TiHabanero

Well, Dr. Thickfinger went up the ol' discharge chute and found nothing more than a few small polyps. Same as last time. This is what I observed while there:

Money, lots of money in this business. 4 docs pumping them out for 8 hours a day. I recommend this as a career field. The place ran like clockwork. Every 15 minutes someone was called into the bowls of the building, and someone was rolled out with a dazed look on their face. Lots of money to be had in this line of work.

Safety in sterilization was the first and foremost thing on my mind. They have machines that sterilize the "wonder hose", but it does make me nervous thinking that some guys inners could be left on that thing as it goes up the ol' wazoo.. Boy oh boy, that thing is really long!!. 4 ft is what they told me. I shudder just thinking about it.

The nurses and docs are very jovial people. I asked if the "wonder hose" was cleaned often enough to protect cross contamination. The response totally dead panned "Every five procedures." I responded in like with "I expected at least every other." We had a good laugh about it. I asked the doc and nurse if they felt like peeping tom's. They just smiled and knocked me out. I took that as a firm "yes".

Fentanyl is unbelievable. I don't smoke, do dope, or drink, but I tell you what I now know why people get addicted to this stuff. I have not slept that good in a decade at least! Wow! Waking up with the headache afterwards is not so nice, but who's complaining after sleeping that soundly. I did tell the nurse to go easy with the stuff. She didn't listen.

Will I do it again, No. I'll be 70 next time around. and I'm not interested in getting to 80. Nor am I interested in the raw bottom from the prep solution!

Stormsedge

LOL...or waste management---good money there too!

canklecat

They use anesthesia for a colonoscopy now? They didn't even give me a tranquilizer the last two I had. It was a little uncomfortable but not bad enough to need to be knocked out.

Hoopdriver

I've had 2 and have done both unsedated. Initially, I wanted to avoid the impact of a day lost due to anesthesia impairment; however I found that the opportunity to watch the procedure on the monitor while discussing with the doc to be rather enlightening. As far as comfort goes, I found the prep process to be the worst part of the whole thing. The actual procedure was mild in comparison with only a few pings of cramping when they used air to inflate. They used carbon dioxide instead of air during my second one because it is absorbed by the tissues so gas build up is avoided, although I did miss that long melodious purge after the first one.

Sedated, you waste the whole day, but you do get a nice nap. Unsedated, you are in and out in the time similar to a barber shop visit + have the opportunity to have a good health-related discussion with the doc.

I think the whole sedation thing is motivated because it generates quite a bit more cash inflow to the treatment facility under the guise of easing patient comfort. I know that a lot of patients are on the wimpy side when it comes to even minor pain; however we all see what this emphasis on "pain" management has done to the country in terms of the opioid crisis.

Biker395 

There may be lots of money in the 'scoping business, but it is a heck of a lot cheaper than colorectal cancer.

I've had two, and the worst part of both was the fasting. I was done and working from home after lunch. Small price to pay for knowing you don't have to worry about one of the big 3 cancers for 10 years. If only there were similarly effective tests for the others.

jppe

Great description and very humorous. Sounds like you had a good report.

I've had quite as few procedures due to a family history of colon cancer plus removing 13 polyps on my first couple scopes. I did wake up towards the end of one of my procedures and watched them "bag" one of the polyps. I recall being awake being pretty uncomfortable but then again I had numerous filings in my teeth without Novocaine while I was younger and was able to tolerate that. I wholeheartedly agree about getting the scopes done. They've even improved the "draino" you drink the day before to make sure there is absolutely nothing left inside of you. I had one earlier this year and didn't have any polyps so they've put me on the 10 year followup, My physician said my last one might just have been the last one I ever have done with Cologuard becoming more common.

Shimagnolo

Are you confusing sigmoidoscopy with colonoscopy?
The former only goes part way up the large intestine, and they use no anesthesia.
The latter goes all the way up and they do use anesthesia

Biker395 

^ I was thinking the same thing.

Sigmoidoscopies are a pretty half-assed (or make that third-assed) solution. The notion is that they are cheaper to perform (a GP can do it), and that there are statistically a higher percentage of cancers that develop in the sigmoid intestine. The problem is, that higher percentage is pretty insignificant, and a great many tumors are found much higher in the large intestine in the transverse and descending colon.

Shimagnolo

Some colonoscopy humor;

First: Dave Barry: A journey into my colon — and yours
https://www.miamiherald.com/living/l...le1928847.html
(He is spot-on describing the flavor of MoviPrep.)

And this:

rumrunn6

best breakfast is after a colonoscopy. at least that's the deal Wifey & I have when we take each other. I have no memory of the drugs, only that I was chatting one minute & waking up the next. sure I had a nap that day after breakfast but was also out raking the snow off my roof later in the day. no memory of a headache. as for the raw bottom, use this combo after every time you "go"

BobG

Heh! ... I call them semi-colonoscopies! ;

Being a rectal cancer survivor I've had many follow up exams. The general surgeon at my local NH hospital uses full anesthesia. My rectal surgeon specialist at a bigger hospital in Portland ME just administers a mild sedative so you are awake during the procedure. He agrees with Hoopdriver. He says that anesthesia is just a money maker for the hospital. That said, I suppose the procedure is safer when the patient doesn't squirm at the wrong time.

Back before Medicare (and Obamacare) I had a huge deductible and would have to pay for most of the colonoscopy. I would always travel to my rectal surgeon to save money.

TiHabanero

I suspect the knock out drug is used to do exactly that, "the procedure is safer when the patient doesn't squirm at the wrong time." I for one don't want complications from me moving one way and the scope moving the other way.

Biker395 

I'm with ya. My SO is a colorectal cancer survivor, and I was her advocate/researcher during treatment. I got to know a lot of other survivors and non/survivors before they passed and a lot more about the subject than I ever wanted to know. CRC is scary stuff, and with adequate screening, much of it unnecessary. We're all presumably 50+ here and have seen and experienced a lot of nasty stuff happen to our friends, family and ourselves. Getting a colonoscopy is in the noise.

rumrunn6

as opposed to? a house call?

BobG

As opposed to the general surgeon at the local hospital who would insist on anesthesia back when I didn't have insurance to pay for it. The out of town rectal surgeon (even though a specialist) would do a colonoscopy for much cheaper with only mild sedation and no expensive anesthesia.

rumrunn6

ah!

canklecat

Yep, my procedures were probably semi-colons. It was 20something years ago, don't recall the details but it wasn't particularly painful. Reminds me, probably time for that again in 2019.

Shimagnolo

Something I just learned about recently: https://en.wikipedia.org/wiki/Virtual_colonoscopy
This sounds great!
No expense or risk of anesthesia.
No risk of a scope perforation.
And you can drive yourself to/from the appt.

Carbonfiberboy 

Our doc doesn't use anesthesia for a full colonoscopy. He prefers the patient semi-conscious so he uses versed, which is a very friendly chemical. I've had several over the years. Because I have polyps, I get one every 3 years. They are no problem at all. Colon cancer is a problem.

Cuyuna

The false positive rate for virtual colonoscopy is about 15%. If read as positive, or if the prep is inadequate and there's too much stool in the colon, then colonoscopy is the next step. At that point, Medicare or your insurance company, which would normally pay for a screening colonoscopy, won't pay because now it's no longer a screening colonoscopy.

Propofol anesthesia for colonoscopy is vastly superior to fentanyl/versed in almost every way, in my extensive experience.

TiHabanero

Received a letter from the doc saying I get to take the same adventure in 6 years. The polyps were pre-cancerous adenomatous type so the monitoring must be more frequent. Thought this was the last one, but I suppose there is one more now. Perhaps by then there will be a better way to clear the bowls out.

Cuyuna

A couple of adenomatous polyps generally means repeat in 5 years unless they were large polyps, very pre-cancerous, or there were several (more than three) in which case 3 years is recommended. The recommendations get a little fuzzier after age 75.

There's no easy way to prep the colon for a colonoscopy.

jimincalif

5teve

AARP's magazine had an article about various tests and procedures and which were worth doing recently. I found their take on this subject interesting. I'm 56, and don't have a family history of cancer so I've stuck with fecal tests so far.

Biker395 

That article is giving very BAD advice. Please talk to your doc instead. Colonoscopies (or equivalent based on risk factors) are now recommended beginning at age 45.

I hope our resident physician chimes in here about that one.