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Doctor note
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Doctor note

I'm a chronic hepatitis patient, and have not started treatment. My current symptoms include fatigue and gas/bloating. I recently asked my hepatologist to write a note for me, certifying that I'm his patient, and that my chronic medical condition could cause chronic fatigue and digestive disorders. The purpose of this note is to help me request for a more accommodating schedule (but with the same work load) from my boss.

To my surprise, he refused to do so. Apparently, he didn't remember much about me. He just pulled out my most recent lab reports, and then told me that my ALT is only slightly elevated, and my viral load is only about 4logs, and thus he would not be able to write such a note for me.

Does anybody here have any experience dealing with such a doctor? Any advice would be greatly appreciated.
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12 Comments Post a Comment
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1491755_tn?1333204962
What was the result of your liver biopsy ?  What geno type are you ? When do you plan on treating ?

Have you asked your boss for the change in schedule al ready w/o a note ?
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29837_tn?1314410659
Find a different doctor...

Magnum
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Avatar_f_tn
Hi James, Thanks for your response. I'm an HBV patient, but I think my issues might apply to HCV patients as well, so I posted here. I haven't done a biopsy yet. My most recent ALT is 41, and my viral load is 4logs. Have talked to my boss about this, but she wants to see note from the doctor.
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Avatar_f_tn
Magnum,

Thanks for your comment. I guess I will find another doctor sooner or later. But the problem is now. I've already talked to my boss, and I thought it would be no problem at all for my hepatologist to provide such a note. After all, I was not asking him to fabricate or exaggerate any thing. But it turns out he's a difficult person.

If I switch, it will probably take a while for me to be able to see my new doctor. If I'm not able to provide the doctor note to my boss in a timely manner, it would make me appear bad, sounds like I'm fabricating things...
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446474_tn?1404424777
My 2 cents worth...
You  must either develop a relationship with this doctor or find a new doc.

How advanced is your liver disease according to a biopsy?

If you are going to start treatment you should have a doctor who cares about you as it is always possible you may need a doctor's note if you should become too ill to work. Better to find out now then later.

This hepatologist said, "viral load is only about 4logs, and thus he would not be able to write such a note for me." Viral load has nothing to do with how ill you are. Any hepatologist or gastroenterologist who works with patients know this basic fact. So I question this point.

You will need to see this doctor more often so they get to know you. If all this doc knows it your last tests results and not the history of your illness then asking him/her for a note could appear to be inappropriate this is the only thing they remember about you. It is like any relationship. It develops over time. You want every doctor to remember as a person, not just another patient. I used to bring chocolates to all my doctor's visits both for my docs and the staff. Believe me they may not remember my name, but they remember me as the guy who brings the chocolates.I have been able to get help many times even after hours as these people know me and always ask how I am doing. It helps when you are depended on a doctor to help you with any serious illness. I have cirrhosis and am waiting for a transplant so my dependence on my doctors and other medical personnel is critical to me and my life. If you see him/her more often, every time you see him/her let them know you are still having a hard time working because of your fatigue.

Although I don't know the nature of your gasto problem, it should be able to be treated and if not "cured" managed so it does not impede your lifestyle.

On the other hand, we don't get along with everyone, so this may be a case of it not working and you will need to find another doc to work with in managing your illness.

FYI: I would not say "chronic fatigue" as that is a different illness. If you suffer from symptoms of chronic fatigue, that is fine.

Good luck!
Hectorsf
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Avatar_f_tn
Thanks, Hector. This doctor is affiliated with a major teaching hospital. I guess he has too many patients to remember me. I live in another state than where the hospital is located. Last time I flew there to be seen by him, he only talked to me for (literally) 2 mins! I felt so stupid! I was basically seen by his physician assistant, who's quite ignorant.

Do you have any good doctors  in the east coast to recommend?
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446474_tn?1404424777
It is always good to have a doc at a teaching hospital as they are aware of the latest developments within the field. But you should also have a local doctor who you see a on regular basis.

"he only talked to me for (literally) 2 mins! " That will not do at all! Thanks for nothing doc!

"I felt so stupid! I was basically seen by his physician assistant, who's quite ignorant."
There is no reason to feel stupid. You are a little part of a very big complicated system that can be overwhelming for patients. You need more of a one on one, doctor/patient relationship. Is there a local gastrenterologist in or near your area? Not everyone needs all the resources of a teaching hospital. If you at some point do, then your local doctor will refer you to the teaching hospital he is affiliated with if that is needed.

"Do you have any good doctors  in the east coast to recommend?"
I wish I could but I live here in San Francisco and the only doctors I know I the east coast I would not recommend.
Others in this community may be able to recommend someone for you. Give time for people to read your post.
Where are you located?

Hang in there you are making progress already.
Hectorsf
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Avatar_f_tn
Good morning Hector,

Thanks a lot for your input. I have a local pcp who usually orders labs for me. I flew to the teaching hospital (located in midwest) a couple of times a year. I currently live in Ohio, but I have many relatives in east coast. So a good hepatologist in NYC will do.
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Avatar_m_tn
I don't feel your doctor did anything wrong. There are many people worse then you that have to continue  to work their regular hours.
From my understanding HBV is not the same as HCV.
HCV is much more a chronic disease where as HBV can subside over time.
Stop worrying about getting a doctors note and instead treat the disease so you can get back to your normal routine.
I doubt you will find a reputable doctor to write you a note.
Best of luck
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1491755_tn?1333204962
HCV and HBV, are not related AT ALL, other than both effect the liver.  HCV is an RNA virus, HBV is a DNA virus.  HCV is closer to yellow fever than it is to HBV.

I understand the general question, and it might as well be posted in every forum.

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1225178_tn?1318984204
Have you had your local doctor check to see if there is another reason for the fatigue and bloating? A lot of things can cause that besides HCV and it would be good to know if you have something else... just to be on the safe side.,

Diane
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1491755_tn?1333204962
She doesn't have HCV she has HBV
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