Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
While at my physical today, I asked if the blood panel I get a fe weeks before eaach visit tot he rheumatologist could be done there, saving me a trip into town.
The doctor asked if I'd eaten before my 10:30 am appointment, and when I said yes, he said to come back another day after fasting.
But, I said, I've been on MTX for nearly nine months now, and had the bloodwork done three times already, and no one's ever mentioned that. (Previous tests were done at the rheumatologist's or at a local walk-in lab.) And if they're just checking for liver damage, what's the difference?
Here was his answer: blood sugar is almost nearly always checked as part of routine bloodwork. If you've eaten earolier that day, you'll get a false high reading. The rheumatologist will just ignore it, as his or her interest is specific to the liver enzymes. But, an insurance company can request your records, and if they see a high blood sugar reading, they can deny you a claim or treatment or coverage based on your 'diabetes'.
He claims this has happened to several of his patients.
I'm interested in your thoughts on this. My family doctor has a wee bit of the tinfoil-hat mindset. While it's simple enough to postpone my bloodwork to a day later this week, I'm remaining just a little bit skeptical about the rationale until someone can corroborate this.
But then, I live in Canada and no one is ever denied medical insurance. Not sure about life insurance and diabetes, we are long past that point in life.
It happened another time because they decided that I couldn't have a med that I had been on for a while because I had high blood pressure- except I didn't have it. I was on a med that is commonly used to treat high blood pressure, but has other uses too. I had to provide proof I didn't have high blood pressure just to get my med covered again. Of course, I asked them what proof they had that I had high blood pressure. They admitted that they had just assumed it and I had to prove them wrong to get coverage resumed.
Some times I think they pay people to sit around and figure out ways to mess with us.
Your doctor must have had to fight some of these battles with someone else.
I usually fast with these tests even though you don't have to. Now I will make sure to do it after hearing this story. I never gave blood sugar a second thought. I was extra careful because my liver enzymes elevate if I eat something 'bad'. I almost lost MTX because of a plate of fried seafood one time and I only eat it twice a year. It is salad, grilled chicken or baked fish for 3 days before that test now.
Hang in there. He isn't trying to be difficult. I really think he is trying to protect you.
Kim
Having said that, my rhematologist has appointments as early as 7:20, and since I only see him twice a year, I try to schedule early times. But, sometimes it doesn't work out, so if I eat, then so what. I don't think anything else in the metabolic or CBC panels that I have taken after my appointment can fluctuate with a meal.
And, I've never had any insurance interference for a slightly elevated glucose test.
I'm glad to hear you've had no problems, that's wonderful, and I wish the same could be said for everyone. I've been asking around among acquaintances since this came up, and I've heard three more stories about a med or a procedure being denied because of something that was buried in medical records.
I think based on my doctor's comments and Kim's, it's not unreasonable to think that a problem could happen, and it's certainly easy enough to fast before blood's drawn for the panel just to be sure.