Oh Say can you C? Compliance, Colonoscopy and more

Yes — today’s post is C-based! …. bear with me…. it will make sense in a moment! And we’ll discuss them — Chronologically!

Thursday, I posted a comment to a blog called AlignMap that is aimed at medical professionals (OK – so I eavesdropped) and showcases patient Compliance – issues that surround patients following a doctor’s instructions. Issues such as: Do they or don’t they? Will they or won’t they? Can we expect them to? And what if they don’t? etc etc. The website and blog belong to Dr. Allan Showalter, a psychiatrist in clinical practice who has followed and written on the topic for years. The blog I responded to regards a question about whether doctors should Coach elderly persons to comply. Here’s the post and comment.

Dr. Showalter later sent me an email thanking me for a thoughtful comment (as if most of the ones he receives aren’t thoughtful I guess?) and we exchanged a few emails. Among them, I replied that I was having my own Challenges with compliance that day because I was in the process of drinking down that gallon of gawd-awful nulitely stuff one must drink the day before a Colonoscopy. Dr. Showalter then linked me to another post of his regarding a new approach to colonoscopies, where one swallows a Camera in the form of a pill. Gives new meaning to a Kodak moment, doesn’t it?

Compliance is an important topic. I’ve addressed it previously through two of my Every Patient’s Advocate columns… and I will blog about it another day. But today I want to tell you more about the colonoscopy.

It was an awful experience. Anyone who has had one will politely tell you that the preparation the day before is the worst part, but in my experience, that was not true. Granted — I had both a colonoscopy AND endoscopy (upper — esophagus, stomach, etc) because I have GERD and have been taking medication for it for about 8 years. However — to me, the prep, as awful as it was, was the easier experience.

Now, I’m not a whiner in general. I’m a tough old broad who has handled everything from two C-sections and hysterectomy, to a Cancer misdiagnosis, to a hiaital hernia — I’m no medical slouch! But if anyone tells you the colonoscopy part is easy — don’t listen to them!! Both the installation of the IV, and the cramps really hurt! And I was sound asleep by the time they did the endo — so that doesn’t even enter into this. The nausea afterwards, and the dizziness, finally gone when I woke up this morning….?

Don’t get me wrong. I’m glad I did it. I’m even more glad I don’t have to do it again for 10 years. They did find one polyp in my stomach and I’ll know in a week or so if it’s anything to be Concerned with. They tell me it’s not unusual for someone with GERD, so no problems are expected.

And I think that’s the point — it was worth the pain and preparation to have the peace of mind that those parts of the aging-me are healthy (or maybe aren’t?) Having answers is so much better than being left with question marks.

But you know me — I’m into managing your expectations. If you are planning to have a colonoscopy, and people give you that half-smile and say “the prep is so much worse than the actual procedure” — tell them I say “bull-pooky!” And then — decide for yourself. The only good part is the peace of mind you’ll have when it’s over.

One side note — the nurse’s name was Soibhan Reilly. Some good luck on the day before St. Patty’s!

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2 thoughts on “Oh Say can you C? Compliance, Colonoscopy and more”

  1. After five years of procrastination I finally gave in to the doctor and my wife, Debbie, and some close friends and I went for a colonoscopy. You are supposed to get one when you hit 50 years old but I hit that milestone five years ago. For those of you who haven’t done it and are afraid to go, here is my account of the procedure. (This was much more fun than my vasectomy).
    My colonoscopy was surprisingly easy and that’s the way they are supposed to be. The hardest part was not eating for two days and that was hard to do for me, but I’m a glutton.
    I had a snack Tuesday night, nothing on Wednesday and nothing on Thursday until I got out of the clinic at 5:00pm. After my procedure my wife, Debbie, wanted to stop at the Target department stores and pick up a few things before going home so I went right to their food section and grabbed a bag of Gardettos’s. Boy, that bag of dry, salty pretzels and pumpernickel tasted much better than usual.
    At noon on the day of my procedure I put a turkey in the oven for my arrival home. I figured that it would be cooked by the time I got back but when I got home the little red temperature popup indicator hadn’t sprung so I had to wait. Hell, I waited 41 hours with just a small bag of Gardetto’s so I could wait a little longer (but I really wanted to rip that bird out of the oven and eat it raw). It finally popped at 6:15 and it probably would have popped sooner if I didn’t keep opening the oven door every minute to see if it was ready.
    The night before my colonoscopy I went to a concert at the Park West in Chicago to see Richard Thompson with my daughter Kelsey. When I got home at 10:30 I had to start drinking a liter of some horrible liquid over a period of an hour. It tasted like baking soda, flour, chalk and alka seltzer without the fizz. For the next four hours I did a lot of late-night reading in the bathroom. The next morning I had to drink another liter of the same pond scum and do some more reading. It was like peeing buckets of Gatorade through my ass.
    After waiting all-day and thinking about that turkey, Debbie drove me to the clinic at 3:00pm. They told me to go into the bathroom, stuff my clothes in a plastic bag and put on the green paper gown with the opening in the back (oh really?). They brought me into a big waiting area that had a lot of curtained stalls and they laid me out on a gurney with thick, brilliant white sheets. The nurse asked me a million questions and stuck an iv in a vein in on the top of my hand. While that was happening, there was a guy across the room from me who was passing gas over and over again and moaning each time he let one out. They fill you full of air so they can see your intestines like the inside of a balloon. He had come out of the operating room just before I got there. That guy was trying to talk to his wife and he sounded drunk but that was the fault of the anesthesia. Then they rolled the next guy out of the procedure room and put him behind the curtains next to me and he was passing more air than a church organ. That place needed a lot of ventilation fans for sure.
    I said to the nurse, “I used to sit in a booth right over there (pointing) when this place used to be a restaurant”.
    It used to be Scoozies, Martinellies and Gagsters before becoming a gastro clinic. She said “the pizza oven used to be right where the operating room is today and now they are going to shove me in there”. I thought it was funny that my doctor’s name was Mitchell. Mitchell was the name of the really bad guy in the book I wrote about my job working in the state mental hospital. It seemed ironic to me that another Mitchell would be in total control of me.
    They pushed me into the oven (operating room) and I met the anesthesiologist who was a nice woman but she couldn’t get the heart monitor to work. She kept ripping those adhesive circles off my chest until she could figure out how to get it to work or find out where my heart was. I didn’t know what she was doing but she finally got it to work and I don’t have much hair left on my chest.
    The doctor came in, all smiles, and made a couple of jokes about what he was going to do to me. I don’t remember them but I’m sure they are the same jokes his profession uses to break the tension. He asked me to roll over on my side and that’s all I remember.
    All of a sudden I woke up and I found myself staring at the same TV monitor that the doctor was using to explore my insides. I abruptly said, “hey, is that me?” The doctor, nurse and anesthesiologist were shocked that I was wide-awake. He said, “hang in there, I’m almost done”. I felt no pain, only hunger. He finished up, they covered me and rolled me out to the big waiting room where those guys were still farting and now we had a chorus.
    While they went to get Debbie from the waiting room to sit with me, I heard the doctor come to visit the guy behind the curtains next to me. He told the guy that he found a lot of polyps and he removed them. However, there was one polyp in there as big as a thumb but he couldn’t remove it because it had a blood vessel in it and if he removed it that would cause too much bleeding. The doctor told him he needed to get an appointment with a surgeon to have that section of his intestines removed. He told the guy that he drew a tattoo around that section of his intestine so the surgeon could find it and remove it. The patient nervously said, “isn’t there a pill for this?” The doctor said “No” and that he was very lucky to have come in when he did because that “thumb” has a high probability of turning cancerous and it wouldn’t have been an issue if he had come in to see him years earlier when it was only a polyup. The doctor told the guy he didn’t need to have the surgery right away but he wanted it done before the end of the month. That sure sounded like right away to me. The doctor said goodbye and the guy and his wife rolled out of the room quite stunned. My own doctor had been pressing me for the past five years to get this done and now I was wondering how many thumbs I have growing in my own intestine.
    Shortly afterward the doctor came by to talk to me. He told me that everything is fine, no polyps, no strange stuff and I’m good to go. He gave me a couple of photos that he took of my insides and he left. I’m glad he didn’t give me the DVD.
    The nurse carefully walked me to the car even though I was perfectly fine and then Debbie drove us to Target. The worst part of this whole experience for me was not eating and the anticipation of the unknown. I feel very fortunate compared to the guy who was behind the curtains next to me and I realized that I was an idiot because I waited so long to have this done.
    That turkey, mashed potatoes, gravy and stuffing was wonderful and I don’t have to go through this again for another five years. I think for the next one I’ll cook a vulture just to make a statement that I’m doing what I can to stay alive.

  2. The worst (and most unecessary part) of colonoscopy is the awful “conscious sedation”. I have had 3 and for the first 2, the doctor insisted on Versed/fentanyl-the exam was more uncomfortable and I still have nighmares about the creepy amnesia caused by versed (a lot of people do)-they lke to give the drug so you don’t remember the procedure-at least until they get you out the door then the nightmares start. Exam #2 was with supposed to be with Propofol (even stronger) and I told them no way…..I agreed to a max of 50 mcg of painkiller (fentanyl)-but then again it wasn’t needed….just made me feel like crap. Exam #3, same BS about you “have to have sedation”…then a nurse told me the best-kept secret: the sedation is so that they can do more exams faster and hopefully the patient’s will have amnesia and tell others how great the exam was. Yeah, right. She told em to schedule the exam, do the prep, show up and write “no sedation” on the consent. Then as they whine and cry
    tell them that you don’t have a driver. Bingo: they will do the exam w/o sedation rather than lose the precious time slot (and money). They tell you in advance that if you show up w/o a driver, that you will be rescheduled. It’s a lie; if you are willing to do it w/o drugs, believe me, they will do the exam. If you want drugs, get them. Check out askapatient under versed and read the comments. it’s scary. And the icing on the cake was: for my last ecolonoscopy w/o drugs, I got yelled at by one of the nurses for not having a ride…then the doc (a nice woman with a sense of humor) said that she had her’s w/o drugs! Yes, there are a few moments of cramps, but it’s not bad. Most colonoscopies done in the world are without drugs. I know several people (2 nurses) who will not get the exam because they have been told that they have to accept the chemical lobotomy and possible memory loss (sometimes perm) from the versed or propofol. These drugs are the highest risk of the
    procedure;but they are very safe. I just don’t like being lied to.

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Trisha Torrey
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