PSA: for those over 45 years

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No, I had versed and fentanyl. Fentanyl is a common anesthetic.

My partner and I use this combination quite a bit when we don't need to intubate someone. People get nervous with the reputation of Fentanyl abuse on the streets, but during transport it is easy for me to monitor someone's respiratory drive and still keep someone sedated.
 
I recently ran across this youtube video by an orthopedic surgeon explaining why they use Fentanyl so much. It's very interesting.
 
Ive had 2 since I was 50. Now 67. Ist time found 1 polyp, non-cancerous. 2nd time clean as a whistle.
They did discover I have

Diverticulosis​

But so far no

Diverticulitis.​


My next scheduled colonoscopy is 2031. Assuming of course I live that long.
 
My partner and I use this combination quite a bit when we don't need to intubate someone. People get nervous with the reputation of Fentanyl abuse on the streets, but during transport it is easy for me to monitor someone's respiratory drive and still keep someone sedated.
Fentanyl gets a bad rap. It is ok if used by a professional and appropriately. The US Army is working with University of Houston to develop a vaccination to avoid Fentanyl abuse. I wonder how that is going to affect the use in procedures.
 
I’m 62 and never had one. The docs always give me the little pack to send back. I’ve asked why. I am told that it is just as reliable…. I don’t know one way or the other. Since I have no history in the family of it, I haven’t worried too much about it.
 
My dad did also, when the weight loss and vicious vomiting started Mom got really scared and practically ordered him to see his doctor,and he ordered both an upper GI and endoscopic exam,and that's when a 5 cm tumor was found in the upper part of his stomach, which had already widely metastasized to his organs and skeleton.It was graded a Stage3 cancer, which in this case was terminal.It's a good thing you did what you did, because stomach cancer generally responds very poorly to treatment, even if it's caught early.It's good that you have the knowledge and training to recognize a potential problem.
That is terrible. Between pancreatic and Esophageal, it is almost always found at a late stage.
 
I won't ever get one, that's the least of my problems. What I don't understand is that the #1 killer is still cardiovascular disease, so why isn't it mandatory to have a CAC scan done ? say at age 30? there's 50% more heart disease than cancers.

What does a coronary calcium scan do?​

The scan provides images of your coronary arteries that show existing calcium deposits. Called calcifications, these deposits are an early sign of coronary artery disease.
 
That is terrible. Between pancreatic and Esophageal, it is almost always found at a late stage.
Yes, it's a horrible thing.I lost my brother to pancreatic cancer in October of 22.By the time the pain arrived it was already too late.Nine months of chemo followed by a month and a half of unbearable suffering.
 
I won't ever get one, that's the least of my problems. What I don't understand is that the #1 killer is still cardiovascular disease, so why isn't it mandatory to have a CAC scan done ? say at age 30? there's 50% more heart disease than cancers.

What does a coronary calcium scan do?​

The scan provides images of your coronary arteries that show existing calcium deposits. Called calcifications, these deposits are an early sign of coronary artery disease.
CAC scans are still a little controversial. They are recommended as A screening method only if you are intermediate risk for heart disease. Not everyone needs them and some us are better served with other studies. Screening for heart disease is something that is not as universal as a colonoscopy. As with any screening test, it is important to discuss it with a clinician and determine if it is the best study for your disease process. If you advanced lung disease or kidney disease, some studies are not as needed.
 
I won't live to see it happen, but down the road you will be able to walk into a physician's office and have a scanner complete a 100% thorough body scan, which will show up and identify every physical problem that you have within your body, and it will eliminate all of the guesswork and troubleshooting of people's physical problems.
 
First colonoscopy at 36. Two polyps. At 41, a nice clean poop chute. Have to get another one next year.

And it’s the best nap you will ever take.

I woke up in the middle of my second one. I was lying on my side and I could feel a little tugging going on down there. I propped myself up and turned my upper body (didn’t want to move my lower body too much just in case) to look at the doctor. She and her assistant were really focused on the camera. I didn’t want to bother them. They hadn’t even noticed I was awake yet, and I didn’t want them making any mistakes.

So I turned my head and found the true culprit. He was standing in the corner talking to his assistant. “HEY!” I yelled out to the anesthesiologist. “Put me back to sleep.” I will never forget the look when he realized I was up. 😆 Eyes wide, panic on his face, he hopped over some wires, and beelined for the machine that administered the drugs. As he turned the dials (or whatever they do), I remember lying back down, closing my eyes and saying, “just don’t kill me, please.” 🤣

I woke up fine, no issues from the procedure. But I think I’m gonna go with a different team next year.
 
Glad I finally got it done. Everything I heard about the prep before the colonoscopy was a bunch of baloney. Just remember to dab and not wipe.
 
No, I had versed and fentanyl. Fentanyl is a common anesthetic.

Thanks for the confirmation. When I hear the F-word, I assume its a bad thing. Maybe its just mainstream media (even though I try to avoid it) that made me think that it was a bad drug. A former co-worker died from a fentanyl overdose. I never knew he was into drugs and apparently he didn't know the heroin he used was fentenoyl or had it in it. I don't know the details, but I do know a good guy is no longer here due to an OD and it sucks that I (or anyone else in his life) didn't know what was going on and that his downward spiral likely ended up terminating due to either suicide or bad drugs.

Glad to know it has a good purpose, even though the only reason I know the name is from the bad purposes.

Sandy.
 
I had my latest colonoscopy a few months ago. He removed a polyp or two. I have diverticulosis which is quite common for someone my age. No diverticulosis yet.

I got fentanyl too. My memories of the post procedure recovery were not accurate according to my wife. Another good reason to have someone you trust to take you home and get the post procedure information.

I have read that insurance may pay for the stool tests OR a colonoscopy, but not both. I think they have removed polyps during each of my colonoscopies, so I prefer that to a non-invasive test.

I did the pills this last time for prep. Never again! I got cramps and bad nausea from both doses. They were over quickly, but they were nasty. I'll drink a gallon of prep before I use those horse pills again. My wife saw the size of the pills I had to take and insisted on the liquid prep when she gets her colonoscopy in a few months.
 
I've had several, no problems, but once, when they were looking for the source of some bleeding, I had a pillcam colonoscopy. Really neet tech. You swallow a pill that looks like it's the size of your thumb, but it goes down surprisingly easily. It then takes flash pictures as it travels its merry way through you. Pics are sent to a receiver/recorder you wear at your belt. It zipped through in only a couple of hours and I didn't notice it'd gone 'til it was down the drain. (In certain circumstances I might have tried to retrieve it as a souvenir.)
 
I've had several, no problems, but once, when they were looking for the source of some bleeding, I had a pillcam colonoscopy. Really neet tech. You swallow a pill that looks like it's the size of your thumb, but it goes down surprisingly easily. It then takes flash pictures as it travels its merry way through you. Pics are sent to a receiver/recorder you wear at your belt. It zipped through in only a couple of hours and I didn't notice it'd gone 'til it was down the drain. (In certain circumstances I might have tried to retrieve it as a souvenir.)
Bleeding is common and increased with higher number of biopsies.

The pill cam is neat but not widely used. Not sure why. I am sure there is a clinical reason.
 
I won't live to see it happen, but down the road you will be able to walk into a physician's office and have a scanner complete a 100% thorough body scan
This would be great and it should be applied to everyone. I'm not afraid of very many things but I am afraid of some kind of serious cancer popping up.

I know a person who in his 30s was diagnosed with colon cancer. He's been taking treatments for it.

I've had 2 of the colonoscopies, sort of. The first one used the camera on an octopus tentacle, no problems found. My doctor said they had a CT scan that would do the same thing. He said it was exactly as accurate as the camera alien probe procedure, plus it would check your other internal organs for problems. The downside was that it requires the same cleansing type of prep, and if polyps are found then you have to go back for the alien probe so they can remove the polyps. Besides checking your other organs, another advantage is that it doesn't require anesthesiology. Well the second time I did the CT scan route and it came up negative for everything. That was a couple of years ago, more recently my insurance company sent me a test kit with packaging to return the brown sample to their lab for testing, negative on that one too.
 
I won't ever get one, that's the least of my problems. What I don't understand is that the #1 killer is still cardiovascular disease, so why isn't it mandatory to have a CAC scan done ? say at age 30? there's 50% more heart disease than cancers.

What does a coronary calcium scan do?​

The scan provides images of your coronary arteries that show existing calcium deposits. Called calcifications, these deposits are an early sign of coronary artery disease.
I've had 2 of these over a 12 yr period. Called a Nuclear Heart Stress Test. I have whats called MILD Atherosclerosis. They compared the two images and found there was no noticeable growth in the plaque in my heart arteries. Not bad for a 12 yr period. next time I think I'll get a MRI of the Heart. I do have or had Peripheral Artery Disease (PAD) in my lower right abdomen. I had 2 stents put in about 10 years ago because I was all clogged up down there.
 
Thanks for the confirmation. When I hear the F-word, I assume its a bad thing. Maybe its just mainstream media (even though I try to avoid it) that made me think that it was a bad drug. A former co-worker died from a fentanyl overdose. I never knew he was into drugs and apparently he didn't know the heroin he used was fentenoyl or had it in it. I don't know the details, but I do know a good guy is no longer here due to an OD and it sucks that I (or anyone else in his life) didn't know what was going on and that his downward spiral likely ended up terminating due to either suicide or bad drugs.

Glad to know it has a good purpose, even though the only reason I know the name is from the bad purposes.

Sandy.

A year or two ago, I was asked to research our most commonly used medications for our ambulances. Not surprisingly, Fentanyl topped the list. While it is a common cause of overdose deaths, it is otherwise a very safe drug for a professional to use. For us EMS, it has a quick onset of action, not a long half-life and it is tolerated better than other opiates by more people. It can be safely mixed with a lot of other drugs, so it's a good choice for us.

I suspect much of the fentanyl on the streets is adulterated with something else. It is strong, standard adult doses are only 50-100 micrograms. I don't know how much people are taking on the streets. The OD issue is bad, but the media stokes people's fears of a professional using or prescribing a generally safe medication.
 
This would be great and it should be applied to everyone. I'm not afraid of very many things but I am afraid of some kind of serious cancer popping up.
Our trauma surgeons will tell you that they frequently discover cancers and other serious problems when they do a complete set of scans for trauma patients we bring in. Sometimes that car accident that results in minor injuries like broken ribs is the reason potentially serious problems are caught early enough to easily treat.
 
Our trauma surgeons will tell you that they frequently discover cancers and other serious problems when they do a complete set of scans for trauma patients we bring in. Sometimes that car accident that results in minor injuries like broken ribs is the reason potentially serious problems are caught early enough to easily treat.
Very true. I had a patient that received a nice shock from lighting while in a tent in a field. The patient survived, and on a scan, we found a brain tumor. He said the lightning bolt was god sent.
 
I've had several, no problems, but once, when they were looking for the source of some bleeding, I had a pillcam colonoscopy. Really neet tech. You swallow a pill that looks like it's the size of your thumb, but it goes down surprisingly easily. It then takes flash pictures as it travels its merry way through you. Pics are sent to a receiver/recorder you wear at your belt. It zipped through in only a couple of hours and I didn't notice it'd gone 'til it was down the drain. (In certain circumstances I might have tried to retrieve it as a souvenir.)
Criminee, we had cloth diapers for 5 kids! I'd have got that bad boy, these hands have been washed of baby poop many, MANY times.

@cwbullet and so many others that had good tips (like dab, don't wipe!) thanks for the thread. I just had my second (at age 67) and instead of clean this time, they took off two small polyps, so it's back in 5 years for me. And along with Dave Barry's account, I give you two more:
Tim Hawkins Public Service Announcement
Bob Stromberg - Old Men have no Mercy

Bob has particularly good fine motor skills. You need to pop that one up to full screen immediately to avoid spoilers.
(Edited for wrong Hawkins link)
 
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I've had two. One at 50 and one at 55. And yes best sleep I ever had. Woke up feeling great! No joke. I don't know what they gave me. The second time, I started counting I don't think I made it to 3. When I woke I was sitting in the consulting room with my wife and the Doc was explaining what was on the screen. And I said oh is that what mine should look like? He said that is you, you have been talking to me for 15 minutes! I don't remember anything. Nothing found either time.

Somebody above mentioned making sure you have a good view from toilet to TV. That's 4SURE. I don't care if you run a 4 40 you ain't gonna make it.
 
A year or two ago, I was asked to research our most commonly used medications for our ambulances. Not surprisingly, Fentanyl topped the list. While it is a common cause of overdose deaths, it is otherwise a very safe drug for a professional to use. For us EMS, it has a quick onset of action, not a long half-life and it is tolerated better than other opiates by more people. It can be safely mixed with a lot of other drugs, so it's a good choice for us.

I suspect much of the fentanyl on the streets is adulterated with something else. It is strong, standard adult doses are only 50-100 micrograms. I don't know how much people are taking on the streets. The OD issue is bad, but the media stokes people's fears of a professional using or prescribing a generally safe medication.
Thank you for the well reasoned explanation. It helps to understand the media-freakout vs. reality based on a professional opinion.

Sandy.
 
My prep was two rounds of a new product called SUTAB. If I recall correctly it is two rounds of 12 horse pills and 16 ounces of water.one the night before and the other the morning of the procedure. Of course it results in the sh**s, but that is but design. No unpleasant taste, just swallowing the tablets and gulping the water.

The horror stories of choking down quarts of vile tasting fluid delayed my procedure by ten years.

I was given Propofol. Best nap ever and beat the hell out of PACU recovery following intubated general anesthesia.
 
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My prep was two rounds of a new product called SUTAB. If I recall correctly it is two rounds of 12 horse pills and 16 ounces of water.one the night before and the other the morning of the procedure. Of course it results in the sh**s, but that is but design. No unpleasant taste, just swallowing the tablets and gulping the water.

The horror stories of choking down quarts of vile tasting fluid delayed my procedure by ten years.

I was given Propofol. Best nap ever and beat the hell out of PACU recovery following intubated general anesthesia.
The key to vile water is refrigerating if after mixing it into lemon-lime Gatorade.
 
I had my last 2 done by a a surgeon who is a friend of mine. He told me two things. One was that colon cancer should be 100 percent preventable if the insurance companies would pay for regular colonoscopies and everyone would have them done.

Second - if you have one - get it done by a colorectal surgeon that specializes in colorectal surgery. Costs no more and if anything is found, it can be corrected on the spot.

I wonder what the percent of perforations happen when done by a gastro doctors that are not surgeons, vs that of colorectal surgeons?

A year or so ago, a very prominent SC legislator died from a routine colonoscopy perforation.
 
I had my last 2 done by a a surgeon who is a friend of mine. He told me two things. One was that colon cancer should be 100 percent preventable if the insurance companies would pay for regular colonoscopies and everyone would have them done.

Second - if you have one - get it done by a colorectal surgeon that specializes in colorectal surgery. Costs no more and if anything is found, it can be corrected on the spot.

I wonder what the percent of perforations happen when done by a gastro doctors that are not surgeons, vs that of colorectal surgeons?

A year or so ago, a very prominent SC legislator died from a routine colonoscopy perforation.
Sort of. The surgeon you see is probably good but he has a financial incentive for you to think he is superior and keep you coming back. The quality of a procedure based physician is not the shingle on the wall but the number scopes performed per year and complication rate.

Number one: It is more complicated than just insurance companies agreeing to pay. They base the standard on the recommendations from the Surgical and GI professional Societies and the U.S. Preventive Services Task Force. This recommendation is based on scientific evidence of when the benefit out weights the risk.

Number two: Most GI docs also correct it on the spot also. Neither is going to perform an open procedure of the cancer is past the colon wall.

Perforations are rare from both specialties. Complications are exceptionally rare. I reviewed the rates for 3 medical facilities over ten years with 1000s of Colos done by both Surgeons and Gi docs and there no significant difference in complications or missed cancers.

As far as quality of care metrics, GI docs score higher than Colorectal surgeons, but it is not statistically significant and there was not difference in complication rates between the two.

The bottom line: Pick a physician and ask them their complication rate, missed polyp, and missed cancer rates. They have to tell you and if they do not know, avoid them.
 
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