Earlier quoted context omitted.
> the lack of market incentives means that we don't train enough medics. I don't think so; the number of medics we train in the UK is mainly controlled by the medical colleges.
That makes my point doesn't it?
Are colonoscopies worth it?
231–240 of 296 posts
Re: Are colonoscopies worth it?
#232It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…
Re: Are colonoscopies worth it?
#233Earlier quoted context omitted.
I find the prep really hard to take. It doesn't taste nice, and it involves drinking much more fluid than I'm used to. I had a sigmoidoscopy about 20 years ago; instead of laxatives, they gave me an enema, whose effects I found surprisingly swift and violent. An enema won't work for a colonoscopy, because it only cleans out the sigmoid colon. The colonoscopy is also extremely unpleasant; not exactly painful, but it m…
I had rectal cancer 18 years ago, and part of my followup was annual colonoscopies for the first decade. So I'm pretty familiar with the procedure, at least how my thoracic surgeon performed them. Yes, the prep can be unpleasant. I tolerated it because of how close I had come to dying, and really didn't want my ticket punched. But the procedure itself was never unpleasant. When you say you weren't allowed sedatives b…
Yes.
> The colonoscopy has NEVER been painful for me.
You've always been medicated.
> I would recommend finding a new doctor. Doing a colonoscopy without sedation sounds barbaric.
"My doctor" is what I call my GP; he's not involved in this process. I was referred for colonoscopy based on a fecal blood test that was centrally-administered. Several consultants (including the dental consultant that did my root canals) have denied me sedation on those grounds. In general, I'm inclined to agree that anaesthesia and sedation are dangerous for drinkers, and should be avoided if they aren't essential. And they aren't essential for a colonoscopy.
Re: Are colonoscopies worth it?
#234Age 39. Presented to family GP with rectal bleeding. He did no exam, pretty much dismissed it as a hemorrhoid. Age 40. Complained again to GP that bleeding was continuing (sporadically). GP finally decides to refer me to the local thoracic surgeon. This surgeon gives me a go over with an anoscope and schedules a colonoscopy the next day. Turns out I had a 5cm tumor...
I was married with two very small kids. Not the best time to get cancer.
A week later I'm starting radiation therapy to try and shrink the tumor. A week or so after that (things tend to blur when medicine moves fast), I'm started on chemotherapy treatments. I start to lose weight (I was 6'2"/240lb at the start of this). I get a portacath above my heart so chemo drugs can go straight into a big vein. I carry a pump around to push my chemo drugs in on a reliable schedule. This combined treatment goes on for a month before I go through surgery. I'm experiencing neuropathy from the oxaliplatin, which makes your extremities very sensitive to the cold (and of course I live where you have real winters). Foods taste wrong too.
Go in for surgery and come out with an ostomy. The surgeon had tried to save enough stuff so I didn't need a bag, but well, sometimes biology has other ideas. The tumor was too large and too close to all the rectal muscles. At least the surgeon said there were good margins, and no signs of metastasizing. So now I have a bag. At this point I way about 160lbs. Nothing tastes good except candy, and the docs are worried about my weight loss. So I get the green light to eat as much candy as I want.
Now I'm alive, with a bag, but alive. I'm taking some experimental oral post-surgical chemo pill 4x daily to try and kill any little bastard tumor cells that might have been released. These suck. Chemo is always a race to kill cancer cells before the chemo drugs kill you. My oncologist is always checking white cell counts, but now has some DNA test that looks for tumor markers. This is pretty cool. My cell counts improve and the tumor market analysis looks good. So I'm eventually sent home. On my way out of my last meeting with my oncologist and his nurse, I ask him how often he gets to send someone home in my situation. The look in his eyes made it apparent how tough a job these folks have.
So now 18 years later, I've been able to run a full marathon, finish my basement by myself, build the coolest shed in my back yard. Settle into a good IT career at a company where I can retire. And most importantly, be there when my kids graduated from school. Be there for my wife when her dad passed away from cancer. Just be there...
So if a colonoscopy scares you, as they say in The Wire; ain't no thing. Don't be like Farrah Fawcett who died of anal cancer because she avoided treatment. 150K new cases of colorectal cancer are diagnosed annually in the US. And if discovered early, it can be treated far less invasively and less life-altering than if found later.
Re: Are colonoscopies worth it?
#235Given people don’t read the full article, and that feels pretty important in this discussion, I will quote the way it ends: > One thing is clear: Screening works. If you’re of the appropriate age, please get screened. If your tubes are acting funny, please get screened without delay. The best method and the level of benefit are debatable, but we know it helps. Use a stool test if you want (multitarget DNA test if you…
> One thing is clear: Screening works. If you’re of the appropriate age, please get screened. If your tubes are acting funny, please get screened without delay. The best method and the level of benefit are debatable, but we know it helps. That's unfortunate, because it's a poor summary of the actual paper the article is discussing. If you bother to read the rest of the article, you'll see the actual summary of the tr…
Re: Are colonoscopies worth it?
#236Earlier quoted context omitted.
And the big disadvantage that to get there your need to book 2 professionals (?) and take pretty much one day off, and there are risks associated with anesthesia and the procedure itself I don't think it scales (Not to mention the interests of doctors of suggesting things that make them more money) Edit: now I see TFA mentions risk of perforation and that the risk is smaller without anesthesia
In Japan, everyone over 40 gets yearly colonoscopies as part of a general health check up. That should be a really good source of data, someone should take a look at that. But what I was getting at is that it can scale.
Re: Are colonoscopies worth it?
#237>3. It’s irresponsible to call colonoscopies “invasive” (as CNN did) since that might make people think they are unpleasant and not do them. LOL. It hard to imagine anything much more invasive than having a metal tube (with light and camera) shoved up your arse. It is definitely unpleasant. I speak from personal experience. That said, it is less unpleasant than bowel cancer. So don't be put off if you really need to…
Putting something in the body and getting it back out without tearing, is not invasive. Eating and vomiting would be categorized as invasive, in context.
A colonoscopy/endoscopy is internal and dangerous, which is not the same thing as being invasive, so the term "minimally invasive" is sometimes used as a happy middleground, which has then been sensationalized.
Re: Are colonoscopies worth it?
#238What about swallowing a pill camera? Could these be a slightly less invasive way to screen your colon? The technology for pill cameras along with AI should keep improving.
One benefit of a "proper" colonoscopy is that the scope has a little wire that's used to remove polyps. Polyps have a high chance to progress to tumors, so nipping them in the bud is a good idea. Can't do that with a pill camera setup.
Re: Are colonoscopies worth it?
#239It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…
Pretty much the same thing happened to me but the bleeding started in my 40s and I was very embarrassed about it. The bleeding was so bad that I developed anemia and had to be on iron supplements. It would cone and go and eventually my doctors convinced me to see a GI specialist and to get a colonoscopy, but I kept putting it off because of fear - fear of the process and fear of what they might find. The GI specialis…
(Yes I vary dosage, mindset, brand, delta 8 vs delta 9, sativa vs indica vs hybrid, empty stomach, full stomach).
Re: Are colonoscopies worth it?
#240Earlier quoted context omitted.
If only Semmelweis wasn’t such a strange chap, we’d have been much more further forward now.
But it cuts both ways: Walter Freeman[1] was only banned from performing lobotomies after 100 patients of his had died of hemorrhage. [1]: https://www.econtalk.org/megan-mcardle-on-the-oedipus-trap/
The point at the beginning of the thread is to do as they do, not to do as they say...