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New GI; not sure how well this is going.

SarahBear

Moderator
Location
Charleston,
So, I was diagnosed in '08 and put on Prednisone and 6-MP. I later switched to methotrexate because injections are easier for me than pills. The methotrexate helped, but I still had problems fairly often (more than before treatment).

When I graduated high school, I didn't go directly to college, and as a result of that, my dad dropped me from his insurance. I've been untreated for a year and a half or more, and just recently got insurance again.

I saw a GP, who referred me to a GI. She set up a colonoscopy before an appointment - so she had never discussed my disease with me. I was both comforted and confused - comforted because I took it to mean she wanted to get things done quickly, and confused because my Crohn's is in my small intestine. A colonoscopy probably needs to be done from time to time, but I didn't understand why it was the first thing she wanted to do. When they called to set up the appointment, I told them this and they said, "This is just the first step." So I assumed there was a reason for doing the colonoscopy first. They also asked who my previous GI had been, so I figured they were getting my medical records. The GP had also asked, so I had originally expected that information to be sent over with the referral.

Well, the first time I spoke with the new GI was moments before they put me under for the colonoscopy. She was under the impression that I had not yet been diagnosed. She asked if I had ever been on Humira before, and mentioned starting me on steroids. That's all I remember. Apparently she talked to my boyfriend after the procedure, told him everything looked good, and moved on.

I got a letter a few days later telling me I had an appointment on the 19th. When I got to that appointment, I spoke with the PA, who asked about my family history and asked the location of my pain. When the doctor came in, she said they were just now getting my medical records from the last doctor, but were having trouble locating the results of my pill cam. She decided she wants to do another one anyway to see how bad the inflammation is now. She said she doesn't want to start me on a stronger medication if a more gentle one would work instead.

When I started to tell her about my symptoms lately, she brushed it off and said something along the lines of, "Symptoms don't matter because IBS can override Crohn's." I don't understand this. I've never been diagnosed with IBS and did not give her any reason to think I had. I mentioned to the PA that my mother has IBS, but that's the only mention I made of it. I was kind of shocked.

She prescribed me hyoscymine for pain and ushered me out the door. And that was that.

Well, they just got around to calling to schedule the pill cam today (conveniently after I called them and asked when I could expect to hear from them about it), but the doctor didn't make note that I can't swallow pills so they have to go through more of a process to set it up. They said they would call me back soon; hopefully I'll hear from them tomorrow.

So, I have a few questions. First, is this GI's attitude towards symptoms normal? I asked that in another thread (where I also asked about hyoscymine) but figured I might as well throw it in here, too. The only thing I can think of is that she assumes she knows my symptoms from the medical records - but that was all from 2008 and 2009. I'm having a lot more and worse symptoms now. Also, I don't quite understand why it took her office so long to obtain my medical records, why she didn't set up an appointment before the colonoscopy, or where on earth the IBS thing came from. Is it normal for it to take about a week to get a pill cam scheduled? Would this process normally take this long? I feel like she's being kind of slow about this, especially after being told that I've been untreated for almost two years and I've been having a rough time with it lately. All in all, I don't feel like she's taking my condition very seriously.

Second, she didn't mention steroids again. It didn't really sound like she intended to prescribe them. Would steroids typically be used in this situation? Is it possible that she's planning not to?

Also, I have problems swallowing pills. I'm working on it, making tiny bits of progress, but in general, pills just do not go down. Neither does liquid, by the way. Injections are easiest for me. My last GI had no problem with that - she put me on methotrexate because of it. This one, however, wants to avoid those medications and use "safer" ones that are only in pill form. If I insist on avoiding pills, am I taking that much of a risk?

I know I should have asked her these questions, but after she brushed off everything I tried to say, I was kind shocked and lost my train of thought. My old GI wasn't like this at all; she was always very concerned with my symptoms and how I was feeling. She explained things very carefully and made sure I understood everything and was comfortable with it. She understood my problem with pills (she said her husband couldn't swallow them, either) and was happy to work with me. Her PA was easily reached by e-mail with any questions or concerns. In general, I felt like she genuinely cared about my health and wanted to help me. I'm not feeling like the new GI is even paying attention to what I say.

Thanks everyone! Sorry if that's long and ramble-y, I tried to keep it short but there's a lot to say! And I'm not entirely sure where this best fits, so I put it in General. :(
 
I think you should find a new GI. It's good that she's being thorough with testing, but it is very shortsighted to say IBS can override Crohn's when it was never determined that you even have IBS. IBS is a dumping ground diagnosis which must be thoroughly supported by clinical evidence in patients with confirmed Crohn's Disease. If it's not supported by clinical evidence, it's only logical that the symptoms are related to your Crohn's. Your symptoms absolutely matter, and can be very important in determining treatment.
GI's get paid for every scope they perform, and make even more if they can get appointments done quickly and move on to the next patient. It sounds like your GI cares more about her pockets more than your health.
Remember, your doctor works for you. You are paying for a service when you go to see her. If she is not performing to your standards, you have every right to move on. I wish you the best of luck.

Brian
 
Heh, your question, 'Is this normal regard for symptoms?' Yes it is very normal. In fact, more normal than you'd think gauging by the stories around here.

Oh, you were asking if it is right? Certainly not, it's absolutely silly, which is why most people don't stay with the GIs that treat them this way. I wouldn't be happy in your situation right now.

Best of luck
Nathan
 
I havent even seen my GI yet but man am i learning alot!!!! I wouldnt put up with that crap. That is one thing i have learned.

You have to stick up for yourself, no one else will.

i hope you can find a dr who actually cares.........i hate drs like that. I ran into one last year at emerg. She argued with me. But i won. Man was she mad though.....
 

SarahBear

Moderator
Location
Charleston,
Thanks for the responses!

The GI is actually moving to a new office on August, and when she does, her patients have the choice of going with her or staying and being assigned to another GI within the current practice. I've already decided I'm going to stay, if I don't switch / find another GI sooner. I'm currently looking, but I can't find many in the area. That's making it a little difficult. :/

I have another appointment with her on the tenth (and still waiting to get the pill cam scheduled) and I'm going in with a list of questions and concerns I have. If she reacts the same way again, I'll be asking to see someone else.

Thanks again, everyone!
 
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