Colonoscopy

[rem223]

I'm 51 and have recently developed constipation alternating with diarrhea; and as if this wasn't gross enough I have occasional rectal bleeding, dark not bright red.  Otherwise, no health concerns.  I just had my annual job physical and the doc said that I had a positive hemocult test, but she though that this could be hemmorhoids.  I work in a university-affiliated hospital, so getting any tests is easy.  The doc doing my physical recommended a colonoscopy; which I scheduled but when they found out that I had a bad (really bad) reaction to Versed during dental surgery they had me reschedule with a CRNA for diprivan instead of Versed.  This wasn't possible because I'm allergic to eggs (therefore allergic to propofol).  I don't want sedation after reading an article in the Wall Street Journal that stated that patients who did unsedated colonoscopy actually preferred it.  The CRNA  told me that GI had a lot of complaints with Versed and tried to sell me on the merits of propofol (diprivan), that is until she realized on the day of test #2 that I'm allergic to eggs.  Again, I don't want sedation, but GI says it's "required".  So no test.  Then after a month, I end up going to the ER with nausea/bleeding/anemia and then GI tells me that indeed colonoscopy can be done without sedation and that they do them unsedated when required.  The problem is that the same doctor that told me that sedation is absolutely reuired a month ago is now telling me that it really isn't required.  This would be fine, but now I don't trust her, especially when the procedural consent includes a consent for sedation.  I'm afraid that they will screw it up.  Can I moify the consent to say "no sedation"?  I asked Gi and all they will tell me is to do the prep and get yourself in here for a colonoscopy or we will come and get you, since I work on the same floor of the hospital....  Am I being obsessive?  Thanks.

[rem223]

Thanks again for the support; you have been through so much and I really appreciate the fact that you took time to share it with me.  Before I read your response, I had decided against the colonoscopy even though my recent ER visit indicated significant blood loss (I just read the labs and they were pretty bad).  The 2 exams that I watched (live) were fairly brutal; the GI doc told me that most aren't that bad...hardly reassuring; even the best anesthesia option (propofol/diprivan) does't seem like it's worth the risk.   In the ER, I ran into a doc whom I know and related my problem  Long story short, she said that you either get the exam tomorrow or get admitted tonight and have the exam tomorrow as an inpatient.  Still, until I had read your response, I was not going to get the colonoscopy; you definately convinced me!  I just finished the prep (not that bad) and showtime  is tomorrow 0730, no sedation and that's just what I wanted.  I just got off the phone with the GI lab (didn't know that they worked on Sunday); they got my labs and want me to come in to be admitted tonight for volume replacement and possibly some last minute prep tomorrow morning because of the bleeding (no big deal).  So, one way or another, I will have this test done by this time tomorrow.  Thanks mammo!  I wish that I could thank you more eloquently for your support, but I really don't feel too great right now.  Thanks again, my gratitude is heartfelt.

[mammo]

I spoke to my son about you, and he has done so much research on sedation and colonoscopies.  He told me which one you could use with no ill effects at all.  But let me tell you, if you are having rectal bleeding, and are fainting and having dizzy spells, you sound anemic, and this is from the blood loss. I lost my brother-in-law at 38 to colon cancer and my my husband when he was 32 to colon cancer, and we had 3 babies.  This is when I learned that FAP a heriditary colon cancer was in our family.  My 3 kids had to start having colonoscopies as kids every year!  It was heart wrenching for me.  My youngest son was diagnosed with the disease at 12, and have to have his entire colon removed.  This disease doesn't end with this surgery, there are many other things that can happen.  Today he is 38, a marathoner,ultrathoner,mountain biker, speed hiker ( which puts out in the middle of nowhere for weeks at a time alone),and he is competing in this summer's ProAm games for jujitsu.  He has polyps in his duodenum and gets yearly endoscopies, and colonoscopies of his rectum.  My eldest son was diagnosed at 16, and had his colon removed, but didn't fare as well.  He was okay for a few years, married and had 2 little boys. Then his problems started over, and he went thru pure hell!  His story is very long, and sounds more like something out of a science ficition movie, so I won't share it now.  But he endured so many surgeries, we lost count, but he kept fighting, for just one more day with his boys, and all of us who loved him dearly.  He had developed a large Desmoid tumor, which was crushing all his internal organs. My son lost his battle when he was only 31, leaving behind 2 very sad little boys, and a family. It will be 10 years on the 23rd of this month.  His boys were 6 and 9 and the oldest had just started having his scopes (they usually start at 10).  Just one year after he lost his dad, his buddy, he was diagnosed with the disease.  Not even enough time to come to terms with having lost his dad.  He had his colon removed, but due to complications, was in the hospital for 3 months.  Then he was doing very well until his stomach started swelling, he was diagnosed with having a Desmoid tumor also.  They were able to remove it but he was dying, 16 years old and dealing with knowing he was dying!  With only 10 days to live, a set of 5 organs came for him, he started crying.  His mom asked him why and he said "I didn't think they would come."  Then he cried on the way to the hopsital asking his mom "do you think the doctors will get them in me in time?"  He died 4 times during surgery, suffered Stage II organ rejection, and had to remain in their apartment for one year (fear of infection) and could not eat anything by mouth for one year.  He was on TPN where he hooked up to IV feedings at night while he slept, just like he watched his dad do every night. Last summer he was doing very well, a typical teenage boy, with plans and dreams for his future.  He wasn't allowed to drive per Dr's orders, but we had a car for him and he was anxious to drive it.  He only had one surgery to go, and this was to remove his colostomy and ileostomy bags, and this would have been his 39th surgery! His surgeon wanted to wait until after Thanksgiving so that Jeff could enjoy his dinner, as he was not allowed to eat any the previous year. This would still allow him time to heal and graduate with his class last month. We were very close, and spent lots of time together, and were always calling each other.  At the end of November '08, I got a call from him, and he was extremely down.  He said he was really missing his dad and wished he were here to just toss a football with him.  We spoke for about 40 minutes making plans to go Christmas shopping the following week.  As we were about to hang up he said "I love you grandma, and I said "I love you too sweetie."  We never got to go shopping.  Just a couple of days later he started vomiting blood, both his bags filled with blood, and he passed out.  He was rushed to the hopsital wher he died, on Dec. 1, 2008, he had bled to death at the young age of 18.  They had to do an autopsy  to determine what had gone wrong, I chose not to here the results.  I want to remember his smile that lit up a room and my heart, and his last words to me.  I cannot take hearing of anymore of his suffering.  His younger brother is still unable to sleep in the bedroom they shared, and his sobbings at night wake his mom.  He watched his dad suffer and die, and now his big brother, his best friend.  He has to live with the fact that he too, may have the disease, and only time will tell.  As I told my grandson good-bye, I said "heads up sweetie, your dad just threw the ball..... So, for all of us who saw what they endured, and still found a reason to fight for one more day on this earth, gives us strength.  When having a procedure or any type of surgery, we think of what they endured, and feel a little ashamed that we aren't as brave.  Not only have I experienced a lot with all the scopes, I also worked for 2 GI doctors, and know how safe they are, and well worth having.  I know it's good to keep researching things on our health, but keeping an open mind allows one to not get too caught up in a few bad experiences we read about.  I have learned far more about FAP than I want to know, but it is this knowledge that will keep my remainig 2 grandsons safe.  Please, get your colonoscopy ASAP.  You're going to have to get one eventually, so why not now and head off something before it becomes serious, or put your mind at ease.  Either way you win! Look at all my family have had, and a lot were done back before they perfected it and the anesthesia.  You're too big a man not to face this fear, and I think what you are truly afraid of is the unknown, as we all are.  But it is the unknown that can kill us.  Just go for it, and I will promise you that I will be hearing back from you saying ..mammo you were right, it was a big nothing. Watching videos of scopes is not wrong, I have witnessed several while working for the 2 GI docs, and they were all uneventful.  I think this doctor should have reassured you that you will do fine, and not to worry.  I would not be encouraging you to do something if I had seen, experienced, or knew of anyone who had a bad experience with one.  Plus, I know first hand the benefits resulting from early diagnoses.  It's either now or later, why don't you make this decision before your body demands it?  If you would like, I could give you my son's email so that you could talk to him, he knows about you and is always ready to help. Please don't give up on you and a life, and put your mind at ease.

[rem223]

Thanks-I just got back from the ER, damned fainting spell and anemia; didn't have the courage to mention the rectal bleeding...........there are time when I wish that I didn't know anything about colonoscopy; after watching 2, I doubt that I will ever get one....the gastro doc told me that watching these was a mistake...

[mammo]

Thank you.  Stay on top of your health since you lost your dad at an early age to colon cancer.  

You too, have a wonderful weekend.

[rem223]

Thanks for your support and I'm sorry to hear about your loss.  My dad died from colon cancer at a young age, way too young.   Your comment about keeping an open mind is important as well as getting as much info as possible.  The GI doc in my hospital must have got tired of my colonoscopy question since she let me watch several in the GI lab.  Now I know why so many people hate Versed for conscious sedation.  Amnesia or not, that patient's screaming bothers me.  Have a good weekend,

[mammo]

I'm so pleased to see someone being pro-active with their health!  Not just taking a doctor's word, as gospel.  I had a son that had his colon removed at 12 and is a healthy 38 year old today.  His older brother had to have his removed at 16 (they both had inherited FAP which had taken their father when they were very young).  The sixteen year old was doing fine, but developed some pain in his abdomen.  I took him to see his surgeon, who said he felt it was scar tissue and that he should learn to live with it. But....if we wanted them "to go in and take a look around" they would.  They left this decision totally up to us as his parents.  We opted for the surgery, which revealed a very large Desmoid Tumor that was crushing his major organs.  We lost him soon after.  So, I am a big advocate of second opinions and educating yourself on any procedure, medication, illnesses.  You have to remain open minded, but it arms you with the knowledge to ask all the correct questions, and get answers, and make some choices of your own as you are doing!  Best of luck to you!

[rem223]

Thanks for the comments.  I'm learning a lot more about colonoscopy "sedation" than I ever knew existed.  I watched several being done with Versed and with diprivan (propofol); the patient is usually awake but does not remember the exam.  The one that I saw done with Versed was brutal; the poor patient screamed her head off and they ignored her cries.  She's a nurse whom I know; sure enough she didn't remember the exam immediately afterwards, but now a week later, she is an emotional wreck from the creepy partial amnesia.   The patient who had propofol did a little better, but they had to support his breathing because the drug put him into respiratory depression for a short while.  He works in our lab and his jaw was bruised from the jaw-thrusts that they had to perform to keep his airway open.   Colonoscopy sedation is obviously no bargain.

[mammo]

No, you have every right to be concerned.  Your doctor sounds wishy washy, and this would concern me.  My son has to undergo colonoscopies yearly, and is also allergic to eggs, so he always has had his done awake.  He is now 38, but when he was young, we were told that it was best to not sedate him, as they needed to know if he is feeling  any discomfort, as they could perforate the bowel.  This has since changed and they seem to sedate everyone, but my son has his done without sedation.  I would not agree to the test until you sign a "no sedation" form, (get a copy for yourself at the same time) and get your other form "allowing sedation" back from them.  If you, and they have this in writing, they will not waver from it, but if not in writing, you have no recourse.  As they say "cover your ...!" Pardon the pun.  Best of luck to you.