Tuesday, August 16, 2011

When The Shit Hits The Fan (Or When Patients' Rights Go Down The Toilet)

I had a colonoscopy nearly a month ago now.  And ever since then, my gut has been off.  A week after, my gut still seemed to be under the influence of the cleansing regimen.  But then a week and a half after, the total opposite happened.  Nothing was moving.  And it made me feel like shit.

So, sorry if this is TMI, but I had this incredible, uncomfortable urge to go to the bathroom.  But despite what felt like a hundred attempts, nothing happened. 

I tried everything I could think of; laxatives, a hot bath, exercise, an enema.  Nada.  Nothing really worked. 

And it was hard for me to walk.  I was in intense pain.  And I couldn’t even stomach food.  Just the thought of putting something else into my body made me feel queasy. 

I realize that something is very wrong here.  And I’ll admit that it made me freak out a little.  I don’t like it when individual systems start going awry.  It makes me wonder what’s next. 

I didn’t want to make a big deal out of it, but I decided to try and get in to see my primary care doctor, just to make sure that there wasn’t anything obvious going on that needed to be taken care of immediately. 

Because I don’t think someone my age, who is relatively active, and tries to eat a balanced diet, drink a lot of water, etc., should have this problem to the degree that I do.  And my PCP agreed.  She said that I am doing everything right.  So why am I having such a problem?

As for the results of the colonoscopy, they were rather inconclusive.  Aside from a few minor things, everything appeared normal.  But everything is NOT normal.  Maybe the problem is not located in my gut.  Maybe it’s farther on down the line.  You know what I’m saying?  Maybe I have a tight ass.  Yes, that’s my official diagnosis.

And for those who don’t know the physiology, I’ll give you a little lesson. 

The problem with stimulant laxatives, such as Ducolax and Correctol, is that they can cause severe stomach cramps.  On the other hand, laxatives like Miralax work by basically injecting water into your gut, which is designed to help get things moving.  Personally, in my experience, I have noticed that your body can become immune to laxatives.  Even though my GI doctor has told me that pretty much anyone can take Miralax on a daily basis, I have found that for me, it eventually stops doing anything.  That leads to the type of situation that landed me in the hospital at the end of last year.  My body wasn’t moving anything on its own.  This can lead to a bowel obstruction, or worse.    

When I saw my PCP a few weeks ago, I was having some problems, which have only continued.  She agreed that I should either get in to see my GI doc before my late November appointment (which has been rescheduled, read: pushed back, three times already) or I should start seeing a new doctor, one who is better-suited to deal with my issues.  She wrote me a new referral and sent me to managed care.  Managed care called GI and basically they refused to do either of the aforementioned things.

If you recall, this isn’t the first time that GI has been unhelpful in dealing with scheduling issues.  So for the last two weeks, I have been off and on the phone with GI, trying to come to some resolution.  I think part of the problem is that “chronic constipation” is a bullshit diagnosis that no ones take particularly seriously.  The problem is more like EPIC FAIL.  At times I feel like I am tethered to the bathroom. 

My current GI doc is an uber-specialist.   I was originally sent to her because my rheumatologist is friends with her, and he also suspected that I had Colitis caused by Cellcept.  Well, Colitis is not my problem, and my GI doc specializes in that.  I think that compared to most of her patients, my GI problems probably are minor.  But it’s all relative, and my life is being negatively impacted by my gut issues.  While I give her props for being the one to do my colonoscopy, she basically had no clue who I was at my last appointment.  And that was very discouraging.  I do believe that she is a great doctor, but I think after three years, with no real resolution of my problem, she’s not the doctor for me. 

Oh, but wait.  GI is refusing to allow me to see a different doctor to get a second opinion.  When did a patient lose that right?  I mean, really?  You’re telling me that the earliest my doctor can see me is November.  And when I ask if I can get in to see some one, anyone, earlier than that, you flat out refuse to let me do that?

Isn’t it endlessly ironic that GI has such a stick up its ass?  I have really tried to be nice, but I may need to call in reinforcements, namely my contact at Patient Relations, who helped me deal with GI last time, when GI refused to give me an appointment within the two weeks that was required after I was discharged from the hospital.   

To be honest, if GI wants to ice me out, that’s fine.  Just wait until I end up in the hospital again.  Then GI will have a real fight on its hands, because while I said I am having problems – and my PCP wholeheartedly agreed – GI is dragging its feet, and I don’t really understand why.

I suspect that this problem is not totally separate, and is directly related to my other health issues because I never had them prior to getting sick.  I do suspect that some of the problem is being caused by medication.  Although since I have finally found a regimen that works, I am not anxious to start playing around with things.

But I’ll tell you one thing.  If the problem really is simply constipation, it needs to get in check, because right now, it’s worse than my lupus and RA symptoms. 

Now isn’t that a load of shit right there?


  1. I think anyone should have the option to get a second opinion! It sounds like you really DO need to go to Patient Relations! I don't know if you can, or if it would help, but there has got to be someone who is "up the ladder" from your GI that you can file a complaint with...maybe even the State of Michigan (who licenses her)??? In my old age I am sick to death of doctors who don't give their patients the proper care, but they definitely have no problem getting that bill out in the mail!! Don't give up, Leslie, and if you need to talk, let me know! Love ya!

  2. Hey Leslie! I'm sorry to hear your GI is being a dink. Thats the last thing you need on top of everything else you're battling. I often wonder why some people work in the medical field. You should be REQUIRED to give a shit (in your case, literally ;)) and be a good listener. The very least she can do is let you get a second opinion. Sounds like she may have an ego problem. I went through ten years of being unable to keep down solid food, and trying laxative after laxative, everything I could think, to no avail before my sister in law suggested motilium, something I had never heard of before. It works like a charm and I can finally eat & get the calories I need. Such a simple fix and yet nobody took me seriously when I tried to explain what a big problem it was. Gah! Anyway, best of luck to you. I hope this problem resolves for you soon! {{hugs}} Hang in there!

  3. I was shocked after my daughter's birth when I wanted to switch to a different doc in the practice that they had to get the initial OB's permission to allow me to switch. And it took MONTHS for her to sign off on it. But I was lucky that they allowed me to see the doc I wanted; I just couldn't get switched to officially be her patient for ages.

    Grrr on this GI doc being a pain in the @ss!! I know it can be tricky to switch docs within a practice; will your insurance allow you to go to another practice?

    I hope you can get in to see someone else SOON! And I'd definitely recommend you file a complaint with your insurer and the doc's practice on how you've been jerked around.

  4. I SOOOO understand and empathize with both of your current issues: chronic constipation and health care professionals being unprofessional!
    Wish I had a quick fix for the constipation but unfortunately I don't. If you can tolerate it, acacai (spelling) powder is soluble (spelling) fiber so it's easier on the system. It has no taste, so I sprinkle it on my food. Another good food to include (again if you can) is golden flax seed meal. Finely ground, it can be added to food as well.
    And, I know what it's like to feel everything you ate still in your system. Good luck; I hope you get going -- to the bathroom and a decent GI specialist!