genuinely concerned for his health. Does he know the standard of care/protocols for CF pts from accredited facilities? Does he care for other CF patients?

4 hours with a toddler!!!!! Dear god that is so inconsiderate.

Can't the city doc order and evaluate all the tests, cultures and annual blood work? If so, I would skip the clinic that seems so uncooperative.

God, 4 hours...I can only imagine how tired you were!! Jody
 

Ratatosk

Administrator
Staff member
Yeah, I agree it's a huge ego thing. 4 hours IS a pain, especially when we arrive 15 minutes before our appointment and then cool our heels for an hour and a half, go 20-60 minutes between seeing people. Toward the end of our appointments it consists of DS throwing himself against the door, yelling LET --- ME --- OUT and us feeling like pushing him aside and doing likewise.

The doctor in the City cares for several CFers and is very proactive. His specialty is infectious disease. He can and has ordered tests for DS when we've gone to see him, though recently has not because we've usually gone to the local clinic a month or two prior to the appointment with him, so we have culture and blood results by the time we go to see him. Plus I don't think he wanted to duplicate tests if it wasn't necessary. IMO, more comfortable with tests in the City because locally we've been told that cultures weren't handled properly and tests were inconclusive, that they took specimens for culture and didn't bother proceeding with the culture. I've often wondered if DS even had pseudo when he cultured it at 3 months because there was some note about contamination. Urgh!

Currently we're leaning toward continuing to see DS's peds doctor, but skipping the CF clinic. Too stressful and I don't believe ds is benefiting from it. We go to the city 2-4 times a year. Local clinic is usually twice a year, too. Our concern has always been dealing with the local medical people in the future. If ds has to be hospitalized. Will he get adequate care or do we hop in the car and head 3 1/2 hours to the City?
 

JazzysMom

New member
Growing up I was very fortunate to have a fabulous local pediatrician who was happy to become Jazmine also BTW. Tho he was great & keeps updated on CF, he left final decisions to the CF doctor. He worked very closely with them & when I was younger would admit me to the local hospital going by the CF clinics directions for care. As I got older & had more exacerbations we (parents, pediatrician & I) decided to bypass him & stick with the CF clinic since I was starting to need their care more. I no longer have a local doctor for myself. I realize I should & if push came to shove like it has in the past I would use the GI doctor as my local doctor & he also worked with my clinic to stabalize me & ship me out. I just hate having to divide my care up so I try to not do so! For you it defeats the purpose if they dont take the recommendations etc. Why bother!
 

anonymous

New member
Personally, I would skip the local CF clinic, use the "city clinic" and use a local ped. that is familiar with CF and will keep in touch with the "city clinic". Our ped and CF doctor keep in close contact through letters (quite extensive ones) and phone calls. It really helps since they are about 2 hours away from eachother.

I worry about what a hospitalization will be like too since we are so far from CF clinic but assume that unless it is an emergency situation, we will just be driving all the way to our clinic's hospital.

HTH!
 

Ratatosk

Administrator
Staff member
DH and I were discussing this on the drive home from the lakes this weekend. Basically we have come to the conclusion that we are not comfortable with the local CF clinic. We don't have much faith in the care he is receiving.

DH is going to talk to a coworker's wife who works at the other clinic. We know there are a couple CFers who go there and to the accreditted cf clinic in the city. We do have a local CF clinic appointment schueduled for this fall and another one in the City.
 
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