Virtual Colonoscopy Anyone?

[catwoman]

This is all rather frightening ........

We **MUST** involve our anticoagulation manager w/ every medical professional doing anything on/to/with/etc. us.
But first, make sure that manager does understand warfarin.

 

[Michaelena]

First and formost... Warren, my best to your Dad, I will pray for him. Thanks to him and you for sharing this very bad experience.

Thanks Al, your expertise has helped me immensely, I was very uneducated in this area until recently.

I must agree from my own experience, doctors are all over the place when it comes to warfarin. I never realized it before, although I have been struggling with my PCP over response time after blood is drawn. My cardio's office has a coumadin clinic, however my HMO requires that my results are processed through my PCP. Also with my forthcoming surgery..when to stop warfarin...no mention of bridge therapy. I have told my surgeon that I am very concerned about the possibility of a blood clot.

In PA there is this big controversy over the cost of malpractice insurance...drs are leaving PA...if the drs would take time to do what is best for the patient and not be strong armed by the health insurance carriers, perhaps they would not have to worry about malpractice.

Recently, I was on a jury it was a malpractice suit - jury found for the dr, the reason being the plaintiff did not tell the surgeon, befor and after the surgery the difficulties he had been experiecing. Bottom line is, go on record with your concerns. It is ashame, this is what it has come to.

Medical care in the USA is the best inspite of it's problems, nothing is perfect.
We must be informed consumers and our own advocates if possible.

Michaelena

 

[loretta]

Bridge therapy

Bridge therapy

What is bridge therapy & also do they have virtual colonoscopy? loret








TE=allodwick]I'm happy to report that the person who sent this halogged on to this site, read the message and has given permission to use his father's name.

One of my patients came 90 miles to the hospital where I work in considerable pain and had a colonoscopy with a polyp removed within a few hours of admission. She experienced no bleeding. Her pain relief was almost instantaneous. When it needs to be done, it can be done. I read her chart and confirmed it with her doctor so I know it is true.

There are legal issues with having a protocol for something that the FDA has not approved. Lovenox has never been approved for bridge therapy.

The only way that this will change is by patient persistence. Refuse to go off warfarin. Insist on bridge therapy (remember that there could still be failures). Insist on virtual colonoscopies. The market repsonds to consumer preferences.[/QUOTE]

 

[Guest]

Yes, there are virtual colonoscopies being done.

You can read about bridge therapy by clicking on http://www.warfarinfo.com/bridgetherapy.htm

 

[twinmaker]

After reading through all these threads, it should make all of us on Coumadin aware that we need to be our own advocates or advocates to our loved ones on Coumadin. I have had bridge therapy with both Lovenox and Heparin Drip. Because of horribly painful hematomas in my abdomen after using Lovenox (not to mention the reoccurance of bleeding from a suture line that hadn't bled for a week), I prefer the Heparin. The Heparin drip was used on me several times before I tried the Lovenox. Of course, the big obstacle with the Heparin is convincing the insurance companies that the Heparin is a better option for me and having to get approval for the extended hospital stay. Bottom line...we all need to do our research and share our ideas and experiences with each other so we can have a say about what happens to us!

 

[warrenr]

prayers for my father please

prayers for my father please

My father's health is declining. He is pretty much bed ridden at this time. He has been fighting bladder infections and seems to be having problems with the ol ticker. His resting heart rate has been running between 130 -150 bpm. He is also in afib and has been for several day's now. Oxygen saturation has been running in the low 90's. His blood pressure this afternoon was 95/50. He has been loosing weight and is down to 143 lbs (he is 6 feet tall). He is being given a combination of Methadone and Oxycodone for severe pain. My sister and I feel that he has given up his desire to live. Can't blame him on that one but it is still so sad to watch. We have been told by several nurses at the nursing home that we might want to look into hospice.

Prayer's please.

Warren R

Please everyone, if you are instructed to stop coumadin for a procedure, make sure you research the perioperative anticoagulation guidelines before going ahead with the procedure. There is a good chance that your physician won't review the guidelines.

 

[catwoman]

Warren:

I am so very sorry to hear this about your dad. He and your family are in my prayers.

 

[Troy]

Thank you for the post. It helps us remember Doctors aren't gods and we should question their every move. However, it is hard with elderly parents/ grandparents. They were taught that doctors were god and not to questions their advice. It is sometimes hard to advocate for an elderly family member. I researched and decided on the ON-X valve for my replacement. My cardiologist and thoracic surgeon were taken aback as they have never had someone select their own brand of heart valve. They were not even aware that there were home monitors for PT/INR levels. Do your research and always Question Authority!

 

[Rich]

Hi Warren,
Sorry to hear about your father, our prayers are with you both.
These doctors just don't get it when it comes to Coumadin.
One of my wife's sisters in Florida was on Coumadin for several years because of a-fib. Her lab was four days late getting her INR results to her. It turns out she was very low and suffered a major stroke before the hospital reacted.
Now just a few days ago she died a needless death.
I believe after the stroke (which totally paralized one whole side), she just gave up on life.
I hope things turn out better for your father.
Rich

 

[Karlynn]

Warren, your Dad and your family have my prayers.

 

[RCB]

Warren's Dad

Warren's Dad

It is very sad to hear of your dad's problems. I hope he understands how much his experiences has helped to educate the people here. We owe Warren and his dad a great deal. I never stop thinking about you both.
Take care.

 

[Guest]

Sorry to hear about this Warren.

I am preparing a set of presentations that I will travel around the country and give to health-care professionals. Your Dad's incident is in it. (No names of course.) At least others will learn from what he went through. His memory will live in many people.

 

[sharon]

virtual colonoscopy anyone?

virtual colonoscopy anyone?

Warren,

So sorry to hear about your father. We will be praying for him.

Al,

I found a doctor in my area who said that he errs on the side of caution and leaves people on coumadin when he does colonoscopies. He said that 7 out of 8 people do not have polyps to remove. With those odds he said that he didn't want me to stop my coumadin. If he did find anything we would then redo the colonoscopy without coumadin - no bridge was mentioned and I'm not sure if he advises that. I was one of the lucky 7 and so did not need to be off the coumadin. After reading all the info I will definitely find out about a bridge if ever I need to be off coumadin.

Sharon Feldman
St Judes avr 4/97

 

[Guest]

If you stay on warfarin, you do not need a bridge.

 

[RCB]

You have a smart doctor

You have a smart doctor

Warren,

So sorry to hear about your father. We will be praying for him.

Al,

I found a doctor in my area who said that he errs on the side of caution and leaves people on coumadin when he does colonoscopies. He said that 7 out of 8 people do not have polyps to remove. With those odds he said that he didn't want me to stop my coumadin. If he did find anything we would then redo the colonoscopy without coumadin - no bridge was mentioned and I'm not sure if he advises that. I was one of the lucky 7 and so did not need to be off the coumadin. After reading all the info I will definitely find out about a bridge if ever I need to be off coumadin.

Sharon Feldman
St Judes avr 4/97

Sharon,
That is exactly what my doctor said when I had my procedure done in 2001. This is proof that there are thinking doctors out there, you just have to find them. I would also remind people, that if their doctor is not well informed about this, what other things does he not know about? Pick your healthcare professional. wisely!

Of course, there is no better choice then our own Al Lodwick!

 

[BDMc]

Thank You

Thank You

Warren, I am so very sorry to read of your ordeal. I lost a dear friend in a similar way. She lasted 20 months after the initial stroke. It was the worst thing I've been through. Her children are so worn down they don't have the strength to file a malpractice suit. I have also suffered from this sort of ignorance, though thank God, I didn't have a stroke. I did end up bedridden for 5 weeks after outpatient knee surgery. I have been putting off a colonoscopy because my PCP said I'd have to bridge with Lovenox. I did that once for gum surgery. Will do it if I have to, but thanks to this thread, maybe I won't! I will be thinking of you, your father, and family. Brian

 

[Dennis S]

The main question:

The main question:

I have asked this before and no one seems to know the answer. Before I even get close to deciding between bridge therapy or not---If I have no complicating factors, what are the odds that I have the beginnings of colon cancer that could be detected by a colonoscopy? I thought I had seen somewhere that the odds are something like 30,000 to 1. Does anyone have an answer as to what normal odds are? I would definitely want to know the odds that I will contract colon cancer in the first place so I can weigh them against the dangers of undergoing the colonoscopy.

 

[geebee]

Dennis,
I have been told the odds of developing colon cancer is around 5%. Age, obesity, sedentary lifestyle and smoking are also risk factors. Since the odds are 5% of the general population, I would think if you do not smoke, are not overweight and exercise regularly, you chances would decrease but I could be wrong.

 

[warrenr]

the odds

the odds

Dennis,

Why such the dilema as to weather or not to bridge. The ASGE protocol for screening colonoscopy is to have the procedure done fully anticoagulated reagardless of the underlying condition for which you are taking coumadin/warfarin.

 

[catwoman]

Dennis:
My grandmother had colon cancer in 1963 at age 61. No one else in our family had had colon cancer. In 1977, my mother had colon cancer at age 50. She was undergoing GI series for a hiatal hernia when the colon cancer was detected. Both she & her mother were cured.

My father-in-law abhorred going to doctors, so he never had a colonoscopy -- until it was too late. He died at home 7-8 months after diagnosis, no surgery, chemo or radiation. He was 79. His younger sister had died maybe 2 years previous from cancer (I think colon cancer, but can't remember). None of his family had had screening colonoscopies.

Enough of the scary stuff.

Your odds of developing colon cancer may not be high, but people do get it. It's curable if caught early enough.

My mom had complained about colonscopies for years before I had mine, so I was braced for a really horrible ordeal.
Instead, it was nothing. I was very surprised. Of course, this was before my MVR and before I was on warfarin.
My GI doc, PCP and (former) cardio all said that I should be fully anticoagulated for my next colonoscopy.

The downside is my company's insurance does not cover a ROUTINE SCREENING colonoscopy. The GI's office said they'd agree to my paying the same that insurance would pay -- about $1,500.
Instead, my PCP & I are trying to build a case to have a diagnostic colonoscopy done.