Questions for first appointment with a gastroenterologist

[idreamofpeace]

Hello all
I have my 1st GI apt on Monday...I have written all my symptoms down, pretty well in detail. Just wondering if anyone has advice/suggestions for preparation for my 1st apt.

Thanks so much : )

 

[Keona]

Hey I dream of peace. One suggestion I was just given is to keep track of all your appointments also. Write down what happened, what was discussed, etc when, where. In hind sight I wish I would have done this. So many of us have been run around the block without getting help I think being able to show them this would also help.

Good luck I hope you get some answers

 

[Astra]

Hiya dream

yes, and also a journal of trigger foods, times of pain, ie after you've eaten etc.
Let them know that you're genned up on Crohn's and meds etc, this gives you a better advantage and reduces the intimidation that docs love to do!
I'm not over generalising here, am I? lol
good luck and be assertive!
Read my siggy line
xxx

 

[Cat-a-Tonic]

I agree with what's already been said - write down EVERYTHING - all your questions, all your symptoms, your food/symptom diary if you keep one, and anything that you've been taking (vitamins, supplements, over-the-counter stuff like Tylenol, etc). Write down how long the symptoms have been going on, if they've worsened or changed, if they can be affected by certain foods or by stress, etc. Write down symptoms that are new even if they don't seem associated with your abdominal issues - extra-intestinal symptoms are pretty frequent with IBD and can include things like headaches, joint/bone/muscle/back pain, weakness/fatigue, change in mood, etc. Especially make note of if you've lost weight, experienced blood in your stool, had a fever, etc - as those things are not signs of IBS but could be indicative of IBD. Sometimes doctors will try to write off your symptoms as IBS, I think a lot of us have been there (myself included) so you might want to take a look at this link (look specifically at the section titled "Red Flag symptoms which are NOT typical of IBS"):

http://www.helpforibs.com/footer/rome_guidelines.asp

I hope that helped somewhat! Good luck with your appointment! Let us know how it goes, I hope you get some answers.

 

[xJillx]

I agree with everyone above with keeping detailed records. Have you started medication or have had testing yet? If you have yet to start any meds, I would suggest doing some homework in the treatment forum to become familiar with all of the different options. And if you have not had any testing done, your doc may suggest starting with some imaging tests (lower bowel series, CAT scan, etc.) or a scope. In my experience, these tests never show enough and a colonoscopy will be needed in the end. So, to avoid endless testing, I suggest just starting with the colonoscopy. I know the prep is awful, but a colonscopy offeres the best results. Good luck and let us know how it goes!

 

[bushydougie]

Great advice from above. I would also add to ask about who to get in contact if anything gets worse after your appointment and before your next one. I didn't ask this on my first appointment and regretted it as I needed to chase up when I woils get my colonoscopy appointment.
If you can take someone with you for The first couple of appointments. This can help if you're bombarded with new information you don't always take it all in.
I had to learn to stand up for my self in appointments. I almost had to beg to be put on pred but was so glad that I did as it was such a relief to start feeling better.
I hope your appointment goes really well

 

[Keona]

I agree - take someone with you ... you will be amazed at how different they treat you.. there is a huge power imbalance between doctor / patient and when you are already feeling like crap... it is difficult to advocate for yourself. This way, the doctor will have to be accountable to just more than you.. sad that it works that way in some cases but it is a reality.

Hope we aren't freaking you out..lol.. we just hope you get the best care possible...

 

[idreamofpeace]

Thanks for all the tips guys. I am gonna type up all my symptoms this weekend so I will be prepared. I called my regular doc to make sure the faxed all my info. I have had test so far the only thing that came back abnormal is a high white blood cell count and elevated liver enzymes...I am glad though so at least they can see SOMETHING is going on!

 

[idreamofpeace]

UPDATE-1st GI VISIT

First I just want to thank everyone for their comments, input and support. I had my 1st GI apt today. It went really well. Dr Daniels is very nice, he did not rush and took the time to go over all my symptoms and recent testings. He def thinks I have IBD, he thinks UC is likely. He scheduled me for a colonoscopy this Friday, did a blood test today that checks antibodies and likeness of IBD and an X-RAY of my lower back to check for damage from possible arthritis or sciatic nerve damage. He also wants me to get my eyes check to see if I have inflammation in my eye. So I plan to call and make an apt today. At this point I just wait for Friday and see what the colonoscopy shows.
Any tips on the prep? And what to expect...
Thanks so much
: )

Below is the symptoms/issues I typed up and discussed with Dr Daniels:
******************************************************************
Issue for the last 6 months, 3 “episodes” starting with cramping, blood in stool and followed with frequent diarrhea. 1st time was a couple days, 2nd time about a week and 3rd time lasted 4 weeks.

Rectal bleeding and irritation around rectum after bowel
Pain inside rectum-sharp stabbing that last less than a min
Constipation and Diarrhea
Diarrhea and floating stool 3-10 times a day
Blood and tissue in stool- 3 different occasions
Vomit bloody tissue- 1 occasion
Abdominal cramping-Right lower abdomen, right upper, left upper-sharp and dull
Bloated
Gas
Nauseous
Headache (right eye)
Dizzy/light headed/shaky
Low fever, often feel warm to touch (back and tummy) but have no fever
Fatigue
Lower back pain
Feeling like I need to use bath...but don't
Have to go to the bathroom really fast, accident in pant

No know food triggers
Pain and symptoms seem to be worse in evening

Went to Fayetteville Primary care, urine test, blood test, stool sample, lower abdominal X-ray, physical exam and CAT Scan---all was fine with the exception of high white blood cell count, elevated liver enzymes and internal hemorrhoid.
Last PAP with Gynecologist was 4-8-11—everything normal, no concerns.
******************************************************************
I am going to post this to more than 1 thread, since I have different people who comment on other threads, sorry if you run across it more than once. Just want to update ALL those who have been nice enough to respond. : )

 

[Cat-a-Tonic]

Dream: Sounds like a good appointment and a good doctor! As for the prep, first of all it's best if you eat lightly for a few days beforehand, so that there's less stuff in your intestines that has to come out. Make sure to have lots of clear liquids available since you aren't allowed solid foods while doing prep - the last time I did prep, I had several flavors of jell-o (make sure you check what colors are allowed - I wasn't allowed anything red or purple since they can look like blood in the intestines), chicken broth, flat ginger ale (you can also do clear sodas like sprite/7up), gatorade or pedialyte, water of course, and sometimes things like tea and coffee are allowed too (again, check with the specific instructions you get - every doctor/clinic is a little different with what they allow). Make sure you have things to keep you entertained like a book or a laptop computer, as you are going to be spending the majority of the time on the toilet!

What type of prep are you doing? I've only ever done the Gatorade & Miralax prep, which was fairly easy to get down but I always get too dehydrated when I do it, so whenever I have to do prep next they might force me to do Go Lytely instead, which I understand is just vile. Drinking the prep and spending hours on the toilet is the worst part, though. The scope itself is really easy, at least that was my experience. They give you great drugs. I had "twilight sedation" which supposedly meant that I'd be minimally conscious and could respond to orders to roll over or move a certain way, but honestly I felt like I was out completely and I don't remember a thing! I remember they put the drugs in the IV, then it felt like I took a lovely nap, and I woke up feeling pretty great. I was in quite a bit of pain the next morning, but I think that was partly because they had taken a bunch of biopsies, and partly gas pain - they pump air into your intestines when they do the scope, so be prepared to fart a LOT afterwards!

Good luck on Friday, let us know how it goes! I hope you get some answers!

 

[Cat-a-Tonic]

Oh, I realized I should also mention this: Sometimes when you start drinking the prep, for the first few hours nothing happens and you start to wonder what's going on and if you're ever going to start going. My experience is, when you're least expecting it, that's when it suddenly hits you and you need to be on a toilet NOW! So even if you feel like nothing's happening and the prep isn't doing anything, don't be fooled and stay near the toilet!

 

[xJillx]

Cat gave excellent advice, especially with the prep hitting you when you least expect it. I most recently did the gatorade & miralax prep for the pill cam, and it took several hours to kick in. But it sure did do the job! And, as Cat said, that prep is easy to drink, but it does dehydrate you a bit. However, I will take it any day over GoLytely. That stuff was awful! I actually couldn't keep it down. After throwing up twice, I called my GI and she suggested mixing it with apple juice. Only then was I able to keep it down. But it made the process much, much longer. I hope your prep isn't painful, and you get some answers for the test. Please let us know how it goes!

 

[maxibear]

make a list, take someone with you, and get 2 more opinions

 

[idreamofpeace]

UPDATE-
Hello All, had the lovely colonoscopy today..it actually wasn't bad at all but the prep was a bit of a challenge. The first two hours I felt like I was in labor and questioned if I could continue the rest, but luckily once the food passed it was pretty manageable.
The procedure it self was a breeze. I went into the room, undressed, gave me an IV and had me rest for an hour. A WHOLE hour of silence! It was wonderful, I read a book and relaxed. (I have small children, this was a treat! lol ) Anyways, so they rolled me back to the room talked to the nurses and doctor a bit and I was a sleep before I knew it. I woke up in the recovery room. My doctor came in shortly after and told me that he expected me to be in bad shape with all my symptoms but said things looked really good. A relief..yes! But know what?! He said the only thing he found was Grade 1 internal hemorrhoids and a small polyp in the ascending colon, which he removed and sent for testing. He said he took a few biopsies for testing over random areas of the large intestines and colon (I think) but overall he thought everything looked good.
He told me his office would be calling me within a week or so once they get the results back from today and from my blood work and X-RAY to schedule my next apt with him. He sen t me home with a copy of his report and pictures, which I thought was pretty neat, I now know what the inside of my colon looks like YAY! j/k of course, but I have to laugh about it...what else can I do?!
So I am very grateful and relieved nothing serious is wrong but am a bit worried that I may continue to have these symptoms and no answers : (
All I can do is wait for my next apt and in the meantime watch what I eat!
Take care

 

[Crohn's 35]

Good news! The colonscopies are not bad, it is the not eating and prep that sucks. Hopefully you are on the mend and get the results back with good findings. Let us know how it turns out. Silence is golden

 

[Keona]

I find the waiting is the hard part...
Hang in and keep us posted
Wendy