Is there such thing as a general consultant who can investigate a few symptoms togeth

76544567

My brother doesnt know where to turn at the moment.
He has lots of different health issues that he thinks are all related to the same thing.
He has been to our family GP, who I agree with him is terrible.
He has changed GP and gone to others who are no help.
He eventually demanded one of the GPs to refer him to a consultant and he did.

So he has been seeing a consultant, about 4 times in the last 6 months who is investigating the symptoms, but only in line with his own area of expertise and after ordering several MRIs of different joints, Hip, Knee, neck, over the 6 months is still no closer to finding out what the central issue is.

My brother thinks it could be heart or brain related, but the consultant is only investigating joints, even though his symptoms are getting worse by the week. He doesnt feel any progress is being made and one test every 6 weeks is slow going.

I was suggesting to him that he see some sort of general consultant who can order a whole batch of tests and MRIs to be done in short order, like Brain MRI, Heart, etc and get everything looked at instead of looking at one thing every 8 weeks or more all the while it getting worse.

He told me he doesnt believe there is such a person existing? That you have to go to one, let him do his thing and he refers you to the next etc.
I think there must be someone who can do all the tests in one go and investigate all of the symptoms together.

Can the good people of boards tell me if such a person exists. Even give me the names of some and I will pass them on. He has private medical insurance. Does he just call the person and make an appointment?

If that person doesnt exists I really dont know what he is going to do. His life is miserable at the moment. He was never sick in 40 years and now he has dizzy spells, headaches, numbness in the legs and feet. Pain in the arms, hands, neck. Heart palpitations. And the numbness in the legs and arms is getting worse every week, especially on one side, and then goes away. And a whole host of other symptoms. But he is not getting to the bottom of it and is very downbeat. It could even be some disease he got years ago and is only presenting now, but who investigates that for him.
Its just one test, its not that, next test, its not that and on and on. Why not do all of them at the same time, in case the illness is time critical.

If he could even get a scan of the brain and the heart, lungs and get the all clear on those he would at least know they werent the problem and maybe cheer up a bit, but his consultant wont do those tests yet until he is finished his own.

I thought Id see if I can find out is there a general consultant and push it on for him. Maybe get it moving with a different consultant.

Arbie

GPs are effectively general consultants but are based in the community rather than in a hospital, so they are limited in their access to certain tests and treatments. As in any field, if your knowledge is broad it may not be as deep so GPs link in with very specialised hospital consultants who focus on their own area. So if a GP sends you to a brain surgeon then the brain surgeon will not investigate your kidney problems, and so on.

Life-threatening and time critical conditions tend to be easy to diagnose - it's the chronic ones bubbling under the surface that are tricky. Some diseases can have dozens of symptoms and a patient could have 10 of them, 1 of them or none of them! Medicine is not like in Star Trek where you wave a machine and it scans everything and spits out an answer. Many conditions are overlapping so you may need several tests over a period of time to rule out one disease and confirm another.

The reason medical training is so long and arduous is because it is difficult to recognise patterns, to prioritise resources, and to know when risks of investigations outweigh the benefits. If we just did all blood tests and all scans on everyone we would spend huge amounts of time and money and end up with very little extra information. This can be very frustrating for patients who sometimes feel they are being ignored or mistreated, but the alternative is chaos and endless waiting lists.

Some GPs are more experienced than others so it is good to get a second or third opinion. If someone is not happy with any of the GP opinions they get, they could ask for a referral to a good internal medicine consultant. These are hospital consultants who practice general medicine and who often have a sub-specialty area as well, such as geriatrics, respiratory, etc. They will have access to most investigations like blood tests, imaging, etc. and will often co-ordinate care with the GP.

76544567

Thanks for that info.
Its a real pity in case its time critical that it takes so long.
His wife is 100% sure that he has Lymes disease and has had it for years, so if that was it then it would be time critical.
I wonder is there any type of Lyme disease specialist that he could go to to rule that out.
Someone other than his own GPs who dont actually believe there is Lyme disease in Ireland.

Stheno

76544567 wrote: »

Thanks for that info.
Its a real pity in case its time critical that it takes so long.
His wife is 100% sure that he has Lymes disease and has had it for years, so if that was it then it would be time critical.
I wonder is there any type of Lyme disease specialist that he could go to to rule that out.
Someone other than his own GPs who dont actually believe there is Lyme disease in Ireland.

Your best option is to find another gp

76544567

Stheno wrote: »

Your best option is to find another gp

He is on his third GP.
Now he has an appointment for a consultant for joint problems for 3 months time.
All he wants is a GP who will get the tests done, but none of them will.
They dont believe there is Lymes in Ireland and nearly laugh at him if he mentions it. They wont even get other tests done for him.
I think I might take him to the UK if I can find somewhere to run investigative tests for him.

caviardreams

It can be hard to find a good GP but I do think this is the best route. As it happens when I was at a consultant recently he asked if I had been tested for Lyme's disease so I don't think you need to go outside Ireland - there are certainly health professionals here who are aware of it being a possibility.

Yintang

I read an article a while back about a lady who was finally diagnosed with Lyme disease after a long period of lots and lost of awful symptoms and no clear diagnosis. If I remember rightly, she had to ask for a specific blood test to be sent to Germany, which confirmed Lyme disease. The lady was Hannah Nolan I think who's involved in a running/weight loss business, think it was called Why Weight or something like that. Just thought it might be of some help to you to get in contact with her.

Mountainsandh

OP I don't know about Lyme disease specific tests, but I checked online recently, and if you search for private blood tests, you will find a few companies that will send you a kit, you go to either their or your own nurse to draw the blood, and then send the whole lot to the UK (or Ireland) for testing.

Like these http://www.bloodworks.ie/

I haven't tried any of them.

I was looking more at thyroid/hormonal tests, but if you contact them I'd be surprised if they don't have an option to test for Lyme. Especially if it goes to the UK for testing.

edit : this lady mentions the German lab and other labs http://www.ticktalkireland.org/suspectlyme.html

poppyseed777

Dont know of a general consultant. With his symptoms I would attend a neurologist. The palpatations are likely a result of stress secondary to the other symptoms. If he believes he has lyme disease he should see an infectious diseases consultant.
Unfortunately consultants often wont refer on fast enough and sometimes you have to decide to change consultant yourself.
Yes you can call any consultant and request an appt, they will likely ask you for a gp referall letter so that youre insurance will cover it.

poppyseed777

If you check iddoctor.ie they have specialists in infectious diseases including Lyme disease

76544567

Thanks for that info.
Will pass it on to my sil and see what she wants to do.
Its very hard when you dont know what the problem is. I guess it just seems really slow when you are the one in pain.
And I hate seeing someone in pain.

caviardreams

Totally can relate OP - I have had a long-running chronic issue with no real explanation for over a year before finally getting to the bottom of it (to some extent anyway), and then finding out that pain management is all that can really be done. It is a lot easier if you have a broken knee/wrist, or something that can be readily diagnosed with a common blood test or scan etc.

Pedro32561

He could consider going to the Emergency Department of one of the private hospitals. They may admit him for investigation which would give access to all required consultants.

Arbie

Pedro32561 wrote: »

He could consider going to the Emergency Department of one of the private hospitals. They may admit him for investigation which would give access to all required consultants.

The criteria for admission at private hospitals can be just as strict as public hospital, maybe moreso in some cases. They won't just admit someone because they want/need tests, the insurance companies would refuse to cover it. If someone does turn up expecting this and does not meet the criteria for admission they would end up with a bill for e150+ and very little to show for it.

OP, I send patients for lyme tests several times a month, as do many of my colleagues. It really is not an unusual test in Ireland. There are many GPs who send patients for the test. I would suggest your friend contact a GP that comes recommended from a friend or family member (someone you know must have a GP they recommend), tell the GP his symptoms and his concerns that he has lyme disease, and ask the GP to investigate for lyme. I would be surprised if that does not work.

neemish

There is such a thing as a Consultant General Physican. the ones I know of are in private hospitals and you would have to get a referral from the GP, would be worth exploring