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Need doctor recommendation 
26th-Jul-2006 03:24 pm
Me: on Ferris wheel 2012-09-09

Aargh. I recently tried to get in touch with my doctor about getting a referral for a sleep study, to discover she is no longer practicing (or if she is, not through Fenway, and I don’t have a way of getting in touch with her).

cathijosephine had previously given me a glowing recommendation for her doctor, Kevin Kapila, who also works with Fenway. He sounded perfect for me in a number of ways. Tragically, I just discovered from his office that he’s no longer seeing new patients. (cathijosephine, if you want to ask about that next time you see him, in case his receptionist is more certain he’s not taking new patients than he is, I’d be delighted.)

So, looks like I’m in the market for a new doctor. Any recommendations? Here are my preference, in approximate order of importance. Note that only the top few are absolutely essential.

  • Is taking new patients. :-(
  • Takes Blue Cross (is there anybody who doesn’t?)
  • In reasonable walking distance either from my house near Quincy Center or from Northeastern University (or T-accessible on a lunch hour from the latter).
  • Can get me a sleep-study referral quickly.
  • Will share information with me, take things I say seriously, and generally not talk down to me.
  • Is comfortable with queer, poly, kinky patients.
  • Will want to take his/her time with me when we have appointments.
  • Is email-accessible, and willing to do quick simple followup things via email or the phone.
  • Can make appointments for relatively urgent stuff in a timely fashion.
  • Takes a relatively holistic approach to his/her patients’ health. (For instance, my previous PCP wanted to know about emotional stresses in my life in case they were affecting my health.)
  • Is affiliated with Fenway Community Health. (I’m assuming this would make the transition go more smoothly.)
  • Is willing to give me advice and not write me off if I don’t take it. (For instance, I’m not going to give up salt or red meat, or stop going out in the sun without sunscreen, even though I know those things might be better for me. I’m happy to hear that they would be better for me, but then I don’t want to fight about it.
26th-Jul-2006 07:56 pm (UTC)
If you end up not finding someone wand want to go outside the city, ping me...
26th-Jul-2006 08:01 pm (UTC)
Thanks; honestly, I think I’d probably go with somebody random before somebody I needed a car to get to at this point.
26th-Jul-2006 08:21 pm (UTC)
HIya! My PCP is Dr. Alex Gonzalez at the Fenway. I really like him. He's young and energetic and very involved with my care. He is accessible by email and he even picks up his own phone occasionally. I called once expecting to leave a message and he picked up!

Oh, and I've been able to make appointments with him sometimes the next day or the day after. He's also been very supportive with the whole sleep apnea thing. OH, and I saw him marching at the Pride Parade this year with the Fenway :) I think he's great!

As for getting you scheduled for a sleep study quickly. The Fenway is affiliated with the BI, which is a good thing, their sleep lab is really nice. The downside of the BI is that it takes quite a while to get in for a study. Or at least it took me a while. I think that's probably pretty standard though. They only have so many beds and tend to book a couple of months out.

That said, I'm sure Dr. Gonzalez would be happy to refer you for a sleep study. He worked with my insurance to get them to cover Ambien so I could get to sleep with my mask on.

Good luck on the Doc search!
26th-Jul-2006 08:27 pm (UTC)
What do you want a sleep study for?

From my experience every one of the sleep studies that have been recommended for people on my caseload have resulted in a diagnosis of sleep apnia and a recommendation of C-PAP for treatment. If you think your sleep patterns were disrupted before, just try to sleep with one of those things strapped to your face.

Here's my prescription: Drink two or more glasses of wine before bed every night.

Dr. Dowdall
26th-Jul-2006 09:09 pm (UTC)
Here's my prescription: Drink two or more glasses of wine before bed every night.
That’s good advice, since Bevin is one of the beneficiaries on my life-insurance policy:
Alcohol and some medications relax airway muscles. Drinking alcohol can worsen or tip someone into obstructive sleep apnea.
I’m pretty sure I wouldn’t have trouble sleeping with a CPAP machine, although it wouldn’t be my first choice for treatment. My first choice for treatment (before doing a whole lot of research) would be surgery if it seemed likely to help, followed by (or supplemented by) one of those little mouth-guard things that pull your lower jaw slightly forward.
26th-Jul-2006 09:57 pm (UTC)
I was diagnosed with borderline sleep apnea in january, and they wanted to give me a CPAP machine.

The night I was fitted for it, I slept hardly at all even though the study claims I did! Even though I was on Ambien, it sure didn't feel like it, and I had to go to work late and take a nap at home.

So I opted for another method...I began diet and weight loss, and after only about 15 pounds lost I noticed a bigggg difference. That worked for me, and I"ve gone on to lose alot more, but my initial motivator was avoiding the CPAP machine.

I hope you find a doc local to you. There is a beautiful sleep lab up here in my town in NH, and I did have a great Neurologist...too bad you're not up here!

Good luck!
27th-Jul-2006 01:54 am (UTC)
Well, I’ve been going to the gym pretty consistently, and am v e r y slowly been losing weight. At this rate it would take me another six months to lose a total of fifteen pounds. :-) But the symptoms that I take to be sleep apnea-related have been getting noticeably worse over that same period. (Of course, there are lots of other variables fluttering around as well.)

Thanks; I am trying to lose weight, but I think that on its own is not going to do it.

I’ve actually never been able to sleep on my back, even when I was a perfectly mesomorphic kid. It was news to me when I found out that some people did, and I wondered how they could breathe that way. Hmmm, in retrospect... (I also had severe asthma as a kid, so sleep apnea wasn’t the first thing that came to mind when I was thinking about trouble breathing.)
27th-Jul-2006 02:04 am (UTC)
I can't sleep on my back either, I think the spinal fusion in the trachea area does have something to do with all of it...
It added to the apnea.

And I'm having this breast reduction soon, and I'm supposed to sleep on my back for a while! Can't crush them ya see.

Recliner here I come....I can sleep reclined.
27th-Jul-2006 01:48 pm (UTC)
Hiya! I was diagnosed with sleep apnea about 6 years ago. I've had a mostly hate-hate relationship with my CPAP for most of that time. It was really hard to get used to. I even renamed it the Squid, it looked and felt like a squid sucking my face :) But, then I discovered Ambien :) Better living through chemistry! Yay!

Anyways, the point! Not that I have one, is that I thought my apnea would get better if I lost weight as well. I lost about 30 pounds, but it didn't get any better. *shrug* Losing weight doesn't work for everyone. I'm glad it worked for you though! I'm hoping to get to a place eventually where I don't need a drug to help me sleep with the Squid. I'm at least at a place where I do see the benefit of using it, which is nice.
27th-Jul-2006 01:51 pm (UTC)
I'm not a pill taker by any means, but I love ambien.

I sleep even better with Lunestra, but it makes water taste like ass and I always felt like I have bad breath on it.
27th-Jul-2006 01:45 pm (UTC)
Curses! You've uncovered my sinister plan!
26th-Jul-2006 10:58 pm (UTC)
Untreated sleep apnea doesn't just mean that the patient doesn't sleep well, with the fatigue, crankiness, and mental fogginess that that entails. No, people with sleep apnea are also at greater risk for heart attacks and a long list of other health problems. People with sleep apnea aren't OBVIOUSLY sick, but they really do need treatment, or they will become obviously sick. And anything that might cause death is a pretty serious complication in my book!
26th-Jul-2006 08:30 pm (UTC)
My PCP is Dr. Alex Gonzalez at the Fenway.

But he's only available when the Sox are in town and not when they have day games.
26th-Jul-2006 08:34 pm (UTC)
26th-Jul-2006 09:12 pm (UTC)
Thanks! He sounds like a great lead.
26th-Jul-2006 11:03 pm (UTC)
I have had Gregory Fenton at Fenway as a PCP for years; not sure if he is accepting new patients and he is only in on Thursdays (he is at JRI the rest of the week, I think), but he was willing to give me a referral for a sleep study when I asked a few years ago, does great followup stuff via email, and is entirely comfortable with queer, poly, kinky (as well as gender-bending or free) patients. He has never rushed me through an appointment, has recommended acupuncture/massage/chiropractic over pills when useful, and has never mocked me for not taking his advice...in general, he fits your requirements except for possibly the taking new patients thing -- but he should be in tomorrow.
27th-Jul-2006 01:22 pm (UTC)
I can't recommend Tom Barber enough. He was my PCP at BMC the past 7 years, but he primarily sees patients at Quincy Medical Center. He fits all of your criteria except the affiliation with Fenway Community Health.
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