colonoscopy

[JulieM]

Our GP gave us both prescriptions to have this procedure done and I've been putting off scheduling it. So I finally made the call yesterday and they told me I couldn't schedule it, that only a gastroenterologist could. So now I have to make us both appointments with another doctor before we can get this done. I'm bummed because I was ready to get it done and now a new delay, not to mention additional cost, since we only have catastrophic insurance.

Does anyone know why it's so relevant to see a gastroenterologist first? Will he do anything more than have us fill out a ton of paperwork and then ask a few questions before setting up the appointments for the procedure?

[LA98]

How odd (and annoying!). DH just had one done, our PCP gave him the prescription during his physical. They gave him the info on the center where he had to have it done, we scheduled it, no problem. I'd definitely give your doctor's office a call and ask them to call the center to find out just what's going on.

[Kathy B]

Are you sure you have to see the gasteroenterologist? Or is that just the policy of the particular office you called? DH and I both have had one, and we only needed a referral from our GP to schedule it ourselves. You might check back with your GP's office to see if it is standard procedure to have an office visit with the GI person before the colonoscopy. Maybe if the GP's office calls the GI, they can schedule it for you?

[JulieM]

How odd (and annoying!). DH just had one done, our PCP gave him the prescription during his physical. They gave him the info on the center where he had to have it done, we scheduled it, no problem. I'd definitely give your doctor's office a call and ask them to call the center to find out just what's going on.

Actually I did that yesterday and they didn't believe me and told me to call Outpatient Scheduling again. So I did and they told me the same thing. I called my doctor's office again and they called me back this morning and confirmed that they could not schedule it--only a gastro can so they gave me a referral. That seems weird. Their unfortunate and scary explanation for the reasoning was that it's a somewhat risky procedure.:eek: Yes you're right... annoying it is!

[suebear37]

When I had my first one, I had to go to the gastro's office to have a meet & greet with the PA, who gave me the lowdown on the procedure & scheduled it at that time.
I didn't meet the doctor until the day of the procedure.

Maybe this is what they're telling you that you have to do?

[JulieM]

Are you sure you have to see the gasteroenterologist? Or is that just the policy of the particular office you called? DH and I both have had one, and we only needed a referral from our GP to schedule it ourselves. You might check back with your GP's office to see if it is standard procedure to have an office visit with the GI person before the colonoscopy. Maybe if the GP's office calls the GI, they can schedule it for you?

Well it's interesting that it's not a universal situation but apparently specific to this hospital. Unfortunately I'd rather not do it at the other hospital it my area.

[JulieM]

When I had my first one, I had to go to the gastro's office to have a meet & greet with the PA, who gave me the lowdown on the procedure & scheduled it at that time.
I didn't meet the doctor until the day of the procedure.

Maybe this is what they're telling you that you have to do?
So maybe the hospital provides the facilities, but the local gastro's do the procedures? That would explain why it can only be scheduled by a gastro. Well that makes more sense.

[Robyn1007]

So maybe the hospital provides the facilities, but the local gastro's do the procedures? That would explain why it can only be scheduled by a gastro. Well that makes more sense.

Yeah, a gastro has to do the procedure so if they aren't set up as a center focused on gastroenterology I would think you'd need to have an appointment with a gastro first. When I had one 5 years ago (on my 26th birthday :mad:) I had to see a gastro first who then did the procedure at the hospital.

[suebear37]

So maybe the hospital provides the facilities, but the local gastro's do the procedures? That would explain why it can only be scheduled by a gastro. Well that makes more sense.

I didn't have mine in the hospital. The gastro practice that I go to has their own little outpatient surgery office. That was much easier than having to deal with the hospital.

[JulieM]

I didn't have mine in the hospital. The gastro practice that I go to has their own little outpatient surgery office. That was much easier than having to deal with the hospital.

That's a good tip!

[pilgrim719]

I didn't have mine in the hospital. The gastro practice that I go to has their own little outpatient surgery office. That was much easier than having to deal with the hospital.

That would have been nice! I had to go to the hospital for mine, which was sort of a hassle. My gastro recommended I have a colonoscopy, and she did it herself so I'm not sure how it would work if your GP wanted you to have the procedure. Hopefully you get it all resolved soon so you can commence with stressing about actually having it done. (That's what I did anyway. :rolleyes:)

Kari

[mst]

Julie- Try calling the gastro- they might give you the referrel without ever seeing you. I know that our doctor did that. Also did not meet him before the procedure.

It is a really, really important test, and well worth the moneytime/annoyance. My DH's mother died of colon cancer, and my DH's father had 8 inches of his colon removed. If my MIL had not been afraid of getting a colonoscopy, she would have lived to see her children get married, and her five grandchildren. The procedure stinks (I have done it twice), but it saves lives. Good luck!

[JulieM]

It is a really, really important test, and well worth the moneytime/annoyance. My DH's mother died of colon cancer, and my DH's father had 8 inches of his colon removed. If my MIL had not been afraid of getting a colonoscopy, she would have lived to see her children get married, and her five grandchildren. The procedure stinks (I have done it twice), but it saves lives. Good luck!

You are right! My FIL just died in late January from colon cancer and he was otherwise very fit. But he simply refused to get the test and now he's gone. So sad.

[HealthyinMN]

I didn't have mine in the hospital. The gastro practice that I go to has their own little outpatient surgery office. That was much easier than having to deal with the hospital.

Jeff just had one done today and we also went to an outpatient office. He was in at 2:45 and we left before 4! We went to our PCP who set everything up and got us the prescription junk (well, that is what Jeff is referring to it after drinking it). We didn't have to see the Gastro doc until the scoping began.

[suebear37]

We went to our PCP who set everything up and got us the prescription junk (well, that is what Jeff is referring to it after drinking it).

My neighbor tells me that they now have pills you can take to, ahem, get things moving... :)

[Laura]

Oh man; definitely do the pill. DH just had his done and afterwords they told him that a pill was available to clean out the colon and it only costs about $75. So much better than drinking the other stuff.

[Gilgamesh37]

Actually, I have heard (and believe me, we have talked extensively to several different GI docs and GI surgeons recently) that many physicians feel the pill is not as effective as the Go-Lytely--so you might take that into consideration. You don't save yourself any grief if--by chance--they do the colonoscopy and decide things are not clear enough for them to see what they need, and you have to do the whole thing over again with the Go-Lytely anyway.

[Laura]

Actually, I have heard (and believe me, we have talked extensively to several different GI docs and GI surgeons recently) that many physicians feel the pill is not as effective as the Go-Lytely--so you might take that into consideration. You don't save yourself any grief if--by chance--they do the colonoscopy and decide things are clear enough for them to see what they need, and you have to do the whole thing over again with the Go-Lytely anyway.


Honestly, I wonder if I could stomach the other stuff. My DH who doesn't usually have problem taking anything said this was the hardest thing he ever had to take and had to overcome the gag reflex a number of times. The colonoscopy itself was a piece of cake. It took all of about 20 minutes and he remembered very little of it.

[Gilgamesh37]

Huh, that's interesting. Usually you can pick what flavor you want the Go-Lytely in, there are about 20 of them, so it shouldn't have to be anything that makes you gag. Usually folks' objection is that the elimination is rather forceful and overwhelming (trying to be delicate here) and then you have an associative aversion to whatever flavor the stuff was. I haven't really heard that the stuff on its own is particularly repellant--well, except that there's a lot of it, and you have to keep drinking it even when the immediate effects of it have become apparent.

[Valerie226]

there are different preps depending on what the gastro likes best. go-lytely isn't used universally. Miralax is pretty popular now and is tasteless powder disolved in a quart of gatorade followed by another quart. not bad really.

the "clear liquid" day before is a killer. DH (especially) is used to eating a lot and the clear liquid day is just plain awful. you are too tired and headachy to do anything but you have an entire day and night to deal with.
If at all possible schedule your procedure early the next morning so you don't have another half day of liquid only. and make sure you have someone to drive you. most places are NOT set up to let people sleep off the anesthetic sufficiently to be driving themselves afterward.

Around here we schedule our own appts. procedures are done in a multispecialty outpatient clinic owned by the docs in the group so no hospital to deal with. you have communication with the gastro office but don't meet the doc until right before the procedure when you are already a bit out of it. Most people feel Ok fairly soon after the procedure. DH was STARVING and ate 2 days of food in the next few hours. In my case I had a lot more anesthetic than usual because of an twisty colon. I was worthless for a good 3 hours after. could not stand, could not walk. fell asleep in the car for at least an hour while DH did errands. Don't schedule anything afterward until you are sure of your outcome.

[mbrogier]

When Rob and I both had ours done in Illinois, we met with a gastro first. He did the procedure at an outpatient procedure clinic at the local hospital. That hospital has a cardiology clinic as well.

I've had issues with the go-lytely. I have to take potassium the day that I prep, or I wind up in the ER on a potassium drip and fluids. My heart just can't take the sudden electrolyte change.

I can't remember if I've had the pill or not. I'd be happy to try it. I've had so many different preps and oral contrasts that are so nasty. I shudder just thinking about them.

I'm always completely knocked out during a colonoscopy. I just tell the nurses I don't like being awake, and they obligingly knock me out. Evidently I can talk and follow directions, but I don't remember anything afterwards. Usually I'm asleep about 10 seconds after the doctor walks in the room.

The prep sucks, but I think colonoscopies are a definite must have procedure. I wish Rob's uncle had gotten his regularly. He's had a rough time with colon cancer.

Rob doesn't remember *anything* the day of the procedure. He tries to work in the afternoon, but he doesn't remember that the next morning. I make him stay home and rest even though he insists he's ok. The third time this happened, he volunteered to stay home on his own. Take your time after the procedure and rest. The nurses won't kick you out the second you wake up, and your driver doesn't want you falling on them because you're dizzier than you think you are and jump out of bed to get dressed.:rolleyes:

[Canice]

If your GP prescribed it, I don't understand why she can't just call in a referral to the gastro and then you schedule? I've been out of the traditional system for about 25 years now (in Kaiser) though, and don't really deal with that stuff. I told my (Ob) nurse that my sister was dying of colon cancer (at age 45) and that afternoon had a call to schedule a colonoscopy and one for a visit with a grief therapist.

Had to go to a presentation in advance of the procedure, but no "meet and greet". And they wouldn't do the procedure without a form providing the name, relationship, and phone number of the person who would pick me up. I just wanted to take a taxi home, but it's not permitted.

[JHaris]

I had one last summer, my first, and my initial plea when I made the apt at the Dr.'s office, was that I heard there were pills to take instead of the liquid. I know I would have had a gag reflex had I taken the liquid, but then that is me. If anything comes in pill form, I prefer it.

The schedule is 4 pills which are about the size of large oval vitamin tablet every 15 min. with an 8 oz glass of water. I usually drink lots of water to quench any thirst as opposed to soda, etc. so this wasn't hard. As for the procedure, a light anesthetic.... I counted and the next thing I knew the nurse was asking how I was feeling and would I like some juice and crackers which I gobbled up I was so hungry. I had it done in an out patient building, but DH prefers the hospital facilities. He felt where I had it done was too "assembly line." Anyway the Dr. proclaimed me "sqeaky clean" and so I am off the hook for another 4 years. I felt fine afterwards other than hungry and just took it easy when I got home. And it was mandatory that someone come with me to drive me home. Taxis were definitely not allowed.

[mbrogier]

The issue with the taxi is that at the time you feel like you're ok. The next day you might be a bit foggy on the details of the whole afternoon. There's also the liability if someone said they were taking a taxi and actually drove themselves home. If they got confused and caused an accident, the center/hospital could be held liable and sued.

I always like having someone (usually Rob but sometimes my mom) with me because getting dressed and out the door when you're still woozy is hard. Also if you *did* have an adverse reaction to the anesthetics, you'd be too out of it to call an ambulance. Sometimes it can take up to 4 hours for your body to react to an allergen. It's also possible to be fine on a certain medication and have no issues and then have a major reaction out of the blue... that's what happened with my orange allergy. I was fine one day and had my throat and lungs close up just by popping a starburst in my mouth.

The chances of any of this happening are about the same as you winning the lottery, but it's just best to be safe just in case.

[Laura]

Huh, that's interesting. Usually you can pick what flavor you want the Go-Lytely in, there are about 20 of them, so it shouldn't have to be anything that makes you gag. Usually folks' objection is that the elimination is rather forceful and overwhelming (trying to be delicate here) and then you have an associative aversion to whatever flavor the stuff was. I haven't really heard that the stuff on its own is particularly repellant--well, except that there's a lot of it, and you have to keep drinking it even when the immediate effects of it have become apparent.

I don't remember what his was called, but I am pretty sure it wasn't Go-lytely He said it was like drinking a quart of saltwater. It wasn't the volume, but definitely the taste.

[Valerie226]

As I said before, I got more anesthetic than most because my colon is "tortuous" and required a lot of twists and turns to negotiate, hence more drugs. I remember a goodly portion of the procedure and remember most of what was said and what I said.
I remember being back in the dressing room. Doctor comes and reviews findings which I can't remember the next day. got dressed OK, but could not walk. got into wheelchair. DH wheels me to the parking lot. I get up & into car without difficulty. eat snack while giving relatively complicated driving directions to a place I'd been before but from a different direction. I am not very familiar with the area. arrive at destination. I wrap up in sleeping bag while he goes in to take care of his medical appt. I sleep soundly for 1 hour. Friend comes out to see if I'm awake. I set off car alarm somehow and can't turn it off because I don't remember I need to stick my keys in the ignition. I go into clinic and carry on seemingly normal conversation, none of which I can remember the next day.

The anesthetic does not dissipate in an orderly manner... moments of sharp clarity followed by passed out state. There are reasons you want someone else YOU KNOW doing the driving...

but back to the original question... I would guess the cost of a pre colonoscopy appt is likely rolled into the total cost of the procedure. I can't imagine why you'd need to see the doc first unless you're an especially high risk candidate who needs pre screening of some sort. and you don't sound like it. but the medical community can differ on how things are done. we just scheduled it( date & time) and they mail you pre procedure directions and a script for the "juice" which you get filled at the pharmacy of your choice. It's so important though to go ahead even if the procedure costs more than you expected.

[HealthyinMN]

I don't remember what his was called, but I am pretty sure it wasn't Go-lytely He said it was like drinking a quart of saltwater. It wasn't the volume, but definitely the taste.

That is what Jeff had to down too... I believe it was something called Nu-Lyte (something like that anyway) and it was a full gallon he had to drink.