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Elizabeth Fluhrer, MSN, APRN, FNP-BC

Specialist in Gastroenterology

A LITTLE ABOUT ME

Elizabeth “Callie” Fluhrer is a board-certified family nurse practitioner at Galen Digestive Health. While she grew up in Lexington, Kentucky, Callie visited her grandparents on Signal Mountain since she was little. 

She attended the University of South Carolina, where she earned her Bachelor of Science in Nursing in 2004. She graduated magna cum laude. Later, she went on to earn her Master of Science in Nursing  from Simmons University in 2021, where she was a member of the Sigma Theta Tau Honor Society. 

Elizabeth grew up in a household that placed a premium on caring for people, which inspired her from a young age to pursue those values in the community setting. Nursing was the best way for her to fulfil her passion and provide an opportunity to contribute those principles to society. Elizabeth practiced as a registered nurse for 16 years and worked in various medical settings before furthering her education to become a Nurse Practitioner. She chose gastroenterology as her specialty after working in oncology for several years. Seeing the complexity of the GI system and its treatment through various illnesses drew her to this field. Her favorite part about her job is the patient-provider relationship, which is key to effective overall treatment. Patients are known individually and treated with compassion, respect, and privacy, which bridges the gap between patient and provider.

Elizabeth’s care philosophy includes providing a tailored, evidence-based, compassionate care plan that treats and equips patients to maintain their health. Holistic, preventative, and specialized care strengthen the patient-provider relationship while maintaining individual respect and privacy.

Her ideal day off work would be a Friday spent with her husband, three school-aged daughters, and their black lab Pepper. She loves to take trips with her family to visit extended family members. She loves going to the beach, cooking, and sports. Elizabeth’s favorite thing about Chattanooga is the community. As newcomers, they have felt so welcomed by everyone, which has made acclimating to a new location easier. She loves how the community cares for others and continues to grow in its offerings for people of all ages.

I SPECIALIZE IN:

I'M LOCATED AT

Galen Digestive Health

BEEN IN PRACTICE FOR:

15  years.

MY CARE PHILOSOPHY:

Elizabeth’s care philosophy includes providing a tailored, evidence-based, compassionate care plan that treats and equips patients to maintain their health. Holistic, preventative, and specialized care strengthen the patient-provider relationship while maintaining individual respect and privacy.

MY EDUCATION:

B.S.N., Bachelor of Science in Nursing from University of South Carolina

M.S.N., Master of Science in Nursing from Simmons University 

A.P.R.N., Advanced Practice Registered Nurse

F.N.P.-B.C., Family Nurse Practitioner Board Certified by the ANCC

I'M AFFILIATED WITH:

Hospitals: 
 

Organizations:

 

SERVICES & PATIENT RESOURCES:

Here at Galen Digestive Health Endoscopy, we perform thousands of endoscopic procedures each year. Our doctors, nurses, and technicians are specialty trained with over 100 years of combined experience in Endoscopy procedures. We are pleased to offer this experienced, compassionate care to every patient, every day. In fact, our reputation among the physicians in the Chattanooga area accounts for the numerous referrals we receive.

Our center has been surveyed and recognized for high-practice standards by the ASGE and AAAHC. We received the ASGE Endoscopy Unit Recognition Award for Excellence in Care. Our procedure and recovery rooms are state-of-the-art and are outfitted with the latest endoscopes and monitoring equipment for maximum visualization, accuracy, quality, and safety. 

Learn more about Galen’s Endoscopy suite here.

For this test, the doctor looks at the entire length of the colon and rectum with a colonoscope, a flexible tube about the width of a finger with a light and small video camera on the end. It’s put in through the anus and into the rectum and colon. Special instruments can be passed through the colonoscope to biopsy (sample) or remove any suspicious-looking areas such as polyps, if needed.

Before the test: Be sure your doctor knows about any medicines you are taking (including daily aspirin, vitamins, or supplements). You might need to change how you take them before the test.

The colon and rectum must be empty and clean so your doctor can see the entire inner lining during the test. There are different ways to do this, including pills, fluids, and enemas (or combinations of these). For example, you might need to drink large amounts of a liquid laxative solution the evening before the procedure. This often results in spending a lot of time in the bathroom. Because the process of cleaning out the colon and rectum is sometimes unpleasant, it can keep some people from getting this test done. However, newer kits are available to clean out the bowel and may be better tolerated than previous ones. Your health care provider can discuss the options with you.

Your health care provider will give you specific instructions. It’s important to read them carefully a few days ahead of time, since you may need to follow a special diet for at least a day before the test and to shop for supplies and laxatives. If you’re not sure about any of the instructions, call the health care provider’s office and get your questions answered.

You will probably also be told not to eat or drink anything after a certain hour the night before your test. If you normally take prescription medicines in the mornings, talk with your doctor or nurse about how to manage them for that day.

Because a sedative is used to help keep you more comfortable during the test, you will most likely need to arrange for someone you know to take you home after the test. You might need someone to help you get into your home if you are sleepy or dizzy, so many centers that do colonoscopies will not discharge people to go home in a cab or a ridesharing service. If transportation might be a problem, talk with your health care provider about the policy at your hospital or surgery center for using one of these services. There may be other resources available for getting home, depending on the situation.

During the test: The test itself usually takes about 30 minutes, but it may take longer if one or more polyps is found and removed. Before the test starts, you’ll likely be given a sedative (into a vein) to make you feel relaxed and sleepy during the procedure. For most people, this medicine makes them unable to remember the procedure afterward. You’ll wake up after the test is over, but you might not be fully awake until later in the day.

During the test, you’ll be asked to lie on your side with your knees pulled up. A drape will cover you. Your blood pressure, heart rate, and breathing rate will be monitored during and after the test.

Your doctor might insert a gloved finger into the rectum to examine it before putting in the colonoscope. The colonoscope is lubricated so it can be inserted easily into the rectum. Once in the rectum, the colonoscope is passed all the way to the beginning of the colon, called the cecum.

If you’re awake, you may feel an urge to have a bowel movement when the colonoscope is inserted or pushed further up the colon. The doctor also puts air into the colon through the colonoscope to make it easier to see the lining of the colon and use the instruments to perform the test. To ease any discomfort, it may help to breathe deeply and slowly through your mouth.

The doctor will look at the inner walls of the colon as he or she slowly removes the colonoscope. If a small polyp is found, it may be removed and then sent to a lab to check if it has any areas that have changed into cancer. This is because some small polyps may become cancer over time.

If your doctor sees a larger polyp or tumor, or anything else abnormal, a small piece of it will be removed (biopsied) through the colonoscope. It will be checked in the lab to see if it’s cancer, a benign (non-cancerous) growth, or something else.

Possible side effects and complications: The bowel preparation before the test can be unpleasant.

The test itself might be uncomfortable, but the sedative usually helps with this, and most people feel back to normal once the effects of the sedative wear off. Because air is pumped into the colon and rectum during the test, people sometimes feel bloated, have gas pains, or have cramping for a while after the test until the air passes out. 

Some people may have low blood pressure or changes in heart rhythm from the sedation during the test, but these are rarely serious.

If a polyp is removed or a biopsy is done during the colonoscopy, you might notice some blood in your stool for a day or 2 after the test. Serious bleeding is uncommon, but in rare cases, bleeding might need to be treated or can even be life-threatening.

Colonoscopy is a safe procedure, but in rare cases the colonoscope can puncture the wall of the colon or rectum. This is called a perforation. Symptoms can include severe abdominal (belly) pain, nausea, and vomiting. This can be a major (or even life-threatening) complication, because it can lead to a serious abdominal (belly) infection. The hole may need to be repaired with surgery. Ask your doctor about the risk of this complication.

The American Cancer Society®

During this test, the doctor looks at part of the colon and rectum with a sigmoidoscope (a flexible, lighted tube about the thickness of a finger with a small video camera on the end). It’s put in through the anus and into the rectum and moved into the lower part of the colon. Images from the scope are seen on a video screen.

Using the sigmoidoscope, your doctor can look at the inside of the rectum and part of the colon to detect (and possibly remove) any abnormalities. The sigmoidoscope is only about 60 centimeters (about 2 feet) long, so the doctor can see the entire rectum but less than half of the colon with this procedure.

This test is not widely used as a screening test for colorectal cancer in the United States.

Before the test: Be sure your doctor knows about any medicines you take. You might need to change how you take them before the test.

Your insides must be empty and clean so your doctor can see the lining of the sigmoid colon and rectum. You will get specific instructions to follow to clean them out. You may be asked to follow a special diet (such as drinking only clear liquids) or to use enemas or strong laxatives the day before the test to clean out your colon and rectum.

During the test: A sigmoidoscopy usually takes about 10 to 20 minutes. Most people don’t need to be sedated for this test, but this might be an option you can discuss with your doctor. Sedation may make the test less uncomfortable, but you’ll need some time to recover from it and you’ll need someone with you to take you home after the test.

You’ll probably be asked to lie on a table on your left side with your knees pulled up near your chest. Before the test, your doctor may put a gloved, lubricated finger into your rectum to examine it. For the test itself, the sigmoidoscope is first lubricated to make it easier to insert into the rectum. The scope may feel cold as it’s put in. Air will be pumped into the colon and rectum through the sigmoidoscope so the doctor can see the inner lining better.

If you are not sedated during the procedure, you might feel pressure and slight cramping in your lower belly. To ease discomfort and the urge to have a bowel movement, it may help to breathe deeply and slowly through your mouth. You’ll feel better after the test once the air leaves your colon.

If any polyps are found during the test, the doctor may remove them with a small instrument passed through the scope. The polyps will be looked at in the lab. If a pre-cancerous polyp (an adenoma) or colorectal cancer is found, you’ll need to have a colonoscopy later to look for polyps or cancer in the rest of the colon.

Possible complications and side effects: This test may be uncomfortable because of the air put into the colon and rectum, but it should not be painful. Be sure to let your doctor know if you feel pain during the procedure. You might see a small amount of blood in your bowel movements for a day or 2 after the test. More serious bleeding and puncture of the colon or rectum are possible complications, but they are very uncommon.

The American Cancer Society®

What is infusion therapy: administering medication using a sterile catheter that is inserted into a vein and secured. This treatment method has traditionally been used only in hospitals, but now infusion therapy can be administered in outpatient infusion therapy centers, or even in your home by specially trained nurses. These nurses have been licensed by the state board of pharmacies, meeting the strict standards and regulations set by the board and by the government.

What does Infusion Therapy treat: Infusion therapy is usually employed to treat serious or chronic infections that do not respond to oral antibiotics. Cancers and the pain caused by cancers; diseases of the gastrointestinal tract; dehydration caused by nausea, vomiting and diarrhea; and other serious diseases, such as Crohn’s disease, are typical examples. Additional complex illnesses that respond best to intravenous medications include: multiple sclerosis, some forms of arthritis, congestive heart failure and some types of immune deficiency disorders. Certain congenital diseases require intravenous medications as well.

Avella offers clinical expertise in meeting the unique needs of our patients using infusion therapies as part of their medication treatment plan. Our pharmacy team can collaborate with your doctor to monitor your therapy while helping you manage side effects and avoid drug interactions. While we know the process of taking your medications by infusion therapy is not easy, Avella is dedicated to making the process of managing your condition through medication as simple as possible. Infusion therapy shouldn’t be uncomfortable or frightening. Leave it to the experts.

Some examples of infusion therapies include:

  • Antibiotic/Antiviral
  • Anti-Coagulation Therapy
  • Anti-Emetics
  • Anti-Hemophilic Factors
  • Blood Component Stimulating Factor
  • Chemotherapy
  • Enteral Nutrition
  • Hydration
  • Inotropic Therapy
  • Pain Management
  • Total Parental Nutrition