Colonoscopy....any tips?


#1

Getting ready to take the dreaded bowel prep. I have had 8oz of apple juice and some horrible chicken broth all day. Blood sugar at 101 now. Will it go lower? On the pump and was told to reduce basal 35%. Has anyone else been thru this?


#2

I did it a few years ago. When I’m in a situation where I’m not going to be able to eat and going to be sedated, I cut my basal in half. Sometimes the drs tell you not to take your morning insulin. I never do that. I always take some.

For the colonoscopy prep, I bought myself a nice jug of Welch’s White grape juice. I really enjoyed it as I would normally never get to drink something like that. I did go low towards dawn and had to down a good quantity of it.

They took me first the morning of the procedure because of the type 1 diabetes. I think I was out of the hospital by 10 am. I went straight home to bed. Was tired from being up in the bathroom all night. Oh, yeah, I was hungry too. Had small piece of lasagna leftovers before I went back to bed.

My only advice is check your blood sugar often, every hour if necessary through the night. Drink your clear, sugary liquids as needed.


#3

A timely thread indeed. I am going in for mine in about 10 days. I’m supposed to cut my Tresiba in half the day before and take no insulin the day of the procedure. My appointment is at 7 AM so I don’t see that as being a real problem.

How long did it take you to recover? Did it give you any lasting issues?


#4

I took the remainder of my morning basal dose when I got home. I had no problems whatsoever afterwards. I slept for about three hours and then continued on with the rest of my day as usual.

Again, the main piece of advice is to test frequently, every hour if you are questioning anything. And have plenty of Welch’s white grape juice on hand or whatever your drink of choice is.

You are only lightly sedated for a colonoscopy so nausea afterwards shouldn’t be an issue.


#5

Thanks! Within a few weeks of being diagnosed I was referred for this procedure. When they told me what I had to do before hand I was freaked out. I barely understood how to eat and stay alive at that time. I have been putting this off since then because of that.


#6

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.


#7

I had my first one a few years ago. I almost had to do a retest because they did not make it clear that someone had to STAY and wait for the procedure to be over to be there for when they released me.

I absolutely hate fasting, but even worse was the pineapple puke flavored Kool Aid I had to drink.

As I waited in my room (by myself) for the procedure to start, my BG began to plummet and I had to yell to get someone’s attention. I had the nurse hook me up with a Dextrose drip and was able to relax into oblivion. However much less insulin you plan to take, take less. I always forget that if I think the word movement that my BG can plummet. It’s just better to be a little high than low.


#8

I agree. Take very little insulin…just not worth it to have to eat something after going thru all this fasting. I don’t think the medical community realizes how hard colonoscopy prep is for a diabetic.


#9

Thanks for your reply. Yes, it’s challenging for diabetics…but then again, what isnt? Lol.


#10

Recovery was a breeze. The anesthesia they use is great nowadays. Still need someone to drive you home, but I felt great…just real hungry!


#11

Thanks Laura, and everyone else for that matter. I knew I would get some good information if I asked a question here. Works every time.

And yes, I do have a driver. I need a driver everywhere I go. That is one of the worst things about everything that I have had to face with this condition. No longer driving due to my eyesight. Sucks. But oh well. It is was it is, just like everything else diabetes.


#12

@Stang777 - Thanks for your detailed write-up, very helpful. I’m faced with a possible colonoscopy and am deciding whether to undergo it or just say “no”.


Colonoscopy
#13

You are very welcome. I think it is very much worth doing it, it can take care of problems before they are big problems that can kill you. Even with the problems I had from the first one, it was still worth doing (and I was so afraid to do it I had put it off for years) and I didn’t have those problems after the second one. I am having the colonoscopy for the followup to the EMR next month, and really have no qualms about doing it. They usually let you choose the prep method you want to do, and I found taking the Duralax pills followed by the Miralax mixed with my choice of drink to be the easiest one for me. I do think it probably helps to mix it with a Powerade type drink so you don’t lose all your electrolytes. I didn’t do that for the first one and I think that was what caused me to have problems after the first one. I think those problems were, at least partly, caused by my getting dehydrated and the Powerade type drinks helps with that more than just regular drinks do. I wish you a lot of good luck with yours and hope that they don’t find anything troublesome, but if they do, I hope they will be able to take care of it right then. Again, good luck to you.


#14

I just said NO. There are less invasive screening tests if you are not predisposed or having any problems most insurance co’s will OK a stool screening test that has no prep/fasting anything. Got the tip on this from a friend that works for a proctology practice.


#15

I just got a referral for my first colonoscopy in my 40s. Unfortunately, I have a terrible family history of colon cancer, and my Uncle just had surgery to remove part of his bowels. So, won’t be able to avoid one in this case.

@JC14, you’re right that there are less invasive tests, but I just discussed these with my doctor less than two hours ago. The drawback is simple: the stool screening test suffers both from false negatives and false positives. So, for someone like me with a high likelihood of developing colon cancer at some point, it’s time to face the music and schedule the colonoscopy.


#16

Thanks, @JC14, I’m inclining that way. From conversations with friends, it seems that the preparation is the worst part, but complications can arise from the procedure itself. And, they were dosed up on Fentanyl. I’m going to retest when I get around to it, to see if the result was wonky.


#17

I will chirp in here about colonoscopy. Before the procedure, I told one of the nurses that I was diabetic and that I had not eaten, but then, after the procedure, when I woke up, my medical handler lady said that it had been difficult to rouse me. I said that I am diabetic. The medical lady’s jaw dropped, like the beak of Donald Duck in the cartoon. She obviously had no idea at all that I was diabetic. I asked for my wife, who was toting my diabetic supplies. This experience made me wonder if a small neatly printed “diabetic” tatoo might go on my arm. I could hide it under my shirt sleeve, but medical people including EMTs would first go to my arm…