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June 12, 2019

Careful Evaluation, Compassionate Care Solve Distressing Digestive Problems

By SharingMayoClinic
Severe digestive issues had disrupted Lynda Rassbach's daily life and forced her to miss out on meaningful events with her family. After a series of confusing diagnoses, she turned to Mayo Clinic, where she received answers and treatment that restored her freedom.

Severe digestive issues had disrupted Lynda Rassbach's daily life and forced her to miss out on meaningful events with her family. After a series of confusing diagnoses, she turned to Mayo Clinic, where she received answers and treatment that restored her freedom.


Lynda Rassbach's daughter was trying on wedding dresses for a group of friends and relatives in Minneapolis. Lynda wasn't one of them. "I didn't get to be there," Lynda says. "I had to watch via FaceTime."

In the months leading up to that day, the Chetek, Wisconsin, woman's world had gotten smaller and smaller. She'd had to quit work. She couldn't go shopping. She missed that milestone day with her daughter. "You can't replace those moments in time," Lynda says.

That moment and so many others had been stolen by a medical mystery involving severe, persistent pain and diarrhea that left Lynda rushing to the bathroom, sometimes as many as 20 times a day. "It was misery," Lynda says. "I lost all aspects of my life. I couldn't even get in the car and go anywhere. I didn't know if it was ever going to end."

Getting multiple diagnoses, but no answers

When Lynda's digestive problems first began in May 2018, she wasn't overly concerned. She assumed the symptoms were temporary. "I'm a wait-and-see kind of girl," says Lynda. "I figured I would wait, and they would go away."

Instead, her symptoms got worse. The pain became more severe and the diarrhea more frequent. In June 2018, Lynda visited a walk-in clinic, but walked out without a diagnosis. "They ran some tests and found nothing," she says. "They told me if I didn't start feeling better to come back. I felt like I was dismissed and sent out the door."

Lynda's symptoms increased, and they started to have a bigger impact on her life. She had to quit her job in the food service industry. She lost 20 pounds, and her hair began to fall out. She became depressed. "I wondered if I was dying," Lynda says.

"I didn't feel like I'd really been listened to or looked at."

Lynda Rassbach

She scheduled an appointment with a gastroenterologist who performed a colonoscopy and told Lynda that her gallbladder was causing her symptoms. She was prescribed a steroid and told her gallbladder should be removed. But that diagnosis "didn't seem right," Lynda says. "I didn't feel like I'd really been listened to or looked at."

Lynda went to a different doctor for another opinion. She was told she had Crohn's disease and should start taking a medication to suppress her immune system. "That was scary to hear," she says. "It was a huge decision to make. I was so confused, so anxious."

Before she could decide whether to take the additional medication, Lynda had a bout of diarrhea so extreme it led to a five-day hospital stay. Doctors there diagnosed her with pancreatitis.

"Three different physicians had given me three different ideas about what was happening," Lynda says. She didn't have faith in any of them. "I felt like every doctor I saw was in a hurry to put me in a box. They weren't listening. And as soon as I knew they weren't listening to me, I didn't want to listen to them. I didn't trust them."

Taking time to listen carefully

Lynda was scared and unsure of what to do. It had been eight months since her symptoms first started, and she was long past thinking they would resolve on their own. She wasn't sure a doctor could help her either. "I'd lost faith in medical providers," she says. "But a little voice in my head — I believe it was the voice of God — told me I needed to try one more time."

"It was a night-and-day difference from what I'd experienced other places. I felt like the only person on her schedule."

Lynda Rassbach

That's when Lynda decided to call Mayo Clinic Health System in Eau Claire, Wisconsin. She was scheduled to see Judy Nichols, a nurse practitioner in Gastroenterology. "My life changed that day," Lynda says. "Judy walked into the office, looked straight into my eyes and recounted my entire medical history. She didn't look at her notes. She looked at me. Afterward, she asked if she'd recalled everything correctly and if there was anything I wanted to add. It was a night-and-day difference from what I'd experienced other places. I felt like the only person on her schedule."

Learning Lynda's story was important to Nichols. "Lynda had been on a long journey prior to seeing me, and she had a story to tell," Nichols says. "Allowing her to summarize what she had experienced gave me vital information about what examinations had been done, what treatments had been tried and, hopefully, gave her the validation that she needed."

After listening to Lynda's story, Nichols recommended several additional tests. It was a Friday, and Lynda wouldn't be able to have the tests until after the weekend. Until then, Nichols suggested she try taking a medication called cholestyramine.

"Judy told me she had a hunch that I had bile acid malabsorption and that, if so, the medication would help," Lynda says. That hunch proved life-changing. "One day after I took that magic elixir, the diarrhea was gone."

Valuing a trusted care team

Nichols referred Lynda to Mayo gastroenterologist Jorge Machicado, M.D., for further evaluation, including an endoscopic ultrasound. Dr. Machicado also proved to be different than the providers Lynda had met elsewhere. 

"I met with Lynda in the office prior to the procedure, listened to her needs, and we developed a plan together," Dr. Machicado says. Part of that plan was another colonoscopy. "The prior colonoscopy in an outside facility lacked important details," Dr. Machicado explains. The new test helped him identify the true cause of Lynda's issues. In addition to bile acid malabsorption, she had ulcerative colitis. Finally, Lynda had the answers she had been searching for — and a plan for treating her conditions.

"I trust them," Lynda says of her Mayo care team. "They take time to listen to me and talk with each other about my case. Their brilliant minds came together to solve this problem. They've always made me feel that they cared about me and had compassion for me."

That's a vital part of the process. "When a health care team has empathy for the patients that they serve, the outcomes often become more positive," Nichols says. "Empathy leads to trust, commitment and, often, to the achievement of common goals."

"Studies have shown that patients who trust their health care providers are better satisfied with their care and are better able to manage their health."

Judy Nichols

Today, Lynda is returning to the life she loved. She's started working again, regularly visits her children and is looking forward to her daughter's wedding. "I feel like I've gotten my life back," she says. And while her life has changed somewhat — Lynda's modified her diet and takes several new medications — they're changes she can handle, especially, she says, "knowing that I have physicians I can trust."

According to Nichols, that trust is key. "Studies have shown that patients who trust their health care providers are better satisfied with their care and are better able to manage their health," Nichols says. "If something is gnawing at your insides about a recommendation or a plan, you owe it to yourself to be thoughtful. Very few health care decisions have to be made on the spot. If something doesn't feel right, research your situation and consider another option. Listen to your gut."

Note: A version of this story previously was published in Hometown Health.


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Tags: Digestive health, Dr. Jorge Machicado, Gastroenterology, Judy Nichols, Mayo Clinic Health System, Mayo Clinic Health System in Eau Claire, ulcerative colitis

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