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Re: 45 y/o hispanic female

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No obviously bleeding hemorrhoid on exam? She needs at least a sig if not a colonoscopy, especially if the blood on exam was occult rather than gross.With a h/o hemorrhoids, this is perhaps her most likely cause, though diverticulosis is the most common cause of bleeding. BUT she is 45 ... she deserves to have polyps/CA ruled out. Maybe someone can cut her a deal if she pays cash, or she can work out a payment plan.LonnaSubject: 45 y/o hispanic femaleTo: "donald lee" , "imp imp" < >Date: Saturday, May 3, 2008,

11:22 AM

Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/ constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stoolShe has no insurance, any recommendations? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

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Where are you?

"You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete"- Buckminster Fuller

45 y/o hispanic female

Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/ constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stoolShe has no insurance, any recommendations?

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I'd send her to the nearest free clinic or University. Both spots could get her a cheaper or free deal. I agree, prob not CA, but it'll be cheaper to find it earlier if it is! Lynette I Iles MD 301 South Iowa

Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

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Chicago, IL I usually tell people to go to Cook County, which is the only "free" service we have around here. All universities will bill the patient. Ramon Parrish wrote: Where are you? "You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete"- Buckminster Fuller 45 y/o hispanic female Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/ constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stoolShe has no insurance, any recommendations? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

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Chirag,She needs a colonoscopy.  Refer her to one of your local teaching programs and/or get her on Medicaid if she qualifies.  If you cant' find anyone to help out in Chicagoland and she can travel downstate to Gibson City I'll do the colonoscopy for you.Ben Brewer M.D. 45 y/o hispanic female

Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/ constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stoolShe has no insurance, any recommendations? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

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Yay Ben!

Subject: Re: 45 y/o hispanic femaleTo: Date: Saturday, May 3, 2008, 7:08 PM

Chirag,

She needs a colonoscopy. Refer her to one of your local teaching programs and/or get her on Medicaid if she qualifies. If you cant' find anyone to help out in Chicagoland and she can travel downstate to Gibson City I'll do the colonoscopy for you.

Ben Brewer M.D.

[Practiceimprovemen t1] 45 y/o hispanic female

Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/ constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stoolShe has no insurance, any recommendations?

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ben-bless your heartNow THAT " s why we are docs and have this list serv.

Chirag,

She needs a colonoscopy. Refer her to one of your local teaching programs and/or get her on Medicaid if she qualifies. If you cant' find anyone to help out in Chicagoland and she can travel downstate to Gibson City I'll do the colonoscopy for you.

Ben Brewer M.D.

45 y/o hispanic female

Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/ constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stool

She has no insurance, any recommendations? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

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She needs to go to Cook County ER, tell her to go early in AM. They will put her

in the system,

give her a number and she can go to the GI clinic (after the number is

processed). It can take

a few months.

She can also try

http://www.communityhealth.org

a free clinic mostly for hispanics but she would have to register as a patient

and they may be

able to refer her through their system.

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This is a not uncommon scenario for us. Did you do anoscopy? It is a very simple procedure and can help comfort my mind in such a situation. In our practice, we send our GI colleagues lots of normal well-insured colons for screening, so asking them once in a while to do a favor is usually well received. IA few years ago, I had an Arabic speaking Yemeni immigrant with recurrent constipation who had been seen twice by a private doc and the local ER. She was advised to get "outpatient follow-up" for her constipation. She was finally directed to St. Luke's. Presented with anemia (spun Hct in office about 30%), periodic obstipation and heme positive. The anoscopy revealed no visible lesion but heme positive stool from above. A very assertive bi-manual recto-abdominal exam suggested a firm mass at the tip of my finger, way up high. I called the local Egyptian-trained Arabic speaking gastroenterologist and he did a charity rate colonoscopy. Her family in the US and

Yemen paid for her plane ticket back home, and then on to India. The Indian surgeon performed an end-to-end anastamosis without requiring a colostomy. Six months later I learned that she was free of disease and received a refill request for lisinopril from a pharmacy -- in Yemen!Charity rate colonoscopy -- $100. Pathology interpretation -- $120. Plane ticket to India via Yemen -- $2500. The warm feeling I get practicing this noble profession each day -- priceless!Bob ForesterSt. Luke's, ModestoChirag Patel wrote: Need advice:45 y/o hispanic female, no insurance, h/o hemorrhoids/constipation x 7-8 yrs, states intermittent blood on tissue for months, no vag bleeding, h/o heavy menstruation, i did see hemorrhoids on pelvic, not big ones, did rectal, heme positive stoolShe has no insurance, any recommendations? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

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