Test Happy Doctors

Hi all

I'd posted not long ago about possible colon issues. I still haven't figured that issue out, but have a doctor issue! (So what else is new?). I feel like due to my original misdiagnosis and the appalling lack of info doctors have on D I've become a bit cynical about doctors.

So I had another doctor refer to a gastroenterologist and her office suggested sending the referral to two doctors to see who had an opening first. When I called them I found out they all wanted to schedule me for a colonoscopy without even asking about my symptoms or history! One did say they could schedule me for an appointment first if I wanted so I did and am now juggling the second doctor who scheduled a colonoscopy in May but is calling me with cancellations. I feel a bit guilty about this doctor juggling.

Now I admit I'm really squeamish about it and that could be adding to my reluctance (in addition to normal hesitation I have the problem of needing to stay over as it's an hour over the mountain and not being able to drink the sugar drink they routinely give you). But doesn't it seem a bit crazy to schedule everyone for a procedure that might seem routine to them but is an ordeal to the patient? Can't doctors talk to someone and find out their symptoms, at least once before ordering procedures?

Just wondering if other people feel as well that doctors are test happy or it's just me looking to avoid the colonoscopy

Most probably it's some of each.

That said, it does strike me as wrong to schedule someone for an invasive procedure, diagnostic or not, before even meeting and talking (or, as you mention, knowing anything about the patient's history).

Finally, this falls under the "everyone is different" category: some people I know found the colonoscopy to be very unpleasant. For me, it was a walk in the park. No more difficult than a routine dental cleaning. So you just never know.

Truth be told, I’ll bet almost everyone is squeamish about this procedure. Unfortunately, for a colon exam, a colonoscopy is the gold standard. Similar to this is the use of the angiogram to inspect coronary arteries when heart disease is suspected. There is no substitute for an experienced doctor’s direct visual inspection.

I know it’s easy for me to say, but I’d bite the bullet and schedule the procedure. Good luck, I wish you well!

By the way, I’ve done this three times and I’ve not had any BG problems due to the prep. In fact, not eating left me with flat BG’s. It’s an opportunity to tweak basals.

What did you use to mix the medicine with, Terry? I'm told it comes with Crystal light with sugar. I asked if I could mix it with herbal iced tea. Even sugar free crystal light would taste nauseatingly sweet to me since I don't use artificial sweeteners.

I actually did schedule the appointment with another doctor in May but I will probably reschedule with this one if that's what he suggests after our appt. Thanks for saying it isn't too bad, guys. Maybe it's one of those things where anticipation makes it seem worse than the actuality.

zoe, yes colonoscopy is standard especially if you're over 50 never had one and a type 1. Ask if you can get a Rx for HalfLytely Prep Kit, it's all in one, just add water, sugar free, etc...and supposed to be the best in terms of taste and minimal preparation compared to the rest of the prep kits. When I saw my GI doc, he did a full exam, ordered blood work - tests, including stool sample (gross but just sayin') to check for something like infections, parasites, etc...but I had blood in my stools and not sure what your symptoms are. I do find it odd that they wouldn't even schedule a pre appointment first. I've rescheduled my colonoscopy 3 times already. My GI doc will keep me overnight too, for the prep..not sure how fasting goes for a type 1. good luck. Maybe ask to see the doc first. Did they give you proper paperwork, instructions to follow to prepare for a type 1?

Hey Zoe, unfortunately I'm pretty experienced with gastro problems. My gastro requires you to come talk to him and then schedules the colonoscopy - the first test they run. Sometimes they will even do an endoscopy at the same time of the colonoscopy while they have you there if your symptoms warrant.

Apparently anything in the abdominal area is just hard to diagnose because they can't see around in there. I ended up having the colonoscopy, a CT scan of the abdomen and pelvic area, and an ultrasound of my upper abdomen to look at liver, kidneys, pancreas.

They never did give me a diagnosis but after all those tests told me that my symptoms sounded like colon spasms and irritable bowel-type symptoms so gastro prescribed bentyl which immediately stopped the pain. My pains seem to only flare up when I'm eating too many salads so I only take it every now and then.

Good luck to you! The prep is nasty but the procedure sounds alot worse than it is.

Thanks, Sarah. I'm not getting it for prevention. I can't afford prevention stuff in addition to what I have already. That's another thing I always feel defensive about with doctors! Thank you so much for that name; the woman I talked to didn't mention it. Does it have artificialsweetener? She is checking to see if I can add the powder to iced tea so I don't even have to drink artificial sweetener. I can't even imagine what a gallon of sugar drink would do to my blood sugar if I could manage to get it down!!?

Yes, I did schedule an appointment with one doc first and left the other doctor colonoscopy appointment hanging too. they did tell me they recommend doing part at night and part in the morning, so it isn't that they are keeping me overnight but that I will stay in a motel because I wouldn't want to drive an hour over the mountain in between!

The second one said she sent me instructions, and we talked about it a bit on the phone. They don't have a clue about Type 1, she said nobody had asked about special needs before! The only thing she did say is that they gave the morning appointment to diabetics. This is based on the assumption that we can't go without eating but for a type 1 on insulin that doesn't matter. But I quietly accepted that perk!

I've had three colonoscopies with different preps each time. Everyone is different, but I prefer a combination of liquid and pills. I mixed the liquid with Diet Sprite once and Crystal Light the other time. I don't like either of those, but could tolerate them for one day, since the combination kept me from having to drinking as much liquid. On the recommendation of a neighbor, I also had all pills for one prep (total of way too many--I want to say 32, but may be wrong-- large, hyperosmotic pills over the course of a few hours). All three preps led to the desired result :), but for me the pills were just too much to swallow, so to speak. So-- no sugar involved in any of those preps. I lowered my basal rate overnight, and my blood sugar stayed okay, around 130 when I went in. I would normally have corrected for that, but they did not want me to risk me going low. I tested when I woke up 20 minutes later, still around 130, and corrected.
I never met any of the doctors prior to the procedure. All were partners in the same gastroenterology group. I did have extensive discussion with their office staff in advance of each procedure. They were very accommodating of my need to be first case as a type 1.

Thanks, smile. Does sound like many doctors meet with you first. When I looked up various conditions Irritable Bowel symptoms sounded the most like what I'm having. The pain does seem to come and go though I haven't been able to tie it to certain foods - I'll keep closer track to have more data. A prescription at my appointment would sure be nice! (:::she said hopefully::::)

Thanks, Kim; I'll ask also about the combination of liquid and pills so I can reduce the outrageous amount of liquid! Yes, the office staff does seem accommodating though one person told me the medication was "the same one Michael Jackson took"....uh, maybe that isn't the best recommendation, lady!

Zoe, your symptoms sound a lot like mine -- abdominal pains that come and go according to no discernible pattern or timing, and that don't seem to correlate to anything external -- food, exercise, whatever. IBS is one of those conditions that can't be diagnosed directly; there is no actual test for it. It's usually diagnosed by ruling out everything else -- which is exactly what happened in my case. Since I've been having these pains for the better part of 40 years, and nobody can find any cause, IBS was the conclusion.

Michael Jackson--interesting reference! I'm sure you'll talk with your anesthesiologist/CRNA beforehand, and that he or she will make sure that your IV has no dextrose. I made him aware of my starting blood sugar and he promised to check during the procedure. I've never liked the preps, but the day of the procedure is fine.

every time my BG's fluctuate a lot, it effects my stomach, bowels. if I stay high for a while, i will definitely notice it. they initially did a CT SCAN on me because I had blood in stools and said it was diverticulitis, put me on a ton of antibiotics (which I didn't want to take and disagreed strongly with the dx) took them and got much sicker, it kills off the good bacteria too. i would just make sure you see someone first before having the test. this is another diabetes issues, I think, bowel problems.

OH, you'll get a kick out of this cuz I sometimes too doubt the advice of health care providers especially when it comes to type 1 diabetes, many of them have no experience or clue. I went in to get blood drawn for my cholesterol, A1C and Vit D level like 3 or 4 weeks ago, got my AlC and lipids back on line but no Vit D. results. So I called last week and of course the lab didn't draw it and messed up. The woman on the phone at my doctor's office said, "OH, you haven't had your colonoscopy yet, you need to have this done, I will send you a kit." I'm thinkin....well, I have the Prep Kit. She said, it's 99.9% effect and will detect cancer. HUH??? I asked, "What kit." She said you just give a stool sample and drop it off at the clinic and it is 99.9% accurate. I said, "there's no kit that can detect colon cancer, you're referring to the test kit - sample given to detect parasites, etc...I asked if she was a nurse. She said, "No, I'm a medical assistant." I suggested she not tell patients there's a drop off kit they can use instead of a colonoscopy that will 99.9% detect colon cancer. GEEZ!

That's one of my pet peeves, Sarah! I first noticed it with my vet. My 18 year old cat who died last year had a lot of medical issues so I called or went to the vet a lot. I'd call and say, "I have a question about Lula's medical care" and then pause, waiting for them to say, "Ok, I'll have the tech call you". They always just said, "Ok...." I'd ask my question and they'd give me an answer and I'd later realize that they were just the receptionist so their answer didn't mean squat!

Then I started noticing the same thing at various doctor's offices. Whoever answered the phone or manned the desk being more than willing to give you "medical opinions" without any medical qualifications at all! I now peer at nametags or ask in my most tactful tone, "Are you an RN?" You would think the doctors would catch on that this was happening and train their staff not to do this!

Thanks, Kim, I didn't even think about dextrose in the IV. I can't think of any worse nightmare than being given a gallon of sugar drink! When I lived in Guatemala where everyone loves their sugar, I had to always remember to say "sin azucar" without sugar. A couple times I forgot and one small sip was nauseating to me! After 18 years, I've definitely lost my taste for sweet things!

Zoe - Sorry, I can’t remember the prep material name but it did require drinking several glasses full. It didn’t elevate my BG’s, so maybe it was artificial sweetener. It had a lemon taste and I was happy when I finished the last one.

One other thing that you may have already anticipated is that most practitioners require that someone else bring you to the clinic, check in with the receptionist, and pick you up when you’re done. It’s done to minimize their liability. My clinic would not even let me take a cab to and from. Since you plan to stay in a hotel the night before, it doesn’t sound like that’s an issue for you.

You’re getting lots of good info here.

Thanks, Terry. Yes, I have thought about the "someone to pick me up" thing. I had my niece do it when I had an endoscopy, but I am now in a rural area and the test place is an hour over the mountain from anyone I could possibly ask. I am planning to stay in a hotel the night before but I'm sure they will give me flack about leaving on my own afterwards. They are just going to have to accept me taking a cab. I'm hoping to either hang out there or go somewhere nearby to hang out for a couple hours until I'm save to drive home. If they really refuse to treat me unless I say I won't drive I can stay over in the hotel the second night, but it is still going to have to be a cab ride to the hotel, unless they want to drive me themselves!

Yes, I AM getting good information (and a bit more comfortable with the idea!).

Depending on just what the person answering the phone says, there could even be a legal exposure. Scary indeed, and not only for the person asking the question.

Yep, that's why I wondered why the doctors don't train their staff to say something like, "I'll have our nurse or NP or doctor call you" and not to venture their own opinions. I can understand things that are within their area of knowledge like the prep for the colonoscopy but it seems like it is extremely common for non clinical staff to exceed their areas of expertise on a routine basis in various doctors offices. I'm sure I'm not the only one who has experienced this!