Wednesday, August 18, 2010

A Nasty Gut Feeling

I had to blink and grip the edges of the exam table to keep from crying or being angrier. I was already a little peeved by her attitude regarding me being a diabetic. Then she had the gall to mention the big G-word that nobody likes. "You know Diabetic Gastroparesis could be a possibility. When you've been diabetic for so many years, it can affect the nerves, even the ones in your digestive tract."

"I am aware," I deadpanned back, willing the tears to stay in my eyes. Willing the bitter hatred to stay inside my chest. I read the symptoms of gastroparesis online at a reputable health encyclopedia website. I had what equated to half a gastroparesis symptom. I had the slightest bit of nausea, maybe a trace of bloat.  Nowhere in the laundry list of Diabetic Gastroparesis symptoms did I see dull, achy lower abdominal cramping for two days following the sudden onset and subsiding of a sharp lower abdominal pain while going to the bathroom.  "But I find it hard to believe that something like that would come on overnight. Also I am not overly nauseous, and I haven't vomited. At all."

Now I realize my doctor is not a mind reader and that I should answer honestly when she asks me how my blood sugar control is. "Not great," I responded sheepishly.

She blinks, her tiny, humorless face a mask betraying any emotions aside from a slight displeasure that I'm not touting a fabulous A1c. I'm sure she sees this all the time. People who say they're fine but they run sky-high every day, or they are constantly on the glu-coaster, up and down, ignoring the symptoms and/or the damages.  "Describe what that means," she tells me.  I tell her what my average BG is during a day, and yes, it's not great. 

My urine test came back negative for everything--ketones, infections, glucose, protein. My lower abdomen still feels crampy and uncomfortable. My stomach feels a bit upset. Maybe I have contracted some sort of virus that is just causing pain and annoyance rather than the usual gastrointestinal unpleasantries we all associate with a stomach bug.

Yet my brain keeps buzzing, "How DARE she?" How could this doctor have the audacity to suggest a diabetes complication for what could just be a bug? Or what could be...well, I don't know what it could be. The doctor offered me absolutely NO diagnosis whatsoever. She said if it is an ovarian cyst problem, I'm already on the treatments. I don't have an infection. I had zero issues that lead her to anything conclusive. Could my diabetes have caused some kind of mild nerve damage that causes colon spasms, to which she somewhat hesitantly tacked on, "despite your best efforts to control your sugars?". Perhaps.

She had no suggestions for any further steps unless I start getting worse. She had no suggestions for any over-the-counter remedies to treat my symptoms.  I understand doctors are not supermen.  They are only human, and do not have all the answers.  But when something is wrong with my body, I would like to be taken seriously.  When someone even suggests that my troubles are related to a diabetes complication, I would like to possibly be tested so I can know for sure.  Or maybe even offered some sort of treatment plan to rule out complications.

If I am still feeling cruddy in two days, I am calling the doctor's office again and seeing a doctor who I very much like and trust. I am only seeing this woman again when it's a dire emergency.

Over the course of the day, I've gotten more and more angry about this. I don't expect rainbows, bunnies and handholding from my doctors, but don't coldly stare me in the eyes, never smiling, never stopping to reassure that my concerns over my own well-being are valid and I'm not a fucking hypochondriac out-of-control diabetic, telling me bluntly there's nothing you can do for me. AT ALL.  Maybe I could take some Tylenol if I have pain.  Do you think it was fair of my doc to throw out Diabetic Gastroparesis as a suggestion for an occasionally recurring problem that no one else has bothered to look into or test for?

I feel like I spent $10 in co-pay on a glorified school nurse visit.  At least the nurse would have handed me the Tylenol before I left the office and offered to let me call my mother.


  1. Yes, I think it was fair to suggest gastroparesis, if that's what she is thinking. I would be more upset at a doctor not mentioning it as a possibility. Gastroparesis is something that people sometimes feel only as occasional attacks.
    What I don't think is fair is mentioning gastroparesis without telling you about treatment or testing for gastroparesis.
    I also don't think it's a good idea to exclude other possibilities based on a presumptive and useless diagnosis. Ovarian cysts can be bad enough to necessitate surgery (my mother had an ovary removed- she was already in the hospital when it burst).

  2. Jonah: I agree that it was at least in her and my best interests to mention it. But you're right--what seemed the most awkward and least fair was not suggesting any tests, treatments, or anything to really help. Also, I was not asked about any family history of anything, and that history includes ovarian cysts, endometriosis, diverticulitis, and colon polyps, which are all a number of things which could produce lower abdominal pain as a symptom.

  3. I agree with Jonah; while it COULD be gastroparesis, then again, it may not be. If she believes that is very likely, your endo really should be referring you to a board-certified gastroenterologist because the reality is that an endo really cannot diagnose gastroparesis no matter how many times they've seen it before; a number of tests are required to prove it. She also could have recommended a gastroenterologist that she trusted for you to see, rather than just giving you some unsubstantiated suspicion on her part. The practice of empathy did not seem to be present here.

  4. What a sucky visit. I mean, you're already hurting and uncomfortable, let's not add some mental trauma to the situation please, *especially* without any advice for what to do or where to go.

    I sure hope you're feeling better, but it would be nice to know what was/is going on.

  5. The more doctors I see for random issues, the more convinced I become that the MO for most doctors is to randomly guess at possible causes until the patient gets sick of dealing with the problem.

    I spent the last 5 out of 6 dealing with similar . . . unpleasant issues, and my doctor kept putting me off with probiotic supplements, OTC meds, etc. I finally figured that it was another medication I was taking that was wreaking havoc on my guts.

    I'm sorry you're going through this. It almost makes you grateful for diabetes -- at least that's diagnosable!

  6. If she didn't know about your diabetes, I wonder what else she might have suggested. Food allergies cause some of the symptoms you describe in your post.

    Anyway, I hope you're feeling a great deal better. Thanks for the Taylor Mali video in your other post.

  7. Ask lots of questions. That $60 copay sounds really high, and they will certain treat all insulin as a non-generic. Best of luck choosing, and learning how to effectively use, your insurance.


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