# Do any doctors see the whole person???



## Commonsense (Sep 13, 2004)

I suffered in silence for almost a year, and now I'm at the beginning of the diagnostic process. All signs and symptoms point to IBS - nevertheless, my (new) internist wouldn't even talk about it with me. As soon as I said the phrase "chronic diarrhea," he reached for his referral pad and said he'd send me to a GI specialist. He did say "Sounds like you need a colonoscopy." This without ever examining me or even listening to my other symptoms.When I got to the gastroenterologist's office, I was seen by a PA who also immediately said "sounds like you need a colonoscopy" (are they parrots?) I told her I'd like to talk about it with the doctor, and that I really didn't think an invasive test was the first thing we should try. I asked about possible food allergies (I know I am lactose intolerant), other causes for symptoms, etc. She drew a blank.Are there any doctors out there who see the patient in front of them as a whole person and not a collection of parts to perform expensive tests on? I also refused to do the stool specimen, because (excuse me very much!) I DO NOT HANDLE MY OWN FECES. There must be a lab person somewhere who is paid to do that. All these years I was thinking "doesn't play with own feces" would actually be in the PLUS column of my bio - who knew I'd be a "bad girl" if I refused?I need a holistic approach. Any ideas?


----------



## NancyCat (Jul 16, 1999)

Chronic D can be from alot of things and some of them aren't good. The best way to rule them out is to get a colonoscopy. You need a GI specialist for that. Sounds like the PA is thinking the same way. I don't know why she wasn't more informative when you had questions. Regarding refusing the stool specimen. Its not pleasant to do but its very easy and can rule out/diagnose things like c.dif, a parasite, samonilla, shigella, etc) which if you did have you could treat with medication and probably wouldnt even need a colonoscopy.My suggestion-Go to the grocery store if you don't have:3pk of aluminum 8X8 square or round pansplastic spoonsHardware/discount storethin plastic disposable glovesdisposable mask(used when painting)Put the aluminum pan in the toilet, it will float.Poop into it. Put on gloves and mask (breathe thru your mouth if you can.)Spoon poop into the container the lab will give you following their directions. If you ask when you get it they might be willing to give you some gloves so you won't have to buy any. You can throw away everything. There are Dr's out there who see the whole person but in my experience they are increasingly rare in practice. The Center For Functional GI and Motility Disorders at UNC in Chapel is one of the best centers for GI and IBS in the country. Their approach seems to incorporate alot of alternative/complementary treatments like hypnosis and CBT, etc. Sounds like you would be comfortable there.Anywhere you go will want to rule out that your D is from a serious condition. I can see why you don't want to jump into a colonoscopy (which in my experience has its benefits)but I would imagine that even a holistic practicioner would want a stool culture, but I could be wrong. Hope this helps


----------



## Commonsense (Sep 13, 2004)

I stand by my original message. Thanks for your input, but I wasn't looking for a way to comply with these doctors' nazi tactics. Is anyone out there who gets my original post?


----------



## NancyCat (Jul 16, 1999)

If you think giving a stool sample is a "nazi tactic" then I dont think that you "get it". Just my opinion.


----------



## Kathleen M. (Nov 16, 1999)

Um if you do not want to comply with the standard tests used by medical doctors and want something else.Try naturopathic doctors (although some of them do stool sampling as well for other things) or a chiropractic doctor.The stool sample is pretty much a good way to rule out the things treated with antibiotics or anti-parasitic drugs. I don't see them as nazi tactics. They are wanting to run the kinds of tests doctors run to see what is wrong with you.If you do not want any medical type tests do not go to medical doctors.Naturopathic may be for you. I mean there are holistic people who will diagonse you by the way you feel, or what happens when you hold different foods in your hands...is that more what you are looking for???There isn't really anything else for a medical doctor to do to diagnose you if you will not allow them to run any tests/get any data to see if anything SERIOUS is wrong with you.K.


----------



## LaurieJ (Sep 3, 2002)

Dear Commonsense,I do not disagree with what has been posted above (and I encourage you to understand what is behind the advice given) I do want to address what I am perceiving is your frustration with the medical system.I only recently became a patient and it was an eye-opener for me. The lack of personal interaction and communication between physician and patient is / was devastating to me. Modern medicine has evolved into assembly line treatment based on what I call "medical profiling". The doctor takes the objective information about the patient (age, weight, sex, vital signs) and then ferrets out a one or two word "chief complaint" from the patient either by looking at the simplistic health history that you fill out prior to your appointment or by asking you during your exam. He / she then plugs all of this into either a mental or actual data base and generates a flow chart to follow. In your case, I imagine that all of the objective data along with your key phrase "chronic diarrhea" generated a flow chart with "colonoscopy" as the first thing on the list. Statistics probably support the idea that persons in your age group, sex, etc are likely to have a condition that is diagnosable by the colonoscopy. So that is what is offered, no matter what the patient wants. Obviously you have the final say in what you end up doing, and a doctor should be willing to listen to why you do or do not want the procedure and he should explain very thoroughly why he thinks you should do it. To just offer it to you with no options or explanations is just another fault of assembly line medicine. To him, it is so logical that it shouldn't need explaining and he may be astonished to hear that you are not interested in going to that degree of testing at this time. You were probably expected to do whatever he recommended, feeling grateful that he took the time to suggest a high tech test. That being said.....I must say that you were lucky to some extent that this test was offered to you. I have read so many stories that related the opposite experience, that is, when patients knew intuitively that something was wrong, the doctors resisted offering the colonoscopy and the patients learned months later that indeed, a colonoscopy found the problem and even corrected it for some. So, while the attitudes that you ran into may not have been warm and fuzzy and personalized....the actual advice that was given was probably in your best interest.Laurie


----------



## Commonsense (Sep 13, 2004)

Some of you are just not "getting" what I said in my original post. Maybe you don't see what's wrong with a doctor who tries to schedule a colonoscopy without ever doing a physical exam. Maybe a lot of you don't know that the NIH has said that in general a colonoscopy is not even neecessary in making the diagnosis of IBD. And I don't mind having stool studies done. What I do mind is being told to do all the icky stuff myself. I'm perfectly happy to give someone a sample, but if they want it divided and put into different containers, played with, etc. they are barking up the wrong tree.Another point I need ot make is that I am in charge of my medical care. Any doctor is someone I have hired to help me in the process of getting well. I need to understand what is happening -- and agree to it -- at each point of my treatment. The minute I fail to do this is when I start to lose control of my life, and this is not going to happen. I will not be a victim.


----------



## Kathleen M. (Nov 16, 1999)

Are you talking IBS or IBD for colonoscopy.A lot of doctors REGARDLESS OF what anyone says will overtest because they will get sued to death if you had IBD rather than IBS and they don't catch it and something bad happens.It is kinda funny...most of the patients on here are so pissed off the doctor won't do the colonoscopy and just tells them it is IBS







While stool work and blood tests and all that can give you an idea of what is going on going in and having a look-see is still the gold standard.If they need biopsies to make the diagnosis (which for IBD's and microscopic colitis they do need) then at least it gets done.I agree you can refuse it, and you have every right to demand they give you a reason for it, but it is pretty standard to do it, and most people get all hacked off at the doctors who won't do them except when there are big flamming red flags.K.


----------



## Kathleen M. (Nov 16, 1999)

And for holistic touchy feely see the whole person....go to a naturopath.They do not have HMO's telling them they have to see 8 patients and hour, etc.They will do the have a whole hour and see the whole person and all that.A few MD's do the holistic thing, but often have to do it outside of the whole managed care insurance hospital thing, and you may have to pay out of pocket for that.K.


----------



## NancyCat (Jul 16, 1999)

Sorry you think I don't get it. I am a strong believer in the fact that we as patients are the consumers and DR's provide a service and their job is to work for us. You need to be very proactive to deal effectively with the health care system today and you certainly are. If you don't feel a colonoscopy is warranted for you then by all means don't get one.As others have said, many people even those with presenting symptoms including blood and weight loss have to beg for a colonoscopy which is the gold standard today. I think the reason they want you to do such a complex stool sample (doing several bottles,dividing stool etc.)is because lately there has been alot of cases of hep c and other public health issues (wrong term I think,sorry)out there and the stool sample is a way of screening so as to identify such cases, treat them and keep them from spreading to others. Some of those vials contain a preservative, so if you gave just one sample by the time you got it to the lab and had a technician fill the smaller vials the tests would be innacurate as the samples wouldn't be fresh or properly preserved.I hope you find a health care professional who will suit your needs.


----------

