Matthew
Touchdown! Greaser!
We picked up hamburgers on the way home. Every ten minutes for about 2 hrs I asked my wife, “Did we pick up hamburgers on the way home?” Ahh, drugs.
FIT/FOBT has poor detection and is based on false premise that all cancer bleedsI mean do you have a good reason to prefer a colonoscopy over a FIT, FOBT or sDNA test?
Ah, very interesting.FIT/FOBT has poor detection and is based on false premise that all cancer bleeds
sDNA is the newest kid on the block and I rec for ppl that have medical reasona that make colonoscopy hard to perform. ie advanced age, anticoagulation, ho severe diverticulosis, etc the test as a ~92% detection rate but can and does have false positives (no biggie we are talking about cancer here) but the test only has a predictive time range of 3 years. So you have to do q3 years.
Virtual colonoscopy - you didn’t mention this one but it is owed a line. A test invented due to a machine capability burning holes in large hospitals wallets. Expensive. Lots of radiation and it can tell difference between polyp that is cancerous or not.And by the way this test is required and air contrast enema. You are awake for this.
colonoscopy- The gold standard. Has risks that advance with age and perforation rates of about 1/1000. But if you see something it get box or removed. A clean colonoscopy gives you 10 year clean bill without other risk factors. Yeah so it’s a tube up your butt. But Contrary to popular belief your friends won’t be there high-fiving drinking beer and taking selfies. The preps have gotten better and I think MiraLAX prep is the gentlest one out there. And just remember to be happy that you’re in America because in some other countries they don’t put you to sleep for this test
Nah...just report date of procedure an dr report that everything is fine. Had 3 while I was on class 3 medical, no big deal.Regarding the drug(s) used for sedation, is that something that needs individual calling out on the MedXpress? or are they "assumed" to be part of the process and don't need to be specifically mentioned?
Dunno - I reported the procedure on my medical, I didn't write down all the drugs they gave me since I didn't know what they were anyway. They told me, I'm sure, but I didn't remember. There was no prescription, so nothing to report there. It's a colonoscopy, the AME and FAA medical probably know all about them.Regarding the drug(s) used for sedation, is that something that needs individual calling out on the MedXpress? or are they "assumed" to be part of the process and don't need to be specifically mentioned?
I put it down as a visit to a medical professional within the last three years, there was nothing else for me to report.Agree with @Matthew and @murphey. Wait to see what Bruce says, but I would bet money that he will agree. I certainly didn't report any of that - just the procedure, and I'm pretty sure I just relayed the results to my AME orally. I do not recall needing to give him a written report, since nothing cancerous was found.
Heh - my story earlier about the lunch stop on the way home... I kept asking, over and over, if we had stopped to get some lunch on the way home. My wife kept saying, "YES!! For the hundredth time, YES!!!" Finally, I wised up. The next time I wanted to ask, I walked into the kitchen and opened up the trash can. Inside was the wrappers and bag of our lunch, and I asked, "Did we get lunch on the way home?"Don't throw out your trash until you check it the next day. I had someone who drove me order fast food for me at a drive through. I can remember sitting on the couch eating a KFC dinner and sharing with my dog before I fell asleep there. When I awoke, I went to throw something in the kitchen waste basket and something glimmering in the bottom caught my eye. It was my silverware. Don't have a clue how it got there, but I don't think Fido did it.
Once nice thing about having this done in Texas....Heh - my story earlier about the lunch stop on the way home... I kept asking, over and over, if we had stopped to get some lunch on the way home. My wife kept saying, "YES!! For the hundredth time, YES!!!" Finally, I wised up. The next time I wanted to ask, I walked into the kitchen and opened up the trash can. Inside was the wrappers and bag of our lunch, and I asked, "Did we get lunch on the way home?"
Don't throw out your trash until you check it the next day. I had someone who drove me order fast food for me at a drive through. I can remember sitting on the couch eating a KFC dinner and sharing with my dog before I fell asleep there. When I awoke, I went to throw something in the kitchen waste basket and something glimmering in the bottom caught my eye. It was my silverware. Don't have a clue how it got there, but I don't think Fido did it.
... but the procedure itself was a piece of cake. (Odd simile...)
so....did they determine if you had optic rectitus?
All considered as part of the acute process!Regarding the drug(s) used for sedation, is that something that needs individual calling out on the MedXpress? or are they "assumed" to be part of the process and don't need to be specifically mentioned?
In what space would you report this? There's not a general question about drugs administered in the past.Regarding the drug(s) used for sedation, is that something that needs individual calling out on the MedXpress? or are they "assumed" to be part of the process and don't need to be specifically mentioned?
Don't worry, soon it will all be behind you!
Few thoughts:
I think you could likely do fine without an antiemetic.
You may not be out of it post procedure. Propofol only sedation is commonplace and if that is what you receive, you will likely feel completely normal between 15-20 minutes post procedure.
We often suggest starting slowly to avoid nausea, etc. You will likely know if you feel up to a buffet before you are discharged.
There is at least one study that found more polyps when a patient is sedated with propofol rather than conscious sedation. The theory regarding the reason for this is that if the patient is more relaxed then the colon expands better allowing for superior visibility of the entire colon lumen. Also, if a patient isn't squirming in discomfort, the endoscopist is less likely to rush.
Propofol is a non-barbiturate induction agent that produces unconsciousness; you will be unconscious for the entirety of the procedure typically. For conscious sedation, typically versed and a narcotic are used. Versed is a benzodiazepine that commonly results in amnesia, so you often do not recall events after the drug is received. If you get conscious sedation, you will likely be a bit out of it hours after the procedure because those drugs last longer.
Personally, I would choose propofol over conscious sedation every day for me, but there are some individuals that are not great candidates for propofol. Lastly, there is no way I would consider a colonoscopy without some sort of sedation.
Unknown ... which is why I am asking.In what space would you report this? There's not a general question about drugs administered in the past.
That most likely was Versed aka midazolam. Frequently it produces amnesia but not always. The amnesia is not retrograde so typically one remembers everything clearly until about a minute after the drug is given. That amnesia may last 30 minutes or all day long; the results are typically much longer in the elderly.Not sure which one they gave me, but they told me I wouldn't really remember because it had an amnesiac quality but I'd still be awake and respond to them.
Yes. However, the amnesiac effect seems to be dosage-dependent. I had conscious sedation with midazolam last fall and remember everything. As an additive along with propofol, it was utterly lethal to my memory.That most likely was Versed aka midazolam. Frequently it produces amnesia but not always. The amnesia is not retrograde so typically one remembers everything clearly until about a minute after the drug is given. That amnesia may last 30 minutes or all day long; the results are typically much longer in the elderly.
Yes. However, the amnesiac effect seems to be dosage-dependent. I had conscious sedation with midazolam last fall and remember everything. As an additive along with propofol, it was utterly lethal to my memory.
Yes, correct, it is dose dependent but is is also dependent on other factors such as age and concurrent medication usage.Yes. However, the amnesiac effect seems to be dosage-dependent. I had conscious sedation with midazolam last fall and remember everything. As an additive along with propofol, it was utterly lethal to my memory.
In my case it was definitely the versed. After that time, I had 2 colonoscopies with propofol alone, and had no trouble either time remembering the debrief from the procedure. The first time, with the added versed, it is lucky my Dad was there, as I had no recollection whatever of what the doc told me. Last fall I had the procedure done by a team that didn't include an anesthesiologist, so it was versed alone or nothing. I told them to use a VERY low dose, and had no troubles with recall afterward.Yes, correct, it is dose dependent but is is also dependent on other factors such as age and concurrent medication usage.
While it is additive with propofol, if you received propofol you likely received enough to render you unconscious like that time back in college... but, I digress. That being the case, the propofol alone typically is enough to prevent any recall.