Coping with Diverticulitis - A Patient's Story

Providence

28 May 202136:44

EducationalLearning

32 Likes 10 Comments

TLDRIn this insightful broadcast, Dr. CherySlad Khan, a hospitalist at St. John's Providence in Santa Monica, leads a discussion on diverticulitis with Dr. Tracy R. Childs, Chief of Surgery at Providence St. John's Health Center, and patient Tammy Leader Fuller. Dr. Childs explains diverticulosis and diverticulitis, highlighting common symptoms and emphasizing the importance of medical evaluation for a definitive diagnosis. The conversation dispels myths about the condition, such as the avoidance of nuts and seeds, and the misconception that all cases necessitate surgery. The broadcast also covers safe and effective treatment options, including dietary changes, oral and IV antibiotics, and surgery as a last resort. Tammy shares her personal journey, which includes a severe case requiring hospitalization and a successful surgery by Dr. Childs, avoiding a colostomy bag. The discussion underscores the significance of patient advocacy, the doctor-patient relationship, and the collaborative approach to healthcare decisions.

Takeaways

🏥 Dr. Tracy R. Childs is a general and colorectal surgeon at Providence St. John's Health Center, with experience in leadership roles and treating diverticulitis patients like Tammy Leader Fuller.
📚 Diverticulosis is a condition where small pouches form in the colon, most commonly in the sigmoid colon, and is found in 50% of people over 50. Diverticulitis occurs when these pouches become inflamed and can lead to complications.
🔍 Symptoms of diverticulitis include left lower quadrant pain, urinary symptoms, fever, constipation, and fatigue. These should be distinguished from mild diverticular disease, which may only present as constipation.
🚫 Common myths about diverticulitis include the belief that nuts and seeds cause it, that all diverticulosis patients will get diverticulitis, and that surgery is always required after an episode.
🍽️ Dietary changes are recommended for managing diverticulitis, with a low-fiber diet suggested to rest the colon during acute episodes.
💊 Antibiotics are used to treat diverticulitis, specifically those that cover gram-negative and anaerobic organisms. Self-medicating with antibiotics not intended for diverticulitis can be harmful.
🔧 Surgical options for diverticulitis include minimally invasive and robotic-assisted laparoscopic surgery, which can lead to faster recovery times and less post-operative pain.
🛌 Enhanced recovery pathways involve pre-surgery nutrition, carbohydrate loading before surgery, and minimal use of narcotics for pain management, contributing to quicker post-surgery recovery.
⏱️ Average hospital stay for elective diverticular disease surgery is one to three days, with a quick return to normal activities and work.
🤝 The importance of a strong doctor-patient relationship is emphasized, with patients encouraged to be advocates for their own health and seek multiple opinions when necessary.
🌟 Tammy's story highlights the importance of trusting one's own body and the value of seeking a second opinion, which led to her successful treatment and avoidance of a colostomy bag.

Q & A

What is the role of Dr. Tracy R. Childs at Providence St. John's Health Center?
-Dr. Tracy R. Childs is a general and colorectal surgeon at Providence St. John's Health Center and has been on the active staff for the last 30 years. She has also held leadership positions as Chief of Staff and is currently the Chief of Surgery.
What is diverticulitis and what are its common symptoms?
-Diverticulitis is a condition that occurs when small pouches in the colon wall become inflamed. Common symptoms include pain in the left lower abdomen, fever, constipation, fatigue, and sometimes urinary symptoms due to the sigmoid colon's proximity to the bladder.
What are some myths about diverticulitis that Dr. Childs aims to dispel?
-Dr. Childs dispels several myths including that nuts and seeds cause diverticulitis, all patients with diverticulosis will get diverticulitis, once a patient gets diverticulitis they will keep getting it, and that diverticulitis always requires surgery or leads to having a colostomy bag.
What are the safe and effective treatment options for diverticular disease?
-For mild diverticular disease, dietary changes such as a low fiber diet may be recommended. Oral antibiotics are used for pain associated with infection, characterized by symptoms like fever and malaise. Intravenous antibiotics are used for more severe cases, and surgery is a final option for patients with complicated diverticulitis or recurrent episodes.
How did Tammy Leader Fuller's experience with Dr. Childs differ from her initial treatment?
-Tammy's initial treatment involved a prolonged hospital stay and the expectation of a colostomy bag. However, after being treated by Dr. Childs, she avoided a colostomy bag, and Dr. Childs used a minimally invasive surgical approach that led to a quicker recovery and no need for a bag.
What is an enhanced recovery pathway and how does it benefit patients?
-An enhanced recovery pathway is a program that includes nutritional pre-habilitation before surgery, carbohydrate loading and adequate hydration before surgery, minimally invasive surgery, and narcotics-bearing pain management. This approach helps reduce the risk of wound infection, shortens hospital stays, and allows for a quicker return to normal activities.
What is the typical hospital stay duration for patients undergoing elective surgery for diverticular disease?
-The average hospital stay for patients undergoing elective surgery for diverticular disease is one to three days, with the average being two days.
How soon can patients resume normal activities after surgery for diverticular disease?
-Patients can typically resume normal activities within one to two weeks after surgery and can return to work, exercise, and regular diet within the same timeframe.
What is the significance of a complete resection in surgery for diverticular disease?
-A complete resection, which involves removing the entire sigmoid colon up to the rectum, is important to minimize the risk of recurrence. If done correctly by an experienced surgeon, the risk of returns is less than 15%.
How did Tammy Leader Fuller's experience with diverticulitis affect her perspective on advocating for her own health?
-Tammy's experience taught her the importance of being her own advocate. She emphasizes the need to trust one's own body and to seek help when something is wrong, even if it means seeking a second opinion or transferring to another hospital for better care.
What advice does Tammy Leader Fuller have for patients diagnosed with a new disease or condition?
-Tammy advises patients to trust their doctors but also to trust their own bodies. She encourages seeking help, asking tough questions, and seeking advice from specialists or experts when something doesn't feel right. She also highlights the importance of having a strong doctor-patient relationship and finding a doctor who listens and collaborates with the patient.

Outlines

00:00

😀 Introduction and Overview of Diverticulitis

Dr. Cheryslad Khan, a hospitalist at St. John's Providence in Santa Monica, introduces the broadcast and its guests: Dr. Tracy Childs, Chief of Surgery at Providence St. John's Health Center, and Tammy Leader Fuller, a diverticulitis patient. The video aims to educate on diverticulitis, emphasizing that the information is for educational purposes only and viewers should consult their physician for medical advice. Tammy shares her experience with the disease and how Dr. Childs helped her avoid a colostomy bag, highlighting the importance of seeking the right medical expertise.

05:02

📚 Understanding Diverticulitis Symptoms and Treatments

Dr. Tracy Childs provides an overview of diverticulitis, explaining the condition as the inflammation of small pouches in the colon wall, most commonly in the sigmoid colon. Symptoms include left lower quadrant pain, fever, constipation, and fatigue. Dr. Childs discusses the importance of recognizing these symptoms and seeking appropriate medical care, which may include dietary changes, oral antibiotics for infection-related pain, and in severe cases, intravenous antibiotics or surgery.

10:04

🛑 Debunking Myths and Discussing Surgical Options

Dr. Childs addresses common myths about diverticulitis, such as the belief that nuts and seeds cause the condition or that all diverticulosis patients will develop diverticulitis. She clarifies that surgery is not always necessary and that modern surgical options are less invasive. The discussion also covers enhanced recovery pathways, which include nutritional pre-habilitation, carbohydrate loading before surgery, and minimal use of narcotics for pain management.

15:04

🚫 Dispelling Fears About Diverticulitis Surgery

Dr. Childs further discusses surgical options for diverticular disease, emphasizing that surgery is a last resort for complicated cases. She assures viewers that modern surgical techniques are less invasive and that patients can expect a quicker recovery. The use of robotic and laparoscopic surgery is highlighted as a significant advancement in treatment, with patients typically spending only one to three days in the hospital post-surgery.

20:05

🌟 Patient Story: Tammy's Journey to Recovery

Tammy shares her personal experience with diverticulitis, detailing her initial misdiagnosis, the severe pain she endured, and her eventual recovery after surgery by Dr. Childs. She talks about the importance of being your own advocate, seeking second opinions, and finding a doctor you trust. Tammy's story underscores the critical role of the doctor-patient relationship and the patient's responsibility to understand their health and treatment options.

25:07

🤝 The Importance of Doctor-Patient Partnership

The discussion highlights the collaborative nature of medical treatment, where both the doctor and the patient share responsibilities in making informed decisions. Tammy emphasizes trusting your body and seeking help when something feels wrong. Dr. Childs stresses the importance of clear communication and understanding between doctors and patients, advocating for a patient-centered approach where decisions are made in partnership with the patient.

30:07

📢 Closing Remarks and Audience Engagement

Dr. Khan thanks Dr. Childs and Tammy for their contributions and invites viewers to engage with Providence Health System through their website and social media channels. She encourages viewers to seek more information about medical services and to reach out with any questions. The broadcast aims to educate and bridge the gap between patients and healthcare providers, promoting a better understanding of health conditions like diverticulitis.

Mindmap

Keywords

💡Diverticulitis

Diverticulitis is a condition where small pouches, known as diverticula, that form in the colon become inflamed or infected. It is a common digestive disorder that typically affects the sigmoid colon, which is the last part of the colon before it meets the rectum. In the video, Dr. Tracy Childs discusses the symptoms, treatment, and recovery from diverticulitis, which is central to the theme of the broadcast.

💡Diverticulosis

Diverticulosis refers to the presence of diverticula, or small sacs that form in the colon. These sacs are most prevalent in the sigmoid colon and are generally asymptomatic. However, they can become inflamed, leading to diverticulitis. The video emphasizes that while many people over the age of 50 have diverticulosis, only a minority develop diverticulitis.

💡Sigmoid Colon

The sigmoid colon is the S-shaped section of the colon that connects to the rectum. It is the area where diverticulosis and diverticulitis most commonly occur. In the video, the sigmoid colon is highlighted as the primary site of the diverticular pouches and where complications from diverticulitis can arise.

💡Colonoscopy

A colonoscopy is a medical procedure that allows doctors to examine the inside of the colon and rectum using a flexible tube with a camera. It is often used to screen for colon polyps, cancer, and diverticulosis. In the video, it is mentioned that 50% of people over the age of 50 have diverticulosis, which is sometimes discovered during a screening colonoscopy.

💡Antibiotics

Antibiotics are medications used to treat bacterial infections. In the context of diverticulitis, oral or intravenous antibiotics are prescribed to treat the infection associated with inflamed diverticula. The video emphasizes the importance of using the correct antibiotics that cover the specific organisms involved in diverticulitis and cautions against self-medicating.

💡Colostomy

A colostomy is a surgical procedure that creates an opening in the colon, usually in the abdomen, to allow waste to pass into a collection bag. It is sometimes necessary in cases of severe diverticulitis where part of the colon is removed. In the video, Tammy Leader Fuller shares her experience of being told she would need a colostomy but ultimately did not, thanks to Dr. Childs' treatment.

💡Enhanced Recovery Pathways

Enhanced recovery pathways are a set of protocols designed to minimize post-surgery complications and hasten recovery. In the video, Dr. Childs discusses the use of nutritional pre-habilitation, carbohydrate loading before surgery, minimally invasive surgery, and non-narcotic pain management as part of these pathways, which significantly reduce hospital stay and improve patient outcomes.

💡Minimally Invasive Surgery

Minimally invasive surgery refers to surgical techniques that result in smaller incisions and less tissue damage, leading to quicker recovery times and less postoperative pain. In the video, Dr. Childs explains how minimally invasive surgery, including robotic-assisted laparoscopic surgery, has revolutionized the treatment of diverticulitis.

💡Nutritional Pre-habilitation

Nutritional pre-habilitation is a practice where patients consume specific nutrients before surgery to improve their condition and readiness for the operation. In the video, it is mentioned that patients are advised to drink special drinks before bowel preparation for surgery to decrease the risk of wound infection and enhance recovery.

💡Medical Myths

Medical myths are widespread but incorrect beliefs about health or medical treatments. In the video, Dr. Childs dispels several myths about diverticulitis, such as the idea that nuts and seeds cause the condition, that all patients with diverticulosis will get diverticulitis, that diverticulitis always leads to recurrent episodes, and that surgery always results in a colostomy.

💡Patient Advocacy

Patient advocacy involves patients taking an active role in their healthcare decisions and seeking the best possible care for their conditions. In the video, Tammy Leader Fuller emphasizes the importance of being one's own advocate, as she sought a second opinion and a different treatment approach that ultimately led to her recovery without a colostomy.

Highlights

Dr. Tracy R. Childs, Chief of Surgery at Providence St. John's Health Center, discusses diverticulitis, a condition that affects many people over the age of 50.

Tammy Leader Fuller, a diverticulitis patient, shares her personal story of how Dr. Childs helped her avoid a colostomy bag and recover fully.

Diverticulosis is a common condition in the sigmoid colon, with 50% of people over 50 having these pouches, but only a few developing diverticulitis.

Symptoms of diverticulitis include left lower quadrant pain, fever, constipation, and urinary symptoms, which are crucial for diagnosis.

Dr. Childs emphasizes the importance of a CT scan for documenting diverticulitis and inflammatory changes in the colon.

Initial treatment for diverticulitis often involves dietary changes, such as a low-fiber diet, and oral antibiotics to cover gram-negative and anaerobic organisms.

IV antibiotics are used for severe cases or when patients cannot tolerate oral medications.

Surgery is considered a final option for patients with recurrent or complicated diverticulitis that does not respond to medical therapy.

Dr. Childs dispels common myths about diverticulitis, including the belief that nuts and seeds cause the condition.

Enhanced recovery pathways, including nutritional pre-habilitation and minimally invasive surgery, are highlighted as modern approaches to treatment.

Patients can expect to be hospitalized for only one to three days after elective surgery for diverticular disease.

Post-surgery recovery involves a quick return to normal activities, with most patients resuming work and exercise within one to two weeks.

Dr. Childs explains that the risk of recurrence after surgery is less than 15% when an adequate resection is performed by an experienced surgeon.

Tammy's story illustrates the importance of patient advocacy and seeking a second opinion when necessary.

The collaboration between the patient and the medical team, including Dr. Childs and Dr. Scott Lane, led to a successful outcome for Tammy.

Tammy emphasizes the psychological impact of a new diagnosis and the importance of trust and communication in the doctor-patient relationship.

Dr. Childs discusses the importance of a comprehensive approach to patient care, involving collaboration with other medical specialists.

The discussion concludes with a reminder of the importance of patient education and the role of Providence Health System in providing medical services and information.

Transcripts

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Diverticulitis Patient Story Medical Treatment Healthcare Advocacy Surgical Options Colon Health Doctor-Patient Relationship Health Education Recovery Process Misdiagnosis Healthcare Experience