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My husband has very mild Crohn’s disease, so mild that doesn’t impact his life in any measurable way and as far as I can tell has zero symptoms as long as he is on Pentasa. His GI said that he is in the top 1% of Crohn’s disease sufferers.
Ok, so that is terrific. However, what is not so terrific to my thinking, at least, is that his GI has him on the same intense colonoscopy schedule as all Crohn’s sufferers. Every two years his GI asks him to get another one. Every two years! That’s five times as much as the average population. This has been going on since 2007 when he was first diagnosed. Every single colonoscopy is always the same. It is always great! Very little evidence of Crohn’s disease (but always just a little).
Given that colonoscopies have risks (I always worry about a possible perforation) and not just benefits, I just doubt that it is in my husband’s best interest to get them so frequently. Maybe if he had new or worsening symptoms that needed to be checked out but he doesn’t.
Anyway, last time I asked him to ask his GI about a more relaxed colonoscopy schedule. He did and his doctor said that he didn’t need the colonoscopies for his health. Instead he needed them so that our insurance company would keep covering the Pentasa.
I just don’t buy this. Crohn’s is a life-long illness. You don’t just recover from it, so why would the insurance company need colonoscopic evidence that he still has it? Something just feels off to me. Also, I would bet that our GI makes most salary from colonoscopies.
I would call our health insurance company and ask a few questions. But, although I feel like writing a post about it is OK, I feel that that kind of more official meddling is not OK. My husband is not one to question his doctor and just wants to do what he is told. So, is it my place to call? Probably not … Also, I worry a little about screwing things up for him. You know — letting it slip that his Crohn’s is so mild his doctors doesn’t think he needs the colonoscopies. Maybe the insurance company will conclude that it is so mild he doesn’t need his medication either.
So, I should probably just butt out and accept the fact that if my husband lives to current life expectancy, he will be having 15 more colonoscopies he doesn’t really need (in addition to the 12 he already had). It seems insane to me. Sigh.
This is your husband's business. If he is satisfied with the regimen he's on and his condition is under control, he can choose to trust his doctor's recommendations. Unless you have healthcare POA for him those decisions are his. Are you a gastroenterologist now? Unless you can provide direct evidence that eligibility for the medication doesn't depend on such frequent colonoscopies I suggest you drop it. Obviously you're entitled to your opinion but at some point setting yourself up as a suspicious adversary to someone else's provider will cause more harm than good.
Last edited by Parnassia; 07-20-2021 at 01:22 PM..
This is your husband's business. If he is satisfied with the regimen is on and his condition is under control, he can choose to trust his doctor's recommendations. Are you a gastroenterologist? Unless you can provide direct evidence for your contention that eligibility for the medication does not depend on colonoscopies I suggest you drop it. Unless you have healthcare POA for him what he does about his health is up to him. Obviously you're entitled to your opinion but at some point setting yourself up as an adversary to his provider will cause more harm than good.
Yeah, I know this and am not butting in. Still, I really don’t think it is right.
I'm suspicious about the excuse that the ins co won't pay for the meds without the expensive procedure on a frequent basis...
...but then I doubt the GI guy really will miss the income from one more or less procedure every 2-4 yrs.
Part f the problem is that we know sufferers from Crohn's have a significanlty higher risk of developing colon ca..but we don't know what that risk is for a guy with such a mild case. Nobody has collected a serie of 1000 mild cases and followed them to see how much ca turned up after 40 yrs....
...so I'm guessing the GI guy is thinking that the one time we decide to skip the colonoscopy will be the time the ca would have shown up and we'll havelost several yrs until it is caught,maybe too late. You know how that goes.
The risk of the procedure is on a par with the risk of dying in an auto accident. Unless you avoid driving due to that risk, you have no need to shy away from this.
Let's hope 30 yrs from now we can look back after he hasn't developed ca and say, "See..I told you he didn't need all those tests!"...Then again, maybe the frequent tests will catch a ca early and save his life.
Yeah, I know this and am not butting in. Still, I really don’t think it is right.
I worried over the hurriedly cleaned scopes full of previous patients blood and matter. Hep, hiv, sepsis, and all those. I didnt make appt. I did make great changes to diet, health and my ibs dx just went away after a couple months. That was awhile ago. Years. Symptom free.
I worried over the hurriedly cleaned scopes full of previous patients blood and matter. Hep, hiv, sepsis, and all those. I didnt make appt. I did make great changes to diet, health and my ibs dx just went away after a couple months. That was awhile ago. Years. Symptom free.
Did your symptoms go away, or also the actual diagnosis? Doesn't Crohn's/IBD usually require a colonoscopy to confirm the diagnosis (and whether it is "cured")?
I worried over the hurriedly cleaned scopes full of previous patients blood and matter. Hep, hiv, sepsis, and all those. I didnt make appt. I did make great changes to diet, health and my ibs dx just went away after a couple months. That was awhile ago. Years. Symptom free.
There's specific recommendations on how often a patient with Crohn's should have colonoscopies. There's monitoring for disease activity using colonoscopy and for screening for colon cancer which they are at high risk for. Because they are high risk the Cologuard is not an option.
Having one done every two years is not unheard of depending on specific circumstances and recommendations.
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