Praise then darkness, and creation unfinished

I just had a telemedicine appointment with the gastroenterologist. Her office called at about 9:30 this morning, to ask if I was available for a 10:30 appointment, and I said yes.

The diagnosis is collagenous colitis, which I already knew from MyChart. The good news is that it's both benign and curable. The treatment will be nine weeks of budosenide pills, starting at three/day for the first three weeks, then two/day for the next three weeks, and a final three weeks of one/day. Those are to be taken with food, and in the morning because it's related to steroids and can interfere with sleep.

The most common risk factors for this kind of colitis are being a woman over sixty, and regular use of NSAIDs. Therefore, Dr. Morgan wants me to talk to Carmen about whether there's a plausible alternative to me taking naproxen almost every day, but she did say there may not be, since tylenol doesn't work the same way and may not be effective for the hip and knee pain I'm using it for.

I asked about continuing the Imodium and the fiber capsules, and Dr. Morgan said I could stop using them when the budosenide starts to be effective for the diarrhea, which might be within a week. I told her that the combination of Imodium and fiber is working well enough that I may not notice a difference, so the tentative plan is to wait at least a week, then pick a day or two when I won't need to go out, and try stopping the Imodium. (Adrian pointed out that I'm currently taking two pills twice a day, so I could try halving the dose and see how I feel. That sounds plausible, but I'm going to ask Dr Morgan if she thinks that's worth doing.

Also, a significant number of people with collagenous colitis also have celiac, so she wants to test me for that. I asked, and it's a straightforward blood draw, which I can do at my convenience: I don't need to wait until after getting blood drawn to start on the new medication.

She is sending the prescription to CVS, and told me to call her office if there's any problem with the insurance company.

ETA: I looked at the doctor's visit notes on MyChart, which reminded me that I should be checking my blood pressure about once a week while taking the budosenide.

!markdown

So, the follow-up test for C. diff was also negative, and the pills Carmen prescribed in the hopes that they would improve my symptoms had no apparent effect. (That was dicyclomine, 10 mg, twice a day.)

With that information, I am trying to make an appointment to see a gastroenterologist. The current state of things is:

• I have a new-patient appointment at Brigham and Women's Hospital on September 22nd, and am on the waiting list for cancellations.


• To get an appointment at Beth Israel Deaconess (where my neurologist practices) as a new patient, I had to fill out a form, and they say they'll probably get back to me in 2-5 days. (Mt Auburn is a different system, despite them both being Lahey Health.)


• The scheduler at Boston Medical Center told me yesterday that they are currently scheduling in July, but can't do anything without an order faxed from my doctor. Once they receive it, someone will contact me. I asked Carmen's office for that yesterday afternoon, and the receptionist said they'd do it right away. If I don't either hear from BMC, or see evidence of the order on my (new) account on their MyChart tomorrow, I'll check with them and if necessary call Carmen's office again. That's a hospital requirement, even if the patient's insurance doesn't require one.


• Mass General Hospital _also_ needs a referral from my doctor to do anything, and they just said they're scheduling 6-9 months out. I'm holding off on that for now, rather than confuse anyone by having two requests for referrals pending at the same time.


• Mount Auburn's website showed me doctors and a shared phone number when I picked "find a provider" on their webpage. I called just after 5:00, and will need to call back in the morning.

Also, after I cancelled my trip to Montreal because I was worried I would suddenly need a bathroom while I was traveling, yesterday, which would have been my travel day was fine. However, today and Tuesday weren't.