Saturday, February 9, 2013

Some Education-Part 2

In health care, there are providers besides the medical doctor.  The title depends on the training they receive.  I do not profess to be an expert, but I will outline the levels I know personally.

The medical doctor (MD) is the one most people think of when they hear the word doctor.  They have four years of general medical training and they go on for more in order to specialize.

Then there is the new doctor of osteopathy (DO).  They have the same schooling as the MD, but they go on to receive more instruction in the body’s musculoskeletal system and manual manipulation.  Kinda like a doctor and a chiropractor combined.  They also look at the whole body and how everything affects a patient.

Then you have the advanced registered nurse practitioners (ARNP) who are nurses that have a Master’s degree and specialized training to treat patients.  In New Hampshire, they can prescribe medications and work under their own license, not needing a physician to oversee their practice.

The last one is a physician’s assistant (PA).  They have the same type of training as an MD, but they have to be supervised by a physician.

All of these categories are qualified to treat patients and deciding on the type you see for a primary care provider is an individual choice.  Our former provider was an ARNP and he did a wonderful job with our family, but as I stated we changed for convenience.

Our new doctor is a jewel!  Dr. Amber Schmidt is a new doctor of osteopathy (DO) and has not learned many of the bad habits of providers that have been in practice for years.  She knows her stuff and is willing to listen to her patients. 

I badgered the Lycan into coming to the office for a visit with Amber.  While looking over his old lab results she noticed that he had not had a recheck on his liver counts for over six months, so she did the prudent doctor thing and ordered a whole slew of lab tests.  Well, his counts came back higher than ever.  She was talking to me about them and we were trying to figure out the cause when I remembered what the CL had said about the SD having a “blood disease”.  I mention it to her and she immediately starts consider about hemochromatosis.

She orders some more testing that includes some iron tests and a genetic test for this condition.  The iron tests come back elevated and the genetic test shows that the Lycan has one of the two most common genotypes. As diagnosis is generally made by a person have both of the common types we did one more iron test.  The results come back FOUR times the high normal limit.  By now, we are pretty certain that he has hemochromatosis, but she wants to get a liver biopsy for two reasons:  one, it will confirm the diagnosis and two, it will tell us if he has cirrhosis.  That information will tell us his long-term prognosis. 

Next on to what hemochromatosis is….

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