Polly - Here's That Endoscopy Report From 5 1/2 Years Ago

[tex]

Hi Polly,

As I mentioned a few days ago, here's a copy of the report on the colonscopy that I had, a little over five and a half years ago. As you will recall, I never trusted this GI, and after reading this report, you'll see why.

At one point during the series of tests, (sigmoidscopy, CT scans, barium x-rays, colonoscopy, and I think I've forgotten one), he mentioned that I might have some indications of diverticulosis, but he never mentioned diverticulitis, nor did he ever mention the stenosis that was apparently already present in my colon at that point in time.

I watched most of the colonoscopy exam on the monitor, since I was fully alert, but it didn't dawn on me to look at the screen, until after the scope had apparently already gone past the constriction, so I didn't see the stenosis, and was not aware of it, (I assumed the pain I was feeling at the time, was a normal part of the exam). The part of the colon that I saw, (everything past the sigmoid section), looked pretty much normal.

Afterwards, when I asked him about making any diet changes, to help prevent any problems from recurring, he told me I could eat anything I wanted. I don't know what I would have done differently, had I been aware of the stenosis, but I probably would have made some diet changes, and at least I would have known what was causing my digestive system to shut down every once in a while. Here's the Report:

DATE: 06/21/2000

SURGEON: Xxxxxx X. Xxxxx, M.D.

ASSISTANT SURGEON: None.

PROCEDURE: Colonoscopy.

INDICATION: This is a gentleman who has had recent episodes consistent with diverticulitis. Barium enema has demonstrated a narrowing in the sigmoid colon. It is unclear whether this represents spasm or neoplasm.

MEDICATIONS: Demerol 50 mg IV push, Versed 4 mg IV push, and Glucagon 1 mg IV push.

FINDINGS: After satisfactory cardiopulmonary assessment, a digital rectal examination was performed which was unremarkable. The procedure was then initiated without sedation. The Pentax video colonoscope was inserted and advanced forward under direct vision. There was a large amount of liquid present but this could be suctioned for the most part. The instrument was advanced to 25 cm where there was intense spasm and angulation. The patient was uncomfortable at this point so the above medications were administered incrementally. There was intense spasm and angulation. After administration of Glucagon, the instrument ultimately could be advanced through the left colon. The mucosa of the proximal sigmoid and distal descending colon seemed somewhat edematous in appearance with scattered erythematous folds. Multiple tics were present in the left colon. Once through this area, the instrument was then advanced rather easily through the rest of the colon to the cecum. The ileocecal valve was identified but not entered. A large amount of fluid was present throughout the colon which was suctioned. Flexures were still not seen completely. The colon itself seemed somewhat capacious. On withdrawal of the instrument, no further findings were noted. The patient tolerated the procedure well with no apparent complications.

IMPRESSION: Left-sided diverticula with findings consistent with diverticulitis.

I really don't understand why he never told me about this. On the final visit, after the colonoscopy, he just told me that everything looked fine, and there was no sign of any cancer. When I specifically asked him what I should do, when the problem of uncontrollable diarrhea returned, he told me that he would recommend removal of the lower half of my colon. Since he didn't offer any reasons for doing that, I thanked him kindly, left, and never went back, (until the ER visit, of course, but I never saw that GI again). It turns out his recommendation wasn't too far off base,--a little extreme, perhaps, since the recent surgery I had, only involved the removal of about 18 cm, (about 7 inches), of the sigmoid section, but still, the general idea was correct.

Now, I'm naturally wondering if this could possibly have been the extent of my problems. My stool test results from Enterolab, showed gluten intolerance, but this was based on the extent of residual damage to my small intestine, based on my fecal fat score. I had already been GF for almost three years at the time of that test, so a direct test for antibodies would have been pointless.

I'm wondering if I should do the dreaded gluten challenge, or just go ahead and fall on my sword now, since it's possible that I may be an MC imposter, in light of this evidence. What do you think?

Love,
Wayne

P S I wonder about the "tics". Do you suppose they were chronic, or just a response to the exam? Are they just nervous twitches, or an indication of something more significant?

P P S In case anyone is wondering, the phrase "edematous in appearance with scattered erythematous folds", is just "doctor-talk" to indicate inflammation, tenderness, and a redish appearance, (at least I think that's what it means).

[Mars]

IMHO, you at the very least, deserved to be given a more clearer understanding of the test involved and the results of each. The findings, and what that would mean for your continued recovery would have been the "follow-through" that we expect from our doctors but don't usually receive. Sad isn't it.

As for falling on your sword, you are not allowed. You presented with signs that you had MC and yes, could also have MC along with Diverticulitis. I do. No matter what you have believed to be your ailement, your expertise, caring, inquisiting nature has brought to light many answers to questions that will be used for a long time to come. A good leader doesn't have to carry the affliction of others, he just needs to "understand" the affliction of others.

Sometimes we aren't meant to know the answers to things gone by but we need to consentrate on the future and what we can do to change it!

To our continued good health
Love,
Mars

[CAMary]

Ummm-

I'll get a medical dictionary and get back to ya

I'm really not sure *what* it all means - I'll wait for all of you "science folks" to weigh in...

Mary

[artteacher]

Hi Wayne,

I know this post was meant for Polly, but I just have to say: You rock! You doctor was a butthead, just like the first one I saw... boy have we learned, huh? Always ask for your own copies of everything: blood tests, lab results, reports. I've known too many teachers to think that they were all experts, and too many policemen to think they were all good at what they did: can doctors really be all that different?

And that's all I have to say for now. ALLLLL my best, Marsha

[Liz]

Hi Wayne. Very interested inthe 'tic' part. Could it refer to spasm or contraction? Both my endoscopy & last colonoscopy showed inconsistent contractions or spasm of both the esophagus & colon. Doc said that instead of rhythmic contraction it was all over the place. A sort of inconsistencies of the nerve messages sent from the brain.

Love

Liz

[tex]

Hi Liz,

My interpretation of the "tics" would be the presence of relatively small, localized twitches in the wall of the colon, such as you might see in a twitch of a muscle in someone's face. I'm unsure, though, because the definition of "tic" is a sudden, spasmodic, painless, involuntary muscular contraction. Maybe they refer to contractions of an entire segment of the colon.

The report does specifically mention intense spasm and angulation, which I would take to be similar to what your exams showed. A spasm is defined as a sudden, abnormal, involuntary muscular contraction, consisting of a continued muscular contraction or of a series of alternating muscular contractions and relaxations. Angulation, of course, refers to the tendency to deviate from a normal path, into divergent directions. IOW, I assume that the mention of "tics" implies something other than spasms, but I'm just guessing about that.

Love,
Wayne

[harvest_table]

Wayne,

Arn't you glad you dug these records up but you must be frutrated to say the least! Your brains working overtime now I'll bet.

Could it be that the definition of the "tics" refer to small pocket pouches on your colon? Check out this link and read the 2nd post (Afghandoc) discussing it. Also, be SURE to look at the cartoon link of what your colon just might look like. HA HA.

http://www.afghan-web.com/cgi-bin/yabb/ ... 1110127534

Just maybe, you may not have MC but please don't fall on your sword for heavens sake. It would be easier to try a gluten challenge. I think it's awful that the GI did not give you the straight skinny on what he found 5 years ago but had he done that, today you might be hosting a board for the diverticulitis community (instead of MC) and we would not have had the pleasure of your company and friendship.

Their loss, our gain.


Love,
Joanna

[tex]

Joanna,

Thanks. That surely is the correct explanation. "Tics" is just an abbrevation for diverticula.

You're right. I do feel frustrated, after reading this report at this point.

Hahahahaha. I appreciate your remark about "Their loss, our gain." I can guarantee you that, now that I have become acquainted with all of you in this on-line setting, I hate to think that I might have missed all this, if things had developed differently. I suppose that GI did me a favor, after all.

Love,
Wayne

[annie oakley]

Wow Wayne...you stay way on top of things. Tha's cool. I have spasams but your Tics sound real painful on top of spasms. Bless your heart. I think we are all lucky to be as healthy as we are....but the knowledge here on this sight is very re-assuring. I know someone will always have an answer on this board more often than not before a doctor that deals in this desease. Love Oma

[Carrie]

Hi Wayne. You wrote:

...it's possible that I may be an MC imposter...

Nah! Those people didn't take any biopsies...so they could not have ruled out MC or even seriously considered it. The symptoms were there but they, not you, didn't follow through.

So, Wayne, whether or not you have MC, you are here to stay! What would we do without you? Youre' the best!!!

Love,
Carrie

[tex]

Hi Carrie,

Thanks for the kind words. I appreciate the sentiment.

Love,
Wayne

[JJ]

MC Imposter....cute Wayne...very cute...you better not leave us! Where would we be without you! Love ya Tex! JJ

[tex]

Jill,

I'm not leaving. Where would I go?

Love ya,
Tex

[Liz]

Hi Wayne. Even if you are not MC, & you could very well still be, If they didn't do a biopy, how could they tell, we would bestow on you life membership in honour of your unrivaled contribution to this board & it's membership.

Love

Liz

[starfire]

YOU BET!!!! (What Liz said).

Love, Shirley