I have recently had two, first time the night before prep day I reduced my dose just by one, had no carbs whatsoever all day as I used a sugar free drink for my prep. The night of doing my prep I only did half my Lantus, woke up low, drank some apple juice when I got up to do the last part of the prep, then some more just before the three hour cutoff for having anything to drink. I was running a little low and since I had never had a colonoscopy before, was nervous about being a little low for it so even though I would not have treated at that level at home, they gave me 12.5 grams of carbs of glucose in the IV, which was half a dose. I went a little high, but not bad. I did the rest of my Lantus when I got home that afternoon.
Not to scare anyone but just to let them know this can happen I will be honest and say that even though I felt fine for a few hours after I got home, I ended up having a lot of painful gas for a few hours later. After the gas was gone, I ended up having a lot of pain that night and even quite a bit for several days after, and it wasn’t gas. I had never heard of anyone having pain after but it turns out about one third of those who have a colonoscopy have pain after.
Just so people know about alternatives to surgery after a colonoscopy, I will tell about the results of my colonoscopy.
After the colonoscopy the doc told me he found two polyps, removed one but the other one was too large and in a spot in the cecum that made the chance of perforation too likely, so he left that and told me I would have to have it removed surgically. He said that it wasn’t that big of a deal, it would be done laparoscopically and even though it couldn’t be done outpatient like my previous laparoscopic procedure for female issues, it would only be a couple of days in the hospital and the recovery would only be a little more than my previous procedure.
Well, as far as I am concerned, HE LIED, flat out LIED. I don’t believe for a minute a doctor in his field does not know what that surgery entails.
I did some research online when I got home and found out that in order to surgically remove a polyp in that area, they remove the entire cecum, not just the polyp. That can lead to all kinds of complications and even without complications during surgery or recovery, it can leave one with issues that could affect ones life forever. One can end up never having solid stools again from having the cecum removed and just the reattachment of the colon itself can lead to problems.
I called the surgeons office and asked if they always remove the cecum in order to remove a polyp in it and was told they do and that I would be in the hospital for between 3 and 7 days. They also confirmed what I had found online about it, but said, most likely, it wouldn’t be that bad.
Well, I wasn’t ready to accept that was what needed to be done to remove a benign polyp so I kept searching online and my searching paid off. I came across a blog post by someone who had been in the same position I was in about 10 years ago and they researched it and found out about a method of removing them that was quite new at the time called the EMR method. Using the EMR method, the polyp is removed during a colonoscopy by a doctor with advanced training using advanced tools. There is nothing removed except the polyp, there is no hospital stay and the person keeps their colon intact.
There are only two downsides, the first one is, if the pathology on it after it is taken out shows it is not benign, then you probably need to have the surgery. The second one is, you have to have at least one repeat colonoscopy to make sure they got it all. If there is much chance they didn’t, you have it in about a month, but if only a little chance, three months, and if the doc thinks he got all of it, 6 months.
In my opinion, those things are totally worth the possibility of avoiding surgery and keeping your colon intact, and, if you end up having to have the surgery after, you still did everything you could to avoid it and the odds are slim that one would still need surgery, leastwise if the polyp was biopsied after the original colonoscopy.
I jumped all over that, researched the hell out of it, found out who in my area could do it, called the office of the doctor who did the colonoscopy and requested a referral to that place to have it done. When that doc called me to give me my biopsy results, he had already received my request and said that he thought EMR was a great idea and should work fine. He said there was still a slight risk of perforation but if that happened, I would just end up with the surgery he originally referred me to. He also said that someone in the same large practice he is in does them and he would talk to him about doing it. Turns out it is a doc who I had checked out the day before and had decided was the one I wanted to do it. I had even called his office already and got the ball rolling, so that part worked out good.
I called the office for the doc who I wanted to do the procedure and told them the other doc would be calling and if the doc there thought this would work after talking to the other doc, I would like to get it set up. I told them what the other doc said about the risk of perforation and was told that the risk is very small. They called me back the next week and set it up and I had it done last week.
So for that colonoscopy with EMR, which is what that procedure was, I did not reduce my insulin the night before prep day, forgot to, but didn’t have any problems. That time I used Propel Zero, which isn’t actually zero carbs, but there is only 8 in 64 ounces. I only took half my usual dose of Lantus that night, woke up a little low but not bad, was higher than the first time. Just like before, I had some apple juice when I got up to do the last part of the prep and a little more just before the three hour cutoff and even though it also brought me up to a level I would not have treated at home, I was nervous about it so they gave me, what they called, 5 saline which has just a bit of glucose in it, but a lot less than their usual one. It made me a little higher than I like, but still wasn’t that high. They did the procedure, removed the entire polyp and I was home less than three hours after I got there. This time, there was no gas after, there was no pain at any time after, I felt just fine, other than being tired from not sleeping much the night before. When I got home I took the rest of my Lantus I should have had the night before and everything was great.
So, the two morals of my very long story are, one, for a colonoscopy, you can drink stuff to keep your levels up right up until three hours before the procedure and as long as your blood sugar levels are high enough the day of the procedure to not have a problem before you get there, they can take care of any low blood sugar you might have. The second one is, if your doctor finds a polyp he cannot remove and refers you to surgery, do NOT do it without checking into the EMR method of removing it.
The docs who do those are not surgeons, (although some surgeons do perform them, I would not trust one to do it, they would rather cut and keep you in the hospital) they are the same type of doctors who do regular colonoscopies but using advanced techniques, or what is also called therapeutic endoscopy.
Today is the 9th day after I had the EMR done and had I not done so much research, had I done the surgery on the same day I did the EMR, I would be recovering from surgery right now, just a few days out of the hospital, but only if all had gone well.
The thing that irritates me so much is obviously the doc knew all about this procedure, even knew someone very well who did it, yet he referred me to a not minor surgery. That just infuriates me.
Honestly, even for just a regular colonoscopy, if you can find a doc who also does the EMR to do a regular one, that is who I would recommend you have do any colonoscopy. After all, they have advanced training and advanced tools at their disposal.
Remember, for benign polyp removal that cannot be done in a regular colonoscopy, the EMR method is the way to go. Tell everyone you know about it as it might save them from someday having a needless, possibly life changing, serious surgery.