I saw my gastroenterologist today and set up my every-5-year colonoscopy in 2 weeks. He noted that I am on warfarin for a mechanical valve and he told me to continue the warfarin (just like in 2008).
I reminded him that in 2008, he had me drop my INR to 2.5 (my range is 2.5-3.5). He asked what it was on my last test. I said 3.2 or 3.3. He said that as long as I am in range, that's OK, that they can do a biopsy or remove small polyps. If he finds a big polyp with a large stalk and big blood supply, they'll do another c-scope while I am unanticoagulated.
I was very happy to hear that.
NOTE: My mother had colon cancer in 1977; her mother had it in about 1963. Both had successful surgery. My mom is 86; her mother died at age 99 years 5 months, basically old age.
What brought me to his office was not a consult for the c-scope, but a consult because a CT scan and ultrasound for other reasons had detected bladder stones. My family doctor referred me to a general surgeon and to the GI doc. The surgeon's office must have gotten the referral first, because his office called first. He was all hot to trot over taking my gallbladder out -- even though I have never had any symptoms.
He tried to put the fear of God in me by saying that if I were out of the country and encountered a problem, well, you get my drift. He considered me a patient in jeopardy because of the mechanical heart valve, that if an infection developed, it could potentially wreak havoc on the valve.
I had gone into that appointment with the surgeon 95% convinced I would NOT have the surgery. Afteward I wasn't so sure, especially when he said that if he were me, he'd have his gallbladder out. He wanted me to have an ERCP done before having the gallbladder out.
The gastroenterologist had a different point of view.
About 15% of the population has gallbladder stones and most of those people never have a gallbladder attack. (Not sure where the 15% figure comes from -- I've seen it many places, guess it's from stones detected during tests like I had on asymptomatic patients). He said the gallbladder and the appendix are fairly useless organs. "I still have my appendix and I'm sure not going to have it out unless there's a problem," he told me.
When I made the appointment with the surgeon, his office was calling it a pre-op visit. I corrected the scheduler and said, no, it's not a pre-op, it's a consult. When he asked me why I was there (if I knew why I had been referred to him), I said, "I'm here to humor my family doctor."
I had done a lot of online research on gallbladder stones (Mayo & Cleveland clinics have wonderful websites) and concluded there was no need to have surgery.
When I had my MVR nearly 10 years ago, I decided not to have any surgery unless it was vital (another heart surgery, cancer surgery, something emergent, etc.).
I was very gratified to hear my gastroenterologist back up my decision. Elevated liver enzymes found on labwork during my annual physical was what prompted the CT scan and ultrasound, and the 3 tiny stones were found on those tests. He advised continuing to have labwork to monitor any increase in levels.
And even better, I found out that he likes cats. :smile2:
I reminded him that in 2008, he had me drop my INR to 2.5 (my range is 2.5-3.5). He asked what it was on my last test. I said 3.2 or 3.3. He said that as long as I am in range, that's OK, that they can do a biopsy or remove small polyps. If he finds a big polyp with a large stalk and big blood supply, they'll do another c-scope while I am unanticoagulated.
I was very happy to hear that.
NOTE: My mother had colon cancer in 1977; her mother had it in about 1963. Both had successful surgery. My mom is 86; her mother died at age 99 years 5 months, basically old age.
What brought me to his office was not a consult for the c-scope, but a consult because a CT scan and ultrasound for other reasons had detected bladder stones. My family doctor referred me to a general surgeon and to the GI doc. The surgeon's office must have gotten the referral first, because his office called first. He was all hot to trot over taking my gallbladder out -- even though I have never had any symptoms.
He tried to put the fear of God in me by saying that if I were out of the country and encountered a problem, well, you get my drift. He considered me a patient in jeopardy because of the mechanical heart valve, that if an infection developed, it could potentially wreak havoc on the valve.
I had gone into that appointment with the surgeon 95% convinced I would NOT have the surgery. Afteward I wasn't so sure, especially when he said that if he were me, he'd have his gallbladder out. He wanted me to have an ERCP done before having the gallbladder out.
The gastroenterologist had a different point of view.
About 15% of the population has gallbladder stones and most of those people never have a gallbladder attack. (Not sure where the 15% figure comes from -- I've seen it many places, guess it's from stones detected during tests like I had on asymptomatic patients). He said the gallbladder and the appendix are fairly useless organs. "I still have my appendix and I'm sure not going to have it out unless there's a problem," he told me.
When I made the appointment with the surgeon, his office was calling it a pre-op visit. I corrected the scheduler and said, no, it's not a pre-op, it's a consult. When he asked me why I was there (if I knew why I had been referred to him), I said, "I'm here to humor my family doctor."
I had done a lot of online research on gallbladder stones (Mayo & Cleveland clinics have wonderful websites) and concluded there was no need to have surgery.
When I had my MVR nearly 10 years ago, I decided not to have any surgery unless it was vital (another heart surgery, cancer surgery, something emergent, etc.).
I was very gratified to hear my gastroenterologist back up my decision. Elevated liver enzymes found on labwork during my annual physical was what prompted the CT scan and ultrasound, and the 3 tiny stones were found on those tests. He advised continuing to have labwork to monitor any increase in levels.
And even better, I found out that he likes cats. :smile2:
