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Discussion Starter · #1 ·
A few weeks ago I visited my HMO GP. I came armed with a folder full of IBS articles and drugs which may help. He was initally resistant; started out with a "who's the doctor here" attitude. That changed when he realized I actually knew what "presynaptic", "hydroxytryptamine" and"biogenic amine" meant. I talked to him about Alosetron, and how it would likely be released later this year. I mentioned I would like to be referred to specialists to see about being prescribed other drugs with 5-HT3 blocking abilities, such as Remeron and Ondansetron. Well, my GP didn't even know what Alosetron, Remeron and Ondansetron were; I had to explain to him what they were and how they worked (it's a weird feeling explaining to one's GP 5-HT receptors and how serotonin affects gut function). He even made copies of some of the references I brought. He also referred me to two specialists, one of whom I'm seeing this week.Since I'm an exercise physiologist, it may have been easier for me to "talk technical" with my GP, and having a graduate degree in a related field may have helped too, but this experience does illustrate two items. One, GPs are too busy to keep up on everything, they can't; they don't have time. And two, it's important for the patient to be self-informed. When Lance Armstrong was diagnosed with testicular cancer, he spend untold hours on the WWW learning about his condition. He got to the point where he knew almost as much about testicular cancer as his physician. In part, that's what this BB is about; information. That's one reason it's so important to have a resource like this. reading as much as one can also helps. When I first contracted IBS in 1995, I didn't know anything about it. Through endless hours in libraries and the WWW, though, that changed. One book I would strongly recommend for those who want to know how drugs work (not just IBS drugs)is: The Pill Book, 8th Edition, Bantam Books, ISBN # 0-553-57971-1 (the ISBN # is the book's fingerprint; unique to all publications). The book costs $6.99.This book describes over 1,500 of the most commonly prescribed drugs. How they work, dosages, side effects, drug/food interactions, the whole nine yards. It's a great resource, and you don't have to be a PhD to understand it.
 

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Thanks, Guy, so you've proved that being well informed really helps! You're so lucky that your doc referred you to specialists! Mine hasn't done that yet. Keep us up to date on what they tell you.
Thanks also for the tip on that book! I always like to read as much about what I'm taking as possible, and I think that's one reference book I'll buy!Jean------------------"Never let the fear of striking out get in your way." Babe Ruth. And I'm also Praying with Bettie for a cure for this NASTY IBS! Jean
 

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Thanks, Guy. I agree it pays to be a squeaky wheel, being a longtime one myself.However, the doctor is the other part of the equation. Mine heard my "news" about Lotronex, which he hadn't heard of as of November, skeptically and somewhat dismissively. His response to my explaining about the studies and (briefly) how it works was: "I don't expect this to really help you," followed by "What are you expecting, a miracle, a panacea?"I replied "Just my old life back," and told him about the researcher for Lotronex who had e-mailed me that this thing was giving people their lives back.When I sent for my records, I saw his note, "She has heard about this new drug due to be released that is supposed to cure all her symptoms and give her a new life. I told her I don't know anything about this drug yet."And so this squeaky wheel will find a new GI.
 

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Guy, I agree with knowledge going into the doctors office. You can get farther sometimes and like Persist says if they don't know what your talking about, time to find a new one. But it helps to give them specifics, especially with IBS.Thanks for your post.
 

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On my next Drs visit may I take one of you along with me.??? Maro
------------------"FRIENDS ARE ANGELS WHO LIFT US TO OUR FEET WHEN OUR WINGS HAVE TROUBLE REMEMBERING HOW TO FLY"[This message has been edited by Maro (edited 01-01-2000).]
 
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Discussion Starter · #6 ·
Great post! The thing that was great about Remeron for me is that the spastic, urgent feeling is not there anymore (usually!) It just seemed to put me, physically and mentally in a more normal state, without all the "freaking out". Here is something really to think about: After I stopped really having full blown panic attacks, and started to get used to doing things again, the IBS increased immediately, to the point where I could barely function. It was as if the anxiety had merely moved to another location. I really determined that my mental situation needed to be treated, with therapy and medications, because it seems that my body was telling me something. The brain refuses to be ignored!
As I repressed the panic, the IBS started in to get my attention. I am still trying to balance everything out... I never stop reading about the disorders I have, and I never will. I won't surrender myself totally to the care of a doctor, unless there is no other choice. I trust the combined judgement of a doctor and myself. After all I am the one who has to live in this body! They don't have the same concern as I have for myself!
 

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I agree with the idea of being prepared. And it is EASY to get your doc to listen if you approach it without making less of his/her knowledge, training and ability. I usually take an article printed from the net, WITH source included, and ask him/her what they think of it. Make them read it! They will look at that easier than listen to you, and there will be no mixup of terminology etc. They will either poo-poo it, or will ask you what you need or want to know about it. "Well, do you think it would work for me?" LET THE DOC think the idea is theirs. I am lucky, I have several docs who listen to me without the games, my GP and my ob/gyn. My colo-rectal surgery still loads me in with the patients he can't give too much information to. With him, I go to the hospital and ask for copies of all proceedures since... or ask my ob/gyn to request copies of his records. His wife/business manager and I then go over them over lunch. She is able to answer any questions, explain any new terminology, etc. it was SHE who explained the biopsy on my first, second, and third rectal surgeries. She also was the one that suggested that although I don't fit the personality profile of an ibser, my symptoms sounded just like it, and to go in that direction for a diagnosis. It is kind of cheating, but having an ally in the medical field makes a difference. They will often even talk to the doctor concerned and make suggestions for you even if it is something they cannoth treat and is outside their field of expertise.------------------Praying with Bettie for a cure for this NASTY IBS!
 
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Discussion Starter · #8 ·
Guy, you're absolutely right. While we can never forget who the actual doctor is, we must take things into our own hands to a certain point. Doctors are people too: busy, under pressure, etc...sometimes they can make mistakes. If you have some weird, out of the norm condition, like IBS, plenty of input & feedback from the patient can only help. I am at the point where I, too, am going to my doc much better prepared. I sometimes wonder if doctors wish we never had access to the Internet. Think about how things worked before. It was not nearly as easy to use libraries to learn as much as quickly as the Internet makes possible. Many thanks to this BB--and YOUR posts also. Jim
 
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Discussion Starter · #10 ·
Guy, I went in today to request a full blood panel lab. I went to another doc that works with my normal GP, and asked him what he knows about Remeron, and he said he knows nothing about it. Doesn't seem too interested either.
It has been out since 1997, and I have known about it for a long time. Kind of disturbing to me. I know doctors can't keep up on everything, but sometimes I get surprised at the ones who don't research much at all, if ever.
 
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