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Old 06-05-2016, 02:20 PM
 
Location: Georgia, USA
30,493 posts, read 32,896,111 times
Reputation: 37736

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Quote:
Originally Posted by chiluvr1228 View Post
Constipation in itself does not cause bleeding, however pushing to try and go to the bathroom can and does cause hemorrhoids or fissures which can bleed.I think it is more than just wanting the fees, however colonoscopies are a big money maker for gastro doctors; it's also a matter of doctors wanting to cover their azzes so they don't get sued; THAT is the big reason for a lot of unnecessary tests.
Screening colonoscopies save lives. That is why they are recommended. In the long run, they save money. If they were not cost effective, they would not be offered. If someone does not want to be screened, he declines the procedure and the it is documented in his health record. That is all the "azz" covering that is needed.

A cancer can also narrow the colon, making it hard to eliminate stool, which causes the cancer to bleed, which can be interpreted as simple constipation when it is not.

OP's mom would not be having a screening colonoscopy. Because she has symptoms the only way to know whether or not she has a cancer or hemorrhoids is to take a look. The colonoscopy would be for diagnosis, not screening.

Quote:
Originally Posted by Leaving4Ca View Post
ACTUALLY my Mom had osteoporosis and was unable lie completely flat in the MRI bed. I heard her screaming -- I was in the room--- insisted for the manager of the clinic to come, we stopped several times before actually starting the MRI. The techs kept trying to straighten her out... Seriously this happened, in Metro DC. The *only* reason I permitted them to proceed was because her doctor at the time insisted it was necessary. Yeah, right. At 92.

I certainly DO understand everything that my Mom went through. I was there and in communication with the doctors constantly. Take my post for the brief outline it was, because I'm not going into MORE of the entire story on this page.
Then the techs were in the wrong. But you did not tell us that earlier, did you?

You may have talked to the doctors, but from what you you've said they failed to communicate with you. Talking does not always mean everything is being understood.

Why did you not take the advice to forgo a feeding tube? Why did you leave her in a nursing home that did not take proper care of her?

I understand how difficult it is when a parent requires skilled nursing care. It happened to my mother, who was bedridden for over three years after having strokes. She had a feeding tube because we thought she would regain the ability to swallow, but that did not happen. She was never allowed to lie in her own excrement and she never had a bedsore because she was re-positioned every two hours around the clock - and I visited regularly at various times of the day and night to check up on her. I would never have allowed her needs to be ignored. If it happened, I would take it up with the administrator of the nursing home. If it continued I would move her and report the home to the authorities.

What you cannot do is use your experience to announce that the only reason colonoscopies are done is for the fees. It's not true.
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Old 06-05-2016, 02:46 PM
 
3,563 posts, read 2,988,112 times
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It isn't clear from OP's first post if the stool sample her mom gave had frank blood in it (i.e., red or black blood that was visible) or if the doc did a Hemoccult test in the office, or what. It also isn't clear just how ill her mom is, and that is a relevant piece of information.

If Mom was my patient and was fussing about doing a colonoscopy, I would probably do a FIT test (or repeat it) after she was on some Colace and/or Miralax to help with the constipation. (And yes, constipation CAN cause bleeding, mainly from hemorrhoids, but also by causing an anal fissure.) Depending on those results AND depending on how sick she was, we would go from there. As in, sit her down and discuss the risks and benefits of the test, LISTEN to her objections to taking the test and try to figure a reasonable solution, etc. (By the way, doing a split prep is becoming more common, and is certainly easier on the patient. Splitting doses: A good strategy for colonoscopy preparation? - Mayo Clinic)

If Mom is extremely ill and her expected lifespan is only another year or two, it's an entirely different conversation than if she has an expected lifespan of 5 years or 10 years or more.

Bottom line is that it is her choice, once she has the information. I have had patients refuse colonoscopies for all kinds of reasons. Some say they would not have surgery if they were found to have colon cancer, so what is the point, they ask. Once we have the conversation, I don't browbeat them into having the test. Sometimes they change their mind; often they do not. For SCREENING purposes (not diagnostic), I always offer the FIT test for anyone that declines a colonoscopy. The evidence is mounting that for screening purposes, the FIT test is excellent.
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Old 06-05-2016, 03:03 PM
 
8,824 posts, read 2,918,808 times
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I didn't read all the replies, but I hope that someone here has pointed out that there are alternatives to a standard colonoscopy.
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Old 06-05-2016, 03:10 PM
 
Location: Georgia, USA
30,493 posts, read 32,896,111 times
Reputation: 37736
Quote:
Originally Posted by LoriNJ View Post
It isn't clear from OP's first post if the stool sample her mom gave had frank blood in it (i.e., red or black blood that was visible) or if the doc did a Hemoccult test in the office, or what. It also isn't clear just how ill her mom is, and that is a relevant piece of information.

If Mom was my patient and was fussing about doing a colonoscopy, I would probably do a FIT test (or repeat it) after she was on some Colace and/or Miralax to help with the constipation. (And yes, constipation CAN cause bleeding, mainly from hemorrhoids, but also by causing an anal fissure.) Depending on those results AND depending on how sick she was, we would go from there. As in, sit her down and discuss the risks and benefits of the test, LISTEN to her objections to taking the test and try to figure a reasonable solution, etc. (By the way, doing a split prep is becoming more common, and is certainly easier on the patient. Splitting doses: A good strategy for colonoscopy preparation? - Mayo Clinic)

If Mom is extremely ill and her expected lifespan is only another year or two, it's an entirely different conversation than if she has an expected lifespan of 5 years or 10 years or more.

Bottom line is that it is her choice, once she has the information. I have had patients refuse colonoscopies for all kinds of reasons. Some say they would not have surgery if they were found to have colon cancer, so what is the point, they ask. Once we have the conversation, I don't browbeat them into having the test. Sometimes they change their mind; often they do not. For SCREENING purposes (not diagnostic), I always offer the FIT test for anyone that declines a colonoscopy. The evidence is mounting that for screening purposes, the FIT test is excellent.
Doing a FIT test would not be helpful. The Mom in the OP has had frank rectal bleeding and a positive stool test of some sort. A negative FIT at this point would not mean anything. A polyp or cancer may not bleed all the time. One positive stool test is all that is needed to prompt further testing even in the absence of frank bleeding.

The OP said

Quote:
... my mother suffers from constipation and prior to giving the stool sample she forced herself to go which caused her to bleed quite a bit
Her colonoscopy is diagnostic, not screening. The assumption that the bleeding was due to straining cannot be proven without further evaluation.

Yes, her choice needs to be informed, but she needs to know the risk of missing a cancer and be sure she wants to take it.

Quote:
Originally Posted by Clarallel View Post
I didn't read all the replies, but I hope that someone here has pointed out that there are alternatives to a standard colonoscopy.
Yes, but even some of those require a prep. Further screening tests are not indicated. The patient now needs a diagnosis.

Last edited by suzy_q2010; 06-05-2016 at 03:19 PM..
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Old 06-05-2016, 04:12 PM
 
Location: San Antonio
7,629 posts, read 15,023,467 times
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My mother died at 86 and NEVER had one...just refused. Her right, her body (and she died of old age, not cancer).

I HONESTLY think that sometimes we THINK we are doing right by them, but are forcing them into something they are not interested in is a violation of their ability to make decisions for themselves.

IF they find CA, there is nothing to say she would be willing to undergo surgery/chemo or any other type of treatment, so love her, honor her wishes and be grateful for each day you have to enjoy being with her.
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Old 06-05-2016, 05:36 PM
 
4,948 posts, read 17,325,612 times
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Quote:
Originally Posted by Caltovegas View Post
I can't imagine an elderly person doing the bathroom run the night before.
I just did start the prep around 4 pm and was in bed at 10 pm. What I did was eat light a few days b4
so I was done early. The question did I want to do it no but glad I did-
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Old 06-05-2016, 06:26 PM
 
Location: Las Vegas
14,188 posts, read 27,013,156 times
Reputation: 27434
Quote:
Originally Posted by gentlearts View Post
If OPs mother won't participate in the prep, they won't do the procedure. It sounds like she won't, so leave her alone.

If she were a fit and otherwise healthy 77 year old, I'd say she should continue have the procedure a few more times. You make it sound as if she has never had a colonoscopy before, so maybe she doesn't understand that it is a painless, spa-like procedure...nothing to be afraid of.
UMMMM...no. Spa-like????
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Old 06-05-2016, 06:44 PM
 
Location: Southern California
28,796 posts, read 11,587,641 times
Reputation: 18462
I will be 78 this year and NEVER had one and probably won't if I have control of my decision...my body. I had some blood years ago and think it was from hemmroids and in recent years no blood...I take more magnesium and Vit C and keep things moving very smoothly. Taking coconut oil daily helps me too. MANY of my friends never had them and some who have, have stopped.

Years ago my daughter made up stories about her friend's mother who as I remember had BC and found it due to mamms. My daughter knew I did not do mamms but she did her best to put fear in me to have them...I had 2 in my early 50's and none since. Now today at 52, my daughter does no more mamms.

My mom died at 91 and she never had one, nor mamms.... we live in a modern medical world of tests tests tests.
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Old 06-05-2016, 09:09 PM
 
16,306 posts, read 15,204,251 times
Reputation: 11669
and if you do have a colonoscopy, always always always schedule it the very first time slot of the day
because yes there is a very real problem with the equipment being clean

i have worked in hospital settings for over a decade, and it is the clinical staff and sterilization techs at every place i've worked that say this over and over and over
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Old 06-05-2016, 09:34 PM
 
Location: Omaha, Nebraska
9,254 posts, read 5,504,635 times
Reputation: 24244
Quote:
Originally Posted by lenora View Post
I started a low residue diet a week before the colonoscopy, mostly liquid two days before and the Miralax in Gatoraid + dulcolax the day before. Did you drink the Miralax in Gatoraid + dulcolax tabs two days before the procedure ?
Yes, I started the prep on Saturday afternoon. That way I had a day and a half to drink the prep mix. I found that spacing it out that way made it easier to get all down, and gave me enough time to drink enough other fluids to stay reasonably hydrated. I can't say for sure if that would work for you, but it might be worth a try.
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