Should I wait for a follow-up to medical tests in 6 months?

June 15, 2014 5:19 PM

Trying to work out what good options would be regarding not having to wait 6 months for a follow-up to a set of medical tests in Canada (British Columbia), which given my current condition, seems an unbearable delay. Not sure what my options are rather than paying to go private.

I've had an ongoing condition relating to my stomach for about 14 months. About 12 months ago I went to my family doctor after I lost over 10 pounds due to not being able to eat very much for several weeks. (Basically quite a lot of the time I either had no appetite or felt sick every time I ate, or if I was hungry and ate then my stomach went ballistic). My doctor tried a few things re diet and at the same time put me on the list to see a GI specialist. Flash forward many months and I've had a range of tests and nothing conclusive has come up, except for the fact that I don't have cancer of some sort (huzzah) and am not celiac, etc, though I have discovered one or two foods that set me off, there's no consistency to it and they're not the usual culprits for this sort of thing.

My specialist was a locum and my last set of tests with her (a few weeks ago) were her last for that practice: I'm now back to the regular specialist who will see me to discuss where to go from here...in December. I was prescribed something right after the tests that seems to have made the condition worse and am sort of stuck now, as there's no way to change that scheduling as my condition is 'not urgent.' At no point have I had a sit down discussion post tests about my condition - I just begged for a prescription right after the tests because she was heading out of town and warned me it might be several months before I could see the regular doctor.

I will go insane if I have to wait for December just to find out more about what I might do or future steps. I feel vile from this. I have felt vile for months. I cry at the thought of feeling vile for more months. My family doctor is out with some long term illness and I have to now rely on the walk-in clinic which operates beside the clinic with family doctors, and there's not much chance that they can or will call the specialist to plead with her. It's Vancouver: the odds of me finding a family doctor in my area are miniscule (I speak from experience), so that's not going to change, I suspect.

So, what are my options? Should I just fork over the money and go private? Should I try to get another specialist and see if that's faster (I suspect not, and I have no idea how keen in BC they are to move you around from specialist to specialist)? Should I try a dietician though I've tried all the various 'your stomach is now your enemy' eating advice and it didn't make a difference? Are there other healthcare options/approaches specific to BC that I should try? I have tried talking to the receptionist for my specialist, but she was firm that this was not urgent and this was the soonest she could see me.

(And I hope this doesn't sound rude, but before people waste their time, I wanted to say that I am not looking for advice on what to eat/not eat, websites on stomach issues, and so on. I've had 14 months of doing just that; I am just trying to think of my options about getting to a medical specialist before I go nuts with this.)

posted by lesbiassparrow to Health & Fitness (10 answers total)

I deal with chronic, undiagnosed abdominal pain, weight issues, and food problems every day for the past 5 years, and even though I've been to many, many gastroenterologists and other specialists, they can't pinpoint what's going on. However, I keep trying, because it affects my life so much.

So I would consider paying to go and see if you can get relief, because feeling miserable if you don't is totally not worth it.
posted by xingcat at 5:27 PM on June 15, 2014

Best answer: Go o the ER. Then a specialist will come see you. Don't go private. This is how you do it. Go to the ER when you are having issues. Tell them you will wait all night, that you need help. Be prepared to wait till 3 am. Take books, tablet/phone, snacks, etc. You might have to wait 12 hours or something. After they see you, tell them you don't have a family doctor and ask if you can follow up with them.
posted by Chaussette and the Pussy Cats at 5:40 PM on June 15, 2014 [3 favorites]

Best answer: Oh that sounds terrible! You really have been dealt a poor hand. I would go in person to the specialist's office one morning and once again request an urgent appointment. If she denies you, tell her you need copies of your medical records because you are going to the emergency department to be checked out. It sucks, but I do find so much of our health care is funnelled through the emergency department. Go to emergency and insist on being admitted because you have been prescribed mediation that is making you substantially more ill and the prescribing doctors office won't see you for six months. You should only have to be admitted as an in-patient for a day or so and this this should set you up with specialist appointments.
posted by saucysault at 5:43 PM on June 15, 2014

This isn't Canada-specific advice, because I can't speak to that, but based on many encounters with patients in your situation (and following on to xingcat's points above), I think one important thing you may want to do at this point is to consider the fact that gastrointestinal conditions are currently not all well understood by modern medicine, and regardless of what specialist you see and how many tests you have done, you might have to find other avenues outside the usual to address your symptoms. I definitely think you should pursue any leads that come up here and see a dietician if you have the means to do so (why not?), and I also respect that you're trying to follow protocol in terms of medical follow ups/specialist referrals and so on. They certainly might still figure out what's going on - I know people who have been in your situation who DID end up getting a treatable diagnosis after having really extensive initial negative workups, but I know a lot who didn't, too. So if all your hopes are on that possibility, you might be setting yourself up for some serious disappointment when you go in for the long awaited follow up and they don't have a lot else to offer you.

Re: the subsequent answers above - not sure how it works in Canada, but as an ER doc I can tell you in the USA the specialist still will not see you in the ER (and you cannot be admitted) unless you have an urgent problem, no matter how long you're prepared to wait or whether you want to be admitted.
posted by treehorn+bunny at 5:43 PM on June 15, 2014 [3 favorites]

Yeah, in Canada ER's work differently to what you experience and it is routine to be admitted, stay for a day or two and get discharged into the care of specialists (usually appointments are the same week). Every time I have been with a family member in ER the situation has been escalated to a specialist. I don't think it is an efficient way of alloting health care but this is the way it has been done in my living memory (40 years).
posted by saucysault at 5:49 PM on June 15, 2014 [1 favorite]

Best answer: I think you need a new GP if your current one is out for long term illness. This is an untenable situation and although it's not officially "urgent," it's negatively affecting your quality of life in a significant way. I am so, so sorry to hear you're in such distress and are doctorless.

I am also in BC, though not in the Lower Mainland, and I went through something like this for about 2 years when my GP left town and I was not transferred to a new doc. At that time there were literally zero doctors in a 100 km radius of my town taking on new patients. I have a GP now, but I'm still dealing with health issues that needed to be followed up on and treated during that period but weren't, because I couldn't get referred to a specialist without a GP.

The College of Physicians and Surgeons of BC has a database of GPs you can narrow by location and ability to accept new patients. This is the list for Vancouver. I don't know how up to date they keep it, but at least it'll give you a place to start calling. If you get nowhere with the Vancouver docs, try widening your search parameters to other municipalities like Burnaby, New West, and Langley.

Good luck. You need and deserve to see a doctor before December.
posted by hurdy gurdy girl at 6:05 PM on June 15, 2014

Re: the subsequent answers above - not sure how it works in Canada, but as an ER doc I can tell you in the USA the specialist still will not see you in the ER (and you cannot be admitted) unless you have an urgent problem, no matter how long you're prepared to wait or whether you want to be admitted.

Yeah, I don't want to pile on, but I did this on the advice of Metafilter many years ago when dealing with an undiagnosed GI problem in a city with a doctor shortage, and all I got was an unremarkable rectal exam and instructions to make an appointment with a specialist, after waiting for 12 hours. Don't do this.

If you have the money, I would pay to get an appointment with a gastroenterologist. I would prioritize that over pretty much any other discretionary spending because frankly you sound really miserable. I also agree with treehorn+bunny that a huge number of people have GI "issues" that can be neither explained nor addressed by the current state of medicine, but you won't know until you try.
posted by telegraph at 6:26 PM on June 15, 2014 [1 favorite]

Just to clarify, the scare quotes around issues are not meant to convey doubt and I apologize if it seemed that way. I only meant to indicate that there's a wide range of GI symptoms that people experience that are currently undiagnosable and I know no better way to characterize them.
posted by telegraph at 6:28 PM on June 15, 2014

Have you tried asking the admin staff at your specialist's clinic to put you on a list for cancellations? If not, I would recommend calling them again and telling the receptionist that you really really want an appointment ASAP and will come at a moment's notice (if you can). All medical practices have cancellations and no-shows, and most doctors prefer to fill them in when they can. If you can be flexible, this could be a possibility.

Also ask if it would be helpful for you to call again next week to check for cancellations. (Don't just call every week--ask first to ensure that they will be ok with it and not annoyed with you.)
posted by snorkmaiden at 8:51 AM on June 16, 2014

Response by poster: Thanks everyone for your advice and suggestions (and sympathy). Alas, snorkmaiden, am already number 71 on the cancellation list and at this stage I'd happily annoy the office, as they've been really unhelpful and rude about the whole process over the past year, and I feel I say that as someone with generally rather low expectations for service in public medicine... :)

Ps. Never try to get a family doctor in Vancouver; hurdy gurdy girl, I've used that list and it's pretty impossible even with that.
posted by lesbiassparrow at 9:31 AM on June 16, 2014