Two months ago after having a 24 hour urine it was determined that I may have a carcinoid tumor. At that time the 5HIAA was 9.5. After seeing a gastroenterologist several other test have been done. The chromogranin A is 150. I've has a CT scan with contrast of the chest, abdomen and pelvis areas which showed no evidence of a mass. An octreotide scan was also done - also no evidence of any mass. Once again I had a 24 hour urine done - this time the 5HIAA was 3.0.
Throughout all this I've experienced episodes of flushing, a very uncomfortable and painful feeling of pins and needles and sometimes a rapid heartbeat.
I've been scheduled for a colonoscopy and endoscopy. I'm concerned about the anesthesia for this procedure. Although it is considered "twilight anesthesia" being used - should I have any prior preparation before receiving it? I've read that sometimes a carcinoid crisis occurs when anesthesia is given to patients.
Lastly, why are these carcinoid tumors so difficult to find? How worried should I be?
I agree with the workup for the possible carcinoid syndrome.
The anesthesia for an upper and lower endoscopy is known as conscious sedation. It doesn't totally make patients unconscious - although in some cases, patients can fall asleep from the medications - and some patients will remain awake, if not groggy.
Typically, the preparation would include not eating or drinking prior to the procedure, as per your doctor's instructions.
Yes, carcinoid tumors can be difficult to find. I agree with the tests done thus far, and indeed, the upper and lower endoscopies are a reasonable next step.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin Pho, M.D.
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