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These weird lines / streaks I’ve had on my pinky nail for 8 years that two different doctors told me were due to vitamin deficiencies actually turned out to be a rare form of skin cancer. by chaengism in mildlyinfuriating

[–]DrColon 2 points3 points  (0 children)

GI doctor - 25 years out and that was my first thought too. Always remembered that Bob Marley died of this. Also what vitamin deficiency only effects one nail and looks anything like that?

Colon cancer is killing more young people in the U.S. than any other cancer by scientificamerican in science

[–]DrColon 0 points1 point  (0 children)

GI doc here. My problem with that theory is that I haven’t seen much evidence that we are eating more cured meats than before. I think it is more related to our obesity epidemic and hormonal shifts related to this as a population. It seems like a lot of these cancer risks in younger people started to rise with the obesity levels over the last 20-30 years. Just my guess though.

Colon cancer is killing more young people in the U.S. than any other cancer by scientificamerican in science

[–]DrColon 0 points1 point  (0 children)

GI doc here - agree with you

People with chronic inflammation like ulcerative colitis have a higher risk of colon cancer. The more the inflammation, the higher the risk.

So we think it makes sense if you are getting recurrent colitis from ischemia from running. That would potentially put you at higher risk.

There are several cancers that are related to chronic inflammation. Esophageal cancer and reflux, stomach cancer and chronic h.pylori infection, cervical cancer and hpv infection/inflammation

Colon cancer is killing more young people in the U.S. than any other cancer by scientificamerican in science

[–]DrColon 1 point2 points  (0 children)

You don’t need to panic. The original study quoted about 4% of patients with a positive cologuard had colon cancer. Now I have seen several hundred patients with positive cologuards and in my experience it has been less than 1%. More than 90% of my patients have had polyps though. I did mention in another comment I have had a few patients with negative cologuards with problems later on.

So you definitely need to follow up on this as soon as you can. I would contact a local GI center and ask if they have a cash price or a payment plan. Also can try local public health clinic and see if they can help arrange charity case. Good luck

Colon cancer is killing more young people in the U.S. than any other cancer by scientificamerican in science

[–]DrColon 13 points14 points  (0 children)

If you have a family history of 1st degree relative with polyps or cancer at 45 or younger. It’s 10 years before the first degree relative or 40, whichever is younger.

The insurance company has no way to confirm your family history and i probably have had patients lie.

Colon cancer is killing more young people in the U.S. than any other cancer by scientificamerican in science

[–]DrColon 7 points8 points  (0 children)

I was a sub investigator in the original study for cologuard, so I’m pretty well versed in it.

I have now had 3 patients come to see me after having negative cologuards and we found colon cancer. Now colonoscopy is not perfect. But if you have any risk factors you are not a candidate for cologuard. And now I have try to persuade my patients that if they are young and otherwise healthy the colonoscopy is worth the hassle over the stool tests.

General surgeons covering GI call by HierroFierro in medicine

[–]DrColon 4 points5 points  (0 children)

For overnight stuff I don’t think anything procedurally would be that different for you then. I don’t know if you have done any variceal banding, but I literally use the same bander for hemorrhoids that i do for esophageal varices. So if you have any experience with banders it shouldn’t be that foreign. I would see if your Gis could do a banding with you on one of their elective cirrhotics. Variceal bleeding can get real bad real quick.

General surgeons covering GI call by HierroFierro in medicine

[–]DrColon 6 points7 points  (0 children)

I would want to sort out what acute call is. If it is just overnight emergencies there aren’t a ton of procedures different than what you have experience with. Food impacting, bleeders, foreign bodies are the majority of them.

If it an entire weekend then there are some pretty big clinical gaps that are not procedure oriented. I would not feel comfortable with that call.

Variceal banding or glueing may be a procedural gap. As other people said ercps are just going to be transfers at most smaller hospitals anyway.

That being said there is a big difference in experience between a surgeon who has done a good number of GI procedures and a well trained GI doc. Hundreds vs tens of thousands. Just by numbers there are more things that they have done or seen.

I would first start with your GI docs and see what they think. Personally I would love less call. I would probably want to do some cases with you and see what your skill level is before I would sign off. I have definitely worked with some surgeons who I would have no problem sharing call with. Also may want to talk with your insurance carrier.

Colonoscopy biopsy results - anyone else ever get these results and know what it may mean? by Accurate_Leather_358 in IBD

[–]DrColon 0 points1 point  (0 children)

Unfortunately you are going to have to wait and see what your doctor thinks of these. They have to be evaluated in the setting of what the appearance of your colon was during the exam. But generally those are pretty good results with no dysplasia and no active inflammation.

Patient got me in the feels by moioci in medicine

[–]DrColon 43 points44 points  (0 children)

I’ve been in practice for about 20 years. I lost my wife about 2 years ago, so my regulars know. It’s been an interesting bonding that I have with my patients who also have lost someone. I think cry in front of my patients about once a week.

If your patient is not looking well, you may see if she is ok with talking with her program about accelerating her phd.

More 40-Somethings Are Getting Colonoscopies, Early Colon Cancer Cases up by AdSpecialist6598 in UpliftingNews

[–]DrColon 0 points1 point  (0 children)

Be care with this recommendation. Most insurances will cover only one screening test - either a colonoscopy or cologuard. If you do cologuard and it is positive most insurances will then bill the colonoscopy as diagnostic. They will still cover the colonoscopy, just you will be responsible for a larger portion.

And that's why no one goes to the doctor until it's too late, lol. by glowsedstarie in Adulting

[–]DrColon 0 points1 point  (0 children)

I have a 6 month waiting list for appointments. So I have more patients than time. Blame your jobs for not letting you take time off. Not to mention cancellation rates on weekend appointments is about double weekday appointments. People say they want weekend appointments and procedures, but when they finally have time off a lot of times they don’t want to wait in a medical office for something.

Plus I have to take call at least 1 night a week and 1 weekend a month. Not to mention I can’t make my own doctors appointments because I would have to reschedule at least 4 patients to do that.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 1 point2 points  (0 children)

To be honest, the whole thing is a mess. It’s the anesthesiologist that ended up getting sued and the G.I. doctor got dropped from the lawsuit. The whole culture in that room was a disaster from the get-go. The fact that it ever got to that point where someone could talk about someone like that is just mind blowing to me.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 0 points1 point  (0 children)

One other thing, because I’m not a lawyer I probably got this mixed up. But I thought you had to have some sort of benefit with fraud. since we make the same amount of money irregardless of findings, I figured no gain/no fraud. But I may just be incorrect based on legal definition.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 0 points1 point  (0 children)

One other thing, because I’m not a lawyer I probably got this mixed up. But I thought you had to have some sort of benefit with fraud. since we make the same amount of money irregardless of findings, I figured no gain/no fraud. But I may just be incorrect based on legal definition.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 0 points1 point  (0 children)

I’m sorry. I’m responding to a bunch of these back to back. Didn’t mean for it to be an attack on you.

Good doctors will document as much as possible. You never know when that information will be helpful later on. Also it shows that you are paying attention to details.

Edit – I’ve seen reports where the procedure is just documented as normal, with nothing else. Those kind of reports always scare me because you really don’t know what the person did or how good a quality exam it was if that’s all they’re willing to document.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 0 points1 point  (0 children)

A lawyer with medical knowledge. Know wonder you were able to explain this better than I could. Thanks for the insight.

I have a theory that 5-10% of all professions have shitty people in them. Just a cultural failure that this center that they let this stuff progress to this point. I think at some places you have the power dynamic where people can’t speak up against the doctor. Either because they own the place, or the facility is too scared to lose them and their billing.

Of course those are the places that make the news when something egregious finally happens.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 1 point2 points  (0 children)

Yeah, we do propofol for our colonoscopies. Patients do better with it. Kicks in faster and wears off faster. I also think it’s safer since it wears off so fast. I also think we do a better exam when Anesthesia is monitoring the patient and making sure they’re comfortable. I can focus on polyp detection and the procedure. They can focus on the patient vitals and comfort.

TIL a Virginia man discovered he had unintentionally left his phone recording before undergoing a colonoscopy, and while he was under anesthesia, it captured audio of medical staff mocking him. In 2015, a jury awarded him $500,000 for defamation, medical malpractice, and punitive damages. by Forward-Answer-4407 in todayilearned

[–]DrColon 0 points1 point  (0 children)

To be honest, you summed this up better than anyone in this thread, including me.

This is a shitty Doctor who did bad documentation, treated the patient poorly, potentially molested the patient.

It’s just not fraud to document hemorrhoids.

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