COLONOSCOPY How hard is it on you?

Parent Cafe Health & Wellness
1824

Yes, your primary care physician can order a stool test for you. The fecal immunochemical test (FIT) is the preferred one, since it is more accurate than and does not require special dietary restrictions like the guaiac-based fecal occult blood test (gFOBT), without costing any more (either is relatively inexpensive). These tests should be done every year; a finding of blood in the stool means a follow-up colonoscopy.

The FIT-DNA (Cologuard) add a DNA testing component. But it is much more expensive, so it is only recommended every three years (but one FIT-DNA costs much more than three FITs).

1825

@Sybylla – it is also possible to get a direct-to-consumer, at-home FIT test that gives you results immediately. (Similar to a home pregnancy test). Cost is around $25-$30. Produced by Pinnacle Labs & called “Second Generation FIT”. So that’s an option if for any reason getting a lab order from a physician isn’t. If you Google it you’ll find options to get it right away, as well as many consumer reviews you can read.

I’d note that this is NOT what I do – I get my FiT test from the same lab where I go for routine blood work & just do it once every year in conjunction with my annual physical. I think you’d be better off doing via a lab – but I’m answering your question since I am aware that may not be an option for everyone.

But if you do opt for that route, be sure you are getting a real kit. Pinnacle Labs is legit, but I can see online that a search for an at-home screening test also turns up some cut-rate ($10 or so) products that appear to be designed to indicate whether there is blood in the stool, but aren’t called “FIT” and don’t really seem to be the same thing.

The statistics about effectiveness of FIT that are on the USPTFS website are based on the OC FIT-CHEK product – my lab offers a different product called InSure – and there is at least one study that shows that to be a little bit more sensitive than the OC product (https://clinicalgenomics.com/wp-content/uploads/2017/12/shapiro_etal_ajg2017285a.pdf ) — I’m not really sure these minor differences are all that significant— but my point is simply that if you opt for a direct-to-consumer product, you’ll want to make sure you are getting the right product.

1826

I wasn’t IV’d during my Colonoscopy last October but, when I do get an IV, I ask for it in my hand. For some weird reason (probably related to my needle phobia) I hate getting poked in my arms— except for lab work. I prefer blood tests over injections for some strange reason.

1827

^It seems like they don’t have any problem when they poke me for blood tests. @Nrdsb4 is there a reason for that?

1828

@MaineLonghorn, that is completely different. When drawing blood, I only need to get the tip of the needle into your vein. When I am inserting an IV, I have to gain access, but then thread a longer needle - so I need a certain length of straight vein that doesn’t roll or collapse on me after I’m in. Then I have to withdraw the needle at the same time I’m inserting a plastic catheter (this is part of the IV catheter mechanism that happens simultaneously), hoping that the vein doesn’t collapse. There are also valves in the veins that are not always visible, so if you get access but hit a valve as you advance the needle, you won’t be able to completely insert the IV, and you have to abort the process.

All this is made more difficult if you have tiny veins, if you are dehydrated (and everyone who has done a prep is dehydrated, even though you may have followed directions to a T), if you have veins that spasm when you experience fear or pain, if your veins have a lot of valves, etc. Even having “big juicy veins” doesn’t guarantee it. Some people’s veins blow every time you insert the needle. My Dad has gorgeous veins, and the nurses all said “Yay!” when they came in with the IV kits. It would take 3 or 4 nurses before someone could get in, and these were seasoned, expert ICU nurses.

1829

@Nrdsbs4, thanks so much for the explanation! That really helps. I wondered why they usually get blood for tests easier.

I tried to drink a ton of water three hours before the procedure, since I knew I was dehydrated last time. I guess it was still an issue, though.

1830

@Nrdsb4 is there anything those of us that tend to be difficult can do to help? Even having blood drawn is a challenge with me, usually requiring multiple sticks and the person always seems to feel so bad about it. I drink a lot of water normally (about 3 liters a day), but is there anything else?

1831

^^same for me. They almost always end up with what I think is referred to as a butterfly needle. I seem to have tough veins to find/adequately poke. Any suggestions @Nrdsb4?

1832

In addition to hydrating, ask your nurse if it would be possible to use a smaller gauge IV catheter since you are a difficult stick. Don’t ask for a “butterfly needle”-those are used for blood draws, not IVs. There are certain procedures where a larger bore catheter is necessary, so there is only so small they can go. The fluids you are receiving also play into this.

Ask if they could place a warm compress on your arm for a few minutes before IV insertion. This helps the veins to dilate.

Don’t think something is amiss if they thump or tap your vein beforehand. This also helps the vein to pop up.

While waiting for the nurse, keep your forearm lower than your heart level. Hang it off the bed-the gravity helps the veins to fill. You can pump you fist as well before they begin.

If you’ve been told that your veins are “tortuous” or have a lot of valves, let your nurse know. Sometimes when the catheter doesn’t advance, the nurse can use techniques to “float” the catheter past the valve. Better to ready beforehand than have to react in the moment.

If you know that a particular vein always seems to be a good one for IVs, let your nurse know. But don’t point at the bend in your arm and say “this one is always good.” The antecubital vein is often used for blood draws, but it isn’t the best place to start an IV. If that vein is injured, the nurse cannot go lower (“distal”). That’s why many facilities have a policy that the nurse start distal, or as “low” as possible. If you blow the vein low (the hand or wrist), you can keep trying upstream, but not vice versa. Also, people bend their arms a lot. When you bend the arm with an IV in the AC vein, the medication or fluid can’t advance through the vein. The IV pump will constantly alarm, or you may find that your medication isn’t giving you the benefit or relief you need.

Try to avoid the temptation to pressure the nurse or blame her competence if he is unsuccessful. EVERYONE misses. I’ve seen patients insult the best IV nurses and doctors for things which are just not their fault. And being human, sometimes you just don’t have a good day. Try to remember that you aren’t perfect either.

If you do have a nurse who misses twice, it’s not unreasonable to ask for someone else to try. Just try not to be a schmuck with the way you ask. If I missed twice, I always called another nurse in to try. Sometimes no one can get one, and other types of catheters must be considered which provide better access but come with more severe risks.

1833

@Nrdsb4 wow THANK YOU for all that expert advice and info. I’m always curious and fascinated by everything when I am in the ER (on one of my many visits with elderly parents) and I love learning why certain things are done a certain way.

1834

Well, gonna try it again. Four years ago, I did the recommended prep (normal diet except for no nuts or seeds for three days), God awful Golightly, hemorrhoids forever, and was told I wasn’t that clean and to return in three years.

This time I have had a low residue (avoided all fiber, nuts and seeds) for a week, started the clear liquids the day prior to the prep, along with some Magnesium Citrate the night prior to prep, and starting the Prepopik in an hour.

Since I’m halfway cleaned out already, I’m hoping that this is less miserable than the last time, and I am clean as possible…with hopefully no return for five years!

1835

Sounds like good prep work, Busdriver. Good luck tomorrow!

1836

Good luck, @busdriver11 !

1837

Thanks, guys! If I mess it up this time, they’ll probably sentence me to annual colonoscopies, with nothing but Golytely…so I’m highly motivated. :open_mouth:

1838

@busdriver11 if it makes you feel better, they said I was well cleaned out, finally! So I don’t have to go back for five years, whoo hoo. The extra effort was worth it!

1839

Yes, it does make me feel better @MaineLonghorn! Yours was one of the posts that inspired me.

And this Prepopik actually tastes good. If it was healthy, I’d drink it for a refreshing drink. Sooooo much better than a gallon of lemon flavored sweat that makes you want to puke!

1 Like
1840

@busdriver, yes, the Prepopik is the best in terms of taste/volume!

Sounds like you have set yourself up very well for success. Good luck!

1841

Hey busdriver11, We are thinking of you! Hope everything went well…

1842

Yay, done!! This was a totally different experience than last time. I felt fine throughout the prep, and was totally clean. No feeling like I was going to pass out or throw up. Two small polyps, come back in five years if they biopsy non cancerous.

Took her two seconds to put in my IV…she said it was easy because I have prominent, straight veins and no subcutaneous fat (I asked her to please not do it on my hand). I also pumped my fist and let my hand hang down from my bed, lower than my heart like Nrdsb4 suggested.What was different this time is that they gave me very little sedation, doc preferred to give minimal and my pulse went down to 40, so I was awake and felt everything the last 20 minutes. Not painful, though uncomfortable. Interesting, and I like this better because I wasn’t doped up at all afterwards.

Thanks for all the advice and good wishes. The info from @Nrdsb4 and @MaineLonghorn was particularly helpful for me. :smiley:

1843

Great news! That means you and I will be doing this again the same month, five years from now!