Bad Dr. Appt.
#180897 - 05/24/05 07:33 AM
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MCV
Reged: 01/04/05
Posts: 740
Loc: Manchester, NH
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I had a checkup with my GI yesterday. I'm really starting to not like him! He takes me at least 30 minutes late every time I go and then rushes me through the appointment. I feel like he pushed me out the door very quickly yesterday. He told me to up my dose of Nortriptyline to 40mg (I was taking 30mg) per day. I told him about the acacia fiber, the probiotics and the Digestive Advantage that I am currently taking. He told me that there is no scientific evidence that any of those things will help with my condition. I can feel free to continue using them, as they are not harmful, but that they won't help my IBS. I told him about this website and that this is where I am getting most of my information and he said that the internet is not the best source for information. I really feel extremely frustrated now. I should also mention that this doc has NEVER given me an exam. All my tests were ordered through my primary care physician. Should I be concerned? I'm just at a loss about how dismissive he was. He has never once actually DISCUSSED diet with me - he just gave me a sheet of paper with bullet points on my first visit. Any advise?
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>>>>>>>><<<<<<<<
Michelle
IBS-A, pain predominant
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Find a new Doc.... if he is not willing to take the time with you... you should not have to feel rushed like that. This site has wonderful information... My Dr had never heard of this site or Heather's books until I brought them with me... he was impressed and tells me that he had told other IBS patients about them also.
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www.facebook.com/shell.marr
www.myspace.com/shellmarr
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Hi there,
I'm so sorry you had to go through that - I think a lot of us on here have had very similar experiences so we feel for ya!
I think Shell is right - find a new doc if you can. It sometimes takes a lot of time to find a doctor that you can really click with.
If you can't find a doctor and you have to go see this one again, I say try and be as assertive as possible. Bring the books with you, like Shell said, and show him specific things that have helped you or that you have questions about. If he says that the things you have found on your own won't help you, ask him WHAT WILL? It is his job to try and make you feel better, and you are completely justified in expecting him to try to do that.
I would even tell him how you felt when you left the appointment... tell him how you are suffering and him dismissing you is NOT GOOD ENOUGH.
I know that I was not taken seriously until I really got into it with a doctor. I took my boyfriend with me so I couldn't back down, and he backed me up when he thought I wasn't being assertive enough myself. If you think you need to, bring someone with you.
If I were you, I wouldn't mention the internet thing again just because he probably WON'T take anything from the internet very seriously. The books are more solid and easier for people to relate to as real information.
Even if you do see a new doctor, go in prepared. Explain what you expect, and I would even say that you have been rushed out of doctor's offices before and left feeling worse than when you came in and you really want someone who will listen to you.. It would be pretty hard to rush you out of the office after saying something like that!
Good luck!!
--Steph
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~~I'm not crazy, I'm just a little unwell-I know right now you can't tell~~Matchbox 20
IBS-D,pain.
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Quote:
Hi there,
I'm so sorry you had to go through that - I think a lot of us on here have had very similar experiences so we feel for ya!
I think Shell is right - find a new doc if you can. It sometimes takes a lot of time to find a doctor that you can really click with.
If you can't find a doctor and you have to go see this one again, I say try and be as assertive as possible. Bring the books with you, like Shell said, and show him specific things that have helped you or that you have questions about. If he says that the things you have found on your own won't help you, ask him WHAT WILL? It is his job to try and make you feel better, and you are completely justified in expecting him to try to do that.
I would even tell him how you felt when you left the appointment... tell him how you are suffering and him dismissing you is NOT GOOD ENOUGH.
I know that I was not taken seriously until I really got into it with a doctor. I took my boyfriend with me so I couldn't back down, and he backed me up when he thought I wasn't being assertive enough myself. If you think you need to, bring someone with you.
If I were you, I wouldn't mention the internet thing again just because he probably WON'T take anything from the internet very seriously. Or turn the book over and show him the website address listed on there  plus he will see Heather's smiling face... how could he resist that??  The books are more solid and easier for people to relate to as real information.
Even if you do see a new doctor, go in prepared. Explain what you expect, and I would even say that you have been rushed out of doctor's offices before and left feeling worse than when you came in and you really want someone who will listen to you.. It would be pretty hard to rush you out of the office after saying something like that!
Good luck!!
--Steph
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www.facebook.com/shell.marr
www.myspace.com/shellmarr
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Any time you feel you're not getting the care you deserve, you should definitely be concerned. Find a new GI. At least you have the tests done, and you can take your records elswhere, to a hopefully better doctor.
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MCV
It is over 30 years now since I was first diagnosed with ibs.d (I am 52) and there was far less known about it then than now. I just want to encourage you to stick with what you are learning from this wonderful site. Heather's advice on food, fiber and supplements is the best I have come across in the last 30 years, especially the soluble fiber. The doctors and hospitals were always telling me to eat a lot of fiber ( but it was the insoluble fiber) so i have probably made my condition worse all this time.
I came across this site last October, I started by taking on board the "eating to break the cycle of ibs", then I introduced the Acacia fiber, then I tried a calcium supplement (not sure if this helped so stopped it after 4 months) and in February added Acidopholus (can never spell it) and I am convinced that the acid... has made a big difference.
Whatever you do, do not let the medical profession get you down - come back to this site and get the information you need from here.
All the best
Judith
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Sorry about your Dr appointment! My gastro guy is the same...he saw 4 patients in a 20 minute period! This site is the most helpful I think...seems like every Dr has a different opinion of what to do and most of it does NOT go along with what these people are saying. These people all have "been there, done that" so I'd stick with this. Have all the tests you need,though, to make sure it is IBS.
Try a new Dr if you can find one! Judy
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Are you a C or a D? This diet seems to work better for D people on the boards. I have been on it for a while and it has made my constipation worse . Maybe it is better for D folks 
I have tried everything I can think of, including adding insolubles at every meal! I drink, walk...still nothing helps. 
Maybe I need another diet approach? I thought Heather's would work. I was praying it would as it has for so many others. I don't know why I am one of the ones that doesn't seem to get any relief, but only worse symptoms.
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Cyndy,
Have you tried keeping a food journal? Just wondering if something keeps coming up that you may not realize.
And you're definitely drink water, as in TONS of it? I know I swing C sometimes, which can be painful, if I don't drink enough water. Feels like a sore muscle in my lower tummy or something. I hate that!
If worse comes to worse, you can always try Kree's Lower Fat Oatmeal Molasses Cookies. I haven't tried them, but apparently they've gotten good reviews for "cleaning you out"! LOL
Hope you find something that works.
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Couple of thoughts. First, the question you raise about how well Heather's approach works for C vs D might make an interesting poll. You could ask people to say whether they're C, D, A, P and then say how well this approach has worked for them. In my case, I'd say, "I'm IBS-D. Heather's approach has worked 90%. I believe it would work 100% if I was 100% faithful to it." It would be interesting to see the results.
Second - and this is an extension of Melissa's food journal suggestion - maybe you could post what you're eating on a daily basis and see if anyone on the Board spots a possible problem. I know one or two other people have done that here.
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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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Re: Bad Dr. Appt.
#180925 - 05/24/05 09:23 AM
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Sand
Reged: 12/13/04
Posts: 4490
Loc: West Orange, NJ (IBS-D)
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I'm sorry you had such a bad experience. I know a lot of people here have, myself included. I wonder if it's because doctors feel really frustrated by IBS since they know there's not a whole lot they can do for us medically. Maybe they just don't realize it would help a lot simply to be listened to, even if there are no magic pills available.
You may already have seen this, but there's a thread on good IBS doctors. You might dig through it and see if there's one anywhere near you. On the other hand, if you've had all the tests you should, trust your Primary Care Physician, and are being helped by Heather's diet, you may not need a GI guy right now.
HTH.
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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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For Cyndy
#180926 - 05/24/05 09:32 AM
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Stephie
Reged: 03/10/04
Posts: 2696
Loc: Vancouver, Canada
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Hi there,
First off, I wanted to say that I am really sorry you haven't found any relief of your symptoms yet. Notice I said YET, we will help you figure stuff out so you can start feeling better!
I think that everyone that has given you advice so far has given you excellent suggestions, I definitely think either keeping a food journal or better yet posting some of your 'daily menus' might get you some really good feedback.
I do have a few questions for you, too. If you have already said this stuff in other posts, I apologise for making you repeat yourself.
1) Have you been officially diagnosed with IBS? Have you had all the tests and everything?
2) How long have you been on Heather's diet? I ask because I know that it takes much longer to get IBS-C stable then it can for people with IBS-D. That being said, I (IBS-D'er) took ages to get stable. I needed the diet, AND other changes, which brings me to...
3) Are you on any medication or doing anything else to help stabilize right now?
4) What have you done in the past? I ask because it seems like a lot of people, especially with IBS-C, have done things before this that make it harder to stabalize like taking a lot of laxatives, for example.
Following that, I would say there are some other suggestions that people have said they found helpful. Drinking a glass of hot water with lemon first thing in the morning to get things moving and then drinking LOADS of water throughout the day. Getting plenty of exercise is really important for some people with IBS-C. Yoga can be especially beneficial. Abdominal massage can also help get things moving, do a search for posts on that if it interests you. Apparently blueberries are good for getting things moving as well.
When you say you are having insolubles, how much? Maybe you need to gradually add more to your diet until things start moving.
Good luck!!
--Steph
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~~I'm not crazy, I'm just a little unwell-I know right now you can't tell~~Matchbox 20
IBS-D,pain.
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blame it on our health care problems here. They are so rushed patients get about 7 minutes on average. I had a good article about that and getting the most out of your visits. I should look it up.
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IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
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Melissa
#180988 - 05/24/05 03:20 PM
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Cyndy
Reged: 03/05/05
Posts: 1301
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Does it need to be water or does tea count? I drink herbal tea all day, but not water. Tea is made of water though.
But I probably do drink less since it is hot and I sip and not gulp. But isn't sipping better for us anyhow? And hot herbal tea is more soothng and beneficial for our systems (chamomille, fennel, anise). Isn't that correct?
So, what do you suggest?
I have tried a food journal for months, but there is no rhyme nor reason to my symptoms. My symptoms are chronic no matter what I eat or not eat. I could eat the same thing one day and have horrible symptoms the next day. The next time I eat the same exact thing, I could have a mild pain/constipation day! I have given up on the food journal. Nothing stands out. I think for D folks the food journal works better. Or am I doing the food journal wrong? How do you do a food journal correctly to get some answers?
Thanks!
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Sand
#180991 - 05/24/05 03:28 PM
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Cyndy
Reged: 03/05/05
Posts: 1301
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I like both your ideas! It certainly couldn't hurt, I guess.
Interesting that you too are a D that has found relief with the diet. Hmmm, my theory seems to be getting support here.
Anyhow, I'm glad you have found so much relief. I'll take 50% or even 20% improvement.
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Cyndy!
#181008 - 05/24/05 05:33 PM
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Kristin940
Reged: 05/04/05
Posts: 104
Loc: Massachusetts
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Hi Cyndy-
I noticed you wrote about the chronicity of your symptoms. Have you tried Heather's stabilization diet?! It could be that your gut is so overwhelmed right now that it needs to be calmed a bit and would hten more sensibly react to dietary triggers.
Have you tried that at all?
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FIND ANOTHER DR!! his job should be to care for you, not make you feel like your condition doesnt diserve a concern. i had a doctor appt w/a doctor who was also unknowledged about the acacia and everything else i talked with him about. my advice to you is to definately get a second opinion b/c his doesnt sound very professional. im sorry that you felt so hassled by him. it seems like if the remedy isnt something that they would recommend to us, then it must not be very good--but if its something they can prescribe, then all the more better for them to help you  good luck!!
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VEGAN ASHLEY~IBS/C
www.myspace.com/dutchflowers
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For Cyndy
Yes, I am ibs.d, also had my gallbladder removed 22 years ago and am on multiple medications for hypertension not to mention the dreaded hormones.(the medications mean that I have a harder battle with my ibs because most of them affect the gut)
However, as I said in my original post, I started by going on Heather's "what to eat to calm down the system" and then followed it with the Acacia. I must say that the Acacia has definitely helped my pain - I rarely get pain anymore. However, trying to stabilise the actual bowel movements/consistency is proving more difficult and I find it hard to "stick to what I should" all the time!!
I still go with what I said before, I do think this site has a lot of good positive advice - have you got Heathers "the first year ibs" book. Everytime I go back to read it, I always seem to find something that I did not find before.
The other point I would make is that it takes time for things to calm down and gradually improve. I am much better than I was but I am nowhere near where I would like to me!
Interestingly, I drink plenty of water and was walking on my treadmill but had to stop that because it was making me go to the loo more! ... so now I have put more weight on!
How long have you been following Heather's diet? Are you taking the "trigger" list seriously?
Judith
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And I don't even think I got a whole 7 minutes with him!!!
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>>>>>>>><<<<<<<<
Michelle
IBS-A, pain predominant
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Re: Sand
#181104 - 05/25/05 09:04 AM
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Sand
Reged: 12/13/04
Posts: 4490
Loc: West Orange, NJ (IBS-D)
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I hope you do the poll. If you don't, I may after a while. My training was as a social scientist and one of the first things my profs taught me was that things "everyone knew" were true often weren't - so I'm real big on data. Or we can wait for Dr. Hershfield's study results - maybe later this year.
As for your IBS, maybe you could try just starting over: answer Stephie's questions so everyone is up to speed on where you are now; follow Kristin's suggestion to go on the Break The Cycle diet (just SF with SFS, water, and herbal tea) for a few days; then start adding in IF very carefully. While you're doing all this, post what you're eating, drinking, and supplementing every day so other people on the Board can take a look and help you out. If it works, great. If not, then you'll know this isn't the solution for you.
HTH. Good luck.
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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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My theory continues...
Yes, I have both Heathers books.
I have been on the diet religiously for about 5 months now. Yes, I take the trigger list totally seriously. I am a perfectionist and I literally don't cheat at all. Yet, still pain and horrible constipation.
Did your gallbladder removal worsen your IBS? I heard it can cause worse and permanent Diarrhea.
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Do you know about the water vs tea question? Is water better to drink than herbal teas or can I count my herbal tea as if it were water?
Did that make sense? I phrased the question better in my post to Melissa above this one 
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I'm IBS-C, too. If I eat lots of rice, bread, & potatoes, it makes me worse too. But I noticed that some of Heather's pointers do help me-- like staying away from dairy products & red meat & by eating low fat foods.
Diet alone has never helped me to be "normal." I have to take Miralax and occasionally Zelnorm to feel more normal. And I still have boughts of cramping, gas, &/or C even though I take those. But I have lots more good days than bad days!
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Yup, tea can count as your water! So, how much do you think you drink a day? It's never good to gulp, so definitely don't do that. But, you can sip on water and tea all day long. I usually have both going on at my desk at work.  The warmth from the tea is good for helping to relax the muscles and ease pain, as well as the natural antispasmodic in peppermint. Not sure if you can drink that or not, but chamomille is a nice alternative.
I've never done a food journal myself, but since you weren't finding any answers, I thought that may help you figure something out. I don't know if there is a right or wrong way, but someone who has already done one may have some tips for ya. (Anyone? )
I try to drink a lot of water/tea though. I take a bottle water to work in the am, and I have to drink it by the time I get to work (it's a 20-30 min ride). Same with on the way home. Plus all I drink in between.
That plus exercise, and upping my insoluble intake usually helps me get things moving when they get stuck. I've never been as severe as you though. I hope you can find a solution.
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and I am rereading it right now. I will post the highlights...
Ok a bullet box of 3 main suggestions
1. make the most of your time by preparing how you will explain your problem fully but concisely, starting with your foremost concern
2. avoid calling doc at times outside of office hours or for non-emergencies
3. be patient. Proper diagnosis and treatment take time
Additional points:
Empathize with doctors stress and fatigue. Think about their day and what they have to deal with everyday: long hours, whiney patients, insurance problems, and having 7-10 minutes per patient.
So their main gripes are
1. patients who ramble
2. patients who demand too much
3. patients who distrust them and rather do their own research and/or don't give treatments time to work
What you can do for the best care from your doctor: (my own words and interpretation)
1. speak respectfully but don't take disrespectful treatment in return
2. ask brief questions so you get exactly how to use the meds/suggestions they provide. If you don't agree then don't say so but say "that hasn't worked so well in the past; should I expect it to now?" or "oh that conflicts with this research I have done; how I am to understand that?" So it doesn't sound like you are distrustful but wanting proper information.
3. Educate yourself about your body and condition. Use medical terms as much as possible- it makes you sound smarter.
4. Even if you are going in for depression or something make sure to come across "sound in mind" or you will be treated like a crazy or a baby.
5. Make a list; be concise; use eye contact; explain how you feel descriptively; there is no need to underplay your pains, but describe them reasonably.
Well hopefully this helps. There is nothing we can do to change a doctor's bedside manner, but understanding what they want from us can benefit us. Of course there are some bad seeds out there that nothing will help! But these are things I have done to receive respectful treatment. In general I have noticed great success when behaving in this way at the clinic.
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IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
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Thanks Little Minnie - great suggestions.
--------------------
>>>>>>>><<<<<<<<
Michelle
IBS-A, pain predominant
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Thanks!
#181331 - 05/26/05 06:58 AM
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Cyndy
Reged: 03/05/05
Posts: 1301
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No I can't handle peppermint, unfortunately. Gives me tummy aches. And I read in Prescription for Nutritional Healing that you aren't suppose to drink chamomille everyday. It didn't say why though. I know some folks have an allergy to ragweed and it isn't recommended for them. But a few books I've read say no one should drink chamomille on a daily basis.  This confuses me as to why not, though.
I never measured out how much I drink in a day. I just try to have a cup of hot tea going all the time. Expect for 30 minutes before a meal and 60 minutes after, which removes a lot of drinking time. I just heard it is better for digestion to do this. How much is exactly recommeded for constipated people? Is 8 cups enough?
How much exercise is recommended for us? I walk 30 minutes a day, but not sure if that is enough for my constipation. Any thoughts?
I know you are D and not C, though. Thanks for taking the time to answer my questions. I really appreciate how the stable people still hang around for us who are still suffering. 
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Cyndy
Following the removal of the gallbladder I felt much better but unfortunately the ibs.d did not disappear.
You say that you have followed Heather's diet for 5 months "religiously" - you do not mention drinking plenty of water or taking a soluble fiber supplement.
I get the feeling from many posts on here that the d's wish they were c's and the c's wish they were d's. Why is it we think the other person has an easier ride?? I think we all suffer and we can learn from each other through these boards.
How I would love a bm every other day only!! Fancy swapping?!!! Only joking!!
bye
Judith
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Quote:
I get the feeling from many posts on here that the d's wish they were c's and the c's wish they were d's. Why is it we think the other person has an easier ride?? I think we all suffer and we can learn from each other through these boards.
Hear, hear!
Quote:
How I would love a bm every other day only!! Fancy swapping?!!! Only joking!!
LOL. And me, too!
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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
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who prefer being D to being C. I way prefer being D, I don't know why. Well, you don't have to give yourself an aneurysm trying to poo when you're D....everything just falls out! But it's still pretty sore on the bum, right??
Ya don't win either way!
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Keep on keepin' on...
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