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"World-class colonoscopy"
Old 10-01-2010, 01:06 PM   #1
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"World-class colonoscopy"

How's that for an oxymoron?

In a week or two I'm going to visit my local clinic for a flu shot. Based on the way my last visit went, this time when they ask me for my age and consult my medical record, I expect the exit doors to slam shut until I surrender to the colonoscopy crew.

Don't get me wrong-- I'm healthy but my father's survived prostate cancer and a few intestinal polyps of his own, so considering my genetic alternatives I'm onboard with this invasive procedure. However I want to do this on my schedule, when the professionals are not overwhelmed with other business, and I want all the good stuff. I also don't want to mess up the holiday season (unless that's a good time to get this done) or my January taekwondo black-belt test. I'm happy to hurry things up a bit (I almost believe myself when I say that) or to wait a few months for optimal timing. Heck, if it's worth it I'll even go to [insert Beavis & Butthead joke here] Bumrungrad.

So here are some questions for you colonoscopy experts and veterans:
- When's the best time of the year for this procedure? The best day of the week, the best time of day? When is everyone the least busy, the best trained, the most proficient and the most alert? For example I've heard about summer waves of fresh-faced interns/residents, weekend medical emergencies, Monday-morning misery, and late-afternoon complications. Assuming I have a blank calendar (a big assumption), what would I want to choose?

- Where's the best venue? If I have a choice do I want MegaMilitary hospital, a smaller local civilian hospital, or a doctor's office? I've had both very good and very bad experiences at Tripler Army Medical Center, so for this reason alone I'm hoping to go civilian.

- Is there a preferred technology? I'm not looking for a souvenir DVD of the experience (with a soundtrack and bonus material) but I don't want to get the equivalent of last-generation legacy large-bore equipment or the latest experimental robotic drilling rig.

- What's the best prep? I vaguely remember reading previous threads (here? Bogleheads?) where posters would claim "Oh, you want to drink this stuff, not that stuff" or "Yeah, that other stuff isn't too harsh, but mix a pint of vodka with it first". I have unlimited free time to "prepare", so I'm not in any particular hurry. At least not until after I swallow the first dose.

- How much time is involved with the prep? 12 hours? 24? 48?

- What's the best anesthetic? Again I'm not interested in watching live video in living color, but I'd rather not be knocked flat on my assets (so to speak) for days of recovery.

- How much time is involved with the recovery? 12 hours? 24? What's the first/best thing to do after you're back in control of your own anatomy?

- Do I have to plan for a designated driver?

- What do you wish your doctor/nurse/intern/tech had told you before the colonoscopy?

- If you got a free do-over, what would you do differently?

- During the prep and the pre-op, are there any warning signs that things might not be going well? I understand "Oops" and "Uh-oh", but at what point before it's too late would I want to say "Do it this way or I'm outta here"?
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Old 10-01-2010, 01:16 PM   #2
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Nords, take a deep breath and exhale slowly. And again....and again...

Now, is that better?

Try to remember the procedure involves running a big hose up your @ss, not performing a 'Braveheart' disembowelment.

The only advice I have is to schedule for as early as possible in the day. You will be empty and hungry, and you don't want to be waiting around all day fearing the worst and listening to your stomach growl.
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Old 10-01-2010, 01:16 PM   #3
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Nords: too many questions for what was for me a piece of cake. Except the thre previous days that you have to observe a special diet and drink gallons of an obnoxious liquid. The day of the procedure complete starvation. I was given a sedative. Almost fell asleep during the colonoscopy. Of course you can´t drive right away. Normal daily routine the next day.
i insist if not for the preparation I wouldn´t mind do it again.
It´s scares me more the epidura anesthesial injection .......
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Old 10-01-2010, 01:19 PM   #4
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This won't help much, but hey, this is the Internet: a colleague is going in for a full alimentary canal scan on Monday. Both ends, and general anaesthetic (decided on by the hospital). In the UK, this would probably have been done under sedation, although having read the Wikipedia article, I think I'd go for the GA.
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Old 10-01-2010, 01:25 PM   #5
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Quote:
Originally Posted by Nords View Post
How's that for an oxymoron?

- Where's the best venue? If I have a choice do I want MegaMilitary hospital, a smaller local civilian hospital, or a doctor's office? I've had both very good and very bad experiences at Tripler Army Medical Center, so for this reason alone I'm hoping to go civilian.

- Is there a preferred technology? I'm not looking for a souvenir DVD of the experience (with a soundtrack and bonus material) but I don't want to get the equivalent of last-generation legacy large-bore equipment or the latest experimental robotic drilling rig.

- What's the best prep? I vaguely remember reading previous threads (here? Bogleheads?) where posters would claim "Oh, you want to drink this stuff, not that stuff" or "Yeah, that other stuff isn't too harsh, but mix a pint of vodka with it first". I have unlimited free time to "prepare", so I'm not in any particular hurry. At least not until after I swallow the first dose.

- How much time is involved with the prep? 12 hours? 24? 48?

- What's the best anesthetic? Again I'm not interested in watching live video in living color, but I'd rather not be knocked flat on my assets (so to speak) for days of recovery.

- How much time is involved with the recovery? 12 hours? 24? What's the first/best thing to do after you're back in control of your own anatomy?

- Do I have to plan for a designated driver?

- What do you wish your doctor/nurse/intern/tech had told you before the colonoscopy?

- If you got a free do-over, what would you do differently?

- During the prep and the pre-op, are there any warning signs that things might not be going well? I understand "Oops" and "Uh-oh", but at what point before it's too late would I want to say "Do it this way or I'm outta here"?

Best Venue, there are offices that specialize in colonoscopies, that was my choice.

Not much choice on anesthetic, or prep, each doctor has his own preference.

Prep is the day before, unless you schedule an afternoon procedure which I DON'T recommend, do it as early as possible in the AM.

Yes, have a driver. Most places won't even prep you if you do not bring your driver in with you.

Free do-over, change my PM appointment to early AM!

Procedure itself is a snap, as soon as I woke up I was ready to jump off the table and run for the door. The prep is the bad part, just because it's an all day deal…..
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Old 10-01-2010, 01:40 PM   #6
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Easy. As everyone says, the worst is the prep. The day before I drank some unpleasant liquid and it dutifully exited my back end. I took the drug that makes you forget what happened, Midazolam?

I did not have a ride home so I walked the few blocks home. Then I took a nap, and was fine.
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Old 10-01-2010, 02:05 PM   #7
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Crystal Lite -- add it to the prep (with your doctor's approval).

Agree with every post above that you are waaay over-thinking this. Go to whomever your primary doc recommends, have a nice nap, and go home with your DW driving.

And do let us all know how it goes, every detail .
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Old 10-01-2010, 02:14 PM   #8
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Look the anesthetist in the eye and say "I don't want to feel this."
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Old 10-01-2010, 02:19 PM   #9
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This will be an interesting read... I just visited the doc yesterday and have it scheduled in a few weeks...

My questions to them... can I have it on a Monday so I don't miss two days of work? Nope, we only do it Tues, Wed or Thur...

Where can I have it done? Here (a hospital) on Tue, another hospital on Wed and a third on Thur... which hospital do you want?

OK, can I have it early in the morning? Yep, but (like an airport or something)... you need to be here 1 1/2 hrs before... so a 9AM means 7:30.. and time to sign in etc... since the kids have to be taken to school.. that is out.. so I am the 4th or 5th in line..

Do I have a choice on what I take? Nope, we have these handy preprinted RX sheets so we do not have to change... SOOO, if you want to take something else, you might have to get a different doc...

How much does this cost? (since I have a high deductible)... Well, for us it is $375, but don't know how much the hospital charges...

What about the other end? Yep, might as well look at that why you are here


The prep (from what I remember them telling me... I have not yet read it) is the day before.. take pills.. then a gallon of some roto rooter... NO solid foods.. no dark drink (you can not drink purple grape juice)... you do not get to eat or drink anything the day of the procedure... (at least before they do it...)... and yes, you need a driver or they send you home so you can prep again the next time you schedule it....
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Old 10-01-2010, 02:24 PM   #10
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I'm 60. It seems there is all sorts of stuff I'm supposed to have done.
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Old 10-01-2010, 02:35 PM   #11
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Nords,

Advice from a veteran of this procedure. Apply Vasoline liberally to the "exit location" prior to and repeatedly during the prep - greatly eases irritation.
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Old 10-01-2010, 02:39 PM   #12
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I'm about to have my 3rd one done at 58 (colon cancer in a sibling) and I agree with all the others -- it's no big deal.

Some people need a nap afterward, I didn't even need that. You're back to normal as soon as you have a good meal.

The prep isn't fun...just be sure you have a good book or some magazines...
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Old 10-01-2010, 03:15 PM   #13
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I avoided the entire procedure by tying a bit of dental floss to a tooth and swallowing the entire spool with a couple of gulps of a milkshake.

When the spool came out of the other end, I just used it like dental floss and took care of the entire "system" by vigorously pulling back and forth until the entire system was clean.

Just kidding ..

Had my latest one at a local outpatient clinic that specializes in the procedure. Like everybody else said, the most "difficult" part is the prep the day/night before. The procedure itself (done early in the day) was a snap. In fact, the clinic gave a discount card to a local diner where DW/me (she was my driver for the day) went to eat after it was done.

Luckily, nothing was found (I had the sig done a few years ago and no problems at that time, either), so I'm "good to go" till my early 70's.

The fear is an actual concern; the procedure itself is not....
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Old 10-01-2010, 03:17 PM   #14
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Old 10-01-2010, 03:25 PM   #15
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Blast!! and here I am going to arrange the same thing myself on the 13th. Just a consult.....the "act" will be after that. 53.....hmmm...... In the UK...unless I am bleeding a lot....this procedure is not considered important. More of a useless cosmetic procedure.
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Old 10-01-2010, 03:25 PM   #16
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Old 10-01-2010, 03:53 PM   #17
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I'm 60. It seems there is all sorts of stuff I'm supposed to have done.

One of the reasons I am going is one of my oldest sisters best friend died of colon cancer in her early 60s... did not want to have the procedure done... and thought she had hemorroids... died 3 months after finding out she had cancer...


but... on the other side.. my 91YO mother has never had it done... one doctor talked about having it done, but we said 'if nothing has gone wrong yet, let's just let it go'....
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Old 10-01-2010, 04:01 PM   #18
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I have had two. The prep is far worse than the procedure!
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Old 10-01-2010, 04:03 PM   #19
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When my DH had his the prep instructions allowed him to eat all the hard boiled eggs he wanted. I asked the Dr. about this and he said that eggs leave no residue in the bowel.
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Old 10-01-2010, 04:11 PM   #20
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Nords, there is nothing to the procedure itself in my opinion (I am 56 and have had two at two different places, different docs....one in a surgicenter of the premier hospital in Pittsburgh and the most recent out-patient at the local hospital). The prep the day before is not fun but it is do-able. Rent a couple of movies (so you can pause) and wear baggy elastic waist pants while you "prepare". Stock up on the recommended clear liquids. I got snowed with lots of good drugs, and don't remember the "procedure" at all. I have to go back next year as I have a family history of colon CA (my Mom). You need to bring a driver for the procedure otherwise you will have done the prep for naught...
The only thing they found this last time was that I have the beginnings of diverticulosis and have to eat a high fiber diet. I was surprised. I thought I ate a high fiber diet, and I have had no symptoms. I guess it is old age or hereditary.
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