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Are colonoscopies worth it?

asteriskmag.com

261–270 of 296 posts

Re: Are colonoscopies worth it?

#261
post #222

Earlier quoted context omitted.

I've had two colonoscopies done in the last 10 years. The second was possibly unnecessary, but I pushed for it because I just really enjoy propofol. Maybe if more people knew that the sedative drugs used in the procedure are fun, they'd be more inclined to have it done. Edit: downvotes? Really!? I'm 100% fucking serious! Work any angle to get people to test!

People really shouldn't get tested unless they meet several criteria. Obviously any bleeding from your rectum should get checked out, and if hemorrhoids are rules out, a colonoscopy is probably the next course of action. And around 45, you should have one since that's the most likely age for colo/rectal cancer occurring. Family history can also affect this timeline. My kids are now stuck having colonoscopies five yea…

In the end, hehe, it was a medical doctor who greenlit the procedure. Patients don't get to decide their own treatment trajectory, but they can certainly respond enthusiastically when the Certified Medical Doctor suggests it as a possible route.

And yes, I was bleeding heavily out my ass and had recurrent stomach and intestinal pain for months that went away and then came back the next year. Not as if I went in for a cut finger and demanded an anal probe for it.

Turns out I'm sporadically - not consistently - lactose intolerant. Russian Roulette. Makes me shit acid that tears up all my soft tissue causing bleeding and eventually clotting. FODMAP, or just lots of oatmeal until it clears up, is the way out again. The lactose sugar-based colon purge laxatives they give you to prep for the procedure work REALLY well on me.

Re: Are colonoscopies worth it?

#262

Earlier quoted context omitted.

I am really curious as to why you enjoy propofol: is this in any way producing euphoria? Normally you should just feel really sedated then pass out, with little difference between this experience and being just tired then asleep. is the large-ish quantity of white fluid getting into you not off-putting?

> I pushed for it because I just really enjoy propofol After about the 4th? time I had it (I've had 9 cardioversions, along with many types of surgeries), I realized I liked propofol. By the 6th time, it was the highlight of any procedure. I found that the high comes from trying to fight the anesthetic and the amazing quality of sleep you get, plus I will agree the wakeup is tricky. Be careful about what you're reall…

This one knows what's up

Re: Are colonoscopies worth it?

#263
post #148

Earlier quoted context omitted.

> Sure but procedural complications are actually quite rare, as alluded to in this article. article actually says that perforation (requires emergency surgery as per article) is between 1 to 100 and 1 to 20000 base on some studies, which sounds very high if it is not mistake.

The high end of that range is much higher than the baseline rates of colon cancer (also mentioned in the article), which are 90/100,000 in the USA. That's one thing that I wish the author had spent more time on.

90/100k cancer rate is likely annual rate, while complication rate is likely per procedure, so you would need to multiply cancer rate by 3 (avg years between procedures) to have reasonable comparison.

Re: Are colonoscopies worth it?

#264

Earlier quoted context omitted.

All of this matters. You write as if he provided a succinct record of a series of experiments he conducted; in fact, he infamously wrote ponderous and impenetrable litanies on the precise cadaveric origin of the particles he thought he was combating. I understand the message board rhetorical strategy of trying to put me on the other side of the aseptic revolution, but (1) no and (2) that has nothing to do with what I…

> he infamously wrote ponderous and impenetrable litanies on the precise cadaveric origin of the particles he thought he was combating Which doesn't invalidate the fact that women provably died less after his methods of combating those particles were implemented and published. Faced with that evidence, they should have accepted the method even if they don't agree simply because you can't argue with results. They coul…

The scholarly debate about Semmelweiss is whether he had syphilis or young-onset dementia. He was not committed to a sanitarium out of pique over his demands that people chlorinate water. Again: you can just look this stuff up!

These points might seem kind of nitpicky, but Semmelweis has become a sort of patron saint for brooding nerds with strong but iconoclastic ideas, a shibboleth for "history will show I was right all along". Semmelweis was not, in fact, right all along, and his evident failure to persuade his peers --- stemming from what was in a sense an opposition to the germ theory of disease --- probably set science back a little bit, on margin. Not by much, though; Semmelweis was in his time one of several people expounding the same intervention.

Re: Are colonoscopies worth it?

#265
post #87

It’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…

I've had the experience that... I was told when I was separating from the military, at 25b(I don't know why and I didn't ask...), to expect a colonoscopy. It didn't happen. I mentioned it to my GP a couple of years later, he said probably between 30 and 35... Now I'm in my 40s. It's perpetually a couple of years away. I get the sense from this, and from other anecdotes in life, that preventative maintenance, of all f…

Since my mom had colorectal cancer at 45 I was expected to start colonoscopy at 35 and then every 5 yrs

I did the first only so far and no polips.

There's nothing to be scared. It takes less than an hour and is painless. The worst part is the prep you do at home a day before. It's very powerful stuff. You'll be shitting clear water by the time they do the exam.

Re: Are colonoscopies worth it?

#266

Earlier quoted context omitted.

I am really curious as to why you enjoy propofol: is this in any way producing euphoria? Normally you should just feel really sedated then pass out, with little difference between this experience and being just tired then asleep. is the large-ish quantity of white fluid getting into you not off-putting?

> I pushed for it because I just really enjoy propofol After about the 4th? time I had it (I've had 9 cardioversions, along with many types of surgeries), I realized I liked propofol. By the 6th time, it was the highlight of any procedure. I found that the high comes from trying to fight the anesthetic and the amazing quality of sleep you get, plus I will agree the wakeup is tricky. Be careful about what you're reall…

You avoid pain killers but love Demoral?

I don’t understand.

Re: Are colonoscopies worth it?

#267

I do regular colonoscopies because of a condition. People are worried about the procedure, as I was my first times. Here are some things that I wish someone had told me: - Taking the meds for cleaning out your system the day before is far worse than the procedure itself. - Have a lollipop to stick in your mouth after Each time you take a shot of the laxatives. It helps with the vile taste of it. - If you need relaxin…

> Taking the meds for cleaning out your system the day before is far worse than the procedure itself.

It depends... in the US I just had to count backwards from 10 and fall asleep -- but I've tried being give a wooden stick to bite -- that was a different experience.

In Denmark they usually just use local drugs, no sleeping, but last time it was no big deal anyways :)

Re: Are colonoscopies worth it?

#268

Earlier quoted context omitted.

> he infamously wrote ponderous and impenetrable litanies on the precise cadaveric origin of the particles he thought he was combating Which doesn't invalidate the fact that women provably died less after his methods of combating those particles were implemented and published. Faced with that evidence, they should have accepted the method even if they don't agree simply because you can't argue with results. They coul…

The scholarly debate about Semmelweiss is whether he had syphilis or young-onset dementia. He was not committed to a sanitarium out of pique over his demands that people chlorinate water. Again: you can just look this stuff up! These points might seem kind of nitpicky, but Semmelweis has become a sort of patron saint for brooding nerds with strong but iconoclastic ideas, a shibboleth for "history will show I was righ…

> Semmelweis was not, in fact, right all along

His results have NOT been refuted. Sanitizing hands saved lives. Not sanitizing hands cost lives.

https://pubmed.ncbi.nlm.nih.gov/17553179/

https://pubmed.ncbi.nlm.nih.gov/35486338/

Whether or not it happened due to "cadaveric particles" is a completely irrelevant detail. People died less. That's enough for public health policy decisions even today. The fact his contemporaries did not accept it would be criminal negligence today.

The "scholarly debate" about his mental state is mere speculation. Here's the first result of looking it up:

> It is impossible to appraise the nature of Semmelweis's disorder.

> It might have been Alzheimer's disease, a type of dementia, which is associated with rapid cognitive decline and mood changes.

> It might have been third-stage syphilis, a then-common disease of obstetricians who examined thousands of women at gratis institutions

> or it might have been emotional exhaustion from overwork and stress.

You clearly believe the first two options. I don't believe that even for a second.

> He was not committed to a sanitarium out of pique over his demands that people chlorinate water.

Here's the second result of looking it up:

> With this etiology, Semmelweis identified childbed fever as purely an iatrogenic disease — that is, one caused by doctors.

> Friedrich Wilhelm Scanzoni von Lichtenfels took personal offense at this, and never forgave Semmelweis for it

> Scanzoni remained one of the most ardent critics of Semmelweis.

The third result of looking it up:

> Semmelweis also angered his conservative medical colleagues — and especially his boss, Johann Klein, who was head of the Department of Obstetrics and Gynecology

> Klein rejected Semmelweis' arguments concerning cleanliness, as did his colleagues.

> He probably felt angry that this precocious Hungarian was making orthodox practices and practitioners look not only ridiculous but also dangerous.

> It was Klein, incidentally, who had insisted that medical students examine cadavers in the first place, and it was he who had relaxed constraints on conducting vaginal examinations during labor.

> Semmelweis seemed to be saying that Klein's policies were the direct cause of the epidemic

> When Semmelweis' temporary appointment came up for renewal in March 1849, Klein blocked his application, despite appeals from senior medical colleagues

> The second part [of his publication] attacked his critics. This was the part that got him into serious trouble. Many leaders in obstetrics in Europe were vilified.

> While the book collected all of Semmelweis' investigations into one volume for the first time, it met with harsh reviews and had little impact in preventing the dreaded puerperal fever.

> Probably as a consequence, Semmelweis' mental state deteriorated.

> He roamed the streets of Budapest muttering to himself and distributing pamphlets directed against those who refused to follow his teachings.

> He seemed to swing from periods of excitement and energy to periods of paralyzed depression. By July 1865, he was clearly deranged.

They clearly hated this guy and found several ways punish him for his insubordination. It's entirely possible and very likely that this was the reason he ended up in the asylum where he was killed.

Re: Are colonoscopies worth it?

#269

It’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…

> The most unexpected thing is that when I actually wanted one, the process took over two years. And that was after a year or so of periodically mentioning it to the doctors, who would give me a sheet of numbers to call

What? When my GP decided I was at risk for cancer of the colon I was scheduled for a colonoscopy within a couple of months and I didn't have to call anyone. This was in Norway.

But also, didn't your GP examine you?

Re: Are colonoscopies worth it?

#270

Earlier quoted context omitted.

The scholarly debate about Semmelweiss is whether he had syphilis or young-onset dementia. He was not committed to a sanitarium out of pique over his demands that people chlorinate water. Again: you can just look this stuff up! These points might seem kind of nitpicky, but Semmelweis has become a sort of patron saint for brooding nerds with strong but iconoclastic ideas, a shibboleth for "history will show I was righ…

> Semmelweis was not, in fact, right all along His results have NOT been refuted. Sanitizing hands saved lives. Not sanitizing hands cost lives. https://pubmed.ncbi.nlm.nih.gov/17553179/ https://pubmed.ncbi.nlm.nih.gov/35486338/ Whether or not it happened due to "cadaveric particles" is a completely irrelevant detail. People died less. That's enough for public health policy decisions even today. The fact his contempo…

1. Childbed fever was not, in fact, caused by cadaveric particles.

2. Nobody here disputes aseptic technique.

3. You've misconstrued the point about Semmelweis' commitment. Alzheimers, syphilis, exhaustion: the point is that he was symptomatic, as you yourself just quoted.

I don't think anybody else is reading us at this point.

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