Went last FRI to see a new GI at the same clinic. She came recommended by someone else suffering worse than I and this GI really helped her. I dislike her as
much as I like her.
The Good: She explained some things
better then any of the last 6 GI's I've seen.
Apparently my pancolitis (severe case of ulcerative colitis where the entire colon is afflicted) coupled with the fact that prednisone does not
put me into remission means I have a very serious case. Since I'm not
responding to full dose of sulfasalazine (3 pills 3 times daily) and
that prednisone isn't putting me into remission she said Lialda and 6MP is
pointless. I nearly lost it
and tried my best to not blow up but asked why her colleagues were
trying their best to get me to take them and she said "I don't want to
argue about that..." fine... so what now?
Given how well I
responded to cortisone suppositories last time she said she's seen
several cases where treatment of the colon can go well but the rectum
still remains inflamed and causing lots of symptoms. (In my research I found there's actually a name for this: Ulcerative Proctosis) In those cases she explained no
pill is going to fix the rectum but the suppositories will. I'll be on
full dose of sulfasalazine + suppositories for 2 weeks and see how that
goes. We both feel there's a good shot at remission here. Failing that
we'll add prednisone on top.
Failing that...it's on to the next class of drugs: immune suppressants. Again... getting conflicting information... from the same person... if prednisone (an immune suppressant steroid) didn't work then why on earth would the other immune suppressants?
The Bad:
I expressed my frustration that her colleagues are saying one thing and she's saying another and we argued about it. She kept pointing to her computer screen saying all the other doctors notes are right here and it's consistent with what she's saying. Too bad that medical file doesn't have every conversation I've had with other GI's which is where the majority of this conflicting advice was given.
Typical arrogance I get with most specialists (not just GIs) and she was a
little rude about mentioning a couple times how much time we're spending on this
visit.
I had written down about a dozen questions I wanted answers too. This was because the last GI had been seeing there was really into hearing himself talk and by the time he shut up and let me get a word in I had forgotten most of my questions. I handed her my list and asked if we could go over these. She looked over it for no more than 10 seconds saying "No, No, Yes, No... ok well..." handed me back the questions then said "candida is an internet myth, I have candida, you have candida, everyone has it." I explained "Yeah, we all have it... my question was about overgrowth?" She blew it off again. So I pressed on asking then about an imbalance of good bacteria, bad bacteria, and gut flora. She at least admitted it MAY help some people with a less severe case but wasn't going to bother with that for my case.
Then I brought up one of my other questions about using a nicotine patch in conjunction with my pharmaceutical treatment. She tried to play the usual card: no scientific evidence or studies. I explained that actually there were and I had read a couple of scientific studies saying the difference between placebo and nicotine use with conventional means was 40% higher. She then went on to explain how this clinic was internationally recognized and that the medical board which oversees them doesn't recognize those results as they weren't good enough and that "...maybe I could find some other clinic that would practice off the cuff things like that but not here."
For now I'm on her regiment and I do agree with it. We both feel it has a good shot at getting me into remission. The ulcerative proctosis was the first real breakthrough in a while. That said I'm scheduled to see a GI at the U of M. for an opinion outside of the clinic I have been going to. After 10 months of this flare up I'm getting rather anxious for some relief.
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