What kind of doctor should I see for this?

[footballmom]

Three to four times over the last three weeks I’ve had something like a micro / mini blackout.  Three weeks ago, I was leaving a little shop with friends and it was like I blinked and realized I had spilt coffee all over myself.  It happened again today and it was the most serious based on what was going on at the time.  No commonalities from these episodes (have eaten, I’m hydrated,etc).  Within the last 6 months I’ve had iron infusions which have “cured” my anemia but I’ve remained low on vitamin B and my white blood cell count has dropped the last three rounds of blood work over 2 years.  I need to get this checked out, right? What kind of doctor should I see? I have pretty good insurance and don’t need a referral to see a specialist.  But, I don’t want to bounce around from doctor to doctor.  

[bolt.]

I'm in Canada, and here we always start with our family doctor (which I think you call a general practitioner?) and use their wisdom to figure out who to see next.

[EKS]

I'd start with your regular doctor.  They may want to get the ball rolling with some basic tests, and they will tell you who to see next.  

Otherwise, if I had to choose a specialty, I'd pick neurology.

[whitestavern]

I’d probably call a neurologist. 

[Carol in Cal.]

I would contact your regular doctor and a neurologist, immediately.  This could be something super simple and treatable or it could be something serious.  Also, quite frankly, and I know this is hard to hear, I would stop driving until this is resolved.

[JennyD]

1 minute ago, Carol in Cal. said:

I would contact your regular doctor and a neurologist, immediately.  

Same here.  

[Innisfree]

2 minutes ago, Carol in Cal. said:

I would contact your regular doctor and a neurologist, immediately.  This could be something super simple and treatable or it could be something serious.  Also, quite frankly, and I know this is hard to hear, I would stop driving until this is resolved.

Yes. I'm afraid the driving is the first thing I thought about.

Hope you get good news quickly.

[footballmom]

13 minutes ago, Carol in Cal. said:

I would contact your regular doctor and a neurologist, immediately.  This could be something super simple and treatable or it could be something serious.  Also, quite frankly, and I know this is hard to hear, I would stop driving until this is resolved.

Yes, agreed.  I’m going to pause on driving until I’ve seen a doctor.

[Catwoman]

1 minute ago, footballmom said:

Yes, agreed.  I’m going to pause on driving until I’ve seen a doctor.

I think that’s a wise idea.

I hope this turns out to be a very minor thing!!!

Have you checked your blood pressure to make sure it’s not super-low? That’s an easy thing that you can do at home while you’re waiting to see your doctors. 

[pinball]

Not to scare you...

but if you have a stroke center or a hospital with a strong vascular program, tell your loved ones that’s where you want to go if you collapse. And tell them to tell ambulance and/or paramedics

it sounds like it could be TIAs

id call your GP on Monday at opening, run everything by them, ask who is the neuro they refer to, and make appts for both ASAP.

[kbutton]

10 minutes ago, pinball said:

Not to scare you...

but if you have a stroke center or a hospital with a strong vascular program, tell your loved ones that’s where you want to go if you collapse. And tell them to tell ambulance and/or paramedics

it sounds like it could be TIAs

id call your GP on Monday at opening, run everything by them, ask who is the neuro they refer to, and make appts for both ASAP.

This seems really wise.

If I had a good family doctor, I would start there. As I don't (but am trying a new one this week), I would ask friends for a specific referral, but neurology sounds right. 

57 minutes ago, bolt. said:

I'm in Canada, and here we always start with our family doctor (which I think you call a general practitioner?) and use their wisdom to figure out who to see next.

Totally an aside from the topic, but I always wonder if countries with nationalized healthcare have better family doctors/GPs. The only wise one I had seemed perturbed when he ran a bunch of labwork for me to see what was up with my chronic pain, and it all came back clean. That was the last I walked in his door because I could tell he immediately thought I was a hypochondriac. The look on his face and the way he talked to me with the results said it all. I had also been in once for what I now know was probably an abdominal migraine, but I'd never had one before, and I know I sounded whacko when I came in--he gave me anti-nausea meds, but I think he probably put that incident with the clean bloodwork and thought I was nuts. Years later I ended up GF (long story), and to my surprise, my pain almost completely receded. The other two have been duds. One just plain refused to talk to her patients and answered in monosyllables if at all possible. The other is certifiable. She doesn't do anything evidence-based, and she makes up wild theories to explain straightforward things. If a specialist asks me to have her schedule a test, she can't manage it without making up other reasons for the test. It's bizarre. Hoping the one I meet on Tuesday is a good one.

If I had to rely on a GP, nationalized healthcare would be completely useless to me. I have had excellent specialists for the most part. 

[footballmom]

20 minutes ago, kbutton said:

This seems really wise.

If I had a good family doctor, I would start there. As I don't (but am trying a new one this week), I would ask friends for a specific referral, but neurology sounds right. 

Totally an aside from the topic, but I always wonder if countries with nationalized healthcare have better family doctors/GPs. The only wise one I had seemed perturbed when he ran a bunch of labwork for me to see what was up with my chronic pain, and it all came back clean. That was the last I walked in his door because I could tell he immediately thought I was a hypochondriac. The look on his face and the way he talked to me with the results said it all. I had also been in once for what I now know was probably an abdominal migraine, but I'd never had one before, and I know I sounded whacko when I came in--he gave me anti-nausea meds, but I think he probably put that incident with the clean bloodwork and thought I was nuts. Years later I ended up GF (long story), and to my surprise, my pain almost completely receded. The other two have been duds. One just plain refused to talk to her patients and answered in monosyllables if at all possible. The other is certifiable. She doesn't do anything evidence-based, and she makes up wild theories to explain straightforward things. If a specialist asks me to have her schedule a test, she can't manage it without making up other reasons for the test. It's bizarre. Hoping the one I meet on Tuesday is a good one.

If I had to rely on a GP, nationalized healthcare would be completely useless to me. I have had excellent specialists for the most part. 

This is exactly it.  The GP I have now has been the best of the lot but there have been gaps.  I.e. she tested DH for Lyme but not with IGeneX test.  He tested negative with the other test but had Lyme.  But, she does listen and will make recommendations for other doctors to see. So, that’s a positive. 

[Bootsie]

I have found that often even if my insurance did not require a referral, a specialist could be difficult to get into without a referral from a GP.  If I were experiencing what you described and knew of a neurologist that I thought highly of, that is where I would start.  I hope it is nothing--my mom had some issues like you describe for while and it turns out that it was migraine related.

[cintinative]

I am leaning toward neurology but the white blood cell issue and iron issue is kind of throwing me off.  I would definitely start with your general practice doctor and see about a neurologist and/or any other specialist.  Where I live, the wait time to see a neurologist is four or more months. I would see what you can do about getting in sooner.  Do you happen to live near a Cleveland Clinic/Mayo?

Is there any history of Celiac disease in your family?  Have you had any stomach symptoms? I just wonder about the low vitamin absorption coupled with the episodes.

[TravelingChris]

WHen they thought I had a seizure, I saw my concierge doctor the next day (it happened at night) and also had an EEG at a hospital that same day.

[Pawz4me]

We would see our primary care PA first. She's absolutely fabulous, and we know from experience she'd get us started on whatever tests were needed and into see any needed specialist ASAP. Plus there are very few types of specialists around here who will make an appointment w/o a referral from a PCP. I hope you can get it diagnosed quickly, and that it's something easily treated.

[Katy]

Go to the emergency room.  You need to be tested for strokes, among other things.  Neurologists can take more than 6 months to see.

[kbutton]

42 minutes ago, Katy said:

Go to the emergency room.  You need to be tested for strokes, among other things.  Neurologists can take more than 6 months to see.

An ER visit is a good way to get into someone sooner--some specialists will take new patients who come this route even if they are busy, or they will prioritize you on their cancellation list. 

If you think you have any chance of pernicious anemia, you might consider an immunologist since it's autoimmune. It runs in my family, and I have mild indicators that my B12 might be off, but it's not off enough to be obvious at this point. https://rarediseases.org/rare-diseases/anemia-pernicious/

I think I have read elsewhere that the jaundice that can occur with pernicious anemia is usually not pronounced--you might have slight yellow tones to the skin, for instance, but not have particularly high bilirubin or yellow in the whites of your eyes. I am not sure if I could find that information again though.

[BlsdMama]

2 hours ago, Bootsie said:

I have found that often even if my insurance did not require a referral, a specialist could be difficult to get into without a referral from a GP.  If I were experiencing what you described and knew of a neurologist that I thought highly of, that is where I would start.  I hope it is nothing--my mom had some issues like you describe for while and it turns out that it was migraine related.

This is exactly what I experienced. In our area, specialists have waiting lists, so not only do they require a referral, but the information your GP provides will determine the urgency timeline. 
 

i have been in a similar boat as you - I didn’t have a GP forever. I ended up using my husbands local GP. He’sa nice man but our personalities don’t mesh so I recently needed to find someone else. It was VERY hard to find someone accepting new patients. If you have a GP you don’t like, I’d still consider using that person for now and make finding a new GP a priority when the dust settles. 

[Ausmumof3]

You already have good advice so just wanted to wish the best for you that it turns out to be minor and easily treatable.

 

[footballmom]

14 hours ago, Catwoman said:

I think that’s a wise idea.

I hope this turns out to be a very minor thing!!!

Have you checked your blood pressure to make sure it’s not super-low? That’s an easy thing that you can do at home while you’re waiting to see your doctors. 

It could be low blood pressure - whenever I go to the doctor they ask if I’m a runner because my blood pressure is low (but not concerning while there). 
 

kbutton, I’m also going to ask about pernicious anemia.  
 

Thank you all for the suggestions and support! I will come back and update - going to call my GP this morning and go from there. 

[hippymamato3]

Neurologist.

[JFSinIL]

Neurologist and family doctor and stop driving in the meantime.  Keep us posted!  Sounds like absence seizures to me, but why are they happening and how can they be prevented?   Whichever doctor can see you first, insist they order tests.  It may or may not have anything to do with your other existing medical issues, so do not let the G.P. assume it is due to low iron etc dismiss them without testing.

Edited May 10, 2021 by JFSinIL

[Alicia64]

I'm team neurologist.

Stay safe.

[Harriet Vane]

I agree with getting in to see someone immediately to check for strokes and such.

But having said that, your low blood pressure makes me think it might even be vasovagal syncope.

You will want to look into the big diagnoses first--blacking out suddenly and repeatedly must be treated like the emergency that it is. 

[mommyoffive]

Thinking good thoughts.  Please update when you can.