Which hospital for serious illness? (Rex: house, best, engineers)

[CHTransplant]

I think I'd be more focused on finding the right physician than on the hospital facility. (Recognizing, though, that one likely flows from the other.)

[frankpc]

Originally Posted by RaleighLass

I would have a 2nd opinion BEFORE any procedures. Most insurance will cover 2nd opinions. but choose a doc that has no affiliation with the first doc and hospital...you don't want them to discuss the case ahead of time and be influenced by that doc's diagnosis comments. If you could share more about the illness it would help. I will say that if it is cardiac related...you are in good hands at Wake med...I trust them completely.If it is cancer related, I would consider UNC and Duke. If brain, then definitely Duke.

Sorry if you told us this, this is an adult we are talking about, right?

I'd concur with this - especially with regards to the specializations.

So while its hard to say without knowing what the issue is and while Duke sometimes comes up short in my opinion for basic medical needs, if you're chasing something that's rare and unusual - there's a better than average chance that someone at Duke knows about it.

Frank

[mskb]

So sorry to hear about this. I'm sure it's very stressful to worry about your loved one and trying to figure out the best place to be. It is more difficult to make a recommendation without knowing the general nature of the medical condition because each hospital (WakeMed, Duke, UNC) has areas they do better in than others, as noted above.

If it's heart or lung related (pacemaker, heart attack treatment, pneumonia treatment, etc), try looking at hospitalcompare.hhs.gov for outcome measures based on Medicare results. It also has survey results on pain care, cleanliness, communication. May be helpful.

That said, a teaching or academic hospital (UNC and Duke) typically see more unusual cases and may have some more resources (although WakeMed is fairly good in some areas like heart and rehab). You should also realize that having an unusual diagnosis (or not yet diagnosed!) means that your loved one will be a medical curiosity. Not in a bad way but you WILL have medical students, residents, and fellows involved with care daily and perhaps even more so because the teaching attendings will want to teach! On one hand, you get more eyes on the case and the trainees may do more research but having a daily parade of people around can also be stressful. Since WakeMed has fewer affiliations, you are primarily dealing with the physicians directly or at most, physician assistants and the physician.

I know you want the very best care but also don't want you to be more stressed by the environment/atmosphere as well when WakeMed may be just as good.

[Mz Scarlett]

Thank you all so much for the comments. Unfortunately, we can't really look for one specific type of doctor due to the variety of symptoms. So far, this person (an adult) is being looked at by several types of doctors covering a span of things--internal medicine, nephrology, hematology, and infectious disease. The doctors seem good, and yes, the case has been a mystery that's stumping a lot of people, which means multiple doctors are curious about it.

We do have a hematologist we see at Duke (unrelated to this), so if it turns out to be something blood-related, we could hopefully get a second opinion from that doctor...

Right now, we're pretty much waiting to see if things get better or worse and waiting for all kinds of test results. I just want to be informed about the options, especially due to the seriousness of the symptoms (currently kidney and blood issues, probably as a result of some type of infection).

[RaleighLass]

Originally Posted by Mz Scarlett

Thank you all so much for the comments. Unfortunately, we can't really look for one specific type of doctor due to the variety of symptoms. So far, this person (an adult) is being looked at by several types of doctors covering a span of things--internal medicine, nephrology, hematology, and infectious disease. The doctors seem good, and yes, the case has been a mystery that's stumping a lot of people, which means multiple doctors are curious about it.

We do have a hematologist we see at Duke (unrelated to this), so if it turns out to be something blood-related, we could hopefully get a second opinion from that doctor...

Right now, we're pretty much waiting to see if things get better or worse and waiting for all kinds of test results. I just want to be informed about the options, especially due to the seriousness of the symptoms (currently kidney and blood issues, probably as a result of some type of infection).

Sounds like you are on the right track with the type of specialists consulting. I'd stay put for now and keep the Duke appt. Docs in this area do consult with each other and Duke does receive many requests from local physicians in cases like this. The absolutely best part of this scenario is that your "person" couldn't be in a better geo location to find the help they need at this time. if local folks can't help, they will know who can. I hope all goes well for you.

[Sweet*Tea]

Originally Posted by Mz Scarlett

Thank you all so much for the comments. Unfortunately, we can't really look for one specific type of doctor due to the variety of symptoms. So far, this person (an adult) is being looked at by several types of doctors covering a span of things--internal medicine, nephrology, hematology, and infectious disease. The doctors seem good, and yes, the case has been a mystery that's stumping a lot of people, which means multiple doctors are curious about it.

We do have a hematologist we see at Duke (unrelated to this), so if it turns out to be something blood-related, we could hopefully get a second opinion from that doctor...

Right now, we're pretty much waiting to see if things get better or worse and waiting for all kinds of test results. I just want to be informed about the options, especially due to the seriousness of the symptoms (currently kidney and blood issues, probably as a result of some type of infection).

If it turns out to be kidney related, I would suggest you try and get an appt/referral with Duke Urology to have him/her evaluated. My doctor at Capital Urological referred me to Dr Ferrandino at Duke to be evaluated due to the complicated nature of my diagnosis.

[Janecj]

Originally Posted by Mz Scarlett

Thank you all so much for the comments. Unfortunately, we can't really look for one specific type of doctor due to the variety of symptoms. So far, this person (an adult) is being looked at by several types of doctors covering a span of things--internal medicine, nephrology, hematology, and infectious disease. The doctors seem good, and yes, the case has been a mystery that's stumping a lot of people, which means multiple doctors are curious about it.

We do have a hematologist we see at Duke (unrelated to this), so if it turns out to be something blood-related, we could hopefully get a second opinion from that doctor...

Right now, we're pretty much waiting to see if things get better or worse and waiting for all kinds of test results. I just want to be informed about the options, especially due to the seriousness of the symptoms (currently kidney and blood issues, probably as a result of some type of infection).

Personally if it is something no one can figure out and you are getting the sense they have no clue, then I would head toward Mayo Clinic in Jacksonville, FL. They are extremely organized, and the team of doctors work together to figure it out. In other words, each one knows what the other one is doing and consult each other on the best course of action to take. Once diagnosed, they will recommend a local Dr. to complete treatment if necessary (you need to ask though). Have one of the Doctors you are currently seeing to request an appointment so you can get in to see them quickly.

[toot68]

From what you are saying, if it was my parent, I'd be looking at getting them a second opinion at a major medical center, there's probably a less than a couple dozen in the country, and we are very fortunate to have two in the triangle in Duke and UNC.

The next step that comes to mind if you feel the diagnosis is not fully fleshed out would be Cleveland Clinic or Mayo, for interdisciplinary approach and the reasons outlined above, although if I was inclined to do mayo I would probably head towards MN rather than FL.

[BalGal]

First of all, I'm so sorry you are going through this! My input would be that we are VERY fortunate here in the triangle to be surrounded by so many wonderful medical facilities. Yes, Duke and UNC are the first two to come to mind because of there national notoriety but Wake Med Raleigh is also a nationally recognized hospital in many fields. I would also like to add that I treated at UNC for life threatening illness, after being transferred from Wake Med Cary…. Wake Med Raleigh would not take me b/c of my condition. While at UNC my doctors consulted with doctors from Duke to come to make sure they were coming to an appropriate decision. My point is I think the area hospitals work very well with one another and always have the patient's best interest in mind and if they can not best serve you they will send you where you can be.

[mjohnson185]

Infection can be very hard to pinpoint, especially if antibiotics have already been started. You may never know the cause of the infection, so you must focus on the course of treatment. Any acute injury to the kidney most always resolves itself even if it takes several months. It sounds like sepsis? Is that what they are telling you? Everybody reacts differently to sepsis. You cannot predict how someone will do, you have to take it day by day. There is no immediate response because antibiotics take a while to work and the kidneys are the last to recognize they need to get back on board. If it appears that the docs can't give you a direct answer...it's because nobody can tell you that A + B = C when it comes to infection. There's no magic test for it and blood cultures often come up negative even when there is really an infection present. So my recommendation...go to UNC Hospitals. By far the best at dealing with infectious disease and all the complications that accompany it.