HealingWell
Search Close Search
☰

Bad doctor visit... please help

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
1 2
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/14/2008 12:55 PM (GMT 0)

Hi Old Hat-

I noticed your comment about Dr. Ullman.  Have you had experience with him or know others to? I recently switched to him b/c I heard he's one of the top gastros in NYC that takes insurance.  I've visited with him a few times now and I actually really like him.  He makes me feel comfortable and he's very thorough.  One thing I admire is that he only uses Prednisone as a last resort whereas a lot of other drs push them right away.  Just curious as to what you know.  I look fwd to your feedback:)

Posted 6/14/2008 3:25 PM (GMT 0)
Glad to hear the preliminary results are good! Let's keep those positive vibes going.
Posted 6/14/2008 6:26 PM (GMT 0)
it's always good to have a second opinion :-)
Posted 6/14/2008 10:36 PM (GMT 0)
Hi, Alycacc! I do not know anyone who sees Ullmann for gastro care. If he accepts insurance, that's pretty exceptional for subspecialists in IBD located in Manhattan. What I do know about him came from online reports that he is a dysplasia fanatic who advocates ripping out colons at the 1st questionable biopsy report. Dr. Daniel Present at Mt. Sinai has debated Ullmann in professional forums because he believes in a more cautious approach to treatment & monitoring that does not rush the patient to surgery as a 1st resort. I have more confidence in his judgment owing to the fact that he's been treating IBD patients for at least 3 decades & following the research, participating in clinical trials, etc., etc. Plus I met him in person & found him very cordial. As for Ullmann's not prescribing Prednisone in every case he treats, my own IBD subspecialist gastro only prescribes it for severe inflammation & would never exceed 60 mgm/daily nor keep patients on it indefinitely-- to do otherwise is bad medical practice considering all the known harmful side effects Pred can induce over time. I hope you'll continue to do well in treatment with Ullmann. / Old Hat (nearly 30 yrs with left-sided UC; currently on 3 Colazal daily for maintenance of remission)
Posted 6/15/2008 2:49 AM (GMT 0)
Thank you Old Hat for your reply!!!

Posted 6/15/2008 3:46 PM (GMT 0)
My previous posts cite my recent diagnosis with Low grade dysp. (18 yrs left side colitis). I met with a surgeon last week and he said that recently, even Dr. Present has changed his view regarding removing the colon if you have had a diagnosis of dysplasia.
Posted 6/15/2008 4:14 PM (GMT 0)
What is their view? Just curious. Are they more cautious now?
Posted 6/15/2008 5:07 PM (GMT 0)
I met last week with the chief of CR surgery at Mt. Sinai.
Its unfortunate for me, as my UC is very much under control, hardly any symptoms, but now had LGD. Anyway, the total consensus of the medical community was to remove the colon if dysplasia was found. I believe Dr. Present had presented a contrary view for many years. My surgeon said at the last medical conference he went to, D.r Present had come around.
Posted 6/15/2008 9:14 PM (GMT 0)
There are different degrees of dysplasia + different risk factors for UC patients to develop malignancy, depending on situations like their family history of colorectal cancer, age at onset of UC, etc. So I don't believe that Dr. Present would lump every UCer with dysplasia, whatever the differentiating factors, into the "must-have-immediate-colectomy" category. A surgeon's inclination is to perform surgery & to defend that approach. From what I see/hear in pursuing medical treatment, there is near-hysteria in every quarter about possible cancer. It gets to be too much when doctors want us to x-ray, dexa-scan, etc., etc., then the dentist wants to repeat bite-wing x-rays-- all exposing us to radiation over and over. A large part of professional examination/ treatment could ultimately increase our chances of developing malignancy over time, but doctors don't want to hear that. / Old Hat (nearly 30 yrs with left-sided UC, etc.)
Posted 6/15/2008 10:56 PM (GMT 0)
njpublish, everyone makes their own choices, but I'd be following the advice of the doctors at this point. It really just boils down to how much risk you're willing to take; some of us are more risk-takers than others. I'm sorry you're having to make this decision when your UC is in good control, that makes it a lot more difficult, I think.

There's rarely 100% agreement on any medical treatment; that's where the "art" part of medical practice comes in. Sometimes we just have to decide to listen to the majority, or just to the doctor we feel confidence in.
Posted 6/16/2008 2:34 AM (GMT 0)
Thanks all. I guess Im searching, in vain, for a medical professional who will say "lets keep an eye on it", but that doesnt seem to be happening. Im going to see one more Sinai GI doc (not surgeon) and show him the bio. I tend to be a moderate risk taker , but would feel too uncomfortable with the odds I see.
Posted 6/16/2008 3:18 AM (GMT 0)
Just thinking, Can they do more biopsies just to make sure and be positive that there is dysplasia? It wouldn't hurt. Just in case there was a mix up some how. Those things happen. I know that they thought they saw dysplasia on my biopsies, but then recent biopsies showed no signs of dysplasia. This I believe was due to the fact that the first time they took the biopsies, I had severe inflammation and the second time there was no inflammation. I would just want more biopsies to double or triple check. I am sorry you are going through this. I will keep you in my prayers.
✚ New Topic ✚ Reply
12