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Discussion:
Specialist or Family Doctor?
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Hello all! I thought I'd start a new thread here with this question. I am 4 months post DVT diagnoses in my left arm. I have been seeing my family doctor for treatment. She told me early on that I could see a specialist if I wanted to at any time, but that she was consulting with one for my case. So, I've left it at that. My family is concerned that my doctor isn't doing enough for me and wants me to see a specialist. I am thinking that I might need to see one, too. Do you guys see a specialist or just let your family doctor handle your treatment?
Posted on 08/05/13, 07:07 am
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Reminder: This is a support group for Deep Vein Thrombosis (DVT). We trust you will do your best to remain positive and helpful. For more information, see our rules of the road.

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Reply #1 - 08/05/13  8:41am
" For both my DVTs, I saw my primary care doctor, an Internist. I did consult with a hematologist just to see if there was any insight into why I clotted, but otherwise, I didn’t feel it necessary to see someone else for treatment.

At this point, I'm not sure if it would change anything for you in terms of recovery but it may be something to revisit with your primary doc if you feel you need someone to reevaluate your arm.

TossNTurn gave a good response to a similar question on the Pulmonary Embolism group which is to consider what you expect to get out of a visit with a specialist.

There may be value in seeing someone if you aren’t getting answers from your primary doc, or if there’s a complexity to your case you feel your primary doc isn’t able to handle, or you just want to hear the information from someone who has more expertise in the matter.

My approach has been to see the fewest number of doctors possible, for my own sanity but that's me. "
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Reply #2 - 08/05/13  10:00am
" I've pretty much just stuck with my family doctor as well. She's available quickly in an emergency and has always been extremely responsive to my needs.

I have, at times, been referred to a hematologist, pulmonologist, and cardiologist, but usually only if I had some sort of exacerbated symptom that we didn't understand or (like RMB) to get tested for clotting disorders. Never turned up anything and haven't seen any of them again past the original testing/results phase. With me personally, the last thing I want is more doctor's appointments.

Here's the thing...lot's of us seem to think that there must be MORE to this recovery thing. But, really, there isn't much more than taking your meds and wearing compression clothes (if possible). It's not like hematologists have got some secret trick to recovery that they aren't telling the other doctors.

Of course, if I remember, you're having increased pain and swelling and it didn't sound like your regular doc was really addressing that. If that's the case, and you think a second opinion might be in order, then go for it. But, really, have a clear idea what you're hoping to get out of the appointment and go in with a list of questions you'd like answers to. Being prepared will help you feel like you're getting the most out of your appointment, for sure. "
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Reply #3 - 08/05/13  10:32am
" I've seen my Family Doc, a Hematologist, a Cardiologist and a Stroke Specialist. My last visit with my Family Doc I told her - "no more". I will not see another specialist!! They don't communicate with one another. They all have different things to say. The confusion is overwhelming. I don't know how your Family Doc is handling your situation. What is your treatment? "
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Reply #4 - 08/05/13  10:35am
" But I think your case, Sandy, is a bit more complex than that of the average bear. "
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Reply #5 - 08/05/13  10:46am
" I see my family Dr, internist for my dvt. I see a rheumatologist for my raynauds and tested me for clotting disorders as did my internist. None found. My family keeps saying to go to specialist too but I think I 'll wait a little longer to see how things go. best answer is time will tell. I'm 4 months out too with dvt in my right leg and still in alot of pain, I work 6 days a week on my feet and that may be why. Swimming and hot tub help me with pain.

Stay gold. Hang in there I'm right there with you. "
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Reply #6 - 08/05/13  11:18am
" I see my primary, a vascular, a hematologist and an interventional radiologist. But I had a pretty complex case -- May-Thurner Syndrome with a case of Heparin-Induced Thrombocytopenia Type II on top of it. And I "gathered" all my doctors because I did end up in the hospital for a month over my DVTs. My doctors do seem to communicate with each other. But I will say, they do sometimes tell me different things. I "trust" my interventional radiologist the most because he specializes in DVTs. And generally my primary just follows my case and does not do much input on what is going on with the DVT.

But I would second what TossNTurn said, if you do go to a specialist -- have a list of questions. I would also say make sure they have all your records, even if you have to carry them in yourself. That would include your Dopplers/ultrasounds if you go to a interventional radiologist or vascular surgeon. "
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Reply #7 - 08/05/13  11:53am
" I would seek the advice of a specialist. I loved my internist but when I was diagnosed with my second DVT last November I felt that she could have done a better job. For instance, she never once told me to take Warfarin in the evening. I had a bleeding incident and it would have been very helpful if I had not taken the Warfarin first thing in the morning because I ended up bleeding internally for three whole days.
This doctor is sought after in our neighborhood and I do believe she sees way too many patients and I suffered for that.
There were other "sins of omission" but I am now living in a different state and the doctors here are fantastic. I saw a hemotologist as soon as I got here and I am quite satisifed with her.
So, just for peace of mind, see a specialist! "
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Reply #8 - 08/05/13  12:57pm
" Well I think sometimes it's not a matter of what kind of doctor you see, but finding one who is on the ball and that you feel like you're in a partnership with. My first Internist was crap with the INR management for instance. My second and current Internist is excellent with it. It's not always that a specialist can do it better. It's sometimes that you outgrow your current primary doc now that you've had a serious health issue. "
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Reply #9 - 08/05/13  1:09pm
" Now I am confused. First I was treated by a Cardiologist and two months later he referred me to a vascular surgeon. I have been thinking that I am seeing a specialist specialized in the study of veins. Now I hear about Internal radiologist and hematologist.

So who is the "specialist" that I am supposed to see now? "
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Reply #10 - 08/05/13  1:20pm
" Sandysan5743, my treatment is just taking warfarin for at least 6 months. I think there was genetic testing done, but I'm not sure. My memory is pretty crappy, lol. So I can't remember if she said that there was genetic testing done. If I don't write it down right away, then it's gone. :) I did just have cholesterol and thyroid blood testing done last week. I go in to see the doctor tomorrow to go over the results and to talk with her about my increased pressure, constant swelling, some pain, and more bruising in my DVT arm. She has been right on top of my INR this whole time, so I'm happy with that. I'm just not happy with how my arm is doing. I don't know if more can be done to get the circulation to improve, or if I just have to be patient and wait.

Thanks for the awesome feedback! It gives me something to think about. :) I do hate all the doctor appointments. More doctors means more appointments...but I want to make sure that everything is being done that can be done.

Now, time to work on that list of questions for my doctor. :) "

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