Recollections of a colonoscopy
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The AARP magazine is pretty famous for bad medical advice.
Yes, the American Cancer Society now recommends colonoscopy screening begin at age 45. Their rationale is actually pretty good. It can be read on their website. As to flexible sigmoidoscopy.....pretty much moot since it’s really, really hard to find anyone doing it. It used to be an office procedure, soak it in some cidex and go on to the next patient. That’s about the only way that it can pay for itself. You want them to clean that scope real well, don’t you? The cleaning and sterile processing that has been shown to be necessary is really expensive...beyond the financial feasibility of a private office or clinic setting. The reason why there are no more sigmoidoscopies is that the scopes only cost a little less than a colonoscope, they require the same tower and video processor, and they have the same cleaning/sterilization process. It doesn’t make financial sense. AARP’s pathetic yearning for yesteryear is par for the course.
About 66% of colon cancers will show up within reach of a sigmoidoscope, meaning that routine sigmoidoscopy will miss 1/3 of the colon cancers they’re looking for. It is true that colonoscopy doesn’t decrease the mortality from colon cancer compared to sigmoidoscopy alone. That other 1/3 of the patients still get colon cancer, they just don’t die from it. That is apparently a risk that AARP is willing to take on your behalf.
No thanks.
Yes, the American Cancer Society now recommends colonoscopy screening begin at age 45. Their rationale is actually pretty good. It can be read on their website. As to flexible sigmoidoscopy.....pretty much moot since it’s really, really hard to find anyone doing it. It used to be an office procedure, soak it in some cidex and go on to the next patient. That’s about the only way that it can pay for itself. You want them to clean that scope real well, don’t you? The cleaning and sterile processing that has been shown to be necessary is really expensive...beyond the financial feasibility of a private office or clinic setting. The reason why there are no more sigmoidoscopies is that the scopes only cost a little less than a colonoscope, they require the same tower and video processor, and they have the same cleaning/sterilization process. It doesn’t make financial sense. AARP’s pathetic yearning for yesteryear is par for the course.
About 66% of colon cancers will show up within reach of a sigmoidoscope, meaning that routine sigmoidoscopy will miss 1/3 of the colon cancers they’re looking for. It is true that colonoscopy doesn’t decrease the mortality from colon cancer compared to sigmoidoscopy alone. That other 1/3 of the patients still get colon cancer, they just don’t die from it. That is apparently a risk that AARP is willing to take on your behalf.
No thanks.
Last edited by Cuyuna; 12-13-18 at 08:35 PM.
#27
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Played softball on the co-ed hospital team and of course I would get one of my team mates whenever I had the procedure. Made for interesting banter at post game pizza.
#28
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my dad had colon cancer, and it's no joke.
My first colonoscopy was done with valium, but I went to sleep anyway. I like that better than being knocked out, which is what happened the most recent 3. I have to schedule a procedure.
The surgeon that did my last one was alternating between scoping gastro and colon. I asked the nurse if they at least cleaned the scope between procedures. Apparently they don't think this is a good joke. There was a fairly big deal made about lack of cleanliness recently.
My first colonoscopy was done as a demo of a new scope. The salesman was there. I think that might have been the most expensive suit and shoes I have ever seen on a salesman.
My first colonoscopy was done with valium, but I went to sleep anyway. I like that better than being knocked out, which is what happened the most recent 3. I have to schedule a procedure.
The surgeon that did my last one was alternating between scoping gastro and colon. I asked the nurse if they at least cleaned the scope between procedures. Apparently they don't think this is a good joke. There was a fairly big deal made about lack of cleanliness recently.
My first colonoscopy was done as a demo of a new scope. The salesman was there. I think that might have been the most expensive suit and shoes I have ever seen on a salesman.
#29
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Valium is virtually never used these days. Some endoscopists still use Versed (along with the opioid Fentanyl). Versed is a sedative in the same class as Valium, but it has a much more pronounced amnesia effect. The general concept is that Fentanyl is given to decrease the pain, and Versed is given so that the patient doesn’t remember the pain. People don’t actually go to sleep, they just don’t remember being awake. The trend toward Propofol, an actual anesthetic, is based on vastly improved patient satisfaction. It also makes the procedure easier, safer, and faster, with less disorientation, quicker recovery, and less hangover.
Ffiberoptic scopes have become more complex as surgeons do more and more procedures with them. That complexity entails more joints and moving parts thereby making them harder to clean. The main issues with recent concerns of scope cleaning revolve around duodenoscopes for ERCP rather than standard gastroscopes and colonoscopes. All of these scopes are washed, soaked, and terminally sterilized for each use. It’s an elaborate and expensive process. The mechanical complexity of duodenscopes makes them a more difficult device to mechanically clean.
Medical device sales people have a demanding job. They get paid a lot of money. I've never seen one in an OR or endoscopy suite in street clothes.
Ffiberoptic scopes have become more complex as surgeons do more and more procedures with them. That complexity entails more joints and moving parts thereby making them harder to clean. The main issues with recent concerns of scope cleaning revolve around duodenoscopes for ERCP rather than standard gastroscopes and colonoscopes. All of these scopes are washed, soaked, and terminally sterilized for each use. It’s an elaborate and expensive process. The mechanical complexity of duodenscopes makes them a more difficult device to mechanically clean.
Medical device sales people have a demanding job. They get paid a lot of money. I've never seen one in an OR or endoscopy suite in street clothes.
Last edited by Cuyuna; 12-23-18 at 08:09 AM.
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I had one some years ago; I was offered a choice of "operatives" but bot knowing who was who, I asked for a "nice gentle female". A foolish choice. I got he local Registrar-ess who was embarking on her holidays immediately afterwards; she was attired in an immaculate red trouser suit and wasn't hanging about.
Thought I detected wry smile on her face as she rammed the device home . . . . .the boot on the other foot; payback time; call it what you will. Women too, can have a sardonic sense of humour no doubt detected by every woman in the place. Well, one actually.
She wasn't able to give the all-clear, so a guy did the same job on another day.
Never felt a thing. And I'm still here . . .
Thought I detected wry smile on her face as she rammed the device home . . . . .the boot on the other foot; payback time; call it what you will. Women too, can have a sardonic sense of humour no doubt detected by every woman in the place. Well, one actually.
She wasn't able to give the all-clear, so a guy did the same job on another day.
Never felt a thing. And I'm still here . . .
#31
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Had a colonoscopy 8-9 years ago. No problems - versed/midazolam. Because it was at the hospital where I have worked for several decades, I knew both the doctor and the RN helping. Which was fine by me. Finished mid-morning. Short bike ride late afternoon. Don't do this at home, kids!
Will probably have one more in another year or two. For those not at high risk, a screening colonoscopy is recommended no more frequently than every ten years. Because there is a bit of a risk of unintentional harm from the procedure. Don't want the risk to outweigh the benefits. More frequently is fine if there is a medical reason.
Will probably have one more in another year or two. For those not at high risk, a screening colonoscopy is recommended no more frequently than every ten years. Because there is a bit of a risk of unintentional harm from the procedure. Don't want the risk to outweigh the benefits. More frequently is fine if there is a medical reason.
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#32
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With the first occurring at age 50, I've now had three colonoscopies. Each time I was talking with the nurse ... then I awakened in recovery. Twice I've had polyps removed, and the test results were negative each time.
My wife still laughs about something from the first one.
The prep and recovery area at the local surgical center (same day type of stuff) has a dozen rooms separated by curtains. As I was gradually awakening from the first one I heard somebody pharrrrrrt! long and loud!
Opening one eye I asked my wife, "who was that?"
At the very moment a nurse flung back the curtain and cheerily exclaimed, "We heard that! You can dress and get ready to go now!"
To the young lady's credit, she had the presence of mind now to use my name and thereby announce to the whole suite of waiting and awakening patients who dun it.
My family of origin has cancer on both sides (paternal and maternal), so my conservative doctor wants me on the five year cycle. The pre-procedure prep is an annoyance, but a small price to pay for the peace of mind.
My wife still laughs about something from the first one.
The prep and recovery area at the local surgical center (same day type of stuff) has a dozen rooms separated by curtains. As I was gradually awakening from the first one I heard somebody pharrrrrrt! long and loud!
Opening one eye I asked my wife, "who was that?"
At the very moment a nurse flung back the curtain and cheerily exclaimed, "We heard that! You can dress and get ready to go now!"
To the young lady's credit, she had the presence of mind now to use my name and thereby announce to the whole suite of waiting and awakening patients who dun it.
My family of origin has cancer on both sides (paternal and maternal), so my conservative doctor wants me on the five year cycle. The pre-procedure prep is an annoyance, but a small price to pay for the peace of mind.
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#33
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At 72 I've now had 3 with anesthesia. Polyps in 2 that tested pre-cancerous so I'm on a 3 year schedule. My wife is a 2 time colon cancer survivor with colon resections each time so I'm not complaining about having these checks done. The alternative is not nice.
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Yup next doctor appointment I’m setting up the same thing I just can’t wait Had a hernia operation in 2015 that was plenty of a violation
#35
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Having it done Monday along with an endoscopy into my stomach. Thinking about asking the doc to take a picture through one scope of the other scope............................
Sunday is the night of a thousand waterfalls, not looking forward to it. Last one was 10 years ago..........
Sunday is the night of a thousand waterfalls, not looking forward to it. Last one was 10 years ago..........
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I've had one colonoscopy without any drugs at all. That one time will be the only time. When they pump the nitrogen in to open it up, the pressure is really uncomfortable. Five more years until my next one. A ten year schedule is fine with me.
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Most endoscopy centers use Versed and Fentanyl for sedation and insufflate the colon with air (not nitrogen). The more "compassionate" programs (modern) will use propofol for sedation (administered by an anesthetist) and use carbon dioxide to inflate the colon. Carbon dioxide is absorbed from the colon about 100x faster than air (oxygen-nitrogen), and and therefore eliminates the gas pain that is common when air is used. Propofol provides for a safer and vastly more comfortable colonoscopy (no pain, no recollection), and clears the body far more rapidly than Fentanyl/Versed so patients wake up quicker and there's no narcotic hangover. For every patient that can have a colonoscopy without sedation, there are about 30 that can't.
#39
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A young friend of mine had colorectal cancer. They removed 9-inches of bowel. After his follow-up colonoscopy he said he was "clean as a whistle...if you're into that sort of thing."
Unfortunately the cancer had spread and after a valiant 5-year battle, he lost.
I miss him.
F**k cancer.
Unfortunately the cancer had spread and after a valiant 5-year battle, he lost.
I miss him.
F**k cancer.
#40
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Most endoscopy centers use Versed and Fentanyl for sedation and insufflate the colon with air (not nitrogen). The more "compassionate" programs (modern) will use propofol for sedation (administered by an anesthetist) and use carbon dioxide to inflate the colon. Carbon dioxide is absorbed from the colon about 100x faster than air (oxygen-nitrogen), and and therefore eliminates the gas pain that is common when air is used. Propofol provides for a safer and vastly more comfortable colonoscopy (no pain, no recollection), and clears the body far more rapidly than Fentanyl/Versed so patients wake up quicker and there's no narcotic hangover. For every patient that can have a colonoscopy without sedation, there are about 30 that can't.
And I considered the preparation to be a challenge - I wanted mine to be the cleanest colon they'd ever scoped. Totally not that bad.
#41
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Yeah I had Propofol, I remember asking the anesthesiologist "When am I going to start feeling sleepy?", and that's the last thing I remember before his waking me up afterwards. It's kind of creepy to know that I might have been conscious and awake during the procedure, but just don't remember it. I don't know what kind of gas they used, but I didn't have much distress afterwards.
And I considered the preparation to be a challenge - I wanted mine to be the cleanest colon they'd ever scoped. Totally not that bad.
And I considered the preparation to be a challenge - I wanted mine to be the cleanest colon they'd ever scoped. Totally not that bad.
#42
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A young friend of mine had colorectal cancer. They removed 9-inches of bowel. After his follow-up colonoscopy he said he was "clean as a whistle...if you're into that sort of thing."
Unfortunately the cancer had spread and after a valiant 5-year battle, he lost.
I miss him.
F**k cancer.
Unfortunately the cancer had spread and after a valiant 5-year battle, he lost.
I miss him.
F**k cancer.
CRC is very curable when caught early, and following proper screening procedures goes a long way to doing that.
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#43
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My SO had it. She had a 50-50 chance of recurrence ... and although it is possible to cure some Stage IV patients, it's quite unlikely. She's 10+ years out so she's probably OK. But I met a lot of people in support groups who did not make it.
CRC is very curable when caught early, and following proper screening procedures goes a long way to doing that.
CRC is very curable when caught early, and following proper screening procedures goes a long way to doing that.
.
Last edited by Cuyuna; 02-27-19 at 02:32 AM.
#44
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Yep ... she was high risk Stage II ... the tumor had gene alleles that were associated with bad outcomes. Scary stuff.
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Yeah I had Propofol, I remember asking the anesthesiologist "When am I going to start feeling sleepy?", and that's the last thing I remember before his waking me up afterwards. It's kind of creepy to know that I might have been conscious and awake during the procedure, but just don't remember it. I don't know what kind of gas they used, but I didn't have much distress afterwards.
And I considered the preparation to be a challenge - I wanted mine to be the cleanest colon they'd ever scoped. Totally not that bad.
And I considered the preparation to be a challenge - I wanted mine to be the cleanest colon they'd ever scoped. Totally not that bad.
#46
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I had my colonoscopy about 3 years ago. No memory of it, however, the "scoper" knows me, the "scopee". I was snowed quite well , thank you. I was also sick for a couple of days after, a low tolerance for drugs of that nature. One tiny polyp removed, not even enough to send for pathology. When I called for the results, the R.N., who I also know, said "good for 5 years". My response, 5 years! It took me 65 years to grow what little I had, in 5 years the backside you see will be mine moving away at speed. That being said I will have my internist do the FIT in a couple of years and see what it show.