Re: Perforation of bowel & other messy problems

From: Christine M. Smith (
Sun Oct 24 11:50:21 1999

At Sun, 24 Oct 1999, Merri Ellen wrote: >
>Thank you for your response to my fear about the colonoscopy. So often
>I feel that my fears or concerns are not of importance to the doctors. I
>think it is the lack of acknowledgment that makes me want to scream! :~o
>There was never any clear documentation that the scope caused the bowel
>perf. It is my opinion. And yes, the GI has scheduled upper and lower
>barium tests before the colonoscopy. The new medicine is not working
>very well. Levbid is supposed to slow down the flailing movement of my
>bowel. It has some nasty side effects. Blurry vision,
>foggy/disconnected sensation. It is a time-release drug so I might feel
>ok and then go foggy slowly. Last night I felt tired and agitated all
>at the same time. It has worked on the bowel problem. Eased the
>cramping dramatically. But it claims to have constipation as a side
>effect and I am having just the opposite problem with it!
>I have been reading all of the posts each day and I feel so bad for each
>of you that are suffering physical as well as managed care problems. I
>am holding out hope that there are qualified doctors and technicians out
>there who have experience with adhesions and that we will find them. I
>too can self-refer without my GP. But that can backfire also. A nurse
>actually came out and told me that while I CAN self-refer, the doctors
>prefer that the GP refer me. After several "chase my tail" experiences
>I decided to find another way. I called my insurance company and asked
>for help. I found a doctor (out of network) 3 hours from here who has
>extensive experience with adhesion cases. Then I asked the insurance
>company for assistance in getting this doctor to be covered by my copay
>insurance. She explained that if there was not a comparable doctor
>within 30 miles of me...they would cover him, even though he was out of
>network. This put the challange of discovery on the insurance company
>NOT on me. She found a doctor with comparable experience in my local
>city. I will see him in November. The insurance company wants me to be
>satisfied and it will cost less money if they will assist me. I could
>self refer to dozens of doctors (incurring high costs) or they can help
>me themselves. We will see! I share this stategy in the hope that it
>may help someone who is discouraged with their managed care situation.
>Merri Ellen

Hi Merri Ellen:

I found your response very encouraging! You didn't say at first that your doctor was doing barium studies before the procedure, that makes a difference in his attitude. If I were in that situation I would feel differently about the same doctor doing the procedure. Your response also makes it more likely for me to request that barium studies (or something like that)be done before the colonoscopy. In other words, I would not feel silly requesting it.

As far as your managed care experiences, it just demonstrates again how very individual everyone's situation is. Health Care "reform" in the U.S. has only resulted in mass confusion, in my opinion. They say it saves money in the long run, but I really wonder.My situation is a little different in that the problem appears not to be the adhesions, but something else. So I don't have to search far and wide to find someone with experience in treating my problem, which appears to be sacroiliac dysfunction. I have opinions from several doctors that my problem is the SI joint, yet my pcp does not follow their suggestion except very generally, such as prescribing celebrex. (doctors he sent me to, by the way). Also, the group I have in mind has a website and a large advertisement in the phone directory so I can't believe they are not interested in self-referrals. If that is the case, then they are wasting their money targeting the public rather than other professionals. There have always been doctors who require referrals from a patient's pcp, at least in my area. Doctors such as cardiologists, neurologists, surgeons have always required referrals, but even this is changing with some doctors. Your response has encouraged me to work with my insurance company. What I plan to do is to call my pcp office this week, tell them I would like to see a certain doctor based on the recommendations of the various specialists I have seen. If he won't refer me,(and he might) I will self-refer (which means paying 25% since I have made up my deductible This is what I used to do). Office visits are manageable, but paying 25% of any tests or procedures would be a financial hardship so I will then ask my pcp to reconsider and refer me back to this doctor. If he doesn't agree, I will contact the insurance company and explain my dilemma (that I am following the recommendations of doctors that my pcp has sent me to in the past) and ask them if they will cover whatever is recommended. (The doctor I have in mind is within the network) I really doubt they will, but I will try. And I will also look for another pcp. Thanks for sharing your experience.

Chris S.

Enter keywords:
Returns per screen: Require all keywords: