OG Nephrologist

I just saw my “local” nephrologist. She is not really OG since she is the third or fourth nephrologist I have seen outside a hospital. When I was initially asked to see a nephrologist due to deteriorating kidney function, I found someone close to all my other doctors. I think she was an Indian woman and I saw her for quite awhile. At some point, she left the practice and I was assigned to the main nephrologist, but he was an ass. As soon as they hired a replacement, I was transferred to him, a Korean man. That went on for awhile, but my kidney function kept decreasing. He also left the practice to move to San Diego, so I got a referral from my primary care doctor, and ended up at the current medical practice. I was supposed to see the primary nephrologist, but was scheduled for another doctor who was more available, and she has been my nephrologist for five or six years now.

The was my first appointment with her since my transplant. UCLA was supposed to send a package with all my notes, medications, and test results. Of course, she has not received anything. I was low-key expecting this since UCLA has probably thousands of active patients, and you are monitored by a team of doctors instead of just one. Good think I had all my records on MyChart on my phone. Long story short, she did not change anything in terms medication or care, but she did have lots of questions for UCLA. The big surprise to her was how fast UCLA stopped my prescription for mycophenolate (Cellcept). She said many patients are on that medication for life, yet it was discontinued for me only after a month. She also said that patients typically get more anti-infection medication for longer periods, while I was only one one, atovaquone.

Even though my nephrologist has worked with UCLA before, I believe she refers most of her patients to St. Joseph Hospital for transplant. I also started there, went through orientation and tests, and met the transplant surgeon. Unfortunately, their transplant social worker was terrible, and rejected by sister as a donor for basically no reason. When I retold the story to my nephrologist and dialysis social worker, they both wanted more information so they could refer the transplant social worker to the licensing board for review. We did not follow through however, and just transferred my case to UCLA. It does sound like the St. Joseph transplant surgeon is much more risk adverse, and keeps transplant recipients on high doses of anti-rejection medications for many years. UCLA seems like the opposite. Hopefully I chose correctly.