My primary care provider is a PA (physician's assistant) who is supervised by an MD. I've had contact with both, mostly the P.A. Investigating recurring, severe anemia is the province of gastroenterologists and hematologists. I've been referred to both. The GI specialists have been investigating me for 6 years. (Colonoscopies, Upper endoscopies, a thing where I swallowed a camera.) Hematologists investigate different causes of anemia, like cancer of bone, auto-immune anemia. For some reason the hematologists said I didn't need them, but should stick with the GI clinic. 6 years ago, GI found a stomach ulcer, but that's all healed up.

My sister has the same condition for 12 years. Back when she got it, I thought it was the craziest thing. Surely they could find the source of the blood loss or blood cell destruction. They haven't. She lives thousands of miles away in an area with the best of medical facilities. When she gets anemic, they give her intravenous iron.

Here's my beef: she gets the I/V iron readily. I seem to have to beg for it. She's never needed a blood transfusion. Her doctors seem to be on it. Her condition is managed by a hematologist. My hospital has now decided I should be seen by a hemotologist. Finally, I will be . . . in a few months.

A likely cause is fragile, tiny veins in the lining of the small and large intestine that break, leak blood, then heal up. It can be very hard to actually see them in an endoscopy procedure. My sister had way more diagnostic procedures than I've had. They found nothing.

I'm mad that my PCP (the PA) didn't send me for I/V iron back in June. She told me to take iron pills. Back in May, I got diverticulitis after months of taking iron pills. Research is now indicating that iron pills are dangerous to the gut.

Tomorrow I have an appointment to get I/V iron at out-patient clinic. (If I can walk well enough to get in there. It's way deep in the hospital. I plan to ask for a wheel chair and transport aid.)

I worry that the I/V iron is too little, too late. I might really need blood. For that I have to go to the ER. My PCP just went on vacation. I wish I had an actual doctor to discuss my worries with. I don't. If I call the GI clinic, I probably won't get a response. I messaged the GI PA assigned to me. He ignores my messages.

I need to consider getting out of this teaching hospital system. Now does not seem the best time.