My Healthcare Team (Part 1)

When talking with people about their journey with COPD, it’s important to remind each person that they are unique in their own disease.

Too often people think that we have COPD.  We have arthritis. We have high blood pressure.  What’s unique about that? They are all different diseases and have different treatments.  That’s that!

Is it though?  Arthritis can affect high blood pressure, because pain can cause it to rise.  High blood pressure can affect our lungs and COPD because anything that causes a rise in pressure to the heart will affect the lungs.  Medication that we take for each, can and often will affect the other meds we take and our bodies.  It’s so very important to look at the whole picture and to find healthcare professionals to treat the whole person, not just part of you. Even though you have your primary physician and individual specialists, the primary doctor is usually the one who directs the care.

I have a wide variety of healthcare professionals that I see.  Since I live in a small town of ~3000 people, I have to travel to see specialists.  So I use PA’s and GP’s when I can, as they are local.

  • Allergist: I have seen a few allergists. They did allergy testing on my back and arms.  One allergist always does blood tests to check my white count and more.  I am often put on antibiotics because of ongoing sinus infections.  She has me blow into the spirometer to see how I’m doing and because of asthma.  I am allergic to so many things.  She gave me serum for allergy tests that I would do at home.  Regardless of how minute, 3/4 of the time I had a reaction and would end up using my epi.  Because the allergist was 212 miles away, I usually see local docs and go to the ER if needed, or rather if I need to use 2 epis and still struggle.  Anaphylaxis is horrible. Thank God that I usually feel it coming on.
  • Audiologist: Specialize in hearing tests.
  • Cardiologist: This doctor specializes in heart health. This doctor is the one who diagnosed angina years ago.  Cardiologists read the EKGs and other types of heart tests, including stress tests.  A cardiologist scheduled the testing and my diagnosis for pulmonary hypertension.
  • Cardiologist specializing in Pulmonary Hypertension: Since Pulmonary Hypertension is an increase of blood pressure in the pulmonary artery or vein, it’s nice to have someone who treats this specifically.  I think of my doc as cardio/pulmonary.  This doctor recommends testing, such as the Echo, stress test and looks over pulmonary testing and results.  He reviews medications, watches for edema and writes prescriptions. He looks at the whole picture.  He figured out that because I had been using my c-pap and oxygen at night, that my pulmonary hypertension had improved somewhat.  Since then, it has gotten worse, but not bad. He also discusses exercises with me.
  • Dentist: I really like my dentist and he lets me make payments!  Because of dry mouth, he has me come in every two months to check for cavities and have cleanings. He’s the one that referred me to an oral surgeon.  Have I said that I am terrified of dentists?  I am, but I really like this one and he’s so understanding.  I hope everyone realizes that if you have a dentist who doesn’t treat you with respect regarding your treatment and even fears, see another.  Find someone you like, because your teeth are so important.  He also helps to keep an eye on the mouth sores that I get so frequently. Medication is possibly the cause for my dry mouth etc., so always be sure to rinse and drink plenty of water.  I have chewables and also use a moisturizing mouth spray.
  • Ear, Nose and Throat: I have had a couple of these doctors. They look to see if there is a reason for all of the sinus infections, which are usually caused by allergies.  They also look for cancer.  They look at septum to make sure that’s ok.  My ENT also biopsied to test for Sjogren’s and sent me to the Rheumatologist.  Because of dry mouth, I had to have 3 teeth pulled.  When pulled, one of the molars left a sinus opening.  He tried to cauterize a couple of weeks ago.  If that didn’t work (which hasn’t happened yet) he will take skin from my cheek to make a covering out of.
  • GP is a General Physician. This doctor treats the whole body and if something seems above his/her abilities, will make a referral to a specialist.  This doctor is my primary physician who helps to oversee my overall health, as well as medications.
  • Gastroenterologist: I have seen this doctor for years. Every 6 months to 2 years I go back for a re-check of my Barrett’s Esophagus, which is a pre-cancer of the Esophagus, caused by acid reflux. This doctor does an EGD to see the changes from the previous EGD.  He does a biopsy of anything suspicious looking in the esophagus as well as the stomach. Sometimes a ph study will be done as well. Yearly or so, he does my colonoscopies. This surgeon also did my Nissen Fundoplication and removed my gallbladder.
  • Home Health: These people are wonderful. They are in my town. They provide my oxygen concentrator and all supplies. They check my oxygen concentrator every 6 months. If my doctor orders a night oximetry, they provide the pulsoximeter and then take the info and send it to Florida for reading. They supplied my c-pap. They will download the information and send to Florida to be read.  They supply all supplies when needed. They supplied my nebulizer and replace it every 5 years. They provide the supplies for this, with the exception of the medication. I have purchased special shoes for myself, diabetic slippers for my husband, bars for the bathtub, walker, grabber and so many things. If they don’t have what I’m needing, they will order them.
  • Neurosurgeon: I see him with problems in my back and neck.  I have had one surgery on my L5-S-1 and know that more surgeries will be in the future as I am disk on disk again in my back.  I also have a disk in my neck pushing against my spinal column, which will have to be repaired sometime in the future. I have degenerative disk as well.
  • Occupational Therapists: I have seen these therapists after my surgeries, hands especially. They taught me how to exercise but also how to strengthen and reuse my hands.
  • Ophthalmologist: Eye surgeon best describes an ophthalmologist.  I had to have cataract surgery done on both eyes, likely caused by Advair.  One eye clouded about a year later, which they said does happen, he had to laser that eye to get rid of the cloudiness.  How wonderful to see.  This doc does glaucoma surgery and for other eye problems.
  • Optometrist: This is an eye doctor. They are the ones that do eye testing, to see if glasses are needed, to change a prescription, to see if there are other eye health issues and to help me with dry eye. He also prescribed the best eye drops.  The eye doctor is the one who recommended me to an Ophthalmologist for cataract surgery.
  • Oral Surgeon: Because of a very dry mouth, my dentist referred me to an oral surgeon, since I had 3 teeth that needed to be pulled. They gave me general anesthesia to get that done.  Dentists cannot give anesthesia, an oral surgeon is who you would see.
  • Orthopedic Surgeons: These doctors I think run and hide when they see me coming.  I give them a bad time about how I want to see one doc for my bones, not a different doc for each joint.  They stress that if one doctor focuses on one area, just think about how much better they are to treat me and that specific area.  So they sold me on that. My leg doc gives injections in my joints. I am to have surgery on both feet by fusing 5+ joints in each foot.  I have put off for some time because the down time and recovery is so long.  When I find that injections no longer help, the doc said to pick the knee bothering me the most and we’ll start with that one, since both are in need of replacement.
    • About 5 years ago my hips had bursitis are due again to x-ray and go from there.  That will wait. My hands doctor has done CMC Arthroplasty on both thumbs. When I need to follow up with my next joint, he is there.  Shoulders will be coming up. Years ago I had bursitis, the shoulders are changing and I can tell arthritis is affecting them also. It’s best I treat and go from there.  I think I will get injections - will be done before long. Probably next time I do my knees. I have had arthroscopy surgery on one knee when I was in my early 30s.

My experience is just one example of how important it is to address the entire body when managing a chronic illness.

But it's not finished yet! Stay tuned for "My Healthcare Team - Part 2"!

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