Another Colonoscopy Question

[just1gary]

Has anyone ever had a "Virtual Colonoscopy" there is an MSNBC article about a procedure that using CT scanning technology in lieu of the traditional method.

http://www.msnbc.msn.com/id/31892143/ns/health-mens_health/page/2/

The article mentions that this would be a better procedure for people on anticoagulants due to risk of internal bleeding.

 

[Ross]

There is very little risk of bleeding if they are going to remove small polyps. Larger ones would require you to come off of Coumadin and be bridged with Lovenox or admitted for Heparin, before the procedure, but not smaller ones.

I did mine fully anticoagulated and had 2 small ones removed with no troubles. Look around for a Enterologist that will do you fully anticoagulated.

Not sure that anyone has so hang in there and lets see.

 

[Nancy]

The problem with virtual colonoscopies is that if there is something that needs to be removed, you have to go through all that prepping again for a regular one, and that is really the worst part. The procedure itself is nothing, since you will be out for it.

 

[csutherland]

Jerry's having a colonoscopy the 28th, one that has been put off twice and is 2-3 years overdue. The last time he cancelled was Dec '08 when his INR had just settled down from the antifungal drug he's on. This spring they extended his time for taking the antifungal so we just didn't feel he could put off a colonoscopy again.

Friday I picked up 10 doses of Lovenox at the pharmacy to the tune of $600, all out of pocket, because he has already been in the donut hole for 2 months, due to the $376 per month for the antifungal and all his other cheaper meds.

Sometime since 2002 when he had his AVR Jerry had a colonoscopy that yielded one polyp. There was no bleeding whatsoever, even though we had fudged a little on the coumadin withdrawal and no Lovenox was prescribed. The doctors don't want to hear this; Lovenox is now the only way to go, blah, blah, blah.

He'll play their game this time, but next time we'll look into the virtual colonoscopy, &/or look for a different doctor.

 

[bvdr]

I had my last colonoscopy several weeks ago while on warfarin without any problems. I did have biopsies taken and that presented no bleeding problems. My gastro doc isn't sold on the virtual ones since you still have to have the same prep.

 

[ALCapshaw2]

There was a discussion of Virtual Colonoscopies on VR some time ago (Search for "Virtual" and set to "any date" to find them).

As I recall, the 'Bottom Line' was that Small Polyps may not be well visualized' with the Virtual Imaging, at least at the time of the discussion (early days of the procedure). I haven't seen much discussion since.

The Better News is that the (GI Doc) Society has endorsed doing Low Risk (esp diagnostic) Colonoscopies while still anti-coagulated. Some Doctors may ask that you adjust your INR to the Low End of your Range. As Ross noted, he (and others) have had SMALL Polyps removed while anticoagulated with NO Problem.

The Biggest Issue is finding a GastroEnterologist who will perform a Colonoscopy while anticoagulated. Many of the "old school" docs are still reluctant.

BEAUTIFUL DOG - what breed is it?

'AL Capshaw'

 

[just1gary]

Both dogs are registered Japanese Kennel Club (JKC) Akita (brindle and a red). There is an Akita movie with Richard Gere coming out, see link http://www.hachi-movie.jp/ that is already playing in Japan.

I've just been dragging my feet on getting the colonoscopy done and thought the virtual test might be easier on me. I haven't been knocked out since the OHS three years ago so just call me chicken.

 

[ALCapshaw2]

Both dogs are registered Japanese Kennel Club (JKC) Akita (brindle and a red). There is an Akita movie with Richard Gere coming out, see link http://www.hachi-movie.jp/ that is already playing in Japan.

I've just been dragging my feet on getting the colonoscopy done and thought the virtual test might be easier on me. I haven't been knocked out since the OHS three years ago so just call me chicken.

They don't 'knock you out' in the traditional sense of full anesthesia for a Colonoscopy. They typically (at least at my local hospital) use VERSED which is classified as "Conscious Sedation". They can take you from "can I watch" to "I don't want to know or remember anything" based on dose. You WILL need to have someone to drive you home. It is suggested that you stay home until the next day as there is a short 'amnesia' effect. Hint: Do NOT go Shopping on the way home !

 

[Nancy]

Here's a hint about the prep that I discovered when I had mine a couple of months ago. This time, I decided that instead of sitting around while doing the prep, it would be better to stand up and move as much as possible to keep the liquid going down in the right direction. Sitting around just contributes to the bloated feeling that happens at the beginning.

So I got on the treadmill (which is next to the bathroom ) and did a slow walk while reading etc. just hopping off to go potty or to take the next dose. It went beautifully and I was not uncomfortable. Granted that I was walking for about 2 hours + but it was much better than feeling terrible.

I think you could accomplish the same thing by just moving around your house doing small chores instead of sitting.

Easiest prep yet, and I have had a few.

Also, the Miralax prep is the best. GoLytely, NuLytely and others like that have way too much liquid and make you feel just terrible. And the Fleet prep, well, I think that went out with high button shoes. That one is brutal.

Colon cancer runs in my family, so I have to have one every 5 years.

 

[sue943]

I have had the CT version, CT Colonography. My GP insisted that I have it after I went to him with a bleeding haemorroid, he wanted to be sure there was nothing sinister that needed to be looked at.

I had to have the revolting preparation as in drinking the awful mixture a couple of times, confining myself to the bathroom for long periods of time and eating/drinking the restricted diet for several days.

In the CT room they decided not to give me a muscle relaxant due to my heart, they didn't want to mess with it. They inserted the tube and filled me with gas, not very uncomfortable and they did apologise. I was then injected with contrast.

The whole procedure really wasn't uncomfortable and the result showed that I had no cancer or polyps. It did confirm what had been shown in another CT scan some time ago and that is that I have diverticular disease in the early stage and it also showed up that I have a kidney stone again - it was having kidney stones treated that caused my heart problems.

 

[jerseysue]

Virtual colonoscopy

Virtual colonoscopy

Agreed with several here, you have to go through the same prep for the VC as the regular one, and that's the hardest part. My gastroenterologist recommends the 'real' one. He wanted me off coumadin 5 days prior, with 3 Drs. telling me that is the limit for being in the safe zone. As soon as I woke up from the C'oscopy, I took coumadin and started getting back on schedule. The 5 days limit was on the advice of my internist, cardiologist and the gastroenterologist.
Sue

 

[ALCapshaw2]

Agreed with several here, you have to go through the same prep for the VC as the regular one, and that's the hardest part. My gastroenterologist recommends the 'real' one. He wanted me off coumadin 5 days prior, with 3 Drs. telling me that is the limit for being in the safe zone. As soon as I woke up from the C'oscopy, I took coumadin and started getting back on schedule. The 5 days limit was on the advice of my internist, cardiologist and the gastroenterologist.
Sue

I am surprised (amazed? DUMBFOUNDED?) that your Cardiologist did NOT recommend Bridging with a Fast and Short Acting AntiCoagulant such as Lovenox (self administered at home) or Heparin (administered via IV in Hospital) which will protect patients until it is discontinued 24 hours before the procedure (and can be readministered after the procedure until your INR is back in range).

'AL Capshaw'

 

[tommy]

I've gone round and round on this topic and here's what I've found. Note that every one's risk and reaction to anti coagulants are different. These are my opinions and experiences.

1. Lovenox bridging is not an approved therapy. Lovenox is expensive. There is no test to verify efficacy or overdose.
2. I believe that the Lovenox dosage calculation is flawed. The last 2 times I bridged, the doctors refused to restart Coumadin until the Lovenox bleeding was under control - catch 22. It took over 2 weeks to resume Coumadin. Once, the GE did a second colonoscopy to try to find the source of the bleeding.
3. My cardiologist and I am comfortable for me to hold Coumadin for a few days at a time. This is always for good reason, and is always negotiated directly between the two doctors (usually 4 days).
4. To me and my cardio, this issue of risk is variable, personal, and an art form based on the valve, the patient, and the alternatives. My cardio and I have had extended discussions about this.
5. Virtual colonoscopies are not reliable for my condition with Crohn's. My GE refuses to use them on me. He is the best in the area.
6. In all of my cases a second regular colonoscopy would always have followed a virtual colonoscopy due to findings.
7. This year I have had a colonoscopy, wide area excision, and double open hernia repair. Three different performing doctors, same cardio consult. All used "holding" therapy. No issues. Very fast recovery.

 

[catwoman]

Because colon cancer runs in my family, too, I will stick to a regular colonoscopy.