Colonoscopy Captures: A Contest of Inner Beauty

[Astronuc]

My father had his first colonoscopy in his late 70s, after the symptoms indicated something wrong. They colonoscopy revealed several well-developed polyps, and one exhibited cancer cells and was close enough to his lymph system.

Not only did he have about 6-8 inches of his colon removed (fortunately they could reattach the ends, so he didn't need a colostomy), but he needed chemotherapy, and subsequently radiation.

The chemotherapy made him quite ill to the point severe abdominal distress. He developed neuropathy in his legs. Basically a miserable existence for about 6 months. Meanwhile, he developed a post-operative infection.

The radiation scarred his bladder, and he developed incontinence.

He said there were times when he felt like dying would be preferable, but he persevered.

He's doing much better today.

All that misery and suffering could have been avoided if he had only had a colonoscopy many years early, certainly by age 60. Turns out some of his uncles and cousins have had colon cancer, and some died because they didn't get treatment in time.

I had a colonoscopy several months after my dad had his surgery. I'm clean so far. They insisted on anesthesia, propofol. It was a very effective anathesia. I woke up later and felt like I had the best sleep in about 30+ years.

 

[strangerep]

Not only did he have about 6-8 inches of his colon removed (fortunately they could reattach the ends, so he didn't need a colostomy), but he needed chemotherapy, and subsequently radiation.

Sounds like he got off lightly.

When I was in hospital several years ago, the guy in the next bed had suffered colon cancer. He told me his story at length: after initial diagnosis, he had to have a lot of his colon removed, his anus surgically closed, and a colostomy bag hanging off his belly to catch his you-know-what. He endured 2 years in this miserable state while receiving chemo and radiation. But the good news was that the overall treatment seemed effective, and he was in hospital at that time simply to have his colon re-attached and anus re-opened so things could start functioning more normally again. So he was surprisingly happy and chirpy as he told me his story. (I, of course, became quite speechless while he was talking -- hard to believe one could survive such an ordeal, both physically and mentally.)

 

[dlgoff]

I received the information/instruction packet in the mail. I'm fairly sure they want to kill me. They want me to drink up to 16 ounces of water per hour for the day; 7am to 10pm. That's up to 15 pounds of water => 12% of my body weight. That's more water than I drink in two weeks. Sounds like Water Intoxication to me.

If I'm still alive at 5:30pm, I'm suppose chug 10 ounces of Magnesium citrate followed by two Dulcolax tablets at 6pm. Then one hour later, mix 238g powered Miralax powder in 64 ounces of Gatorade and finish drinking all by 10pm. 238g ?

The usual dose is 17 grams (about 1 heaping tablespoon) of powder per day (or as directed by physician) in 4 to 8 ounces of water.

http://www.rxlist.com/miralax-drug/indications-dosage.htm

Now it's time for two more Dulcolax tablets with 8 ounces of water.

They must feel fairly confident that they're going to succeed in killing or injuring me, as they included forms for Durable Power of Attorney For Health Care Decisions and a Statutory Living Will Declaration.

If I do happen to survive the night and make it to the appointment, they'll probably make me drink more chemicals.

 

[SteamKing]

Well, you could always catch the E-train (enema, that is). It's a wet and wild ride.

 

[D H]

I received the information/instruction packet in the mail. I'm fairly sure they want to kill me.

They don't want to kill you. They merely want to make you think that dying might be preferable. You will definitely feel that way shortly after the last dose.

It is worth it. It's but one day of agony at most every few years to stave off a rather nasty death. My first time, clean as a whistle (pun intended). My second time, snip snip. I'm now on the every few years cycle as opposed to once a decade cycle.


One last word of warning: Do not do anything serious after the procedure. Keep your hands off your checkbook! My wife paid the mortgage twice on the day of her first colonoscopy. She paid lots of bills twice that day. Some doctors use drugs that severely impact short-term memory. Hers did. The drugs did not affect reasoning abilities. She was fully aware, fully logical, after the procedure. She realized it was the time of the month to pay a bunch of bills, so she did that. Then she forgot that she did that. Later she realized it was the time of the month to pay a bunch of bills, so she did that. Again.

 

[dlgoff]

One last word of warning: Do not do anything serious after the procedure. Keep your hands off your checkbook! My wife paid the mortgage twice on the day of her first colonoscopy. She paid lots of bills twice that day. Some doctors use drugs that severely impact short-term memory. Hers did. The drugs did not affect reasoning abilities. She was fully aware, fully logical, after the procedure. She realized it was the time of the month to pay a bunch of bills, so she did that. Then she forgot that she did that. Later she realized it was the time of the month to pay a bunch of bills, so she did that. Again.

Thanks for the "checkbook" warning. They're going to put me out and warned of the short-term memory loss. I already knew about that. I had a same-day surgery for a hernia and the surgical [STRIKE]sweet[/STRIKE] suite nurse was an old girl friend. Apparently, according to my driver, I was trying to put the move on her as she walked me down the hall after recovery. I always did love that girl.

 

[Evo]

Dl, I would call them and ask if the amount of water is a typo, I have had 2 colonoscopies, and I was not told to drink water, but to do the miralax in 64 ounces of gatorade. The second doctor had me also drink some lime drink for constipation, 8 ounces I believe.

 

[Matterwave]

You guys are weird.

 

[D H]

I was told to drink *lots* of water. Lots and lots of water.

 

[dlgoff]

15 lbs was the maximum amount over the time specified. At 8 to 16 oz/hr, the minimum would still be more than I'll ever be able to drink.

 

[Astronuc]

I received the information/instruction packet in the mail. I'm fairly sure they want to kill me. They want me to drink up to 16 ounces of water per hour for the day; 7am to 10pm. That's up to 15 pounds of water => 12% of my body weight. That's more water than I drink in two weeks. Sounds like Water Intoxication to me.

If I'm still alive at 5:30pm, I'm suppose chug 10 ounces of Magnesium citrate followed by two Dulcolax tablets at 6pm. Then one hour later, mix 238g powered Miralax powder in 64 ounces of Gatorade and finish drinking all by 10pm. 238g?

I think I drank a total of 32 or 64 oz of clear Gatorade with the Miralax. I also stopped eating pretty much the day before, so that I didn't have much to void.

One should not be drinking 15 pints of water. That seems excessive.

 

[Evo]

This is similar to the instructions I received, just told to drink plenty of liquids. The amount was up to me. The instructions you were given sound dangerous.

http://www.concordemed.com/files/232-east-30-st/miralax-gatorade_colonoscopy.pdf

 

[strangerep]

You guys are weird.

And you will join our ranks -- eventually.

 

[strangerep]

The discussion about pre-colonscopy preparation and post-colonoscopy care makes me wonder about the quality of such things in different parts of the world.

I was given a self-contained package called "Prep Kit C". Stuff had to be dissolved in a reasonably large quantity of water, and the entire amount drunk gradually over a specified period. (I had to hold my nose while drinking portions of it, the taste was unpleasant.) The instructions also advised not to be too far from a toilet during the prep day. Overall, it was far less of a hassle than I'd been expecting.

At the institution where the procedure was performed, it is mandatory for someone to stay with the patient for 12-18 hrs afterwards -- to prevent bad consequences of the temporary mental problems that persist for a while afterwards (poor memory formation/retention, etc). If there is no such accompanying person, the patient must stay in hospital overnight until the effects wear off. If a patient turns up without an accompanying person, and without making prior arrangements for overnight stay, they refuse to perform the procedure.

 

[Evo]

I think it definitely has to do with insurance issues of different countries.

My first colonoscopy was done in the doctor's office with "conscious sedation", demerol and something else, I was wide awake but had no discomfort, if I have it done again, this will be what I insist upon. And I got to watch it! The doctor positioned the screen so I could see what he was doing. We had a good time joking and I had half a dozen polyps removed!

My second colonoscopy was done in the outpatient day surgery department of a local hospital. I was put under light general anesthesia and the pain I felt afterwards was pretty bad. I was released after an hour in post OP. Since there was no overall sedation with demerol, it was a rather painful day, and I had nothing removed. I do not recommend the general anesthesia in the US. Do the conscious sedation, it will be a much better experience for you, maybe not what your doctor wants as it takes more skill to do the conscious sedation, but he's not the one with a probe up his arse.

You do have to have a person drive you home.

 

[Evo]

Oh dear, you're having this procedure tomorrow?? I hope it goes well.

 

[dlgoff]

My prep day is Tuesday and the procedure is Wednesday morning. No eating all day Tuesday, only water and the chemicals as described. The water amount is excessive, especially for my body weight, so I'm only going to drink what I know my body will allow. I did try to opt for staying awake but they said it would be too painful. I asked if I would be sore afterwords and they said not at all. Yea right.

 

[Astronuc]

My prep day is Tuesday and the procedure is Wednesday morning. No eating all day Tuesday, only water and the chemicals as described. The water amount is excessive, especially for my body weight, so I'm only going to drink what I know my body will allow. I did try to opt for staying awake but they said it would be too painful. I asked if I would be sore afterwords and they said not at all. Yea right.

Check with the doctor. One should probably drink no more than 64 oz of clear fluid - with the Miralax.

Also, I believe one can drink chicken broth, so that one will get some nutrition.

 

[strangerep]

I asked if I would be sore afterwords and they said not at all. Yea right.

I had twilight sedation, and no pain afterwards. None at all. I was quite surprised that Evo reported pain the 2nd time even though nothing was removed. That should not happen.

Imho, try to comply with drinking the extra water -- gradually. The chemicals, etc, are stimulating your insides to flush everything out, which normally would cause dehydration.

 

[lisab]

I had twilight sedation, and no pain afterwards. None at all. I was quite surprised that Evo reported pain the 2nd time even though nothing was removed. That should not happen.

Imho, try to comply with drinking the extra water -- gradually. The chemicals, etc, are stimulating your insides to flush everything out, which normally would cause dehydration.

My first one is in a few weeks, I'll post how it goes.

My daughter had to have one a few months ago, she had some issues that needed attention. She was sedated, and said there were no issues at all with the procedure. No pain, no discomfort afterwards. She was worried beforehand but later realized all the anxiety was for naught.

 

[Evo]

They were looking for problems and went a bit further than with a standard colonoscopy the second time. The pain afterward was pretty bad, I believe it's from trapped gas, they inject gas into your colon, and I had heard this pain tends to be more common with general anesthesia, with conscious sedation, they have you move and gas is expelled during the procedure. I remember during the first one I kept saying "sorry", but by the end of the procedure, no trapped gas and I was on cloud nine the rest of the day thanks to the demerol.

After the general anesthesia, I was doubled over in pain for hours. Not doing that again.

But it depends on how gentle or rushed the doctor is and other factors. I hope you have no issues dl.

 

[strangerep]

After the general anesthesia, I was doubled over in pain for hours.

Ah, ok. I misunderstood. Didn't they give you pain relief??

About 8yrs ago I had laparoscopic hernia repair (general anesthesia of course). In the recovery room, I had excruciating pain across my shoulders (i.e., nowhere near the site of the op). They had to max me out on morphine to relieve it, so then I became nauseated later. The anesthesist later said that this happens to some people when their insides are inflated with gas (as occurs in laparoscopic procedures), but they have no way to anticipate who will be affected. I'm not sure I buy this explanation however.

2 yrs later, the same hernia needed to be redone (simply gluing a patch by laparascopic procedure wasn't strong enough). This time they did a conventional open repair, and I was fine. Woke up -- no significant problems except for some very mild pain around the wound. But they also used a different cocktail of anesthetics this time, given my intolerance for opiates.

 

[Evo]

Ah, ok. I misunderstood. Didn't they give you pain relief??

No.

About 8yrs ago I had laparoscopic hernia repair (general anesthesia of course). In the recovery room, I had excruciating pain across my shoulders (i.e., nowhere near the site of the op). They had to max me out on morphine to relieve it, so then I became nauseated later. The anesthesist later said that this happens to some people when their insides are inflated with gas (as occurs in laparoscopic procedures), but they have no way to anticipate who will be affected. I'm not sure I buy this explanation however.

2 yrs later, the same hernia needed to be redone (simply gluing a patch by laparascopic procedure wasn't strong enough). This time they did a conventional open repair, and I was fine. Woke up -- no significant problems except for some very mild pain around the wound. But they also used a different cocktail of anesthetics this time, given my intolerance for opiates.

Wow, we seem to have so many of the same problems.

 

[DevilsAvocado]

I did try to opt for staying awake but they said it would be too painful. I asked if I would be sore afterwords and they said not at all. Yea right.

You are the customer, go somewhere else if they insist on general anesthesia. There is no logical reason for this (except maybe larger/complicated procedure = more money/profits), it's not like they're going in with Saturn V... it's a little flexible "snake":

When I did this some years ago, I felt absolutely nothing during the examination, except once when the doctor reached the sharp "u-turn", higher up in the colon. Of course, this kind of feedback is impossible if you are put unconscious...

There's always a risk (even if it is tiny); but ask the doctor why you should increase the risks of complications, by choosing something that is completely useless??

Anesthesia-related deaths by ASA status

The death rate of colonoscopy is 0.6 in 10,000 cases (of course the overall patient status is crucial).

I agree with Evo – the examination was interesting and fun! The nurses said I was mumbling that this was more thrilling than Sweden wining the hockey Olympic Games, and I encourage the doctor to go further and further... almost cheering for every inch...

... and yes, I did get laughing gas (nitrous) as painkiller, which probably helped to "implement" the cheering "hockey mode" ...

Same as Evo, the worst part was afterwards – the stomach felt like I had been run over by a truck (no gas). I had to stay for a couple of hours before I could stand up.

But this is very different from person to person, and maybe depending on the examination. I my case, there was no polyps or removal, just biopsies/tissue, but the doctor was trying to enter the small intestine. I have friends that have had no problems whatsoever during/after examination. Ask for painkillers if you get problems afterward, and take the rest of the day for resting, and you will be okay.

There's nothing to worry about, these guys are skilled, and if something happens they have other fancy tools to fix basically everything!

 

[Borek]

Typical problem with docs - each one knows best and each one says something completely different.

Which is why I prefer multiplication table.

 

[Pythagorean]

Typical problem with docs - each one knows best and each one says something completely different.

Which is why I prefer multiplication table.

Last time I tried to do a colonscopy with a multiplication table, I just ended up with toilet paper.

 

[Monique]

It can't be that bad right? Discomfort for a day sounds tolerable. Indeed I would question the general anesthesia, is it for the benefit of the doctor or patient?

 

[DevilsAvocado]

Last time I tried to do a colonscopy with a multiplication table, I just ended up with toilet paper.

You were lucky... most of the time it all ends in a messy brownian motion...

 

[DevilsAvocado]

It can't be that bad right?

For me, physically it was no more than using an old analog medical thermometer (i.e. regarding the actual examination). Intellectually, it was a 'revelation' seeing the inside of you live...

Indeed I would question the general anesthesia, is it for the benefit of the doctor or patient?

It's definitely not for the patient, except maybe in some special cases of extreme anxiety or maybe unusual medical reasons, but in the general case – no... I have had much more pain at the dentist, despite LA.

I can't understand why they even consider general anesthesia... who would ever dream of doing GA at the dentist?? :uhh:

 

[Evo]

I can't understand why they even consider general anesthesia... who would ever dream of doing GA at the dentist?? :uhh:

I was reading that it's just to get more money. Now your insurance is charged for the hospital surgical outpatient facility, the anesthetists, nurses, and they can crank out patients faster, meaning the doctor can schedule a lot more patients in a day and rack up the $$.

When I had it done in office under "conscious sedation", my co-pay was $40, when I had the general anesthesia done, my co-pay was $350.

 

[DevilsAvocado]

I was reading that it's just to get more money.

Bingo!

This is what I suspected all the time (don't want to delve too deep in this 'sensitive' issue)... but I think there's quite a big difference between countries with one-size-fits-all-public-health-care, and private alternatives... I can't remember I've ever heard of anyone doing GA for colonoscopy in Sweden? But we're going private* now, so it might be more common here also... I dunno.


*We now have schools run by venture capitalists in NYC... as the one of two countries in the world, the other is Augusto Pinochet's Chile... it sucks, some schools goes bankrupt and runs with taxpayers money, and the kids don't even get their grades... :yuck:

 

[strangerep]

who would ever dream of doing GA at the dentist?? :uhh:

It depends on the severity of the procedure. I've heard of unfortunate people who needed to have all their teeth removed -- it was performed under GA, with subsequent overnight stay in hospital.

 

[davenn]

I have had 2 colonoscopies, one ~ 16 yrs ago and another last year ... both were done with me under general anaesthetic no problems during and no nasty pains afterwards
( have never walked the same since ... kiddin')

The first one , 16 yrs ago, was almost immediately followed by the Endoscopic Examination down the throat and into the stomach. That was really uncomfortable, horrible gagging reflexes.

I did joke to the surgeon at the time that I hope its a different instrument that the one that went up the "tail pipe" haha

cheers
Dave

 

[DevilsAvocado]

I've heard of unfortunate people who needed to have all their teeth removed

Ouch! This is lethal!

Or at least it used to be... a relative back in the old days, when old people all had (removable) false teeth, went to the dentist to remove all teeth, but the shock was too overwhelming and the old man got a stroke, a few days later he passed away... :/

But you're right, larger/complicated dental treatments require GA. In my country most dentists don't have the license/equipment to carry out this treatment; it has to be done at the hospital as a 'surgery'.

Talking about crazy dental experiences... as a teenager I fell headlong into the pavement (in a ridiculous situation that I'll skip) and I knocked out a front tooth. Just a few days before my mom did read about a car accident where the driver had knocked out a tooth, and put it back, and the tooth "grow back"... so, I picked up the tooth from the ground and put it back, and there it stayed for many years. Finally the tooth "went pink" and it was time for a dental implant. I had removed several teeth before and wasn't especially worried about this procedure... but the (dead) darned thing had joined/grown into the bone of my upper jaw... the dentist worked so hard he went red with sweat pouring down his face, repeatedly asking me "Are you okay? Are you okay?", I said yes, but was really waiting for the whole head to drop lose... expecting the dentist to next use his feet/legs against my chest to brace the stubborn bastard out. Finally he got it out, and then it was time for the titanium implant, which was also a "funny" experience... I'll skip the greasy details, but it's basically about putting your head as close to the floor as possible and your feet in the roof, and with the world upside-down watching a "specialist" entering the room, with something that looked like a rotary hammer drill, eager to drill a hole in your skull/jaw...

Colonoscopy is a walk in the park in comparison!

 

[dlgoff]

The type of anesthesia they're going to use is called a "procedural sedation". As I understand it, you won't remember the procedure but will be able to respond to the doctor for changing body position and give feedback as to the discomfort at the time. I am waiting to hear back from them about some of my concerns.