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Old 09-27-12, 10:15 AM
  #1  
Yen
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Another Colonoscopy thread

My husband had a routine colonoscopy (the results were normal except for a very few diverticuli in the lower descending colon). A week later, he was in the ER with a small-bowel obstruction several inches above where the small intestines join the colon. Long story short, the obstruction resolved on its own and he was released 4 days later when he was able to tolerate liquids and the doctor was certain he would not need surgery. The doctor believes the obstruction was actually a kink in the small intestine, and once it was emptied and allowed to relax without any more food or drink going in, the kink resolved on its own. Back home, he tolerated easily-digestible foods very well (yogurt smoothies, V8-like vegetable juice, pureed lentil soup), and now is back to eating regular foods making wise choices and eating smaller portions, and doing very well.

It would be nice if they gave him written discharge instructions to read at home after all the sedation has worn off, including Do's and Don'ts and suggestions of foods to eat and avoid the first 1-2 days, and an explanation of why. That could prevent a week in the hospital, tons of radiation, painful tube down the throat, morphine, exposure to germs, and even surgery and all the complications that can follow that.

So, this message contains a warning and some questions:

WARNING: Eat light, avoid heavy foods, and do a lot of walking around when you get home.

Questions: Were any of you sent home with written instructions? Is this complication more common in people with IBS (even a "mild" case like his)?
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Old 09-27-12, 11:31 AM
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Absolutely! He should've had these in written instructions. You can't trust the memory of a patient coming out of the twilight meds. I believe those were the instructions(spoken and written) I had as well about a meal and maybe the walking. I don't think I completely came out of the haze until the next morning--I had to report by 8 AM. Don't have IBS and didn't have any complications from my procedure in June, 2011.
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Old 09-27-12, 11:38 AM
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"Were any of you sent home with written instructions?" Well, I don't know. I don't remember leaving the clinic, or much of the rest of the day.
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Old 09-27-12, 11:43 AM
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Yen, I'm glad that your husband's condition relieved itself, but am a bit non-plussed by the lack of written instructions. Verbal guidance would be quickly forgotten after one comes ouf from those medications.

My gastroenterologist gives me written and verbal instructions upon discharge. They're not in front of me now, but I recall that they warned not to make any "financial or legal decisions" for 24 hours. Who knows, I could've decided to marry a ham sandwich down at city hall the way I was feeling after coming to...

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Old 09-27-12, 11:51 AM
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I have had the procedure 3 times and have had IBS bouts but very rarely over the last 15 years.

I never had any written instructions that I can remember and have been told to go get some lunch or breakfast depending on the time of day. I have normally done that and after the fasting and preps have been quite hungry. I normally have craved soft foods after so that could be a good thing. By the time I get home the meds that counteract the meds that put you to sleep must be wearing off because every time I have slept a good 4 hours after eating.

I haven’t had any problems but really appreciate your bringing up this question because it is very logical to refill your digestive slowly and carefully, and move about to help the process.

Sorry to hear about the trouble he had with his and your advice I hope will help someone else. I also encourage anyone that hasn’t had one that’s in the target age range to go get one done. I won’t say it’s fun to go thru but it’s not that bad and the peace of mind it brings is a great feeling.
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Old 09-27-12, 12:16 PM
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I wasn't sent home with any written instructions, but the hospital wouldn't do the procedure unless I had another adult with me for the post-procedure consultation and, needless to say, the drive home. So my wife told me later on at home what the doctor told me earlier at the hospital. Our roles were reversed when it was her turn.
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Old 09-27-12, 12:42 PM
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Producing written instructions, especially in every possible foreign language, costs money and someone has to be paid to do it. I had to sign an agreement that I would be with him and take him home. I repeated the instructions throughout the day.

What's most important is that he survived the ordeal and both of us learned a lot. And banana yogurt smoothies with chocolate syrup are really tasty.

I may submit a suggestion to the hospital for written instructions to go home with the patient. It could prevent a lot of unnecessary pain and suffering, or worse.
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Old 09-27-12, 12:49 PM
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Leave the details to the people that do it every day. You wouldn't want some Dr. coming to your place of work telling you how to do it or writing you a letter telling you how to do it, would you?
I know you feel you "were wronged" and feel you might be "helping" but think about if some wrote you a letter telling you how to do your job.
Best thing is to see the Dr or nurse in person and NICELY suggest something. Nothing worse than a non-professional trying to tell someone how to do their job.
With that said I'd bet in the instructions for the procedure you got BEFORE it, there are instructions on what to do after. Also, I'd think it would be kind of common-sensical not to eat a steak dinner and go lay around afterward. I'd start myself out on some liquids and something light.
We've all had food poisoning before. Never once did I think of writing a letter to a restaurant, describing how to prepare, store, and serve their food.

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Old 09-27-12, 01:04 PM
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Originally Posted by Spoke
"Were any of you sent home with written instructions?" Well, I don't know. I don't remember leaving the clinic, or much of the rest of the day.
Having had a number of colonscopies and other procedures I can say I was always discharged with written instructions, generally computer generated, before I left. I guess it depends on the facilities but I've had the procedures done at several and each time i was given instructions... you sure your husband didn't just throw them away?
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Old 09-27-12, 01:33 PM
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I've had similar issues (doing fine now, thanks), and I did get written instructions. He should have, too--but it occurs to me that he's an adult, the instructions aren't that complicated and apparently he didn't follow them anyway. At some point he, and you, have to take responsibility for his health. If you need instructions, call the doctor's office and ask for them.
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Old 09-27-12, 01:37 PM
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Originally Posted by Pamestique
Having had a number of colonscopies and other procedures I can say I was always discharged with written instructions, generally computer generated, before I left. I guess it depends on the facilities but I've had the procedures done at several and each time i was given instructions... you sure your husband didn't just throw them away?
I've had two, and each time I was given discharge instructions. Most of which dealt with the effects of the anesthetic used. I highly doubt that what happened to the OP's husband was in any way related to the size of the meal he ate. More likely it was caused by a ham-fisted gastroenterologist who screwed up a routine procedure.
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Old 09-27-12, 01:40 PM
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Yen, I have to agree with Velo Dog here. You admit to being there when the instructions were given. You were the responsible party for your husband. Why didn't you ensure he followed the instructions?

I am sure everyone is sympathetic to the problems your husband incurred and your concerns for his health, but surely you've got a hand in the responsibility stakes, too. Perhaps the attending nurse didn't think there was a need to issue written instructions because you were there for the admonishment (which, I am sure, is the wrong word, but still...).
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Old 09-27-12, 01:43 PM
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I don't remember getting any written instructions; my daughter had all of the paperwork. I did read all of the pre-procedure instructions carefully beforehand so it might be good to include the post-procedure instructions ahead of time.
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Old 09-27-12, 02:55 PM
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I got written prep instructions before the procedure along with discharge orders all before the procedure. My wife had to sign a form stating she was driving me home and the post procedure instructions were included with those papers as well.

Mexican Vanilla ice cream tastes awesome after fasting for 24 hours too!
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Old 09-27-12, 03:56 PM
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Originally Posted by Rowan
Yen, I have to agree with Velo Dog here. You admit to being there when the instructions were given. You were the responsible party for your husband. Why didn't you ensure he followed the instructions?

I am sure everyone is sympathetic to the problems your husband incurred and your concerns for his health, but surely you've got a hand in the responsibility stakes, too. Perhaps the attending nurse didn't think there was a need to issue written instructions because you were there for the admonishment (which, I am sure, is the wrong word, but still...).
We can't force adults to do what they ought to do. Even the best doctor or nurse can give the best advice, but it's up to the patient to choose to follow it. As his wife, I do assume responsibility for his health which is why I spent all day and all night at the hospital at his side, walking with him around the unit during the night, suctioning his NG tube at the bedside for hours while my back ached, losing a lot of sleep and eating little, asking questions, and praising and helping the nurses to give them relief -- all the while keeping a watchful eye over his care.

I don't blame the hospital; I agree that a patient and patient's family assume ultimate responsibility. I'm really only curious, and I have nothing but praise for all the personnel, nurses, doctors, and other staff who went out of their way. I'm not the type of person who expects royal treatment, but that's what we got.

I just now looked over the paperwork again and the only mention of after-care is "unless told otherwise" he may resume normal diet that day and usual activity the next day.

If I send a letter it would be a friendly tone and include abundant praise for everything done right, and finish with a comment that written instructions might help some patients who won't recall later after the sedation wears off.
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Old 09-27-12, 04:19 PM
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The only instructions I was given were no driving or cycling for a day.
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Old 09-27-12, 05:12 PM
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A poor system for post-procedure care?

Reading this thread I see that other folks had problems AFTER the colonoscopy that indicate room for improvement at the medical center. The anesthetic drug (fentanyl) knocked me completely out in seconds. In my lay opinion I was encouraged by staff to just go home, the faster the better. I was still drugged (fentanyl, too much and you're dead), I was totally dehydrated and hungry as hell. So I fainted on the living room floor, my friend called 911, my heart was beating 40 instead of normal 50, they took me to the ER. After the fentanyl wore off and I had several bags of fluid dripping into me I got sober and fed up and signed myself out against the wishes of that young doctor. Medicare took it on the chin because the post colonoscopy care was non-existent in my opinion. Of course being drugged on my ass may have clouded my judgement of the day.
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Old 09-27-12, 05:59 PM
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Originally Posted by Yen
My husband had a routine colonoscopy (the results were normal except for a very few diverticuli in the lower descending colon). A week later, he was in the ER with a small-bowel obstruction several inches above where the small intestines join the colon.
It seems unlikely that the obstruction was due to something he ate a week earlier. Could be just a coincidence or perhaps the colonoscopy irritated the bowel causing some spasms. In any case I don't think what he ate was the issue.

I recall getting a pamphlet with the prep instructions and it had some info on getting home after the procedure. I don't recall if it had instructions on what to eat but I just ate normal meals.

Given your hubby ignored the nurses and your instructions I don't see how having the instructions on paper would have changed his behaviour.
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Old 09-27-12, 07:08 PM
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Glad for your husband and family that everything worked out in the end.
My father died of colon cancer, and my brother had surgery for a kink in his intestine so your story struck a cord with me.
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Old 09-27-12, 07:32 PM
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I just pulled out the paperwork that was given to my daughter.

Patient instructions: Do not operate vehicles, dangerous machinery, or do anything requiring judgement or coordination until tomorrow. Rest today. Call your physician if any of the following occur: sever pain, rise in your temperature, excessive bleeding, unable to urinate for 6 hours.

No mention of what food to eat or walking. We got hamburgers at the nearest fast food place because I was starving. When we got home I took a nap.
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Old 09-27-12, 08:29 PM
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Written discharge instructions after a procedure with sedation is best practice and safest practice and should be the standard everywhere.
That said, I don't believe there are one-size-fits-all instructions regarding eating after a colonoscopy.

Hospitals should and, generally, do appreciate feedback about the care given to customers.
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Old 09-27-12, 08:40 PM
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This thread makes my buttocks sore.
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Old 09-27-12, 09:22 PM
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Wife was irritated with me after my release from the colonoscopy, apparently I asked her about five or six times what the doctor said in the 15 minute drive home. I had written instructions stating do not drive, operate equipment or make any critical decisions until the next day. Went home and slept all afternoon, meds really mess with your mind.
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Old 09-28-12, 06:10 AM
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Originally Posted by El Segundo
Wife was irritated with me after my release from the colonoscopy, apparently I asked her about five or six times what the doctor said in the 15 minute drive home. I had written instructions stating do not drive, operate equipment or make any critical decisions until the next day. Went home and slept all afternoon, meds really mess with your mind.
I did the same thing! The wife didn't get annoyed, actually laughed, that I asked several times the same question.
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Old 09-28-12, 08:21 PM
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Yen, sorry to hear about the complications your husband had.

I had a routine colonoscopy on Friday morning, sept 14th. The hospital gave me written instructions for before and after the procedure the week before when I registered.

After my colonoscopy on the 14th I was back at a different hospital that same day at 4pm to register, lab tests and to give blood for inguinal surgery on sept 18th.

On tuesday sept 18th I had inguinal hernia surgery and was back for a full day of work on Friday three days after surgery. Worked a normal 50 hour week this week. Next Wednesday I see the surgeon and hope to get clearance to ride my bike again. Feeling like I could do an easy ride now, but will wait for clearance from the doctor.

For both hospital visits (two different doctors and hospitals) I was given specific instructions of what to do before and after the procedure. Since I now live alone (widower) I followed those instructions to a 'T'.

Guess I was lucky, no complications here!
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