Appt w/ gastroenterologist Wednesday

[catwoman]

Figured I'd better get rolling with the (ugh) colonoscopy I have to have this year.
Called the gastroenterologist who did one in 2001 and talked with his RN, Ken. I phoned him back in the early spring, so he was aware I've had MVR surgery and am on Coumadin. I told him today that my cardio wants me to use Lovenox.
Got an appointment at 10:20 a.m. next Wednesday to go in, talk about my health, yadda yadda yadda yadda. Including listening to my heart. Don't remember that before my first colonoscopy.
Any advice? Am sure many of you have gone through this post-op. Would appreciate any tips on handling the appointment, even if I have to find another GI doc.
I'll be printout out anything I can find to arm myself with next week.

 

[ALCapshaw2]

Are you aware that SOME gastroenterologists will perform a 'look-see' colonoscopy while you are still on Coumadin?

The down side is if they see something that needs to be clipped, you will have have a repeat procedure, OFF Coumadin.

It's worth discussing with your GI Doc.

Let us know what you decide. I'm in the same boat.

'AL'

 

[catwoman]

Al:

Three years ago during my first colonoscopy, I had 2 small polyps removed. I was told I should have started having colonoscopies at 39-40 because my mother's colon cancer was detected at age 50. (Rule of thumb is to start colonoscopies 10 years before age closest relative was diagnosed with colon cancer.)
Based on this, I doubt the gastroenterologist will want to do it with me on Coumadin. I don't want to have to repeat the prep or take more time off work. And my insurance company would probably balk at paying for 2 procedures.

 

[catwoman]

Update -- and question

Update -- and question

My GI doctor wants to do the colonoscopy with me ON Coumadin. If he finds something, he says we'll schedule a 2nd procedure. Sounds kinda like a virtual, huh? Says the polyp he found 3 years ago was so small that he doesn't think he'll find one this time.

He said that for most people on Coumadin, he has them stop prior to the procedure. HOWEVER, for people w/ mechanical mitral valves, he has them go into the hospital for heparin drips. (Guess the colonoscopy is done in the hospital???)

I told him my cardio wants me to do bridge therapy (Lovenox) instead of heparin, etc. He asked who my cardio is. Turns out he was a resident at Parkland in Dallas at the same time my cardio was a resident. He spoke very highly of my cardio.

Anyone have a colonoscopy while on Coumadin and have to repeat it because of a polyp? I've scheduled this for mid-October, which will give me enough time to change plans and do the bridge therapy, "just in case."

 

[tommy]

Marsha,

Golly, if the chance of finding a polyp is very,very small, you may want to roll the dice and just to a test first (staying on Coumadin).

The prep work isn't so bad. Seems like doing that twice isn't so bad. But paying out of your own pocket for the second one sounds expen$ive. Check with your insurance to see if they will pay for a second procedure.

Al Lodwick suggests the Virtual Colonoscopy. He has a recent post on the subject. If you find a GI doc in the area that does these, please let me know. I'm still concerned about accuracy, but over time I believe the "virtuals" will replace the tunnel rat.

The heparin drip requires hospitalization. Tehcnically the heparin drip give you more protection since it is virtually instantaneous vs. Lovenox's 12 hours. Still, I prefer the Lovenox bridge - injecting myself at home.

I had 4 small polyps in June. The GI doc said that means I get to come back in 4 years for another. No polyps would have indicated a 5 year repeat. Here's the link to the thread for my colonoscopy in June. http://www.valvereplacement.com/forums/showthread.php?t=7534

Sounds like October gives you a long while to fret about this. I'm wired to do it right away once I have made up my mind. But if you haven't made up your mind, take your time.

Good luck!

 

[tommy]

On the lighter side, while your GI seems to be up to speed on valves and Coumadin, the nurses may not be.

My GI's nurse thought that the valve clicking sound was my watch. As she took my pulse on the initial visit, she told me that my watch was keeping time with my pulse. At 70 clicks per minute? What a hoot!

 

[Johnny Stephens]

Sounds like you need a new watch, Tom.

 

[catwoman]

Tom:

I chose mid-October so I could get past an echo at my cardio's on 10/7... I wouldn't mind having it next week, but I want to check w/ insurance, my cardio, etc., before committing to having it on Coumadin and risking a repeat immediately after that insurance won't pay for.

BTW, I liked the Run On! store. Bought a pair of shoes there. Thanks for the tip.

 

[tommy]

Right. If the echo shows something needs to be done (hope not), it would be higher prioirty than the c-scope. Good luck with both.

 

[bvdr]

Marsha, I had a colonoscopy in January while I was already on Lovenox. I had biopsies done and resumed the Lovenox immediately after the procedure. I think if your GI doctor is confident to do it without you interupting your coumadin then that sounds like a good plan to me.

 

[Robt Z]

having fun with colonoscopies

having fun with colonoscopies

I just had a long visit with a gastroenterolgist about this very subject. Initially he wanted to do a regular colonoscopy while I remain on Warfarin. He said risk of puncture was very low. After a while he agreed to refer me to a virtual colonoscopy expert for a virtual. Just hope the HMO approves his referral.

Robt Z

 

[Guest]

Robt, you pointed out a very important aspect of this controversy. If an optical colonoscopy is done, the gastroenterologists make the money. If a virtual is done, the radiologists make the money. So it is a turf battle as well as a quest for truth. Foe the most part, physicians are running a small business. What business owner would send a customer to a competitor?

 

[mbalfour]

Colonoscopy while on Coumadin

Colonoscopy while on Coumadin

See my post under the thread "Virtual Coloscopy Update".