Dr. Me was Rectal Progress

Through my mid-50s, the ridiculous and annoying problem with my hemorrhoids was continuing. I became aware of a doctor in a large urban area not too far from my home and my workplace that seemed like he was right up my alley. I’ll call him Dr. Me. He specialized in hemorrhoid diagnosis and treatment. So I decided to make an appointment.

I had no problem scheduling an appointment for a couple weeks out. The scheduler told me that the medical assistant would be calling me in a couple of days for a pre-appointment interview. She called, and it was a good 15 minute conversation, asking for insurance information, reason for coming in, brief medical history, and even the names of my primary care physician, cardiologist, and urologist (I’ll have urology stories in another blog post). She also mailed me a more detailed medical history form, which the medical assistant told me to fill out and bring to my appointment. The medical assistant specifically told me it was not necessary to take an enema beforehand or any other prep.

I arrived for my appointment at Dr. Me’s office which was in a small strip mall which had other doctor’s offices in it, too. The sign at the front of the office plainly said “Dr. Me, DIseases of the Rectum”. I entered the small waiting room where there were a couple of other people waiting and was greeted by the receptionist who took my completed forms and insurance card. Almost as soon as I entered, one of the other patients in the waiting room (a man) was called back. The office had a number of brochures in a rack that pertained to colon & rectal health. I read several of them while waiting. However, while waiting, I could also overhear some of the conversation of the office staff. I formed the impression that they didn’t like Dr. Me as a boss, because it sounded like complaining.

Just before I was called back, a woman exited from the back of the office and was seated at the table just inside from the waiting room where patients checked out. The medical assistant gave her a prescription. She asked the patient if she knew how to use the ointment prescribed to her. The patient responded, “Oh, I know where it goes!”. She had a sense of humor.

The medical assistant that brought me back for my examination first had me stop at the restroom. She then took me into the examining room, which was one of two in the small office. It was a somewhat small room with a pocket door opening into the hallway. The proctology table was not a standard tilt table but a cushioned table in three sections which looked like they could be moved independently. It was covered with sheets and had a pillow. The table was parallel to a wall which had drawers for medical instruments, a sink, and a rack with a couple of sigmoidoscopes hanging on it. Gloves, lube, a metal anoscope, and several other instruments and medications were on paper out on the counter for easy access by the doctor. The room also had artworks depicting people’s backsides in artistic settings. I thought these were a nice touch to the decor considering this doctor’s specialty.

The medical assistant had me sit on the table. She took my blood pressure, which surprisingly was only slightly elevated, considering how apprehensive I was. She then went on to explain what would happen during the exam which I describe below. She told me she’d leave the room, I should strip from the waist down, sit back down on the table, cover my lower body with the paper drape, and Dr. Me would shortly enter the room.

I did as instructed, and very shortly Dr. Me came into the room. He was about my age. He briefly reviewed my reasons for being there and my medical history. He then explained that he was a board-certified proctologist, as opposed to a colon & rectal surgeon. He said he therefore was best qualified to handle long standing hemorrhoid problems such as mine.

Dr. Me then had me lay on my left side, with my head on the pillow and my knees drawn up. He raised the table with his electric foot pedal, lifting it way up, at least midway to Dr. Me’s chest height. He moved the drape so as to fully expose my buttocks. He spread my cheeks well apart so that he could fully visualize the pudendal region, the anus, and some of the internal anal tissues. He inserted his finger, doing a thorough digital examination of the anus and the walls of the rectum. Dr. Me then inserted the anoscope, which definitely felt cold to the perianal tissues. I was surprised that he used a metal one, considering that disposable plastic ones were widely available by that time. I suppose the scope went in about 2 or 3 inches.

After withdrawing the scope, Dr. Me applied a lotion of some sort to the anal tissues, as well as a small piece of a cotton ball which he left in place. He then re-draped me and lowered the table. He then had me lie on my back on the table and adjusted the drape to expose my abdomen down to my pubic area. He then palpated my abdomen, re-draped me, and had me sit up. He explained that I had irritation of the perianal area from the persistent hygiene issues. He wrote down the name of a special lotion to use after bowel movements to help resolve the irritation, but I can’t remember the name of it. He also said to apply “Triple Paste”, which is a diaper rash ointment, to the perianal area, after daily showers together with a small piece of a cotton ball. He also gave me a prescription for a cortisone ointment which he said to use daily for two weeks but no more. Dr. Me also instructed me to come back in 3 weeks at which time he would do infrared coagulation therapy for the hemorrhoids. He explained that this is a simple office procedure that scars over the blood supply to the hemorrhoids, thereby constricting them. And that was that for this particular appointment.

I had several follow-up appointments, including three in the following three months, and one per year for the next three years. These became a matter of routine. The medical assistant would call me back, tell me to stop at the restroom, and then into the examining room. There, I’d strip from the waist down and sit on the tilt table with a drape. Dr. Me would walk in, briefly ask about my condition, and then say “Let’s take a look”. He’d have me lay on my left side, he’d elevate the table, expose the buttocks and spread the cheeks wide for a visual examination. This was always followed by digital rectal examination and anoscopy. Then he’d insert the device for infrared coagulation therapy, which was pretty much painless. And that would be the end of the appointment. I never got the feeling that the infrared therapy helped much, and I stopped going to Dr. Me.

As I think back about Dr. Me, yes, he did me some good, more than any other doc I had been to for that problem. But I reached a point of diminishing return and he seemed to want me to continue to come back endlessly. That in itself seemed silly. In fact, some of the on-line reviews of Dr. Me were negative, some patients saying he was mostly interested in the money. But he did help me for a while. Also, I think his office was very efficient, which I appreciated. For years afterward, I received post cards in the mail from Dr. Me’s office saying it was time for me to come in for an annual anal follow-up.