I see my gastroenterologist on tuesday afternoon (right in the middle of a bad patch of symptoms).My symptoms at present are steady weight loss because of a lack of appetite and long term nausea.At present i am on endansotron/metoclopromide for the nausea and fortisips and calogen to try and maintain some sort of calorific input.i think i am also becoming depressed as i cry a lot thinking about my health.Tests i have had so far are endoscopycolonoscopysmall bowel seriesultrasound of abdomenbarium x-ray of stomachtests for caeliacs/lactose intolerance/h-pylori/SIBOall have come back negative.I am fed up of the nausea and being unable to eat because of the lack of appetite.I really want to have a HIDA scan but he keeps on insisting i don't have any symptoms of biliary disease (i do get right upper abdominal discomfort)...my gallbladder didn't have any stones on ultrasound.I am scared that my symptoms are getting worse and i feel like i have hit a brick wall. i amalso scared that i will end up being admitted with malnutrition sometime over the next couple of weeks as my weight of 58kg is low for my height of 5"10.Does anybody have any ideas about what i could ask him and how i should approach this appt with him.
what to ask my gastroenterologist
1 - 20 of 28 Posts
Riddick I would ask the Dr point blank ...what he thinks is causing the nausea. Also I would let him know that the meds he has prescribed apparently are not helping.Also..you can ask again about the Hidascan since everything else was negative. Perhaps there are not any stones but there may be poor function and would that contribute to your symptoms??The nausea meds... are there maybe other alternatives that might be more effective for you?? Wish you all the best with the appointment!BQ
Joined
·
34,955 Posts
Well, I would avoid going in saying you have your own diagnosis and require the doctor to do any specific test for you. The doctor has a lot more info and experience at picking out which things to test for and which problem you have and even if you happen to be right you may not get what you want if you go into it demanding and fighting for something that may or may not fit your symptoms. Especially since all tests have some level of risk and just doing them for no reason doesn't usually sit well with doctors especially when they are taking about exposing you to more radiation.There are other things in the upper right quadrant, including the colon and lots of other reasons for nausea.What I would do is be clear about what symptoms are bothering you and to the degree it interferes with your life. If they are too busy arguing about what test you don't need they don't have time to really listen to how much a symptom is screwing up your life.Also be open about all your symptoms. If you are having a lot of anxiety let them know that. It can often make minor issues really bad because of how your anxiety will interact with the physical symptoms. So something that may be easy to deal with if you are not anxious becomes overwhelmingly difficult to deal with if you are anxious about it.Let him/her know you are looking for a game plan. A where will we start and what will prompt moving on to plan B, or plan C, and a list of what you have tried and how well any given thing worked. That way you can make a game plan based on what you know already. Even if there are things you have tried that this doctor didn't give you.I thought you had some evidence of gastoparesis or something in one of the tests, so maybe ask about checking into that more completely, or seeing if something to treat that might be worth putting in the game plan.
The gastropresis was a symptom of not eating for 2 weeks...the radiologist said it was very mild in any case.I asked him last time what he thought was going on and he said that he had to be honest with me and said that he didn't know.I am wanting a HIDA scan but i also do not wnat to offend this Dr as he is a really nice bloke.I think i need anti-depressnts for definate. i am such a changed person from one year ago...i never feel well enough to socialise and have lost contact with several friends.Thankfully the one rock in my life has been my girlfriend.My best week symptom wise this year was a trip to rome when i didn't have a worry in the world and the sun was out every day!
As far as nausea meds go there is nothing else left to try.....i've tried them all!Nausea is the one symptom i can't deal with and lets face it who can function with virtually constant nausea?My weight drops because of this then i become more depressed and worried about my future.I will lose my job because of this illness;; i am in a pretty dark place at present.
About the nausea... have you given ginger capsules a real good try?Also I find myself the less I eat the more nausea I seem to get.. so that might be the case with you as welll?? I don't know.. but sometimes I do not feel well enough to eat either but I do anyway... no matter that I know I will get severe pain afterwards or liquid D or nausea... I know.. I have to eat.. so I just work my way through it. Sure ask the Doc about anti-depressants... could help you & your appetite maybe??All the bestBQ
Joined
·
34,955 Posts
There may be non medication things to try, and having some game plan of what to do tends to be more forwarding than assuming all hope is lost and not even bothering to see what other options could be out there. http://www.springerlink.com/content/u70164457476851v/ shows some of the low does TCA's used for IBS seem to help some people with functional nausea, so even if you are out of anti-nausea drugs it may not be the end of all possible things to try.
Joined
·
34,955 Posts
I really wasn't suggesting that one just "cowboy up" and force yourself to eat. Sometimes antidepressants or some mind body therapy may be something that could be used even if it isn't an anti-nausea medication.
I think he thought I was suggesting that Kath... I wasn't Riddick it is just that sometimes we do need to force ourselves a bit to function is all.But just see what the Doc says about about possible functional nausea or Chronic nausea and ask about the Tricyclics like Kath suggested. In that link she gave you there is does say they have helped some people. Could be the one thing that helps you... ya never know.All the bestBQ
I've never heard of functional nausea (i'll google it!).I am trying to stay positive.The way i look at it is this way. It's not a terminal disease...it's a pain in the ass. Even if i lose my job i'll still have my girlfriend and family...and they are the most important things in my life bar nothing.I still have a way to go with tests with the gastroenterologist......i am going to ask him about gallbladder and why he thinks it's not GB disease.What should i say if he says its not GB due to no stones on ultrasound? I don't want to offend him but i will have to point out that i'm not stupid and i realise gallbladders can be disesaed without stones.I know i bang on about gallbladder but my symptoms could be this and i won't be happy until it's been ruled out properley.
Joined
·
34,955 Posts
I just want to be sure you would be happy with a HIDA scan, there are other tests (some a lot riskier) and I just worry you may start pushing for those if you don't get the answer you want from the HIDA scan.
I think ultimately kathleen i will continue to ask/pursue whatever tests are out there until i get some sort of answer that i can live with.I sure can't live with my symptoms as they are at present...the nausea is too much.I am due in work tomorrow and i will be going in to at least sort my diary out. After tomoorrow i don't expect to be in work until these symptoms are under control as i can't concentrate.I have patient's of my own to look after following cardiac bypass suregery and heart attacks and i can't do them justice when all i am thinking about is if i'm going to throw up in their homes!I may be off work some time. Luckily i am able to be sick for 6 months with full pay and 6 months with half pay and then its dismissal time.........then its social security benefits (which doesn't amount to much in the UK). I basically have 12 months to sort this.
Joined
·
34,955 Posts
Just don't get so narrowly focused on one possibility you won't be open to other ideas.I'd hate to see you get a surgery you don't need and have bad diarrhea in addition to the nausea if it isn't the gall bladder and something like 50 mgs of a tricyclic could take care of the original problem.We've just seen a few to many who got the GB removed "just in case" that ended up worse than they were before the surgery.
To be honest i am scared and frightened. I also heve emetophobia and a phobis about things being put down my throat like endoscopes and tubes etc.I am so frightened about what all this is doing to my health. I can't live on fortisips and calogen (even the fortisips are making me nauseous now. Once i can't tolerate those i'm in real trouble as my weight will drop very quickly.Every day is now an ordeal and the only peace i get is when i'm asleep.I just want my life back and to be able to marry my girlfriend and be a good husband to her...i feel like i'm losing my mind.
Joined
·
34,955 Posts
The phobias and anxiety probably don't help, and I'm not saying don't try to find something that works. Just don't get so focused on one answer that may end up making things worse if you don't need the surgery that you can't see there may be other things going on.If the worry and anxiety is something you can't easily control on your own getting some help for that may be part of getting everything under control. It never makes symptoms better.
When i last saw the GI doc he wouldn't give me anything for the anxiety. he wants to finish all the GI tests before he goes dwon the anti-depressant route.Trouble is here in the UK it takes months to have the tests and the follow up.I'm gonna pour my heart out to him on tuesday and let him see the devastating effect all this is having on me.
i just forced down a small bowl of breakfast cereal.I think anxiety about eating is a major problem now. I don't feel too bad after the cereal and i have just eaten before bedtime (11pm here in the UK).I am sorry for going on like i have. I just feel supported on this forum and it means so much to be able to discuss with others what i am going through...God bless all of you. x.
I went in to work this morning and my boss sent me home immediately...said i looked shocking. i am going to ask to be admitted to hospital tomorrow as i feel terrible.....i think my anxiety levels aren't helping either..the more anxious i get the more my nausea increases as well.
Joined
·
13,221 Posts
HI riddick so sorry for all that you have been going through --and i know this isn't the first time since i know you've been through it all before with the weight loss,hospital stay and tests. and of course i'm no expert and i don't know how insurance works in the uk but all along i've been wondering why the dr doesn't give you the test for your gallbladder just to see if that's a possibility since the other tests came back negative. and the antidepressant sounds like a good idea too.i have nausea when my constipation gets bad and you're right--anxiety makes it worse as does an empty stomach but yes it is very hard to force oneself to eat when nauseous although i manage to do that...very light frequent meals.i really hope your gastro pays attention to you this time..your weight sounds dangerously low and malnutrition is a factor too and well as your quality of life. i don't understand why your doctors have let it all go on like this. hospital sounds like a good idea at this point...i really hope they do something to help you..this has all gone on far too long.
1 - 20 of 28 Posts
Join the discussion
