Telling your doc

[SusanJ]

Orange, providing family history is always good. You might want to pare the rest to just your 2-3 top concerns. It gives your new doctor some focus.

In my experience, when I switched to a new doctor who is not trained in functional medicine or Bredesen's protocol, I didn't mention things like MTHFR or other genetic issues until other appointments, as needed. Some doctors won't know what to do if you throw out genetic results or terms like ApoeE4 or MTHFR.

I just said, I have a family history of AD and carry a gene that puts me at higher risk, so I'd like to get some blood tests and need to work on HRT. I offered other details once we started working together.

[Stavia]

OrangeBlossom, its too much information at this stage for your GP. If a patient gave this to me before I studied this area I'd be overwhelmed and wouldnt know where to start and what to priotitise.
You are going to have to manage a lot of it yourself at this stage. Luckily its not difficult.
All you need from him right now is the homocysteine test and for him to know you are at risk of bleeding from Nsaids.
And honestly if you dont get the homocysteine test its probably good enough to take the three vitamins as per Bredesen and us.
Drop the other genes. I agree with Susan, methylation is too much. No GP worth anything in the British based medical system will consider a statin for a 40 year old woman. And you are far off HRT - it could be 15 years. The atrial fibrillation and weight gain gene are also too much information and don't help a GP in day to day practical decision making. At 40 your risk of atrial fibrillation is vanishingly small and the FTO gene is irrelevant to his work.
Pare it right down. Explain apoe4 succinctly. If he is a good GP he will go to UpToDate or another textbook or even wikipedia and check it out himself. I never rely on a patient's interpretation of a condition anyway.

Sorry honey, I just know how GPs think. I've worked as a GP for 25 years in a British based medical system. Not the same as US medicine.


Sent from my SM-G930F using Tapatalk

[slacker]

Sorry honey, I just know how GPs think. I've worked as a GP for 25 years in a British based medical system. Not the same as US medicine.

I don't think it's much different in an insurance based US practice. Short appointments, high volume, additional time spent at lunch or after hours returning calls, refilling meds, reviewing labs, finishing documention of questionable "quality" measures for each face to face visit that day. Taking additional time to research new areas that are outside of what is taught in medical school ends up not being a priority. Many many US providers are in burn out mode, especially primary care. It's a sad state of affairs...

[Orangeblossom]

Thanks for your replies. Really helpful. My insurance may cover the homocysteine test, we'll see. NHS stuff is hugely rationed / under scrutiny at the moment. It felt good to share it with them though. I haven't even met them but they know I get anxious and seem happy for me to write rather than see them (unless it needs an exam). Then they tend to ring back, or get their secretary to do so, with the next steps.

[Jan]

Good persistence and follow-through, Orange. Way to go, proactively looking out for your health!

[Orangeblossom]

Thanks Jan!

I sent my (modified) letter and just checked my online medical records while ordering a repeat prescription and see they have recorded it, it simply says 'Apolipoprotein E4' under my last recorded data input by the GP.

[Orangeblossom]

GP has now put this on my online record as needing done

Pathology Request (Awaiting Sample):
Creatinine & electrolytes (Postponed), HbA1c (Postponed), LFT (Liver Function Tests) (Postponed), Lipids - fasting (Postponed)

Checked online and seem to be general tests of metabolic health.

Hmm, not the best time for tests just after Christmas (been with relatives eating etc) but guess will go make at the appt. Seems the creatinine one can measure something about if eaten too much meat, etc so maybe doing that instead of the other one, not sure.

[Orangeblossom]

I just had a call from the GP's surgery - a message that he got the letter, they don't routinely test for homostyciene on the NHS but the lifestyle measures sound helpful. Nothing about these blood tests booked though. oh well, will just go along next week and see.

It may be possible to get the test done privately but my doc would need to write that there is a 'clinical need' first and might be a palaver.

[Orangeblossom]

.