Colonscopy...won't say "never again" but..probably never again

allnurses Guide · Aug 7, 2013

Scopes are not pleasant in many ways. They do, however, save lives.

I almost always write for MoviPrep because the cost is balanced by a better prep and a overall safer profile for older and chronically ill population.

MAC is normally fairly well tolerated, sorry yours wasn't. Did a CRNA do it?

Hope you feel better and you'll be cleared for another 10 years! Keep fingers crossed VC will be SoC by then!

brownbook · Aug 8, 2013

Sorry, I am sure you feel bad. Maybe just want to vent. However I think your experience was one of those one in a million reactions. We do many colonoscopies a week and call all our patients the next day, 99% say they feel fine.

I have had two for routine screenings, the first one was fine. The second one I just felt weak, tired, the day of the procedure but was fine by the evening. Honestly I think it was partially my fault I felt so weak, I hadn't drunk much clear liquids the day before.

You think you feel bad three days after the procedure. Think how you would feel undergoing treatment for colon cancer?

OCNRN63, RN · Aug 11, 2013

I live in an area with a large Amish/Mennonite population. A lot of them don't have sedation for colonoscopies or EGDs.

Just sayin'...

I agree with the above poster. You'd feel a lot worse if you had to have FOLFOX/FOLFIRI.

CapeCodMermaid, RN · Aug 18, 2013

I resisted having a colonoscopy because of the storied I heard. I had one...the prep was far worse than the test itself. The worst part was the IV stick. After that, I don't remember much. Of course I went back to work the next day.....

RNsRWe, ASN, RN · Aug 21, 2013

OP, thankfully your experience is mercifully rare. Truly. My unit does 50-55 per week, on average, and I'm actually trying to remember the last time we called someone back the next day who WASN'T fine.

Different docs use different preps, and different preps on different people. We routinely use three or four. Most people really like EZ-2-Go (how funny is THAT name?) because it's easily prepared, easy to get down, and gives results that don't keep them up all night running to the potty. Start early, finish early, and get some sleep.

Not a fan of Demerol/Versed, I have to say. We use Propofol, and the usual reaction when we wake them up afterward is "it's over?? That was IT??"

Some do without sedation, although I don't recommend. Discomfort to extreme discomfort from zero sedation (and panicking from hurricane spray-only EGDs) isn't what I'd want for our patients. People here are comfortable, it's quick, and our satisfaction / success ratings are through the roof.

And, as has been said on this thread already, I'd rather have an explosive prep than tx for colon CA any day of the week. Oh, and FWIW, I too have a family hx, zero bleeding myself, zero s/sx, but decided to get it done 4 years before the usual recommended time. And good thing I did: several polyps, all pre-cancerous. But the good news is they are GONE now, because I did the danged test.

VC is not something I'm so keen on because since no biopsies or snare removals of tissue can be done, if something IS spotted, a whole new prep and scoping must be scheduled to get to them. Do it twice? No thanks.

twins4paiges · Aug 25, 2013

I too have a family hx. My dad was first diagnosed at 42 and ended up with a colostomy bag. I have had three colonoscopies I think and am sensitive to narcotics but have never had a problem. After the first one, I did sleep the rest of the afternoon, but this last one I think they used propofol cuz I walked out of there w/in 15 minutes of being done, talked bizarrely to my mom the whole way home, took a nap and awoke like nothing had even happened. I've never had any problems the day after. I am so thankful that it is detectable.

dcinma · Sep 4, 2013

I seriously doubt I'll ever do it again. I had one in 2001 at the age of 40 due to some bleeding; woke up partway through the procedure and saw a polyp being excised on the screen. No pain and I drifted off again and awoke after to a great deal of confusion. At that time they had used the typical versed/fentanyl combination. The doc called later, said I had a tiny adenomatous polyp, acted rather like I'd wasted his time and then told me to come back in 3 years.

Well that time went by and my PCP kept issuing referrals for the procedure which I kept running through my shredder when I got home (except once when my girlfriend found one on my desk and got on my case to schedule...which I didn't). Finally after a great deal of harping last year I at least agreed to see the gastroenterologist. The one I wanted to see, who'd done an upper GI on me a few years back, wasn't available, so I met with a newer doc. Nice guy, extremely persistent, made me feel like I was in a time share sales pitch. I told him that I have major modesty issues and really don't want to go through anything like this again, particularly if there is no good reason to do it but if I decided to, I'd insist on using propofol since I don't wish to experience this conscious again. He said he always uses propofol and would opt for it himself. I also preferred a same gender team since this is so humiliating of a procedure that I really don't want to be exposed in mixed company. He said "no problem". So I agreed to schedule the procedure for a couple months ahead although he tried to get me in the next week.

I got to the date without cancelling, he told me to come in even though I was getting over a bad episode of bronchitis. We get in the procedure room, of course he had forgotten about the same gender request (the nurse was very kind and offered to switch with a young male colleague; at that point I said forget it, I was comfortable with her)...and they were going to start with the versed/fentanyl again. I reminded them and they checked the chart and found he had ordered propofol so they got the anesthesiologist, another woman, and we got underway.

Of course I woke up halfway through the procedure again as he was working down through the descending colon. I remember talking to him, which he half acknowledged, and having a great deal of discomfort, feeling the whole thing. After we got back to recovery (which was much faster), he said he'd found a tiny polyp on the right side; later pathology reported a sessile benign adenoma and the doc requested a 5 year return, when I turn 56.

From my point of view, I have no plans to return for this procedure again. Both times what was found was insignificant and the prep and procedure was embarrassing and uncomfortable and frankly not worth the time. Perhaps if I have symptoms of some sort...but this is really something I don't care to repeat a third time just to check on things.

brownbook · Sep 12, 2013

Okay. Dcinma......I am sure it won't be at all embarrassing when you are dying of colon cancer !!!!!!! Geesh, medical professionals looking at hundreds of rear ends a week are not even conscious of what they are seeing in terms of an " embarrassing" part of someone's anatomy.....it is about as exciting as looking at someone's elbow!

dcinma · Sep 13, 2013

Not to be sarcastic, because I do take health seriously, but the odds are pretty good. According to the CDC, a 50 year old man has only a 1.9% chance of developing colon cancer in the next 20 years....that's 98% that won't.

CDC - Colorectal Cancer Risk by Age

Since I have been scoped twice, I would think it safe to say my personal odds are likely less.

I have come to the conclusion that this particular procedure and many other preventative procedures are over done in this country. There is a strong profit incentive to keep everyone scared that they might possibly have an undetected cancer.

Certainly lives are saved by colonoscopies. Every once in a while a symptomless cancer is found and removed successfully. That's a good thing. But many many more people are put through a very humiliating and painful procedure, often scared to death of what might be found. In my case, each time a millimeter scale adenomatous polyp was found. Perhaps these could have developed into cancer....some do....but the fact is that something like 20 - 30% of people over 50 have polyps...and the vast majority never present any danger.

People should get screened if they really feel that they want to know...with a full disclosure of what the odds really are, what the experience is really like rather than having a doctor harping on you that your life is at great risk if you don't get screened.

While I have incredible respect and admiration for medical professionals and have been well taken care of by some wonderful nurses...please don't assume it's a comfort to those of us with modesty issues to say something along the lines of "I see hundreds a week and it doesn't do anything for me." OK, I get it, seeing my private parts is no big deal for you. That's fine, you are comfortable with it....this kind of statement only goes to what your feelings are as the caregiver. It does absolutely nothing to alleviate the embarrassment and humiliation I feel when asked to expose myself. No big deal for you...it is for me...and having you tell me it is no big deal only dehumanizes me somewhat as if my feelings don't matter at all. A lot of medical professionals...well meaning I'm sure...use this kind of statement. Please rethink that, it is not comforting in the least and doesn't help.

Again, I'm not likely to comply with my doctor's wishes to have me do this again in a few years. To me it was humiliating, I woke up during the procedure even under propofol and I felt like I wasted my time, my insurance company's money and my doctor's time that he could have used treating patients who actually did have a problem in that area.

That said...I do highly respect the people in this profession and on this board and thank you for all that you do.

turner76 · Sep 13, 2013

I had a colonscopy when I was 20 because of complications I was having with my irritable bowel syndrome, and they didn't fully sedate me. As they were doing the procedure I could feel the scope in me and started crying that it hurt. The doctor came in to talk to me about what they saw and found, and she then told me that I would have to be put to sleep in I ever received another because they gave me as much medicine as they legally could. So I understand how you feel about never wanting to have another one done.

Other than that my experience with the nurses was fantastic!

brownbook · Sep 14, 2013

dcinma, I really appreciate your points. Studies are finding yearly mammograms and pap smears, are not really needed, and perhaps colostomies will go that way also.

Please believe my cavalier response here on All nurses is not a comment I would ever make face to face with a patient. I would acknowledge their feelings and sympathize, empathize, etc. I honestly believe whatever a patient tells me is true to them regardless of my, or any HCP's ideas or thoughts. I would never say what I said to you in our faceless, I don't know you, encounter on All-nurses.

Saying that, I just happened to mention to my patient today a posting I had read about colonoscopies being embarrassing. She had had a colostomy and illeostomy, several years ago. She said...."he thinks it is embarrassing.....try standing in a checkout line at the supermarket and having your colostomy start making loud, farting, gurgling, noises....try riding in a friends car and look down and see your colostomy leaked and you have a brown stain down the front of your clothes.....that is embarrassing!"

I don't know....meeting my patient today, knowing personally of friends who have died of colon cancer, being in the GI room and seeing a large cancerous lesion in someone's bowel, I hate to have the general public get the idea that colostomies are to embarrassing, or the prep to harsh.