Like I said, they are not common. When I refer to a "GP" I usually refer to someone who is an MD or DO but who hasn't done a residency. That is really rare. Many refer to the Family Medicine docs as GPs, but they do a residency/internship combination, or did when I worked with them. GPs are the old "family doctors" who did house calls and such. I have known a few.
We had one when I was a kid in Indiana. His office was in his house around the corner from us. Dr. Shannon.
[ Maybe a GOOD nutritionist must fix what is broken from here.[/QUOTE] So true.....a good nutritionist.
My GP thinks I have diverticulitis. I guess it's no biggie. A colonoscopy in 2018 showed I have the pouches. So I got a second antibiotic to take and have an appointment Monday for a CT scan. The doctor took an x-ray this afternoon to see if poop is impacted and will call me with the results tomorrow. On the upside, the new urologist I'm seeing called and told me to go see a nephrologist regarding that urine analysis. So this guy put me on antibiotics and he made this recommendation, neither of which the prior guy would do. That's a good thing.
So the nephrologist appointment got moved from December 30 to today! Yeh, I jumped on it. What a great doctor. He started off as a GP before going into nephrology. I wish all my doctors were this smart and this personable. The doctor thinks that the bad urine numbers are all attributable to the effects of the cath bacteria, but he's ordered a series of blood & urine lab tests. My GP did a panel yesterday, and my blood serum test showed a Normal calcium level, so the nephrologist does not think my kidneys are a causal issue...but we're doing the lab work to make sure. He has the same opinion regarding the source of the sediment...it's likely the bacteria and nothing going on with my kidneys. The blood work will also preliminarily evaluate the parathyroids. We both know he's at a disadvantage by not being able to get clean urine specimens. He has other patients with this type of cath, but they are all MS folks or spinal cord people. He was kind of surprised to see someone in my state of being having a dead bladder. On the downside, my Monday diverticulitis CT Scan got pushed back until Thursday. The scheduler did not notice that I have a mild iodine dye allergy on my chart (encountered the issue 30 years ago), so they won't do an iodine contrast outside of a hospital setting (no dedicated scanning facilities.) I called today to get the pre-op instructions and discovered that this test uses iodine, so we had The Conversation. I'm glad I found out before I drove out there and wasted everyone's time. The deferral is not that big of a deal...my doctor already has me on antibiotics, so this scan is not in the critical path of treatment.
Just to update the moving parts of my failing body... The nitrofurantoin seems to be doing the job. I've also been doing a daily irrigation (a very minor thing that takes less than 2 minutes), and everything is free & clear. My last blockage occurred 2 weeks after a fresh catheter was installed...tomorrow I go in for a scheduled 4 week change and there is no evidence whatsoever of any sediment being produced. This is the first scheduled change I've arrived at without being derailed by a crisis (3 1/2 months of this crap.) My remaining risk is the bacteria developing a resistance to the antibiotic, but nothing I've read (decades of product literature and first-hand accounts) indicates that this is likely. I will probably just see a nurse tomorrow to have the routine swap done, so I bought a Thank You card to leave for my new doctor. Now that I've received what seems to be The Remedy that I researched, requested and was previously denied, I am more than infuriated at what my mind and my body were needlessly put through, and that I would continue to have endured had I not crossed paths with this new guy. I've not decided what I'm going to do about it. And now that I have an engaged urologist, I'm going to make an appointment to discuss my history & my present situation and get his opinion on any possible different paths forward. ************************************************* The nephrologist ran a whole bunch of blood & urine tests: -Basic Metabolic Panel -Calcium Ionized -Calcium,Random Urine -Magnesium -Phosphorus -Phosphorus, Random Urine -Potassium,Random Urine -PTH Intact -Urine Protein/Creatinine Ratio -Vitamin D 25 Hydroxy (For Vitamin D Deficiency) -Vitamin D, 1, 25-Dihydroxy (Sendout) Everything was within the Normal Range except my Potassium level in the Basic Metabolic Panel. It was 4.9 MMOL/L where the Range is 3.4 to 4.8 MMOL/L. The Potassium/Random Urine does not have a reference range...it says Diet Dependent. That level was 19.8 MMOL/L, but bladder bacteria may have rendered the reading useless (as it did with my urine calcium level.) Interestingly, potassium is one of the few things I do not supplement, and it's slightly elevated. I'm going to discuss the possible benefit of another 24 hour urine test now that the nitrofurantoin has taken the bacteria out of the equation. ******************************************* My diverticulitis felt like it was cured with the first course of amoxicillin/clavulanate (125mg @ 2x/day), but the CT Scan really aggravated it. I exited the procedure with different bowel issues and with days of gastric pain and discomfort I did not have before. The good news is that I finally saw the radiologist report that says "Inflammatory changes adjacent to the sigmoid colon in the region of diverticulosis may represent early diverticulitis. No evidence of perforation, abscess, or other complication." So the words "may represent early diverticulitis" are the best I could hope for...the earliest possible stage. I had the CT Scan the day I took my last antibiotic, and since the scan showed there was still inflammation, my doctor put me back on the antibiotic @ 3x/day to knock this thing out. He says that the current thought is to not prescribe antibiotics at all for diverticulitis (I did not ask exactly how an intestinal infection could possibly self-heal), but for some reason the presence of the supra-pubic catheter concerned him, so he put me on them. Given that my diverticulitis seems to be a low-level case, I don't know why the initial course of meds did not knock it out. Hopefully this one will. If it doesn't, at least I am in the early stages and not on the verge of a crisis.
Sounds pretty good, @John Brunner. The nephrologist has ruled out a lot of stuff, so that is good, IMO. I hope you feel it is worthwhile contacting him/her. I am also glad you now have a urologist you can work with. Some intestinal infections can heal themselves when the causative issue is removed or corrected, but I know nothing about diverticulitis healing itself. I certainly hope it does. The "MAY represent" makes it sound as though there is little or no inflammatory disease at all. Did any of this come from a colonoscopy? I forget if you said.
I had a routine colonoscopy in September 2018 and was then told I had the pouches (diverticula.) I've not had one since. This issue manifested itself a couple of weeks ago in interrupted bowel movements...small volumes of very wet stool. I've had no discomfort ever in the lower left area, except for the exam when my GP applied pressure there. There was maybe a fifty-cent-piece size area where it was tender around the circumference and then painful when pressure was applied right in the center. An x-ray done by the GP said "Mild to moderate colonic stool burden. Nonobstructive bowel gas pattern." The GP listened to my bowel noise and said it was fine. I don't know why the CT Scan made things way worse (BM stuff came back and stomach distress started), other than because of the timing I had nothing to eat from dinner Wednesday until 3PM Thursday. Things got bad on Friday, but I felt fine throughout the entire Thursday exam and immediately after...the barium and iodine did not cause any immediate distress. Heck, I walked around the hospital for 45 minutes after drinking it to make sure it got circulated. And I've not had any ill/sore/painful feeling at that lower-left region--or the lower-right region--at any time throughout this entire ordeal. I sit here now--a full week after the CT scan--and my stomach upset comes & goes, but the frequency is decreasing...it's been fine all day today. Again, the stomach burning/pain/upset problem started after the CT scan and before I went back on the antibiotic, so the increased meds are not the causal issue (although it's possible they might have become an "in addition to" factor, but I don't really think they are.) The x-ray and the CT scan both point to issues near the sigmoid colon, and stomach distress can be part of diverticulitis (if that's what I got.) This is only my 3rd full day on Round 2 of the antibiotic (I had my first dose late Monday evening.) The prior course of meds took 4-5 days for the BMs to be normal (my only symptom at that time.) The current course of antibiotics are helping the BM problems (although they are not normal yet), just as they did before, so there must be an infection somewhere that's getting remediated. It's just odd that things got back to normal, then I had the CT scan, then stomach issues began.
Just a side note here... I changed my eating habits (cut out the crap, changed the time of day I eat my large meal, eat a smaller meal for dinner, and no longer eat close to bedtime) and I went from a porky [for me] 180# back to a more reasonable 160#. Another 5# or so would not hurt, but (thank goodness) my weight is not a factor in this. Six months ago it might have been. Lack of exercise is a different story.
hey @John Brunner... congratulations! isn't it great how the body moves and feels now that you've trimmed down a bit? i've had a similar transition in the last few years and it makes me feel like skateboarding again... or trying some qi gong... possibly even extreme knitting
I've hit that 180# 2-3 times in my late-adult years. When I was working I could hit a gym on my way home. I'm fortunate that once I put in the effort, I can quickly get rid of the pounds. I weighed under 120# when I graduated high school and desperately tried to gain weight. I literally ate 6 full meals per day. Three months later I had dropped 5#!!! A physical confirmed that it was "just the way I am." When I got into bicycle riding (commuted to work on it, went on Saturday and long weekend rides) I picked up a quick 10#. I had a metabolism like a rabbit, and needed the high cardio stuff to regulate things properly.
i was at 120 in my prime and knocking on 200's door thirty-five yrs later. had it in the back of my mind, for some reason, that maturity meant the ubiquitous spare tire then hated when it arrived. yet there i remained feeling a little clumsy but accepting. went intermittent, occasionally abstaining from food if activity was at a minimum and now sitting purty around 170.
I'm lucky. If I move enough, I can eat anything and maintain a decent weight. I'm unlucky. I've become a lazy S.O.B.
John, Reading through your post I'm glad you're getting the appropriate treatment your doctors are doing a good job. I've had three diverticulitis attacks back in the late 90s early 2000s I can tell you that they are nothing to play with so have it checked out and take your antibiotics. My doctor told me do not take any GI Series test or anything we're insertion is required while you're under an infection. After not having an infection for 6 months I did go for the GI test they told me they stopped Counting at 40 pockets. I take certain precautions now and I've not had an attack for over 20 years now. While you have an infection a bland diet is helpful. You're in my thoughts and prayers I wish I had a magic wand, until I do take your medicine.
Thanks, Tony. It seems I have a pretty mild case, and I want to avoid a worse one. What precautions do you take? I read a ton of conflicting stuff out there regarding diet. At first I was eating baked beans and bean soup and lentils to get fiber, but then I read to avoid those very things because they create gas. I bought veggies and dip for the same reason, and then I read to avoid broccoli & other cruciferous veggies because of gas. I'm on that second course of antibiotics. The pharmacist got "a look" on her face when she saw 125mg of amoxicillin 3x per day. She took extra time with me to go over the side effects and what to do. I guess she does not see a lot of scripts for folks with lower gut issues...you gotta take a pile of antibiotics so there's something left by the time they get way down there.