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10-21-2013, 12:01 PM   #1
Trysha
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Ageism

It would interest me to know if anyone has encountered age as being a factor in crohn's treatment.I am a senior.
Currently I have experienced very subtle overtones on two separate occasions, from the booking clerks at my specialist clinic, suggesting I have overstayed my welcome., which has made me feel uncomfortable.
Is this a "top down" approach to reducing clinic patients.?
The specialist is the architect of his hospital clinic and staff and is a well recognised GI
It is not easy to change from these specialists since the demand is greater than the supply.
Interested in anyone's thoughts on this subject.
Trysha
10-21-2013, 03:32 PM   #2
Lisa
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How can you overstay your welcome? Are they hinting you need to find a new doctor? If so, I'd be PISSED!.....

To me, finding a good doctor is key - and also keeping that doctor as long as possible for continuity of care! I've been with my GI now for almost 11 years - yes, I've had to see other doctors in the clinic from time to time, and probably more so now as my GI has taken over as head of the GI department (or something like that) after the head retired a couple months ago......I also went to the same clinic for about 6 years when I was in high school before I moved away....

Again, I'd be PISSED - and I would say something to the doctor next time I saw them....
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While my experiences may not be what everyone has had- I feel it is worthwhile to share any and all experiences that may be beneficial to others.
10-21-2013, 04:22 PM   #3
Trysha
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Thank you Pasobuff.
The specialist I see has only ever scoped me.He never checks me out, sometimes residents have, other times not.The attention is minimal.
My last appointment with this specialist followed a harrowing weekend of abdominal pain,and for two days I was unable to walk because of it.I did not want to go to ER or call an ambulance since again, the experience is different there for a senior. All they think of is getting you out as quickly as possible. I have experience this on the one occasion I went there and said at the time never again.So I tough it out .
Finally the acute phase subsided and a few days later when he saw me it was so much better.
I related this to him and he just looked in disbelief since I had taken nothing for pain.Fact is he has never addressed the pain issues at all in the four years I have been seeing him.,and never physically checked out any symptoms..
I recognise he is not a good GI for me and believe it is age related.
Since I have a degree of renal failure I am reluctant to take any kind of medication without supervision and usually have to tough it out. I survive using hot water bottles and the recliner instead of bed. It is very uncomfortable to lie down.
Unfortunately I have had bad reactions to Imuran and Remicade and he seems miffed about this.I am very sad that I had these reactions and would love for them to have worked .In fact the Remicade did work, he termed it a partial response- but sadly
since he stopped it,
no longer being able to take it-- the symptoms are creeping back.
It has made me feel very despondent and feel life is not worth living if it's going to be like this.
Without the support of a good specialist I believe I am sunk.
His front desk booking clerks have greeted me on two separate occasions with
"we thought you came to say good bye!
How would anyone else interpret this?
I do have another appointment with him, but do not wish to go through all this again.
However I will be asking him exactly what he is trying to do to me.
The conclusion is --don't be a senior!
Trysha
10-23-2013, 06:14 PM   #4
Susan2
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Hi Trysha. Are there other GI specialists in your area? In your situation I would certainly try to find someone else. I am 70 and have never felt that either my GI (whom, fortunately, I have had to see very rarely since my proctocolectomy) or my GP are displaying any ageism towards me. Nor did my GI ever give up trying to find me an alternative to Prednisolone, although we experimented, and failed, with whatever was available.
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10-23-2013, 06:33 PM   #5
Trysha
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Thank you Susan for your support.
I have yet to talk with my GP who is absolutely superb and regularly monitors me but insists on my staying with a GI specialist. I am going to see if he will let me move to another GI, but last time I had a problem with this GI being quite rude to me he would not let me change.
I have always remained polite and cool in all circumstances and very patient .It is all very difficult.
Best wishes
Trysha
01-10-2014, 01:22 PM   #6
Trysha
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Sequal to above:
I kept the GI appointment and was given the opportunity to speak about all the issues with the current GI specialist.
He was astounded to hear of my problems with him and the staff and said he had always tried to do his best for me and would do better. He was most upset to hear of his office staff behaviour and wanted their names, I was initially reluctant to give them but he pressed me for them, so I responded. He said he would never allow them to speak to patients in such a way.
I believe him and feel much better about the situation.
He was most concerned because I started to faint on him, twice.
He has prescribed salicylates and given me a way to contact him at any time I feel necessary. He also said if it does not work he intends for me to go back on Remicade for life. He also said he must continue to monitor me at regular intervals and has no intention on giving up on me.
So it was really worth summoning the courage to raise the issues and deal with them.
I really have to hand it to him for listening so patiently and being so willing to change the climate and accommodate my needs..
Maybe I had it all wrong in my imagination.He has now referred me for psychological help which I am reluctant to accept but have little choice under his pressure to do it.
He said it need only be one visit but feels the benefit would be great.
Because of all the emotional trauma I have experienced this last year such as the break in to my house and subsequently selling it--(-moving to a lush apartment very well run and very secure), bladder tumor removal, and family sadness due to bereavement and the continuing saga we all have with crohn's I realised maybe I should comply .It is now being arranged.
I feel with all the help from the forum and my family I don't really need it--we will see and I will keep you all posted with results.
The only other dilemma facing me is an appointment with another GI which was arranged by my GP.
This GI is someone who knows me well as an individual and I had asked for this specific referral.
How am I going to deal with that without hurting his feelings by cancelling it.
My GP will likely be angry at me for cancelling it.
Always something to worry about!
01-10-2014, 02:38 PM   #7
Grumbletum
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Well done you for speaking out. I think probably a lot of us, including myself, don't do it often enough because we don't want to appear to be making a fuss. I wonder if it's worth keeping the appointment with the other GI, just for a second opinion?
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01-10-2014, 03:18 PM   #8
Trysha
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In a way I would like to do this since we were good friends and collaborators in scientific research some years ago.
He went into GI practice and I shortly after retired.
Never expected to be a crohn's patient ever, such a shock, which I know is familiar to all of us on the forum.
In another way I feel ashamed that I may have misjudged my current GI because I thought he was not doing enough for me.So many treatment failures.....
This turns out to be because there is not that much more he can do---my expectations were not realistic., and I was resentful.
Now that I am studying the situation with a fresh look I feel guilty about the misjudgement of him., and realise it is not a question of my age.
He was very magnanimous in allowing me to say whatever I wanted, and he encouraged it, but was surprised by what I said.
Then he dealt with it in a gentle and appropriate manner, I think he may have been a little hurt though.
When I started to faint ,annoying to me in the middle of speaking out, he put his arm around me and suggested I lie down on the exam couch. I soon recovered.,but was enduring so much pain .
It surprised me that he did this since he is quite reserved and always a perfect gentleman.
He then responded to my critique and made a careful suggestion that I might benefit from psychological help. Initally I declined but he gently persuaded me to accept a referral,so I consented.
Regarding the second opinion, I think it could be good to have it, but don't know how to handle it all
.I don't want to be hurting anyone else and I just don't know how to proceed.
For ongoing visits how do I handle two specialists.
Have to think hard before acting.
I really appreciate your comments Grumbletum---I know you have had your difficult times too.
It is lovely to see you feeling so good ---hope it stays that way for you.
Hugs
Trysha
01-11-2014, 04:41 AM   #9
DustyKat
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To be honest Trysha I would have been surprised to find a GI that is ageist unless they specialised in an area that greatly reduced the number of older patients they see. I am only speaking from our experience but we see the opposite when it comes to GIís. The vast majority of their clientele are in the older age groups and my kids stand out like a sore thumb. I imagine most of the people in the waiting room think I am the patient and the kids are accompanying me!

It is not hard for a doctor and their patient to be on a different wavelength Trysha and all the while the doctor thinks everything is hunky dory because the patient doesnít say anything to the contrary. If you donít question and ask he assumes that all is okay and you understand and have no issues, and in his defence, he canít read your mind.

I donít think a second opinion ever goes astray especially when treatment options are becoming exhausted. If they have no new ideas then at least you know where you stand and it validates what your current GI is saying.

Please donít feel bad about speaking your mind Trysha, it helps to clear the waters and enhance your relationship. Without it he would not have known the issues you were having and you would not have known that he was unaware there was a problem. To me it sounds like you both now have a deeper understanding of each other and what your needs are. That canít be anything but good.

As to the psychologist, I think it is well worth a visit. If first impressions do nothing for you then walk away knowing you need never go back but there is always the chance that it may be just the tonic you need after the year you have had.

Trysha, you arenít hurting anyone with the decisions you make, you are just doing your best based on what you are feeling and what you know at this point in time.



Dusty. xxx
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01-11-2014, 05:00 AM   #10
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Had a bad year past. In hosp.They wont operate. I need my life back!!Have been put on azathioprine and infliximab infusions.NOT working. Back at work after 4 months and cannot retain fluids! Shitting pish!!

Whats a man to do??

Last edited by Dode1; 01-11-2014 at 06:38 AM.
01-11-2014, 10:45 AM   #11
Trysha
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Well said DustyKat, as usual you cover all the salient points and hit the nail on the head.
Your helpful comments are much appreciated.
Usually I accept whatever the day brings but I had so much bottled up and nothing to lose by speaking out.
I still feel a bit ashamed for basely thinking badly of someone but now it is all sorted feel
much better.
Now to pick up the threads and move on.
Hugs
Trysha
01-11-2014, 10:55 AM   #12
Trysha
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Hi Dode1
Welcome to the forum!
Sorry to hear you are so down and hope you will soon start to feel better.
Sometimes there are good reasons for not having surgery since it may not be the answer for a particular problem.
Easier said than done.
How long is it since you started the aza and infliximab (Remicade)--- these can take a little time before the benefits click in.
Have a look at the treatment sections on the forum and see what others have experienced with these medications.
I can share your frustrations having had a few experiences myself.
Feel better soon.
Hugs and best wishes
Trysha
01-11-2014, 03:19 PM   #13
carrollco
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I am so glad you shared. I have been feeling 'old' lately as my next birthday I will celebrate 60 years. I see that my feelings were projected onto my doc as, like you, I have had so many treatment failures. I think now his frustration is not directed at me personally, but at a disease that refuses to be conquered. Thank you again.

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Previous Meds:

Methotrexate--had kidney/liver damage
Lialda--allergic to aspirin--but didn't know until my Crohn's got much worse.
Prednisone--only when I have to!
01-11-2014, 05:45 PM   #14
DustyKat
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I still feel a bit ashamed for basely thinking badly of someone but now it is all sorted feel much better.
I understand and hear where you are coming from Trysha.

I know it would have been difficult to say what you had to but donít be hard on yourself, it was borne out pain and suffering and that is never something to be ashamed of.

Onwards and Upwards,
Dusty. xxx
01-11-2014, 06:45 PM   #15
Naturelover
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Trysha, Don't feel bad for speaking your mind. You may have just taught the doc and office a lesson in dealing with the aging population. You may have also taught the doc a lesson in bedside manners and the necessity of conveying important information to his patients. Let us know how the new GI appt goes. It's not the end of the world to see the psychologist. You've been through a lot and perhaps the psychologist can give you some tools to deal with whatever may come at you next. Hugs!

I was talking with my new GI doc over the phone and really got into it with him. I wasn't cursing or anything like that. Just being very firm and insistant on getting a colonoscopy sooner rather than later. The only regret that I have is that I didn't insist on a double balloon colonoscopy. I didn't know they existed. He told me after the procedure that he didn't check the TI. I know he wasn't expecting the entire colon to have inflammation or perhaps he would have checked the TI. I did apologize to him when I arrived for my procedure. He really appreciated it and said I had nothing to apologize for. He's a good doc, but I suspect he's being run ragged with long hours at the office, hospital and different procedure locations.

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MTHFR - Compound Heterozygeous for C677T & A1298C Dx 3/2015
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Multiple vitamin/mineral deficiencies & toxicity dx 3/2015
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01-11-2014, 07:17 PM   #16
Trysha
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Thanks Dusty---I owe you a lot for all the helpful support

Naturelover---thank you for your kind comments.
Sorry to hear you are not doing so well.
How often do we think of our docs and how they may also be pressured by admins---wrung out is the word.Some do give up, here there is a local neurosurgeon always a short supply of these specialists, he gave up and now has a very specialised mushroom farm. These are not ordinary mushrooms---they are very special.He was fed up with the system---government rules and regulations----underfunding---you name it.
Feel better soon
Hugs
Trysha
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