My colonoscopy goes better with propofol and Suprep

Colonoscopies aren't fun. But they're really important to have, because colon cancer is a lot less fun. Yesterday I had my third colonoscopy.

It was the most pleasant of all. I'll explain why below. 

First, though, I'm pleased to retract what I said five years ago in my post, "Think twice about getting a colonoscopy in Salem (Oregon)." Things have changed for the better at Salem Gastroenterology Consultants. 

I had my first (2009) and second (2011) colonoscopies elsewhere after being turned off by Salem Gastro's two-full-day prep period. Also, by not being given a good reason for this unusual protocol other than our doctors know best.

I was all set to go elsewhere again. After a single benign polyp was found in both of my previous colonoscopies, I was scheduled to have another exam three years after the second one.

Then a friend told me that her Salem Gastro colonoscopy went fine.

She had requested, and gotten, a low volume prep kit, Suprep. And she liked her Salem Gastro physician, Richard Brandes. Along with Grateful Dead music being played in the procedure room, which I agreed was a clear plus.

So I decided to give Salem Gastro another chance.

I'm glad I did. This time the atmosphere at Salem Gastro struck me as much more relaxed and patient-centered. Lots of joking around. Laughter. Also, efficient. My name was called within a few minutes after I'd checked in at 8:15 am. 

I preferred sitting up in a chair during the pre-colonoscopy preparation period: vitals taken, questions asked, etc. Seemed less clinical and medical'y than lying on a bed, like I did in my first two colonoscopies. 

Salem Gastro has you keep your shoes and socks on, since you walk to the procedure room. I was wheeled into the procedure room with my previous colonoscopies. Again, more patient-centered. I got juice and a granola bar soon after I woke up from the propofol -- which fits with the sticker I was given that said "FEED ME. I Just Had a Colonoscopy at Salem Endoscopy."

Suprep rocks.

It was great to only have to drink sixteen ounces of good-tasting oral solution, followed by two sixteen-ounce glasses of plain water within an hour (two times: at 9 am the day before the colonoscopy, then at 8 pm that evening).

I recall a gallon of Golytely having to be consumed before my previous colonoscopies. Disgusting. It was refrigerated, so I got chilled from all the cold fluid in my pitifully empty stomach. Suprep tasted quite a bit like a flavored soft drink. I didn't mind drinking it at all.

Nor the two same-sized glasses of water that followed. The results seemed the same as the dreaded Golytely. I'll leave the details at, "Everything came out just fine." 

When I met with a physician's assistant at my Is Salem Gastro right for me? appointment, I made a point of asking if I could have propofol rather than a usual sedative. It was fine with the P.A., but he wasn't sure if it would be OK with my insurance company.

Fortunately, it was. Oregon's Regence MedAdvantage plan covers propofol for us Medicare enrollees. I had it for my second colonosopy. Loved propofol. Wrote about the blissful experience. 

Some pleasantries were exchanged with the doctor and the nurses. Then the nurse anesthesiologist said she was starting to inject the propofol. For about fifteen seconds I felt completely normal. I was mildly concerned that the sedative wasn't working.

Next thing I knew, the nurse was telling me "We're all done."

My instant intuitive reaction was disappointment. I was disturbed to be back in everyday reality. It had been a lot more pleasant wherever I'd been, consciousness wise. I sort of felt like I'd jumped into ice water after basking on a warm beach.

Exactly the same reaction I had yesterday. 

When I heard my name called, "Brian," I opened my eyes and instantly was wide awake. In a flash I realized that I'd just had a colonoscopy. As before, emotionally I was disappointed. I liked being in Propofol Land a lot better. 

There's some controversy about whether the additional cost of propofol for a colonoscopy is worth using this drug rather than a traditional sedative. All I can say is, I much prefer propofol.

As did most gastroenterologists and endoscopy nurses who were asked what sedation they would prefer if they were having a screening colonoscopy. 

Rockey and Agrawal received responses from 451 gastroenterologists and 460 nurses. Most responders in both groups said they preferred deep sedation with propofol, mainly because they didn't want to feel anything and the recovery time would be faster.

My colonoscopy resulted in Dr. Brandes finding one 8 mm polyp, along with two diminutive polyps. Haven't gotten the pathology results yet. Hopefully they will be the same as before. 

All in all this was the easiest colonoscopy for me.

Though after reading the patient instructions that came with the Suprep Kit, I did mentally fuss a bit about the Salem Gastro prep schedule -- since Suprep says "On the day before your procedure you may have a light breakfast or have clear liquids ONLY; please have nothing for dinner."

Well, on the day before the day of my procedure I was told to stop eating regular food at noon.

I fudged a bit. Made an Amy's Pizza about noon and ate almost all of it by 1 pm. But this was just four hours different from the prep schedule for my second colonoscopy, where I was told to stop eating at 5 pm on the day before the day of the procedure.

I was hungriest on the evening of the first day of my prep, Wednesday. By Thursday I guess my stomach had entered a state of acceptance, or whatever. Fueled with coffee, clear apple juice, fruit-less jello, and fake  "chicken" broth, I actually felt pretty damn good all day. 

My main advice for those getting a colonoscopy: ask for a low-volume prep like Suprep (don't know if there are other choices). And get knocked out with propofol if possible.

Comments

[tucson]

I agree about propofol and the low volume prep being preferable.

I had a colonoscopy a few years back which revealed a very large abnormal growth (non-malignant) that covered 273 degrees of my rectum. I didn't fool around and had surgery to remove it asap. Dr. said the thing would likely have progressed to bad news (cancer) if I had waited much longer. A follow-up colonoscopy was clean. Dr. said come back in five years.

Folks, get a colonoscopy if you are middle aged or older. Just fucking do it. It's no big deal and it may save your ass like it did mine.

[Jenny McCutcheon]

Had my third colonoscopy a few days ago. This prep was the worst. Not only was Suprep very expensive ($99 at Walmart) but it tastes horrible. The worst part of the colonoscopy is the prep. The procedure is nothing to be concerned about.
I managed to get the first dosage done. Spent the evening in the bathroom. Had to take the second dosage at 2:30 am. I got about 1/3 down and started vomiting. I threw up at least 6 times in the kitchen sink. I could not try to get more of the stuff down. I was nauseous for two days. Finally got prescription for the nausea. This didn't work as quickly as I thought it would but did slowly get better. I am so thankful that I won't need to have another for 5 years. I believe there is a new procedure where one is washed out with water until all is clear, but it is not available near me. The closest is in San Antonio. If anyone has had the same experience with Suprep, I would recommend going to San Antonio. Suprep is the worst of all preps! I will be going to San Antonio in 5 years.

[Nancy]

Had Suprep for colonoscopy today and propofol for the procedure. I recommend chilling it first then drinking smart water as last time I gagged with all the sweet Gatorade. I also highly recommend the propofol. Piece of 🎂 cake!
Started my first prep 3PM day before, 3AM day of for a 1030 procedure. I recommend starting earlier. They would have had me go 6PM then 630 AM and I would never made it.