Do you think Dr. tend to be too surgery happy?

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Trigirl
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Date Joined Jan 2006
Total Posts : 768
   Posted 3/21/2009 11:01 PM (GMT -7)   
Just a question because I have had my second opinion Dr.(surgeon) say he thinks the whole large intestine should come out and I feel like I have gotten a lot better the last six months. Almost weird to have a good? day. I have a friend whose father had colon cancer and she has had polyps but is feeling perfectly fine and they want her to get her colon completely taken out.

So the question is.. why if quality of life wouldn't be any better or worse would they want to take someones colon out until it does have cancer or does block completely?

Oh and what does a blockage feel like and what do they do for it when you go to the hospital?

OK that was more than one question but Dr.s in Canada don't take patient calls too much and at visits I'm usually a basket case. Heres one for the rude Dr. book... When I said I wasn't ready to have the surgery and would go home and think about it he told me I need to take my head out of the sand and that I shouldn't be so vain about having a colostomy (did I spell that right?)

what have you guys to say?

spookyh
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Date Joined Oct 2008
Total Posts : 1342
   Posted 3/21/2009 11:34 PM (GMT -7)   
I do think some doctor's are scalpel happy. I've had some GI doctors tell me to avoid surgery at all costs, and one tell me, "You've had crohn's for 10 years. You should have surgery." This was before he even looked at me or my test results mad! The surgeon he sent me to said I was fine and didn't need it (how bout that, a surgeon who didn't want to cut me open). Personally, surgery is a last option for me. If my quality of life was horrendous, I'd have it done. Until then, I'll keep chugging away.

As for your friend, have they cut the polyps out and tested them to see if they're precancerous? I think that you can feel perfectly fine right up until the colon cancer is serious, but it seems like it would be enough to be monitored through colonoscopies and biopsies. But, I'm not a doctor, so who knows smilewinkgrin?

I've had a few blockages. It starts out as a mild pain that comes and goes. Then the pain starts to get stronger and come more often (kind of like contractions). Eventually it's almost solid pain, and the abdomen is very tender to touch. That's usually when I head to the ER. They give me anti-nausea meds and pain meds for a day or so. They take x-rays and a ct scan to see if/where there is a blockage, and keep me on bowel rest for 3 or 4 days. Then they send me home, usually on prednisone. The last time was a couple of years ago. They tried to insert an NG tube that time, but couldn't get it in (I'm a small person). One doctor wanted to do surgery too, but I said I wanted to wait and see if the blockage resolved itself. It did.

My dad, who also has crohn's, had a doctor tell him he had a "cavalier" attitude towards the disease turn. I guess that's just the way some doctors are. If you don't agree with their assessment, they get all pissy.

isergodur
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Date Joined Jan 2009
Total Posts : 831
   Posted 3/22/2009 1:48 AM (GMT -7)   
my doc would not like me to have surgery unless i was dieing.
24 year old female
Diagonsed with Crohns disease in December 2008..
Medication - Asacol, Remicade, Entocort


caroline_r
Regular Member


Date Joined Apr 2004
Total Posts : 94
   Posted 3/22/2009 2:56 AM (GMT -7)   
OMG I'd die if a doctor told me such things mad

Honestly, I think you need to get second opinion(s). Doctors should opt for surgery only as a last resort, when there's really no other option, when the person's about to die if he or she doesn't have the surgery...or you have fistulas that are going towards your bladder or stuff like that.

But I mean, why did he tell you this? Is your whole colon under inflammation? Or is your anal canal in danger? Can you lead a normal life or are you constantly in the hospital, can't walk because you're too exhausted? What about your weight? And is your colon leaking? Does your anus look so bad that you have to get it out to avoid other problems?

I mean, if your anal canal is ok, they could just get out the rest of the colon if they have to and put your small intestine on your anal canal that you don't have to get an ileostomy. If he's mentioning colostomy, that means they wouldn't get out all your whole colon but just a bigger part of it, but if they can leave you with a part of colon then they could just take out the stuff in between the ascending colon and the anal canal...and then again you wouldn't have to get a stoma, right?

You need to tell your doctor to stop treating you like a kid and tell you things like "You need to take my head out of the sand and you shouldn't be so vain about having a colostomy." That's very unfair of him because it's a normal thing to go home, to process the information and make a decision. In the end, it's not his decision, it's yours and his decision, the one you make together. It's stupid of him to say that you're vain if you don't want a colostomy. I don't remember that ever being qualified as being vain. It's a huge difference in life, esp if you're young. It changes your whole world, and you have to face with the fact that people you want to get involved with might turn you down cuz of the colostomy. And getting a stoma can even mean not to be able to have an orgasm anymore if they cut the nerves they aren't supposed to...it's not vain to think about all of these things.

Why not get you a temporary stoma? Why is it that you can't ask him questions like that. Instead of him saying stupid things you could've had a very informative talk about all the different solutions out there.

One question, is he a gastroenterologist or a surgeon? Because surgeons tend to have a thing for cutting people open.........

Trust yourself! At least you'll know it was your decision. It's worse to blame yourself for not being smart enough to trust your instinct, than to blame yourself for making the wrong decision...that's how I feel. Do the best you can to read your medical history to make sure what your progress was during all of this time, make sure you've tried all of the available medicines and just learn all you can about colon and it's function and about the difference between ileostomy and colostomy and stand up for yourself!

If you can, read the ECCO consensus just to get a different picture from a different continent...maybe you'll find interesting different ways of dealing with your problem. I'd fight with every part of me to not to get a stoma if I didn't have to...

Good luck!!!
21 yr. old with crohn colitis. Diagnosed in March 2004. No surgeries so far.


belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 3/22/2009 5:42 AM (GMT -7)   
What does your gastroenterologist say? What medications are you on currently? Why is your surgeon advising surgery now?

Surgeon's cut -- that is their job. You should be discussing all of this with an internist who specializes in crohn's/colitis. Do you have access to a board certified gastroenterologist locally? If not, you should ask your GP for a referral even if it means travelling to a large centre.
Belleenstein:

30+ years living with Crohn's.


caroline_r
Regular Member


Date Joined Apr 2004
Total Posts : 94
   Posted 3/22/2009 5:59 AM (GMT -7)   
belleenstein said...
What does your gastroenterologist say? What medications are you on currently? Why is your surgeon advising surgery now?

Surgeon's cut -- that is their job. You should be discussing all of this with an internist who specializes in crohn's/colitis. Do you have access to a board certified gastroenterologist locally? If not, you should ask your GP for a referral even if it means travelling to a large centre.


I agree...it's their job! And they are always in disagreement with gastroenterologists. But the truth is that they don't really know much about CD...a gastroenterologist knows that surgery is the last option. The only thing a gastroenterologist can do is tell the surgeon his or hers opinion, but the surgeon is the one who decides what to do when he opens you up. It depends 1. on what he finds inside, cuz sometimes the test we do don't show us the whole picture, 2. his skills...

Sux big time...
21 yr. old with crohn colitis. Diagnosed in March 2004. No surgeries so far.


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 3/22/2009 6:32 AM (GMT -7)   

While I disagree with caroliner on the only time to do surgery is if you are dying, I do agree it should only be when you have no quality of life.  If you aren't feeling that bad, I wouldn't do surgery.  But if you are miserable every single day, and have no quality of life at all, then yes it is time to do surgery.

And I agree you really need to see a GI about your Crohns, not a surgeon.  Hope you get this all figured out soon.

Hugs,

Gail *Nanners*


Gail*Nanners* Co-Moderator for Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 3/22/2009 6:41 AM (GMT -7)   
My GI is scalpel adverse. He is very cautious about surgery because of the risk of recurrence. He'll tell me that some patients wish they did it way sooner, but some (who have recurrence problems) wish they waited or never did it. He gauges what is best for the patient by how well they are handling the current situation. If you are getting by, why risk making it worse down the road for temporary relief? We were close to surgery twice, but I have since been in a 5-year remission w/o surgery so I'm glad I waited. The surgeon I consulted with, though, was ready to go with surgery. I think surgeons just tend to be that way.
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


caroline_r
Regular Member


Date Joined Apr 2004
Total Posts : 94
   Posted 3/22/2009 8:10 AM (GMT -7)   
Nanners said...
While I disagree with caroliner on the only time to do surgery is if you are dying, I do agree it should only be when you have no quality of life. If you aren't feeling that bad, I wouldn't do surgery. But if you are miserable every single day, and have no quality of life at all, then yes it is time to do surgery.

And I agree you really need to see a GI about your Crohns, not a surgeon. Hope you get this all figured out soon.

Hugs,

Gail *Nanners*


I didn't say the only time to do surgery is when you're dying but that it should be the last resort, when you're either dying, have major fistulas problems and then I said "and stuff like that". There are a hundred if not more situations when a person needs surgery and I sure don't know what they are hehe. I agree with you 100%...if there's no quality of life then that's time for surgery.

And inflamed is right too :)
21 yr. old with crohn colitis. Diagnosed in March 2004. No surgeries so far.


Trigirl
Veteran Member


Date Joined Jan 2006
Total Posts : 768
   Posted 3/22/2009 9:06 AM (GMT -7)   
Thanks guys,

Bell. I did see a GI first and he is good. He said we could go with monitoring things. They did biopsies and found pre cancerous cells but in my mind people live their whole life with those and do fine. I just want to wait until it is absolutely necessary to take out large colon. It is the end that is messed up and so they said it couldn't just be resectioned. Surgeon thinksit's only matter of time bfore it's worse, but hey I canwait awhile. I will ask about giving it a rest though. I could go for that first. I think they just don't care about patients as much in our this government medical system b/c it has such a large crazy load of people if they can get rid of a problem they will try to help. I don't doubt their desire to help I just think they are rigid in their approach to healing. Surguring can be the greatest blessing alive in some cases.

Caroline, I'm so nervous going to Dr. because of the stress I feel. I need to write down questions. I truly wasn't ready for this weird surgeons behavior and comments. Funny considering my dear dad was an internal medicine Dr. for his whole life. I do feel better these days (I guess this is what remission is??) and I'm not on any medicine except tylennol and my ton of vitamins and minerals morning and night. I keep trying to do my part to make myself better. Haven't mastered the SCD diet yet but am going back to it.

I am not adverse to medicine or Dr.s (to top it off my GI is even cute for a young guy). I just think everyone should be listened to and respected for their own opinions. The surgeon probably could have changed my mind with the right approach. I felt like sending him "How to win friends and influence people". Or "Kitchen table Wisdom" great book by a Dr. with crohn's and all it's complications.

Nanners, while my quality of life is no longer the elite triathlon status,and I don't race, I can still do lots of things better than non-sick friends. So I try to remeber that when I feel depressed. I have been layed off in a few months and that was horrible but as you pointed out i another post "could be a good thing".

Still trying to figure out life. You'd think by 53 I would have some answers. I just have more questions!

Anyway, thanks for listening yet again. I learn so much.

janicea
Regular Member


Date Joined Feb 2009
Total Posts : 350
   Posted 3/22/2009 9:28 AM (GMT -7)   
A surgeon is not qualified to diagnose and treat, but like the others say, just cut. I would agree with everyone here. Just hang with your GI's watch and wait approach. And LOL don't try to teach a surgeon to have a nice bedside manner, it's like the old saying "don't try to teach a pig to sing...." they do much better with unconsious people!! that's their job.
hang in there!!

chico41
Regular Member


Date Joined Jan 2006
Total Posts : 135
   Posted 3/22/2009 9:44 AM (GMT -7)   
 have they considered trying Remicade or Humira before doing the surgery?  yeah   

Wolfie40
Veteran Member


Date Joined Dec 2008
Total Posts : 947
   Posted 3/22/2009 4:39 PM (GMT -7)   
My surgeon gave me the option yes or no. I'm glad I did because it was worse than what they thought. I was told emergency surgery would have happened soon if I didn't have surgery. My GI said that surgery was the next best option for my Crohns. I don't believe that all surgeons are cutters.
Just my 2 cents.
Diagnosed with Crohns in 2001
First and hopefully last Ileocecectomy 2/18/2009

Medications: Asacol, Folic Acid, Multivitamin, Dbl. Calcium, Probiotics, Protonix, Monthly B-12 injections.

Living a Great life with my Wife and my two Chocolate Labs
Hunter & Hailey.
I love them dearly.

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