colonoscopy prep based on insurance

Specialties Gastroenterology

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my father had a colonoscopy and paid out of pocket. he didn't get go-lytely, he swears he got a powder that started with an "s" that he mixed with gatorade. i can not think of what this would be!! anyways, my father was very pleased with all of the procedure.

my mother in law was given go-lytely and mag citrate at her last one and is having another one next week. can someone tell me an "easier" more gentle way of doing the prep so i can tell her? i would greatly appreciate it. thank you so much in advance.

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can someone tell me an "easier" more gentle way of doing the prep so i can tell her?

Has she talked to her doctor? Seems like the physician should be involved in any decision regarding the cleansing procedure. I think we can all sympathize with the need to help our family members, but keep in mind that different bowel preps have been associated with side effects ranging from renal failure to electrolyte disturbances and dehydration. If it were my family, I wouldn't be comfortable recommending something like that unless the pt's physician was on board with it as well.

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Has she talked to her doctor? Seems like the physician should be involved in any decision regarding the cleansing procedure. I think we can all sympathize with the need to help our family members, but keep in mind that different bowel preps have been associated with side effects ranging from renal failure to electrolyte disturbances and dehydration. If it were my family, I wouldn't be comfortable recommending something like that unless the pt's physician was on board with it as well.

it's frustrating because at work we have the patient instruction sheets for colonoscopies. on the top of one of them, it says "colonoscopy prep for patients of Dr. ***** with insurance or private pay" on another one, it says "colonoscopy prep for patients of Dr. ***** with Medicaid"

so i'm just trying to help my m-i-l suggest something to her doctor.

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The phosphosoda prep and the magnesium citrate prep are OTC and inexpensive. They may save patients w/o insurance or high copay some money. There is little difference amongst the various PEG solutions, they require a script and they are considerably more expensive than the PS or Mag Cit.

One that seems to becoming quite popular is Miralax as a prep. Its a PEG and requires similar prep accomodations but is not so terrible tasting and thus much more easily tolerated and accepted by patients.

There are also some tablets called Visicol which, if I remember correctly, are also a form of the PEG prep and they require taking some 28-32 tablets w/LOTS of water over a short period of time similar to the PEG solutions but avoiding the horrible tasting fluid.

I can't off the top of my head think of a prep starting w/S but the PEG solutions usually have a Lytely in their name: NuLytely, GoLytely (yeah, right!), and, I think, CoLyte.

Its always worth discussing the pros and cons of each prep w/the gastro and having some input into which prep one has to endure.

The advantage to the PEG preps from the patient's standpoint is that they do provide some of the electrolytes lost due to the cleansing diarrhea and most scopists prefer them as they promote enough fluids to pretty much ensure a clean colon. Patients may tend to not continue drinking enough fluids for a good rinsing of the colon w/the PS and Mag Cit. Miralax seems to be the only PEG prep that has managed to overcome the bilge water taste of the other PEG preps.

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Specializes in LTC,Hospice/palliative care,acute care.

so i'm just trying to help my m-i-l suggest something to her doctor.

I don't know-I try NOT to make "suggestions" to my doctors-i don't have the knowledge
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Well, I tend to make suggestions from time to time since I am the one who must endure the consequences of any procedure, medication, etc. we try. I don't make a habit of it but if it is something that concerns me or that I've had an unpleasant experience with previously I'm not above asking about and discussing all my options with my doctor rather than just the one he/she suggested. This has worked well for me and has not offended my doctors at all. If it did I would be shopping for another doctor immediately. Doctors don't walk on water, they are human just like the rest of us.

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Well, I tend to make suggestions from time to time since I am the one who must endure the consequences of any procedure, medication, etc. we try. I don't make a habit of it but if it is something that concerns me or that I've had an unpleasant experience with previously I'm not above asking about and discussing all my options with my doctor rather than just the one he/she suggested. This has worked well for me and has not offended my doctors at all. If it did I would be shopping for another doctor immediately. Doctors don't walk on water, they are human just like the rest of us.

I agree completely. Now that I understand the informed consent process, no thanks to anyone at my hospital, I expect to actually have a discussion of the risks, benefits, and alternatives prior to any future procedures.

Keeping things in perspective, I have not come across any information to indicate that I could have gotten better treatment for my bad GI bleed in 2003 anywhere else in the world. Quite impressive for a hospital that is not even a trauma center. However, they seem to have a pre-1980 view about patient information (We know what is best for you; we will only tell you what we want you to know). The informed consent process may have improved with the 2005 JCAHO regulation changes, at least I hope so.

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Michigan law gave a patient a right to a copy of their medical records and in the past I have had to tactfully but firmly remind hospital and other medical personnel of that. They did/do have a legal right to charge a "reasonabale fee". One of our local hospitals gave me a bit of a problem but had to concede I had a legal right and charged me a $10 "access fee" plus 75 cents a page (in this instance a one page report $10.75) which I paid but then requested to speak to the Patient Advocate and lodged a complaint and requested the names and addresses of the entire Board of Directors with intent to bring the exhorbitant fee to their attention. I didn't get a refund or reduction but I got my next (2 page) report at no charge. That was after this relatively recent federal law change so I don't know if my protest actually did any good or not. The thing that had angered me most was that at one point I told them I'd just get a copy from my family doctor and they told me that he could NOT legally give me a copy, only the generating facility (that hospital) could.

I refuse to utilize that hospital any longer (fortunately we have two in this town to choose from). I well remember the days, heaven forbid the patient should even know what their BP, pulse or temp was!!!! For too many years the medical profession cloaked itself in this inane "mystique". All it did in my opinion was promote a distrust and lack of faith in the medical profession. I very much appreciate and like this new air of openness I am now encountering!!

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