had a appt after 21 years since my jpouch was installed. Saw dr rolandell who did my colectomy and jpouch in October 2001
he would try to advance the pouch in a pouch advancement operation similar to a redo.
my colonoscopy reports from my gastroenteroligist of 21 years really are poorly written . I don’t have an ileorectal anastomosis the rectal cuff of 2-3 cm remains . There is no sigmoid or left or right side of colon just the reports state so
he Performed an anoscopy/flex dig in office to confirm that my Gus reports are mis communicated/dictated
no one with a jpouch and just 2 3 cm of cuff needs miralax prep for scopes which my gastroenteroligist calls colonoscopies
surgeON rolandelli said it’s not good for my compromised kidneys to use miralax either
i will have a ouch advancement with mucosectomy but first he would like a mri without contrast to make sure none of the jpouch anenomas polyps are malignant but gastro can’t specify what is what and it’s not clear if there is even low grade dysplasia
the screen for anoscopy today shows a large tubular andenoma and others which were friable my surgeon described and bleeding
i live in pa so the anoscopy isn’t covered fully I just have Medicare 80 percent since nj dr don’t take pa Medicaid . Anoscopy costs 4k so I’ll find out soon what it will cost after Medicare pays there part that I’ll have to pay
the trip was well worth it to see dr rolandelli 1 hr and 45 minutes I’m glad I won’t need to go to Cleveland for a redo/ with advancement
i still have questions for dr rolandelli but I prob won’t persue a surgical oncologist at. Fox chase cancer center here in philly because rolandelli said it doesn’t look good in the pouch it has to go
looks like april sometime I’ll have surgery in the beginning
if I won’t no longer be bleeding intermittently from my rectum and loosing ferritin will I no longer require iron infusions?
I have low grade dysplasia but the mei will rule out true malignancy my gastro said it was low grade dysplasia everywhere and pathology didn’t show cancer
rolandelli wrote in my after visit summery his nurse wrote in the patient portal patient will get a acr anterior resection removing anus rectum and Anus and diverting ileostomu I don’t want an appliance but I told his nurse I’ll take the kpouch should the j advance not work I just. Don’t want a permanent unconinent appliance
so the story is I need a redo advance and all these years of treating me 20 yrs gi doc has been. Throwing words and n my reports that I have an ira ileo rectal anastomosis I don’t have any colon just the texts 2 3 cm cuff.
so he rest of this week I’ll get to scheduling my mri without contrast for rolandelli and then we move forward with a surger date and the course of action to take