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Spokane, Washington  Est. May 19, 1883
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Dr. Gott: Patient’s time is as important as MD’s

Peter H. Gott

DEAR DR. GOTT: I have to make an appointment a month in advance to have a checkup. Then I sit in the waiting room up to three hours, get undressed in the examining room and wait up to another hour.

I am a female, 5 feet 1 inch tall, weigh 110 pounds, and am in my late 70s. I’m physically active, jog, bike, swim regularly and do yoga. Is this the norm for all physicians now? I hate the thought of changing doctors, but I will if necessary. Why is my time so unimportant?

DEAR READER: Along with being rude and inconsiderate, your doctor should not keep you waiting for four hours. If he is that busy, he needs to reschedule office patients.

I feel you should meet with him to discuss this scheduling nightmare. If he resents your approach, wave goodbye as you leave his office for the last time. The doctor who has given up listening to his patients is missing out on one of the treasures of medical practice.

As I have written before, the receptionist should inform patients who are waiting that the doctor is running late and would like to reschedule an appointment at a more appropriate time. Communication is the key in this situation.

DEAR DR. GOTT: I have been suffering from anal pain for a year. My physician suggested a gastrointestinal series, and the results were normal. The pain is excruciating. Kindly help with any suggestions.

DEAR READER: Anal pain is rather common, and there are a number of reasons for it to occur. Causes include an anal fissure (a crack in the tissue), constipation, diarrhea, hemorrhoids, fecal impaction, proctitis, Crohn’s disease and, rarely, colon cancer.

I will briefly define some of the causes that are not widely known. A fissure is a small tear in the lining of the anal canal that can develop by the passage of large or hard stool. A hemorrhoid is a swollen and inflamed vein in the anus or lower rectum. Proctitis is an inflammation of the lining of the rectum. Crohn’s disease is a form of inflammatory bowel disease.

If your doctor ordered a GI series that was negative and he or she was unsure of the next step, you should have been referred to a gastroenterologist. Examination of the area can rule out or confirm several possibilities. If a visual exam isn’t appropriate, the specialist will be able to determine what the next appropriate step should be.

While you are waiting for an appointment, I suggest the following: Sit in a tub of rather warm water several times a day. If the pain is caused by a hemorrhoid or anal fissure, the pain should ease as the tissues shrink. Unless you experience adverse effects from them, take over-the-counter nonsteroidal anti-inflammatory medication or apply hemorrhoid cream or a hydrocortisone cream for pain relief. Use stool softeners if appropriate to facilitate bowel movements. Modify your diet to include more fruits, vegetables and whole grains. Exercise every day in a way that you feel comfortable with.

Remember, most anal pain has a benign cause. Only rarely is it an indication of colon cancer or serious infection. Regardless of the cause, see your physician again or a specialist to determine the cause.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed, stamped, No. 10 envelope and a check or money order for $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dr. Peter Gott is a retired physician. Readers can write to him c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.
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