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Old 07-06-2020, 08:35 AM
 
Location: NY>FL>VA>NC>IN
3,451 posts, read 1,384,200 times
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Quote:
Originally Posted by Arya Stark View Post



My experience with GI doctors have all been super bad. Another reason I am hesitant.
Oh yes, I know. After she assumed management of her own case when she moved away to uni at age 18, she ended up with a terrible GI, truly awful. She now has a good one (is in another state and city) and an excellent GP as well but the three years she was under that one guy's care, really sucked.
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Old 07-06-2020, 10:12 AM
 
Location: The Driftless Area, WI
4,729 posts, read 1,969,135 times
Reputation: 11273
A couple points:

They don't use real "anesthesia" for a colonoscopy. They give you Versed, related to Valium and such. It causes amnesia. Virtually no effect on BP, HR or RR(ie- quite safe) You're actually "awake" enough that if they tell you to "roll this way" or "move your leg here," you'll do it. You just don't remember any of it.

Performing a colonoscopy is kinda like crawling thru a long, flimsy plastic bag. It would collapse around you so you can't see where you're going. To prevent that, you blow a lot of air in to keep "the bag" puffed out. That's why the curtains in the recovery rooms are in constant motion and the sound of thunder is everywhere as all the pts expel that excess air afterwards....Without the "twi-light anesthesia," the stretching of the colon by that inflation can be painful-- gas pains on steroids. No good reason not to accept the Versed.

Re: value of stool occult blood test--quite useless. Sensitivity only 50% and specificity not much better at 75%. Just flip a coin-- heads you got cancer, tails you don't. and avoid the mess and bother.
https://www.ncbi.nlm.nih.gov/pmc/art...20respectively.
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Old 07-06-2020, 10:23 AM
 
32 posts, read 17,128 times
Reputation: 131
Quote:
Originally Posted by guidoLaMoto View Post
A couple points:

They don't use real "anesthesia" for a colonoscopy. They give you Versed, related to Valium and such. It causes amnesia. Virtually no effect on BP, HR or RR(ie- quite safe) You're actually "awake" enough that if they tell you to "roll this way" or "move your leg here," you'll do it. You just don't remember any of it.

Performing a colonoscopy is kinda like crawling thru a long, flimsy plastic bag. It would collapse around you so you can't see where you're going. To prevent that, you blow a lot of air in to keep "the bag" puffed out. That's why the curtains in the recovery rooms are in constant motion and the sound of thunder is everywhere as all the pts expel that excess air afterwards....Without the "twi-light anesthesia," the stretching of the colon by that inflation can be painful-- gas pains on steroids. No good reason not to accept the Versed.

Re: value of stool occult blood test--quite useless. Sensitivity only 50% and specificity not much better at 75%. Just flip a coin-- heads you got cancer, tails you don't. and avoid the mess and bother.
https://www.ncbi.nlm.nih.gov/pmc/art...20respectively.
Not true regarding anesthesia. GI drs are routinely using propofol for endo and colonoscopies these days. For endos with FNA they want you OUT and not moving. For colonoscopies, the ease of you being makes the procedure much quicker for them. The downside is no airway. I didn’t like that at all but I got it done.
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Old 07-06-2020, 10:25 AM
 
Location: USA
1,049 posts, read 278,483 times
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No, too risky. The benefits outweigh the alternative, although there's got to be an easier way to prep for the visit to the "Rear Admiral"...
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Old 07-06-2020, 10:34 AM
 
Location: SW Florida
11,510 posts, read 8,362,611 times
Reputation: 17543
Quote:
Originally Posted by guidoLaMoto View Post
A couple points:

They don't use real "anesthesia" for a colonoscopy. They give you Versed, related to Valium and such. It causes amnesia. Virtually no effect on BP, HR or RR(ie- quite safe) You're actually "awake" enough that if they tell you to "roll this way" or "move your leg here," you'll do it. You just don't remember any of it.

Performing a colonoscopy is kinda like crawling thru a long, flimsy plastic bag. It would collapse around you so you can't see where you're going. To prevent that, you blow a lot of air in to keep "the bag" puffed out. That's why the curtains in the recovery rooms are in constant motion and the sound of thunder is everywhere as all the pts expel that excess air afterwards....Without the "twi-light anesthesia," the stretching of the colon by that inflation can be painful-- gas pains on steroids. No good reason not to accept the Versed.

Re: value of stool occult blood test--quite useless. Sensitivity only 50% and specificity not much better at 75%. Just flip a coin-- heads you got cancer, tails you don't. and avoid the mess and bother.
https://www.ncbi.nlm.nih.gov/pmc/art...20respectively.
I'm told it's propofol they mostly use for this type of anesthesia these days. Sometimes fentanyl is added, sometimes it isn't.
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Old 07-06-2020, 10:43 AM
 
3,720 posts, read 1,559,110 times
Reputation: 5775
Quote:
Originally Posted by SarahB60 View Post
Not true regarding anesthesia. GI drs are routinely using propofol for endo and colonoscopies these days. For endos with FNA they want you OUT and not moving. For colonoscopies, the ease of you being makes the procedure much quicker for them. The downside is no airway. I didn’t like that at all but I got it done.
I have guido on ignore but he made a massive error here I hope to correct.

I am NOT having a stool occult blood test- please people try to pay attention. I am having a stool DNA test. It is 92% accurate for colon cancer. This is a new test.

It tests not only for blood in the stool but DNA markers of malignancy and much much more than one. You would think a "doctor" would know that.

https://www.ccalliance.org/screening...hods/stool-dna
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Old 07-06-2020, 10:48 AM
 
32 posts, read 17,128 times
Reputation: 131
Yes I saw that. Cologuard tests for DNA not blood coming from the GI tract. The only thing about Cologuard is doesn’t detect the precancerous polyps (from what I can recall). I had one 2017 and it was negative, but the recent colonoscopy I had found a precancerous polyp.
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Old 07-06-2020, 10:51 AM
 
Location: SW Florida
11,510 posts, read 8,362,611 times
Reputation: 17543
Quote:
Originally Posted by SarahB60 View Post
Not true regarding anesthesia. GI drs are routinely using propofol for endo and colonoscopies these days. For endos with FNA they want you OUT and not moving. For colonoscopies, the ease of you being makes the procedure much quicker for them. The downside is no airway. I didn’t like that at all but I got it done.
From what I've read, and been told that with the "conscious sedation" with propofol and sometimes fentanyl is added, patients aren't put out enough (even when it's deep enough they fall asleep) to affect their ability to breathe on their own.

Patients are also monitored by nurse anesthetists who keep an eye on their vital signs and administer the anesthesia as needed to keep the patient comfortable and get the job done.

As you may have noticed when you had your procedure, they woke you up when they were finished, and maybe after a short length of time where you might have been a little sleepy/groggy/disoriented after the procedure, you were pretty much awake, aware and ready to go. With anesthesia to the point where you need intubation, it takes longer to recover and there may be side effects from the anesthesia.
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Old 07-06-2020, 10:54 AM
 
32 posts, read 17,128 times
Reputation: 131
Quote:
Originally Posted by Travelassie View Post
From what I've read, and been told that with the "conscious sedation" with propofol and sometimes fentanyl is added, patients aren't put out enough (even when it's deep enough they fall asleep) to affect their ability to breathe on their own.

Patients are also monitored by nurse anesthetists who keep an eye on their vital signs and administer the anesthesia as needed to keep the patient comfortable and get the job done.

As you may have noticed when you had your procedure, they woke you up when they were finished, and maybe after a short length of time where you might have been a little sleepy/groggy/disoriented after the procedure, you were pretty much awake, aware and ready to go. With anesthesia to the point where you need intubation, it takes longer to recover and there may be side effects from the anesthesia.
In my case, I had a MD anesthesiologist at the hospital, so I wasn’t 100% freaked out. And I understand all of the inner workings with anesthesia. I don’t like not having an airway. I don’t care how small the amount of anesthesia is. That’s just me though.
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Old 07-06-2020, 11:02 AM
 
190 posts, read 108,823 times
Reputation: 1064
I had a colonoscopy six years ago when I was 60. I'd put it off and finally decided to do it, then was disappointed when the doctor couldn't complete the test due to an unusually twisty colon. He just couldn't maneuver the scope all the way through my kinky guts. He got about 2/3 of the way. He didn't find any problems in what he was able to see and I've never had any significant bowel issues and I have no family history of which I'm aware. He recommended in the future I opt for the DNA stool test first and go from there if any problem is detected that way. Seems sensible. Not sure when I'll do that, maybe when I'm 70, I guess.

The procedure itself was no big deal. The prep is not pleasant, but wasn't any kind of big deal either. I liked the anesthesia.
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