Dr. Good was the Rectal Solution

Seven years ago, I moved to a new locale, unfortunately having brought my anal and rectal problems with me. By then, I had also had prostate cancer and obtained an apparent cure but I had in the meantime developed a difficulty with some occasional pelvic floor problems, which were manifest in part as spasms around the anus. So there was an additional anal / rectal issue. I checked out the local medical community and discovered there was a card-carrying proctologist in the area, a woman no less. I’ll call her Dr. Good. I scheduled an appointment for about two weeks out. Like some previous appointments I had for similar problems, there was no need for an enema or any other prep beforehand.

I arrived at the office for my appointment, which was in a modern building with a large waiting room. Dr. Good shared the office with a urologist and two gynecologists. I checked in with the receptionist and also used the restroom located off of the waiting room. The restroom had a sign prominent in it saying that any examinations or procedures that involve disrobing must have a chaperone, regardless of the patient’s gender or age. I had never seen such a sign before.

After a short wait, the medical assistant called me back. She introduced herself as Terry and was Dr. Good’s nurse. She was wearing a scrub suit and I noticed on her ID badge that she was in fact an actual RN. She brought me to the examining room, which was a somewhat large room, with a curtain that could be drawn about the door so that medical personnel could come and go without compromising the patient’s modesty. The room had a very modern tilt table with a large instrument tray next to it. There were several chairs and a small desk with a desktop computer.

Terry asked me to be seated while she sat at the desktop computer and started her interview with me, which was a statement of why I was there and a fairly comprehensive review of my medical history. She then took my height, weight, pulse, and blood pressure (which was definitely elevated). Her demeanor was excellent and professional. Terry told me to remain seated while she checked with Dr.Good.

A couple of minutes later, Terry came back to tell me to follow her down the hall to Dr. Good’s patient consultation room. It was a small office with Dr. Good sitting opposite me behind her desk, which also had a computer monitor on it. We exchanged pleasantries, and then Dr. Good asked me detailed questions about my problem and the history of the problem. She told me she’d do an examination and determine the course of treatment which was almost always simple and easy. Dr. Good then escorted me back to the same examination room where Terry had interviewed me a few minutes before. She told me to strip from the waist down, sit on the edge of the table and cover myself with the drape, which was on the table. She then left the room, closing the curtain around the doorway behind her as she left.

A few minutes later, both Dr. Good and Terry re-entered the room. As Terry prepared the instrument tray, Dr. Good told me to lie back on the table so she could palpate my abdomen. I did so, and she told me to sit up again and then stand, while she held the drape in front of me. She told me to turn around and kneel on the knee pads of the tilt table and lay my chest down on the table, as she held the drape to preserve my modesty. Dr. Good then elevated and tilted the table, so that I was feeling like I was nearly upside down, although in reality it was probably only a little more than 45 degrees.

Dr. Good then lowered the drape to fully expose my buttocks. She then spread my cheeks so as to visually examine the afflicted region. She explained everything as she proceeded. She palpated my pelvic floor all around my anus and then did a thorough digital rectal examination. She then said she’d insert a small instrument into my rectum. She didn’t call it a speculum. The anoscopy took only a minute or less, and the whole examination was painless and easy and very professional.

Another memory I have of the experience was of lying on that tilt table nearly upside down with my head turned on the table. During the examination I could watch Terry walk back and forth as she assisted in the examination. Given that she was an attractive middle aged woman, it was a pleasant distraction.

Dr. Good then wiped the lube from around my anus, straightened the table, and had me sit up. She said to get dressed and she’d return to the room to discuss the findings. I did so, and on her return she told me that the rectal pain was a case of “levator ani syndrome” which is simple spasms of the muscles around the anus, probably a lingering effect of the prostate surgery. She gave me a prescription for diltiazem ointment which had to be prepared at a compounding pharmacy. I was to use it as needed. She said if the ointment didn’t help sufficiently, then pelvic floor therapy would be the next step. Regarding the hemorrhoids, she said that I’d benefit from rubber band ligation, which is simply to apply rubber bands to the protrusion. It would strangle the protruded hemorrhoids, and they’d fall off painlessly. Dr. Good said this was a simple and easy procedure and she could do the procedure in another appointment. She said that I should do an enema before the ligation appointment.

My first appointment for rubber band ligation was three weeks later. I did two of those Fleet enemas, and I should have known better because they don’t cleanse well. But it didn’t deter Dr. Good from proceeding. As before, Terry brought me back and did preliminaries, which were much briefer than the first appointment. Dr. Good came in and told me to strip from the waist down, sit on the table, and drape. She also said there’d be a few minutes delay while she and Terry prepared the instruments for the procedure.

On her and Terry’s return, Dr. Good positioned me on the tilt table. Rather than fully exposing my buttocks as before, she made a tear in the paper drape sufficient to expose my gluteal fold and nothing more. She did a visual examination and digital rectal examination. I don’t think she did anoscopy but my memory is fuzzy on that. With Terry’s aid, Dr. Good inserted the instrument for rubber band application and did the banding. This took just 2 or 3 minutes. She then straightened the table and had me sit up. While Terry cleaned the instrument tray, Dr. Good explained that she banded the two largest hemorrhoids. She said they’d painlessly fall off in a week or less. She told me I’d almost certainly need a second application for the smaller hemorrhoids and to make an appointment for one or two months off. In fact, the next week went really well for me, with no problems whatsoever.

I received the bill a few weeks later. I was pleasantly surprised at how low Dr. Good’s charges were, given the specialized nature of her work. BTW, regarding Dr. Good herself, she explained to me that she initially did colon & rectal surgery of all types. She said she relocated to this locale herself for family reasons. I really liked her. I just wish I had found a proctologist like Dr. Good many years before. She seemed to be one of a kind and a throwback to an earlier style of medicine.