Another new doc

Today I had a consultation with a physician who specializes in mitochondrial disease and other neuromuscular illnesses. Mitochondria are the energy powerhouses of the cell and it was suggested that I may have a disease of this type, there are lots of them. Ralph and I brought selected notes from my medical record for this doc to review. He also took my history and did an exam. I'm always impressed by how physicians approach this task. Each brings his biases into the room with him, as do I when I'm with patients. Thankfully, he liked my response to his query about why Ralph and I have different last names because that set the tone of the meeting. Things might have gone differently if he had missed my humor or been more traditional about married couples sharing a name. I am so cognizant that much in medicine turns on the interaction between patient and physician. This is especially true when the patient presents with unusual symptoms or has an uncommon illness. Today I lucked out.
He noticed that the muscles of my left hand have atrophied, first neuro to comment to me about this. We believe he gained some sense of how much I've lost in terms of function and how hard I've worked at getting better. If he really reads the records I've brought him then that will become more obvious. He is not sure if I have a mitochondrial problem or not so I'll have a muscle biopsy on Friday. It can take 6 weeks for the tests to come back. He also did a few blood tests that hadn't been done. He did convey his belief that something was amiss with me. His other diagnostic consideration was chronic Lyme's. I mentioned that I was tested for that but he told us that conventional tests are for acute Lyme's and miss the chronic form. Only a few centers can do tests for the latter. We'll head down that path if need be.
Medicine is growing increasing complicated and our current system is inadequate in ensuring that new knowledge is disseminated quickly to those on the frontline of medical care. I always score very well on my boards and process information quickly yet my own illness has shown me how much there is to master. I had never heard of POTS or mitochondrial cytopathies before I became ill. No one can learn all of medicine; we need to develop information networks that point physicians to references which are easily accessed and well indexed by disease and symptoms. We also need a referral system that gets patients to the right specialist. We found today's doc thru a combination of old connections and pure chance. Most patients rely on their primary care physician to find the right specialist yet their doc might not even be aware of the availability of many subspecialists. Changes in this process are needed to ensure that patients reach the specialist who is most able to help them. Who'll take responsibility for moving this forward? Maybe it'll take docs like me who have been on both sides of the exam table to get things going. I can think of worse ways to spend my time.

PS I'm going to edit out the typing errors as they bother me and might keep people from reading my blogs.