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Doctors office refusing to check for c.diff

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Ulcerative Colitis
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Posted 10/15/2019 5:19 PM (GMT -5)
So I’ve posted recently about a change in my bowels. Was diagnosed with proctitis 8 years ago. Recently developed one day of bad pure water diarrhea followed by a few days of very loose stools and some type of intermittent burning/cramping. Couldn’t get in to see my gastro doc but was able to see his PA today. I had a fairly normal BM this morning before my appt. Scheduled my colonoscopy for November 15th(earliest I can get an appt). I asked for a stool culture to check for c.diff. They told me no because they will only do it if I have diarrhea. I’ve had c.diff. twice. I realize I may be atypical but both times I did not have diarrhea. My BM’s have a more foul smell than usual and I want to be sure I don’t have c.diff. The PA told me to call the office if I develop diarrhea and I can come pick up a kit. So...guess who started having looser, foul smelling stools after my appt? Me. I’m so annoyed because in my situation of not feeling good it’s not convenient to have to drive back to the office to get the kit. I’m not saying I definitely have c.diff but why can’t they trust us as patients and that we know our bodies. November 15th is a long time away. I’m also going to keep calling the office to see if they have any cancellations and can move my colonoscopy up.
Posted 10/15/2019 5:56 PM (GMT -5)
What a real PITA to have to drive back to get the kit.

When I was having problems getting a test ordered I finally said to him that I had insurance that would cover it so why was he so resistant, what harm was there in doing the test? He didn't have an answer and ordered the test. It was to check my Entyvio levels. They were low. I don't think I will have problems if I ask for a test again.

I have had more problems with PA's than I do docs. I think they get intimidated when they have a patient who is knowledgeable. It's not like I don't respect them ... but they don't seem to like questions or requests.

Hope that you feel better soon ... hopefully it's not c diff!
Posted 10/15/2019 6:57 PM (GMT -5)
CC, after being gently berated by my gastroenterologist yesterday....I'll just tell you as he told me....don't let them put you off in having the c. diff testing. The longer you wait to begin treatment, the longer it will probably take to get rid of it. Keep insisting and best of luck to you.
Posted 10/15/2019 7:35 PM (GMT -5)
I don't see why you can't lie. Just say you have diarrhea to get the test. The doctor himself won't be looking at it.
Posted 10/16/2019 2:47 PM (GMT -5)
In my IBD support group, we cynically call this "lazy care"... when doctors don't do their jobs because it requires them to put in a few more minutes of extra time and effort. A lot of these doctors have very tight schedules and they've mentally calculated how much time (in minutes) a patient appointment is worth. If they have to put in time that exceeds what they feel the value of the appointment is worth, then they won't order extra tests, etc.

These are the types of doctors I end up firing because they have become health care workers who are hollowed out, empty shells who either never cared about helping people in the first place, or they forgot the reason why they got into medicine.

C. diff is serious and if there is any suspicion you might have it, you need testing. If it's covered by insurance then why not!
Posted 10/16/2019 6:35 PM (GMT -5)
Yeah, that is ridiculous they would not give you the test. My GIs have always been the exact opposite -- always pushing for stool tests before they would even give me prednisone when I was almost positive it was a UC flare (now that I've had c diff. I have no problem doing the tests, but before it was a little annoying to have to wait days for prednisone). I agree, it's really hard to drive or leave the house when you are sick. My gastro.'s office and the hospital are a 35 minute drive away from me. So I have to drive there, pick up the kit and then drive back to drop it off. I know it sucks to lie, but I would seriously just lie and say you have diarrhea if this happens again and they won't give it to you...or get a new doctor if it comes to that. You really have to advocate for yourself sometimes. Best of luck!
Posted 10/16/2019 6:54 PM (GMT -5)
Update: The doctor agreed to order the stool test. I was able to complete the sample this evening. I’ll have to drop it off to the doctors office tomorrow morning.
Posted 10/16/2019 6:55 PM (GMT -5)
That's good. Keep us posted.
Posted 10/16/2019 10:42 PM (GMT -5)
Whew! Hope you don't have to wait too long for results.

q
Posted 10/17/2019 1:25 AM (GMT -5)
There's a good chance it is not your doctor's office making this call. The lab at my hospital will NOT process a c diff test on a formed stool. Just this week my doctor forced me to do a C diff test even though I've never had C diff and am not having any unusual symptoms (they do this all the time), and the lab rejected it and told my doctor they won't run the sample because it isn't liquid. Even if your doctor agreed to order the test, the lab may refuse to test your sample.
Posted 10/18/2019 8:56 AM (GMT -5)
noodles -- That's interesting. Didn't know that.
Posted 10/18/2019 11:55 AM (GMT -5)
I can confirm that our local laboratories are required to reject formed stool for C.diff testing.
Also this is not a test for an infection or to find the bacteria. It is a test for the toxin.
That said, it is possible that other rules should apply to IBD patients since we are at higher risk.

A friend (not IBD) was treated for C.diff and the symptoms were not subtle. Massive diarrhea that reminds me of descriptions of cholera.
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