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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
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Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Colonoscopy-- When my doctor does a colonoscopy, he uses Versed

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Colonoscopy-- When my doctor does a colonoscopy, he uses Versed and fentanyl. In the past I had doctors who used valium and demerol, and I was able to be awake and collaborate with the exam (which was only mildly 'pokey' rather than painful). My current doctor who is expert in the field, yet does a painful exam--and loads on the medication despite my request for limited sedation (so I can be aware during the exam). I have asked for something other than Versed because I hate the amnesia feature, but he only uses Versed. In addition, because I comment when I feel 'poked" during the exam, he ends up loading increasing the medication, and the nurse says I 'requested" more meds (of course I can't recall what I said due to the Versed)--and then she says that well, I expressed that it hurt. I am wondering how to find a more 'patient-centered' situation for medical exams like this (I just learned that there are now 'virtual colonscopies, but I also get upper endoscopies periodically). Can you help me understand:
1) Why one doctor conducts a more painful exam than another and is less collaborative--could speed of exam have something to do with it?
2) And-- How can I find a doctor who is more collaborative and still knowledgeable in this area?
3) Where / how can I find a hospital system that will do a virtual exam, and that provides patient-centered care?

Thanks!
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 3 years ago.
1. That is a matter of personal training and style.
The doctor you describe is more conveyor belt, not wanting to take the time to get you relaxed, have you cooperate, deal with any issues, etc.;
2. You have to ask around, to put it frankly. Find out which GI docs have a patient centered reputation..call the medicine department head offices at university or teaching hospitals, or any hospital, and ask this question...easiest and best way to find out.
3. you are talking bout the pill cam I take it, and this is not very useful for follow up colonoscopies, and is not proven to be as good for screening. You can not remove a polyp with this technology. It would be the practitioner, once again, not "the hospital" that does this...same person to contact, same question.
You might not even have to leave the hospital system you are in..just find the right doc.
Call the department head.
good luck

Let me know if you have further questions, details or need clarification, just use reply.......

Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

Customer: replied 3 years ago.
Thanks for the answer--just one point of clarification--I was referring to the virtual colonoscopy--which apparently is used at Mass General (although it also does not remove polyps--I was on this occasion worried I COULD have a polyp, but have never had one, and my results have been consistent each time). Other systems also use the virtual colonoscopy--I did not know about it prior to my recent procedure, and my doc did not mention it.
Also--I have spoken with my doctor previously about these issues, but he seems set on one method. He invented an upper endoscopy approach that is an advance (but this is the colonoscopy). I wonder if I can get a doctor who can do the coloscopies, and keep this one for the upper endoscopy--or find another doc who uses the same upper endoscopy method.
Expert:  Dr. Thomas, MD replied 3 years ago.
Again...same resource
Docs don't advertise to this degree of specificity..although some might advertise virtual colonoscopy.
Frankly, stool tests for blood yearly, or flex sigs...short scope are not much worse than colonoscopy for detection..and if you never had a polyp your scope should be good for 10 years as far as colonoscopy.
So I am not sure why you seem to imply that this should be a frequent procedure.
In 10 years technology might have advanced quite a bit.
So unless you have reasons for upper endoscopies periodically such as monitoring barret's esophagus, and reasons for more frequent colonoscopies, such as hereditary poly disease...then I would not do this.

good luck
Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57747
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 5 other Medical Specialists are ready to help you
Customer: replied 3 years ago.
Actually, you are very close--I do have Barrett's esophagus. And I have had lower GI issues for years--but mostly consistent with IBS and food allergies. I had the lower GI test a bit early this time due to bleeding. Thanks for your feedback.
Expert:  Dr. Thomas, MD replied 3 years ago.
You are very welcome
Find me anytime
dt
Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

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Dr. Thomas, MD
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Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc