"World-class colonoscopy"

[golfnut]

Had my 2nd colonoscopy 2 weeks ago (i'm on the five year plan because of polyps found in both procedures). Everything went well. The worst part is the day prior to the procedure -fasting and prep. It's amazing how full of sh*t we are.

[Orchidflower]

No polyps, clean as a whistle but because my Grandma died of colon cancer I have to go back every 5 years; but, now that I read one of our board members has to go back every single year, I will quite beefing about it. I am lucky it isn't every year I figure.

[FreeAtLast]

I just went in thursday for my first time and all went well. I was on my way home by 10:00am. They removed 2 polyps so they want me back in 2-3 years for another one. I have a family history so I should have gone in a long time ago as i am 59.

[Orchidflower]

Quote:

Originally Posted by FreeAtLast I just went in thursday for my first time and all went well. I was on my way home by 10:00am. They removed 2 polyps so they want me back in 2-3 years for another one. I have a family history so I should have gone in a long time ago as i am 59.

I hope you do just that, because I watched my Grandma die and it is a very painful way to go it looked like.

[FreeAtLast]

Quote:

Originally Posted by Orchidflower I hope you do just that, because I watched my Grandma die and it is a very painful way to go it looked like.

Thank you for your encouragement. i have already put it on my calendar for 2 years out.

[Nords]

Quote:

Originally Posted by jj Nords, Did you let everyone know how your 'procedure' went in another thread? I was just re-visiting this thread as I am overdue a colonoscopy and have finally mustered the courage to make an appointment. I got to the end to find no follow up from the OP!! Thanks to the ER community for sharing their experiences on this important topic.

Well, I'm not going to inspire you to scamper to the doctor's office.

I've been flushed, borescoped, and hydro'd, but it was a bust and I want that 48 hours of my life back.

We're still waiting on the biopsy results, but they carved out one 7mm polyp all the way at the transition from the small intestine to the large. The rest was declared "poor prep" and "unable to see any polyps smaller than 10 mm in the fecal residue" along with a sentence of "return in three years". I have no idea whether 7mm is "Mickey Mouse" or "King Kong" in the polyp world, but at this point I'm afraid to ask the GI experts for clarification. (Feel free to provide me with additional website links, however.) The video evidence will not be nominated for any awards shows, either.

FWIW I feel that Dave Barry may have slightly exaggerated his own experience, which could have made me paranoid on the anticipation: Dave Barry: A journey into my colon -- and yours - 02/11/2009 | MiamiHerald.com But I eat a pretty boring high-fiber high-protein diet with occasional pizza orgies and chocolate indulgences.

Prep day was Monday and the event was Tuesday. Thanks for the advice on being first up, too, because if I'd had even a late-morning appointment then I would've been starving to death. Tuesday morning turned out to be perfect because Monday never goes smoothly, and the vast majority of people want a Friday appointment for a "long weekend".

Anticipation of the prep was far worse than the actual experience. I mixed the four liters of Golytely with half an envelope of Crystal Lite powder (lemonaid), chilled it in the fridge, and ended up with Gatorade. (The sodium & potassium in the Golytely is unbelievable-- nearly 6000 mg and 3000 mg.) Tripler's staff prescribed Dulcolax. They also prescribed Simethicone, which made the Gatorade taste greasy but was quite effective at keeping down the gas. If your clinic doesn't use Simethicone then it's worth buying it at a drugstore and adding a tablespoon or two.

Tripler has its "customers" avoid veggies & nuts & fruit peels on prep morning, stop solid food NLT noon, take the Dulcolax at 2 PM, drink about 2/3 of the Golytely between 5-7 PM, and then hang on for the rest of the evening. At some point you're presumably able to sleep because they tell you to awake at 4 AM to finish the rest of the Golytely, and then nothing else (not even water) until the actual procedure. Keep in mind that most of Tripler's customers are combat veterans.

The PA who did my consult advised deviating from Tripler's procedure by trying to drink it all between 5-7 PM. Since I'm a hypercompetitive nuke, I avoided veggies & nuts for two days before prep. I had my last solid food at 10:30 AM. I took the Dulcolax on schedule and started the Golytely right on time, but I accepted the drinking challenge to chug the jug by 6:30 PM (~12 ounces every eight minutes). Spouse banished me to the opposite end of the house with my own independent acoustic insulation, ventilation system, guest bedroom, & bathroom. I had a short nap between 10 PM-midnight and managed to drop off again by 12:30 AM until 4 AM, so I thought things were flowing going pretty well. (Let's just say that the resulting evidence was "clear".) Now that I've received the "poor prep" verdict (including full-color photos) I'm wondering if I should have stuck to the procedure, or requested an extra liter for a 4 AM chaser, or asked for bigger scrubbing bristles on the doc's borescope, or if I was just (as REWahoo says) "full of it". I can attest that discharge flow rate, back pressure, and volume were impressive. Tripler advised walking around to aid the peristaltic action in between pit stops, but sometimes just standing up for a few seconds was more than enough.

I was one grumpy guy by the time we joined rush-hour traffic for the 7 AM show time. I was also a tad sleep-deprived, so they probably could've achieved the same anesthetic results with a placebo. The actual procedure had me under the anesthesia by 8:15 AM and in the recovery room before 9:15. They even warmed the blankets that they use in the operating room. This was my first anesthesia and an interesting experience-- I watched the Versed/fentanyl go into the IV and didn't feel any reaction. But seconds later my sensory system just sorta stopped writing the RAM cache to the hard drive, and next thing I knew I was being wheeled into the recovery room for graham crackers & OJ. No complaints there.

I've lost four pounds and I'm about 2000 calories behind... I've been trying to make it up all day but my digestive system is still trying to figure out what the heck it's supposed to do. I guess it needs a certain critical mass to work with before production is re-established.

Nobody really wanted to discuss the prep issue, probably since they'll all be gone in three years and by then the procedure might be different. (I sure hope so.) It was a busy place, too-- Tripler must've cranked through a dozen 50-year-olds in that waiting room before lunch.

I felt a lot less sorry for myself when I saw two 20-something guys, probably active-duty Army, awaiting their own colonoscopies. I don't want to know what got them elected for the procedure at that age.

For you local military posters, Tripler requires chauffeurs who literally have to sign their wards in & out. In retrospect spouse should've spent the intervening time anywhere else but the waiting room. We have a bad history with Tripler from our daughter's birth there, and 18+ years later spouse was still having labor & delivery flashbacks. She was getting a little grumpy herself when she signed me in, and the time I stumbled back out to the waiting room her temper was downright vicious. Next year when I return the favor for her I'm going to bring earplugs and wait down in the cafeteria until I estimate that she's ready for pickup.

[W2R]

Nords, sorry about the puzzling "poor prep" comments. I didn't get them, but then "all was clear" (so to speak) for >24 hours before my procedure and I did do the longer-than-most prep exactly as specified. Two nights of almost no sleep. Prep is a miserable, miserable, miserable experience IMO. Did I mention it is miserable?

I had to have a driver (F., of course) who signed me in and out, too. He was required to sit there in the waiting room (no option of "waiting in the cafeteria") until I was in recovery, and he was there when I awakened.

As for the polyp size, my two benign polyps were 2 mm and 3 mm. Due to my father dying of colon cancer, I wanted to know if those were big! I searched online and got the idea that apparently those were small. I don't know about 7 mm but suspect that is not gargantuan. Ask your doctor, or do an online search and you may get some idea.

[WhoDaresWins]

Nords, I am not a medical professional but I think anything under 1 cm is considered a small polyp. You will have to ask your gastroenterologist why you might have had an incomplete prep.
I was surprised when I was told almost 3 years ago that I had the beginnings of diverticulosis and was given a high fiber diet sheet upon discharge home. If I had any more of a high fiber diet, I would have to quit my job and stay at home! I think some things are hereditary. I know my Dad had diverticulosis (Mom died of colon CA so I am on a 3-year recall for colonoscopy checks). I have had no symptoms of diverticulosis I might add.
Some hospitals are more strict about the designated driver it seems. I took a friend to a very small hospital for hers, and they never checked to see if she had a driver. She just came bounding out into the waiting room for me to drive her home. I chose a larger hospital for mine and the GI lab nurse wanted to know who was waiting for me, she went and talked to her, had her sign a paper that upon discharge said friend was responsible for me for the next 24 hours, made her bring her car around to an exit to pick me where I was waiting with an orderly who had wheeled me to the curb in a wheelchair!

[Khan]

I've decided I'm not going to bother.

[GregLee]

Thanks for the careful account, Nords, which many of us read with great interest. I have no idea why they didn't like your prep so much, but, anyhow, I guess the pathologist's forthcoming report is sort of the bottom line. (My third colonoscopy yielded a precancerous polyp in the cecum, which is where I gather they found your polyp.)

[Sue J]

Thanks for the update, Nords. I've been following this topic and avoiding the inevitable. A few weeks ago I got very brave and made an appointment. I picked a 7:30 am start time so I need to be there by 7:00. I did this for DH a few years ago so it's his turn to return the favor.

The prep instructions are a little different but I picked this doctor because along with the Miralax, Citrate of Magnesia and Ducolax he allows hard boiled eggs with the clear liquids.

[Moemg]

Quote:

Originally Posted by Nords We're still waiting on the biopsy results, but they carved out one 7mm polyp all the way at the transition from the small intestine to the large. The rest was declared "poor prep" and "unable to see any polyps smaller than 10 mm in the fecal residue" along with a sentence of "return in three years". .

You were lucky .In the Endoscopy units that I worked if someone had a poor prep they were sent home with instructions to not eat repeat the prep and return in the morning .They were not happy campers !

[GregLee]

Quote:

Originally Posted by Sue J The prep instructions are a little different but I picked this doctor because along with the Miralax, Citrate of Magnesia and Ducolax he allows hard boiled eggs with the clear liquids.

You're picking a doctor because on one day every 5-10 years he'll let you eat a hard boiled egg? I'm not being critical --- just trying to clarify my understanding.

[Nords]

Quote:

Originally Posted by Moemg You were lucky .In the Endoscopy units that I worked if someone had a poor prep they were sent home with instructions to not eat repeat the prep and return in the morning .They were not happy campers !

So... did they get a lot of repeat business?

Spouse has been informed that she has to complete a pregnancy urine test within 72 hours of her age-50 colonoscopy. She's just motivated all to hell by this particularly bureaucratic attempt of the medical community to look out for her best interests.

[Moemg]

Quote:

Originally Posted by Nords Spouse has been informed that she has to complete a pregnancy urine test within 72 hours of her age-50 colonoscopy. She's just motivated all to hell by this particularly bureaucratic attempt of the medical community to look out for her best interests.

All Surgery or Endoscopy centers have these rules . I even had Nuns do Pregnancy tests . We actually had one woman ( not a nun ) fail the test . Surprise !

[Nords]

Quote:

Originally Posted by Moemg All Surgery or Endoscopy centers have these rules . I even had Nuns do Pregnancy tests . We actually had one woman ( not a nun ) fail the test . Surprise !

Tripler's interpretation of this requirement involves a bureaucrat with a stopwatch, not a sympathetic attitude. I'm not going to smear the hard-earned reputation of command sergeants major by invoking that stereotype, but you get the point.

I'm just sayin', a little internal motivation goes a long way. Admonishments that the onerous requirements are for our benefits... well... that's far too common, especially in the military.

I also can't be the first guy to show up on the table who did everything right (perhaps too right) only to achieve the wrong results. I was pretty groggy coming out of there, but someone could've tucked a copy of a "Sorry about the bad prep" form letter into my pocket for later reflection.

But Tripler called today to make sure that I've completely recovered from yesterday morning, and they'll send a postcard about the biopsy. Perhaps that'll be when we start talking about "bad prep" issues.

[Sue J]

Quote:

Originally Posted by GregLee You're picking a doctor because on one day every 5-10 years he'll let you eat a hard boiled egg? I'm not being critical --- just trying to clarify my understanding.

The options are fasting with a clear liquid diet vs hard boiled eggs and a clear liquid diet.

Also, he is the doctor that did my husband's colonoscopy. So I got to meet him and ask questions while I still had my clothes on.

My husband had a good enough experience (or was that the Versed talking) and the facility is close by. The eggs issue is... icing on the cake.

[BigNick]

Quote:

Originally Posted by Sue J The options are fasting with a clear liquid diet vs hard boiled eggs and a clear liquid diet.

Why do they allow hard-boiled eggs? Are they easy to spot on the camera?

Seriously, though, I'm glad I don't have to go through this. I just turned 50, so I got to submit my first screening stool sample this week. Pooping into an ice cream container is already enough contact with this area of medicine. (Why yes, since you ask, it was chocolate chip.)

[Sue J]

The doctor told me that eggs leave no residue in the colon. He's been in more colons than I have so I'm going to trust him on that.

[Nords]

To Tripler's credit, they followed up the postcard over the phone.

When the doc observed the "poor prep" and snipped the polyp, he initially recommended three years to the next inspection.

The biopsy came back "7mm adenomatous polyp: benign (normal) at this time. Could have become cancer after many more years." So he awarded a meritorious raise to five years.

The physician's assistant didn't have much solace to offer on the "poor prep" assessment besides "sometimes that happens".* Other than patient misbehavior it doesn't happen often enough for them to have figured out why. Her "solution" would be to have only clear liquids on the prep day before the colonoscopy (no solid food at all, not even breakfast), to still finish the four liters of Golytely the afternoon/evening of prep day, and to have an extra bonus chaser liter of Golytely at 4:30 the next morning. I guess it could've been worse... corrective action might've involved jumping up & down 100 times between bathroom breaks to shake everything loose from the walls.

Lookin' forward to round two, and hoping that the prep makes some quantum-leap improvements over the next half-decade. But I've dutifully put this on the tickler list for late 2016. Very late 2016.

* Yeah, I know, but it's a hackneyed cliché punchline and they're tired of hearing it.