I didn't have my colonoscopy today but it wasn't my fault.

There are rare moments in one's life when time freezes and you question reality. Today it happened while I was standing in a hospital room wearing nothing but ECG pasties questioning the competence of the clinic staff to my GI surgeon.

The last few months I have been experiencing increasing amounts of blood and mucus in my stools due primarily to changes in my 5ASA drugs. I was switched from Asacol to Lialda and I slowly started to bleed and flare. Two months ago I asked to return to my old maximum dose of Asacol but the doctor only prescribed four pills/day then just three. At the same time he scheduled a Chroma dye colonoscopy to root out any polyps hiding in my pseudopolyp scarred colon. I have contacted the clinic multiple times by phone and email to ask for an increase of my Asacol HD to 6 pills per day to address the bleeding but they blew me off by saying I needed to speak to my GI directly nevermind he has been on vacation for weeks.

After the usual colon prep I arrived at the clinic and was told everything was on schedule. After getting an IV line and ECG hookup the surgeon who was going to do the procedure walked in and asked me if I had active bleeding. I explained that I did and that I had reported my bleeding and constipation to the clinic multiple times in the last two months. He then told me because of the active bleeding he could not use the Chroma dye enhancement and would be limited to a normal visual inspection and biopsies. At this point I expressed my frustration with accusations of incompetence. He refused to throw his coworkers under the bus and tried to salvage the situation by noting I had already done the prep so why not just do it.

Nope - two different doctors thought I needed the enhanced detection of a chroma dye and I agreed. Now because the clinic ignored multiple requests for help regarding my active bleeding I could not get the correct procedure.

The surgeon attempted the standard methods for dealing with upset patients but having been trained in customer de-escalation for phone tech support I resisted everything he threw at me. I stood up from the bed, started pulling the ECG leads from the machine to trigger the alarms and ripped off my gown to start removing the pads. He asked me to sit back down but after realizing he could not fix the problem I informed him I was going to leave immediately. He quickly realized I would not change my mind and left the room. A nurse came in to remove my IV and I calmly apologized to her for the trouble and thanked her for removing it. She wasn't to blame for the problem and I wasn't going to blow up at her.

I briefly considered doing the normal colonoscopy but that would result in essentially double-billing for the work when I finally had a chroma colonoscopy. Furthermore since they were pressuring me to get the Chroma procedure done ASAP this would force them to fix my bleeding issue ASAP.

Afterward I ran to the nearest fast food joint to end my 30+ hour fast and chase it with my meds and a large cup of gourmet coffee.

shakes head

That's outrageous!!!!!!!!!! However, speaking from personal experience, I would urge you to avoid coffee/caffeine at least until you achieve a secure UC remission. Best wishes for you to get back on helpful meds ASAP! Change gastros if that's what it takes!!!!!!!! / Old Hat (34 yrs with left-sided UC; presently in remission taking brandname Colazal)

Good for you for standing your ground.
Good luck.

This is crazy, but sadly not that shocking. The number of unnecessary procedures that doctors just want to go ahead with is insane. Sometimes, I think they propose whatever comes to mind as a way to shut us up (ie: I keep complaining about symptoms. Rather than actually talking to me about that, just schedule the second colonoscopy in 4 months, a CT, etc..).

I'm sorry you had to go through that.

I don't understand the interrupt between the GI and "the surgeon doing the scope." I keep seeing this, and it always brings me up short. Every GI I've ever had has done his own scopes, thus eliminating that possible route of mis-communication. Does this differ in other areas?

My GI's clinic is a teaching facility in the hospital where the clinic is, so although he's in the room during my scope he's always teaching up and coming GI's how to do scopes so he directs them as they do they procedure on me, I have no issue with it cuz he's in the room guiding them so I'd assume they proceed with quite a bit of caution as they're just learning.

Good for you!

Your doctor is covering his you-know-what. Why would a patient who's bleeding be on a maintenance dose? Maintenance is for when you have no symptoms or very mild ones -not bleeding.

Absolutely right that the treatment drug should NOT be lowered until the patient is off steroids.

I finally had my GI appointment Monday. From our exchange of emails it was clear he was not going to admit fault. Additionally his office sometimes took a week to fill my Pred/Asacol ignoring multiple pharmacy requests. I had the pharmacy print out the multiple requests so I could confront him about this issue.

He tried to muddy the waters by claiming symptoms like bleeding are too simplistic to determine treatment ie he stuck to his guns on the low dose of Asacol. He also tried to pin the blame of the colonoscopy fiasco on me claiming I did not follow GI's instructions. I interrupted him with a simple declaration - BULLSNOT (or possibly a similar noun). He completely ignored the insurance pre-approval issue. I guess he didn't have a prepped response ready. Lastly he claimed the GI staff made nothing more than minor mistakes aka the minimal blame distribution argument. Called a foul on that one too - so where does the buck stop? Every time I interrupted him he became visibly annoyed as if to say "How dare you!" He is definitely not used to being challenged. In short - he BSed, I shot it down, lather-rinse-repeat.

I did get refills for all my meds so that will make things far easier for me. When I scheduled this appointment I realized it was only 2 weeks away so I doubled my Asacol to my old dose thereby burning through my 30 day supply in just 14 days. It was refilled for 6/day as I requested.

A word of advice for anyone facing a possibly hostile clinic appointment - bring along a friend or family member. Some clinics have "patient advocates" who can join your appointment to resolve conflicts but a family member is better since they are on your side. My mom came along for this visit and she helped immensely.

Post Edited (weirdal1968) : 8/25/2015 6:00:47 PM (GMT-6)