2nd Colonoscopy

[Mdlerth]

Schedule carefully

I've had two colonoscopies, 5 years apart, and the key lesson I learned from the first one was to double check the date. They wanted me to set it up ~5 months in advance; that's way too far in the future for me to know what else might be going on. I goofed up badly, not realizing that my appointment was set for the Monday after the Super Bowl. Being my first time, I didn't fully comprehend the horror of prep day.

In my family, Super Bowl Sunday is one of the top food days of the year, on a par with Thanksgiving and Easter and the Christmas Eve Feast of 7 Fishes. So we had two dozen people gathered to watch the big game, everybody chowing down on wings and brats and tacos and beer... everybody except me. The only comestible I was allowed was that gallon jug of prescription phlegm lightly seasoned with some artificial lemon flavoring.

The prep goo is unappetizing enough by itself, but when you're surrounded by the most sinfully yummy junk food on earth, the contrast is stark.

I was a starving orphan at a bakery window, helplessly drooling at the sight of bowls and plates and crocks of seductive, unattainable ambrosia. The savory scent of nachos and onion dip taunted me mercilessly, but all I could do was sniff it and then try to choke down another glug of lemon-scented wallpaper paste before rushing off to the powder room. I lost count of my sessions on the throne, which guaranteed that I missed all the key plays, the best SB commercials and the halftime show.

Five years later, I took no chances. I made sure to schedule my procedure for a Tuesday.

 

[robnplunder]

Had my first at age 60 and had a half dozen small polyps 4-8mm. This morning at age 66 had a second colonoscopy and they snipped out 18 of the little buggers, mostly small but one was in the 20mm range.

Hmm, you seem to have more than your share of the polyps. I only had a few at age 50. I am due for another one this year. If I am clean, maybe, I can do another one in 10 years.

.

 

[Clone]

I had my initial colonoscopy at 50, and they found 3 small polyps. At 55, nothing. I think the next is scheduled for age 65.

I was completely out both times, no memories of anything unpleasant. Other than drinking the saltwater or whatever that was. The first time was yuck. Second time was not so bad.

 

[Focus]

The procedure usually now is administered with an anesthesiologist. Most use propofol. They will monitor you carefully. It is safe. This is not a Michael Jackson situation. One reason MJ used propofol is there really is very little side effect.

Well ... that wasn't my experience. I was given a combo of propofol and versed, and I felt extremely nauseous for a day afterward.

The next time, I did the procedure without anesthesia. It was a much better experience, even though there was some discomfort when the tube made the curves. (They used a thinner tube to make things easier.) I'm going to do it this way from now on. At the end, you just get up from the table and walk out -- no driver needed.

 

[JoeWras]

Well ... that wasn't my experience. I was given a combo of propofol and versed, and I felt extremely nauseous for a day afterward.

Versed - why? Sorry to hear about that.

And not everyone takes propofol very well. Most do, but not everyone.

I think it is worth knowing that that procedures do differ among doctors, clinics and anesthesiologists. The prep solution is still one that differs a lot.

By the way, a few years ago there were these "little pills" people were taking. The good news was you only had to drink water. The bad news was that it was causing severe kidney damage in a lot of people.

 

[Amethyst]

Mr. A. and I were each advised to drink a bottle of magnesium citrate (cheap OTC laxative) after dinner, the day before the "real" Rx prep.

It was insurance, and it worked...the last thing you want is for the Dr. to send you home without a result because your prep didn't work well enough, and now you have to go through it all over again.

Once with Moviprep and once with Suprep. We mixed the stuff with clear lemonade and gulped each separate dose very fast, so other than a salty tang on the back of the tongue (the prep is very salty), there wasn't a truly "horrible" taste.

So next year when I am due, I'll try to a prep that at least works before I go to sleep.

Suggestions for prep that has worked good for you?

 

[athena53]

The next time, I did the procedure without anesthesia. It was a much better experience, even though there was some discomfort when the tube made the curves. (They used a thinner tube to make things easier.) I'm going to do it this way from now on. At the end, you just get up from the table and walk out -- no driver needed.

My first was without anaesthesia, which I did after talking to my mother, who always did without. No problems at all, even during the snipping. Unfortunately, when I had to select a new doctor, and specified that I wanted it done without anaesthesia, he came in just before to discuss it with me. Yes, he was willing, but he didn't like the idea. He wanted to be able to twist and turn all he wanted without worrying about causing me discomfort or, heaven forbid, my flinching and causing something to go wrong. If he'd tried the "I'm the doctor and I'm smarter than you" approach I'd have hated it, but I could understand his wish to minimize risk.

Now that I'm on Medicare and don't have to worry about possible high OOP costs, I'll probably go back to the doc who did it without anaesthetic. I'd be curious if they made me have a driver anyway, just in case they found something that required sedation to remove- but I much prefer not to bother with anaesthetic. Pretty interesting view on the TV screen, too!

 

[Bklyn55]

After extensive reasearch and reviewing the risks of propanol, fentanyl, midazolam etc. I decided to have a drug free colonoscopy. It was almost pain free (my dental cleanings hurt more), and I walked home right after the procedure. It was hard to find a doctor who would agree to this, and I did have an IV inserted and an anesthesiologist sitting next to me (reading her kindle) the whole time. In my opinion, the trend towards the use of deep sedation in colonoscopies is costly and unnecessary. It’s also a United States thing. Unsedated colonoscopies are routinely practiced in other countries.

 

[irishgal]

Oh gosh. This thread might be a lifesaver for those of us who have never had the procedure. Thanks- because I’m going to get my PCP to write an order for one.

 

[Lawrencewendall]

First one was at 47 and they found one and diagnosed me with diverticulitis. Had one last year and was clean. I did wake up during that one. Not the best feeling. On the 10 year plan.

 

[MRG]

I'd forgotten my most memorable one. I had lunch at the Phoenix in KCMO and they served me old rotting mayo.

Six hours later I go to the bathroom and take a bucket with me. After two days in the bathroom. I went to the ER and they did all kinds of tests including a CT of my belly.

A while later a gastroenterologist tells me the CT shows something possibly serious and the need to perform a sigmoidoscopy! I'm like doc I'm not going drink the prep! He assured me there's not much to prep I'll only give you half! At least I don't remember it and there was no problem other than food poisoning.

I had an upper under versed while I was taking other benzos. Never went out, listened to the doc the whole time. Had I not been so sick I would have refused the procedure. Their office admitted they screwed up by not having propofol for me.

 

[Rianne]

For those who are considered low-medium risk, this might be of interest.

My doctor just ordered a Cologuard collection kit for me. It costs $650 and is covered 100% by Medicare. https://www.cologuardtest.com/

It's a non-invasive test that arrives in an 8" cube box, with all the instructions, etc. (A major thing is not to collect on Fri or Sat so as to reduce the return shipping time.)

It avoids a lot of the issues with a colonoscopy: having to do the prep, arrange for a driver, take the day off work or play, deal with anesthesia, etc.

My doctor said she's planning on doing one of these every X years (I forget what she said, 6 or 10 years) until she dies, assuming her results are good.

I have a friend who is scared-to-death of having his colon perforated if he undergoes a colonoscopy, so he is quite interested in the Cologuard test.

I'm 60, never had a colonoscopy. I use the Cologuard. My primary doc said it is becoming a "preventative" on the healthcare list as an option to colonoscopy. I understand the Cologuard reaches further into the colon and detects cancer cells that a colonoscopy would not. For instance, flat cancer and farther into the colon are issues with the colonoscopy (it only goes so far). Yes, polyps are removed, but the polyps shed cells that the Cologuard picks up and the DNA is picked up on the right as well as left part of the colon, that is a weakness of the colonoscopy. I was advised to get the Cologuard every 3 years for a good baseline.

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[H2ODude]

Had one done 10 years ago, no polyps. Got another scheduled next month. DW had several removed, one pretty good sized but don't recall exact measurement. Her mother had colon c so that was a good catch.

Ambivalent about anaesthesia. Really don't care to remember any part of a colonoscopy so will take it. Have had a few minor surgeries, DW had her colonoscopy, and we have a tradition of how to break the fast after these procedures....off to IHOP! It's the only time we go, and has become our joke of a tradition. So after next colonoscopy it's off to IHOP!

 

[O2Bfree]

Just want to applaud everyone who keeps on on this test. My dad missed one by 6 or 7 years, started having symptoms, and was found to have cancer. He had some intestine removed, including the ileocecal valve, which began years of woe as he (and poor mom) dealt with chronic, often uncontrollable diarrhea due to the missing valve. This caused his activity level to drop significantly, taking a toll on his strength, mobility, and mental health, and basically scuttling the quality of his last years. All possibly for lack of one test and some polyps snipped out.

 

[Dash man]

Two procedures, one at 50 and another last year at 60. All clear and don’t need another until 70.

 

[Ian S]

IIRC, the commercials for Cologuard state that it's not for folks who've had cancer OR polyps. But probably an excellent idea for everyone else.

 

[Teacher Terry]

A friend of mine got her last one at 70. She said after that age your lining thins out and she did not think it was worth the risk. I did not have polyps but both my siblings did. Had one at 55. It said you couldn't use cologuard if you have hemorrhoids that bleed but I wonder if you can use it when they are not bleeding.

 

[Walt34]

Suggestions for prep that has worked good for you?

Went to see the doc today, the stuff is called moviprep.

But of course YMMV. DW can't keep the stuff down. I have lots of practice drinking vile stuff (mostly with alcohol in it) so it doesn't bother me a bit.

 

[Focus]

Versed - why? Sorry to hear about that.

Forgot to mention that they did an endoscopy along with the colonoscopy the first time. Maybe that accounted for the versed.

In my opinion, the trend towards the use of deep sedation in colonoscopies is costly and unnecessary. It’s also a United States thing. Unsedated colonoscopies are routinely practiced in other countries.

 

[Ologist]

I had one done at age 50 at UCLA. It seemed like it was over in 5 minutes (I guess it was the Fentanyl sedation). They found nothing. I have to go back at age 60 for another. Although now they do stool DNA test first instead.

Usually for a colonoscopy propofol is used for sedation. At times versed & fentanyl can also be added.

 

[Ologist]

Usually for a colonoscopy propofol is used for sedation. At times versed & fentanyl can also be added.

Versed is given for amnesia, fentanyl is a narcotic pain reliever. Propofol at low doses causes sedation but at higher doses can induce general anesthesia.

Practiced Anesthesiology for 33yrs before taking ER at age 63yrs. Have seen the speciality practiced all over the world. Americans in general prefer to be “totally out of it” for most surgical or diagnostic procedures. BTW besides providing sedation during endoscopy the anesthesiologist is monitoring the patient, which is vital for safety.

I agree deep sedation is not needed for the vast majority of endoscopes. If deep sedation is required such as for an upper endoscopy when the patient is vomiting. It is better to use general anesthesia with an endotracheal tube so that the patients airway (lungs) are protected.

Sorry did not mean to turn this into an anesthesia forum.

 

[braumeister]

A friend of mine got her last one at 70. She said after that age your lining thins out and she did not think it was worth the risk.

75 is the usual cutoff, since studies have shown little benefit after that age. But it's an individual decision.

 

[jim584672]

That Propofol stuff is great. 3-2-1 out like a light.

 

[Scrapr]

Just want to applaud everyone who keeps on on this test. My dad missed one by 6 or 7 years, started having symptoms, and was found to have cancer. He had some intestine removed, including the ileocecal valve, which began years of woe as he (and poor mom) dealt with chronic, often uncontrollable diarrhea due to the missing valve. This caused his activity level to drop significantly, taking a toll on his strength, mobility, and mental health, and basically scuttling the quality of his last years. All possibly for lack of one test and some polyps snipped out.

Sorry to hear this. My ilecocal valve was removed in my resection for Crohns. And the diarreha was a major problem. Then mt GI doc got me on a med called cholestramine. It binds salts where that valve used to be. Take it in the am and good to go for the day (mostly)

I'm sorry for your Dad. It really is embarresing and frankly humiliating.

 

[HFWR]

Put me in the “wake me when it’s over” camp...