Questions about my first Colon Screening

AggieMike88

AggieMike88

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The original "I don't know it all" of aviation.
My first colon screening is scheduled for next week. No issues, but this is one of the "over 50" inspections that's recommended of everyone.

Some solace is that it won't be too long before our good friend Br-y-an will have to do it. And I fully expect the satirical video to document his experience.

79230-5642240Fr.jpg


Some questions to gain some hive mind wisdom on the procedure and getting ready for it...

Prep: Was given Suprep as the "full strength" cleanser to consume before the procedure. Any suggestions/wisdom on making this stuff tolerable as I take it? Instructions say mix with water and follow up with 2x 16oz servings of water over the next hour.

Not clear in the instructions if I am supposed to quickly "chug" the prepared dose or if I can take reasonable swallows over a short span of time.

Suprep-Bowel-Prep-Kit.jpg

Prep: In additions to the dietary instructions provided by the Doctor and his staff, what other bits of wisdom is there? Lots and lots of hydration, check. But what else?

Anti-Nausea: I was provided a prescription for Zofran to combat any nausea. A search on the AOPA medications database says NOT ALLOWED. So, @bbchien and @lbfjrmd, should I not fill this scrip at all? Or is it permitted to take for this one time use? I know "not allowed" often can be interpreted "you cannot be operated an aircraft while consuming this medication", which I definitely won't be. But what I don't know is if you can take something like this; wait a sufficient period; return to flight; and not get attached to another object by an inclined plane, wrapped helically around an axis.​

I have no idea how I'll react to the prep meds from the nausea angle. The doctor assistant providing me information about the prep had a few suggestions, so I might not need to Zofran. But I'd like know the FAA angle on this if I do need to take it.​

Day Before and Day Of: I think I got a good handle on this.
  • Only consume the clear liquid diet they told me about,
  • Remain very hydrated with water, Gatorade (no red or purple), and fruit juices
  • take my existing medications as they said.
  • And don't stray very far from the toilet.
Post procedure: My procedure is scheduled at 9:00am, so I expect to be home shortly after Noon.
  • I know I'll be a bit out of it from the sedation, but should I ask the person brining me home to stick around for a few hours since I live alone?
  • What is suggested regarding food choices as recover?
    • What can I eat the day of the procedure?
    • What can I eat on the day after?
  • When can I return to normal routine, including exercise on stationary bike.

Reporting to the FAA:
  • Of course the visit to a medical professional will be listed.
  • The procedure will done at one of the "day surgery centers" that surround the local hospital. But do I need to report this as a hospital visit? (Question 18u, Admission to Hospital)
  • How do I report the procedure on MedXpress? (what boxes and such)
  • Should I bring a copy of the results/details to the AME if is (hopefully) "no problems found"
  • If I do choose to take the Zofran, I'll report it. But will doing so create a world of reporting hurt?
  • Any other reporting items to be aware of so to make this a total yawn?

Also pinging Dr. Bruce and Dr. Lou for their input/comments on how to report at the next medical. @bbchien @lbfjrmd
 
Interesting prep .... my gastroenterologist told me to go get the big jar of MiraLax. She also recommended Propel for hydration, which I despise....I can't tolerate artificial sweeteners.

I never needed anything for nausea, nor was anything ever suggested.

I use ginger ale for the prep, followed by clear chicken soup (home made, of course). No need to chug....16 oz or so the first time, then another dose in 4 hours is fine, then another 4 hours later - however that's my doctor's prep. You need to contact your's to find out the method they prefer.

Avoid toilet paper - lots of very soft baby wipes. You may want to put the furball in boarding for the day/night because you will not be able to walk him.

After the procedure, don't go overboard on food - you're cleaned out inside. I usually go for waffles with whoever is chauffering me. By dinner, anything and everything you want. Regular activities by the next day.

My most recent one used Propofol...hadn't had that before. Out in 2 seconds, almost no reaction waking up. I can understand why it's become widely used.

You're really not out as with a general, you've been given an "amnesiac" drug....you won't remember anything. But if your doctor is like mine, you'll get pretty pictures of your colon, suitable for posting on your refrigerator door.

Other suggestions in PM.
 
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I’d definitely have someone drive you home after. I’ve had three (all clean, pun intended) and while I felt ok after to drive myself, good to leave the driving to somebody else just in case.

Cheers
 
It's not nearly as bad as people make it out to be the prep isn't much fun. I had heard that most of the world does it without sedation. I do not like the feeling of being "out of it" so when I had my first a few years ago I decided to forgo the sedation myself. It was not all that bad and kind of interesting to watch on the big screen. There is some slight discomfort mainly pressure when they are making the turn at the top of your intestines and when they are looking at the back side of your rectum it is uncomfortable like you need to make a bowel movement. Otherwise it is a quick 20 minutes and you don't ruin the rest of your day. YMMV
 
Just follow the directions you were given. The new style prep is a non-event. Chug it down fast! The old way was gross and exhausting...

Especially follow the instructions for what to eat and what to NOT eat in the three or so days before the procedure.

The best part is that the sedation will make you forget the whole experience. You will be right back to normal (?) in a few minutes!

Most hospitals will provide a detailed book of images and diagnoses. I'ts a little gross, but reassuring.

No, you can't go back in a week and do it again. You will have to wait five years unless there are polyps or worse...
 
Just don't flavor it with something you want to drink again in the future. I flavored my colon-blow with Crystal Lite margarita flavor.

I haven't had a margarita since
 
X3 Skier said:
I’d definitely have someone drive you home after. I’ve had three (all clean, pun intended) and while I felt ok after to drive myself, good to leave the driving to somebody else just in case.
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Thanks for reminding me of this. Already in the plans.
 
Why would you report the Zofran if it's something you won't be taking at the time of your next medical? You don't have to report every med you ever took, only the visits, the reasons for them, any diagnoses, and anything you are currently taking. Unless it's a "red flag" med like a benzo or SSRI, or something that points to a serious diagnosis (e.g. nitroglycerin), the FAA could care less what you took 10 months ago during your colonoscopy prep.

As far as after the procedure, I can only give my experience: the one time I allowed them to use a combo of propofol and Versed, I couldn't remember anything the doctor said when he saw me afterward. Now I prefer no or only conscious sedation with a very low dose of something like Versed. Or if they insist on knocking me out, then propofol only. But a couple of hours later even with what I call the devil's med combo, I was fine to be by myself around the house. Just not to drive or operate heavy machinery.

Otherwise, it sounds like you have it covered. The prep is by far the worst part of the whole process, but it goes by and once the procedure is finished, you should recover quickly.
 
I did the prep for my recent colonoscopy with Suprep. It tastes bad, so I chugged it. I was not offered any anti-nausea medication, nor did I need it. I have not had a medical since this last colonoscopy, but it seems that last time I simply wrote down "screening colonoscopy - normal". It wasn't questioned.

I took Silver Ride home, since I didn't want to bother anyone during a workday to bring me home. Silver Ride is offered in some cities as an alternative to having a friend bring you home. They won't allow you to take Uber, Lyft, or a taxi. I live alone and did not have anyone stay with me. It wasn't necessary. I felt normal by the next day.
 
azure said:
Why would you report the Zofran if it's something you won't be taking at the time of your next medical?
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Which is why I am asking the question.

Like you, I'm an active knowledge vacuum of what Dr. Bruce and Dr. Lou shares with folks via the forums. But I don't recall what, if any, guidance was provided on a question similar to mine when I was paying attention. So following the "own your medical" mantra, I want to find out and be certain ahead of filling the scrip.
 
AggieMike88 said:
Which is why I am asking the question.

Like you, I'm an active knowledge vacuum of what Dr. Bruce and Dr. Lou shares with folks via the forums. But I don't recall what, if any, guidance was provided on a question similar to mine when I was paying attention. So following the "own your medical" mantra, I want to find out and be certain ahead of filling the scrip.
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Sounds like a good attitude. My comment was in response to "If I take the Zofran I'll report it"... good to find out first, as you just said. I'll be VERY surprised if the answer is that you have to.
 
Just made me think of this...

upload_2019-8-7_19-54-9.png

Agent Hurley, I want you to give this guy a cavity search! I'm talking Roto-Rooter!
Don't stop until you reach the back of his teeth!

Good luck!
 
Non-event. Youngest of ten here, colon cancer/polyps run in my family. Had my first at 40 because of family history. I've had 5 thus far and am due for one now. Stayed awake for two so I could enjoy the show on the screen. Numerous polyps removed over the years, only clean twice.

I'm definitely an azzhole, but not a perfect azzhole.
 
My dad and both my paternal grandparents died of colon cancer, so I'm scheduled for colonoscopies every three years. They always find a polyp or two or three.

Follow the instructions and don't make any plans that will take you more than a few feet from the bathroom the afternoon and evening before the procedure. If you're anything like me, the procedure will be over before you even know it happened.
 
Since I will be pushing a significant quantity of fluids out.... I'm curious as to how this might affect my "water weight". I have a scale that measures that... so for my own info, I think I might do some before and after tracking.

@benyflyguy ... Hopefully I won't have to strain that hard.
 
AggieMike88 said:
Since I will be pushing a significant quantity of fluids out.... I'm curious as to how this might affect my "water weight". I have a scale that measures that... so for my own info, I think I might do some before and after tracking.

@benyflyguy ... Hopefully I won't have to strain that hard.
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Are you disqualified from a FIT, FOBT or sDNA test?
 
During today's office visit, they were particularly inquisitive on alcohol and coffee intake. Neither of which I do very much of.

But what gastro intestinal info are they gathering by asking about those two?
 
I remember my nurse and doctor were cute.

My prep was a 4x dose of MiraLax or something like that. I drank some flavor of Gatorade, any flavor was allowed as long as it didn’t have any red dye. I could have chicken broth, water, and the Gatorade. I expected worse, it wasn’t nearly as bad as I thought it would be. The procedure is nothing. You close your eyes, you open your eyes, and it’s time to go home. Make sure to get a ride, sometimes that anesthesia does funny things.
 
asicer said:
I mean do you have a good reason to prefer a colonoscopy over a FIT, FOBT or sDNA test?
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ummmmm..... I am going by the guidance of primary physician who recommended this screening due to age. No other alternatives were discussed, and the three you mention is the first I aware of them. Well, actually, I do recall the DNA thing via the "poop in the box" Cologuard commercials.

This round is already planned, scheduled, and paid for. But I'll add to my knowledge the other ones for future needs.
 
Chug it like a future Supreme Court nominee (sorry, I’ll ban myself now)

Make sure you read the instructions and note the markings on the cup carefully. I figured out after the fact I filled to wrong line — I.e. did not dilute with enough water — made it more vile than usual.

Afterward, had my son drive me to nearest taqueria for breakfast tacos and coffee.
 
AggieMike88 said:
ummmmm..... I am going by the guidance of primary physician who recommended this screening due to age. No other alternatives were discussed, and the three you mention is the first I aware of them. Well, actually, I do recall the DNA thing via the "poop in the box" Cologuard commercials.

This round is already planned, scheduled, and paid for. But I'll add to my knowledge the other ones for future needs.
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My guess is that @SixPapaCharlie will do one of the poop tests :)
 
timwinters said:
Many (most? all?) require that you have a driver. Period, exclamation point.
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This doctor's office made a big point of requiring it. And that area is handled.

A bit of a surprise was when the assistant said that I could opt for an Uber ride home. But not doing that since a ride home is already arranged.
 
AggieMike88 said:
  • I know I'll be a bit out of it from the sedation, but should I ask the person brining me home to stick around for a few hours since I live alone?
  • What is suggested regarding food choices as recover?
    • What can I eat the day of the procedure?
    • What can I eat on the day after?
  • When can I return to normal routine, including exercise on stationary bike.
Click to expand...
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.
 
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