New Colonoscopy Instructions

[warrenr]

For those familiar with my father's stroke in March 2004 from stopping coumadin 4 full day's prior to colonoscopy as instructed by the Gastro without any bridge, here is that Gastroenterology Groups new instructions for patients on anticoagulants. Of interesting note is the fact that during the deposition of the gastroenterologist, he stated that the instructions were not changed because of my father's stroke but that they were changed because of a new guideline that came out from the ASGE in 2005. As most of you know the most recent guideline from the ASGE was published in 2002. The good in all of this is that they did change there instructions regardless of the reason.

http://www.ohiogastro.com/Fleet_Prep_Afternoon.pdf

Special Instructions for patients taking Coumadin, Plavix, Aspirin
or other Prescribed Blood Thinners:
· Please continue using these medications.
· The colonoscopy can still be done.
· Biopsies of your colon can be done while you are on these medications.
· If a large polyp is found, the colonoscopy test may need to be repeated
under different circumstances to remove this polyp.
For patients who must remain on Coumadin:
· Please have your doctor fax us your most recent PT/INR.
· If your INR is greater than 3, your procedure may be postponed.

 

[briansmom]

My son actually had a colonoscopy done while he was in the hospital for his first surgeries. His INR was 5. The docs just said that they would not be able to do anything if they found something that needed to be removed. They were not thrilled to do it at a 5 INR, but it needed to be done so that he could go home. I have learned so much from you guys (and my son's experiences). The INR thing is not as big a deal as most people make it.

 

[Ross]

As long as the message gets out to these gastro guys. I might as well of thrown all my papers away when I saw my first one. The second guy kept me on Coumadin and removed a polyp anyhow, even after we had decided to do it twice if necessary. There was no bleeding at all afterwards either.

There is a new or relatively new flushing procedure using Miralax and Gatorade. It's much more pleasant then the others. Miralax has no flavor, so all you taste is Gatorade.

 

[EVELYN]

Tyce and I both had our colonoscopies done last year....he fully anticoagulated with absolutely no problem with our gastro guy.....I'm sooo glad he agreed to it. I truly do believe med schools have to step up to the plate and learn more about managing coumadin so it can be properly taught to their students. Evelyn

 

[csutherland]

We pretty much ignored the instructions for Jerry's colonoscopy. He just took his warfarin as usual, the procedure went smoothly (so to speak) and they even removed one polyp. No bleeding whatsoever.

 

[Marty]

Warren, You have done a good thing. I think your father's experience wiill change colonoscopy instructions nationwide. Warm regards Marty

 

[Karlynn]

It's very sad that your father had to leave such a vital legacy, but we are all grateful for it.

 

[Guest]

I'll work this into my continuing education program. I have six scheduled in Louisiana and Texas over the next two months.

 

[perkicar]

Thanks for the update--I'm going to print this off and take it to my GP's office. For my last colonoscopy they had me go off 2 days before, and then never even checked my INR the morning of the procedure. It just makes me way too nervous to completely go off my coumadin! And you can believe I'll be using these guidelines when I have my colonoscopy at the end of this year!

 

[jenny]

Colonoscopy ..what to do?

Colonoscopy ..what to do?

Hi everyone, I hope I am posting this right, but maybe someone there can help me out there in computer land. I am suppose to have a colonoscopy done soon, the doctor that is doing it says for me to stop coumadin for 3 days before the proceedure and to use lovenox to bridge, however he also says" lovenox is short acting in can be held 12 hours beofre your procedure so there is very little time where your boold would not be thin and a procedure can be done safely. He says the risk of a clot is very small. I have to have this done for my mom died of colon cancer, however I am so so so afraid of having a clot and having a stroke. Ugh, but at the same time I am also afraid of injecting a needle in my stomach...I know I am a baby!!
So there would be a period of time that I would not be protected from a clot, I take coumadin for a st. jude valve and the maze. I would so appreciate a reply to this. Thank you all so much...Jen

 

[geebee]

Jen,

One of the options these days is to have the colonoscopy without bridging and then having another one if they find polyps that need to be removed. In fact, a couple of people have had polyps removed while on ACT.

Perhaps you could talk to your doctor about that possibility. If they find no polyps then you don't need to worry at all.

I will not go off coumadin for a colonoscopy. So far I have been lucky and no polyps have been found.

 

[BDMc]

Clonoscopy Instructions for ACT Patients

Clonoscopy Instructions for ACT Patients

Warren, Thanks very much! I am finally about to make an appointment for mine. I'll run this by my PCP. All the best to you, Brian

 

[lance]

Lovenox injections

Lovenox injections

Hi everyone, I hope I am posting this right, but maybe someone there can help me out there in computer land. I am suppose to have a colonoscopy done soon, the doctor that is doing it says for me to stop coumadin for 3 days before the proceedure and to use lovenox to bridge, however he also says" lovenox is short acting in can be held 12 hours beofre your procedure so there is very little time where your boold would not be thin and a procedure can be done safely. He says the risk of a clot is very small. I have to have this done for my mom died of colon cancer, however I am so so so afraid of having a clot and having a stroke. Ugh, but at the same time I am also afraid of injecting a needle in my stomach...I know I am a baby!!
So there would be a period of time that I would not be protected from a clot, I take coumadin for a st. jude valve and the maze. I would so appreciate a reply to this. Thank you all so much...Jen

Hi Jenny,

I too share your dread of stroking and needles into the stomach area aren't cause of celebration either. Actually the needles are injected into a pinch of fatty tissue and speaking from experience when properly injected they are not cause for concern. I had one minor bruise at one injection site only. All the rest left just the puncture mark from the needle. It is imperative to follow the instructions to the letter. It's better still if you can find someone to do the injections who has years of experience injecting penicillin into horses' butts. Hee Hee. I hope you feel a little better about Lovenox now.

 

[Bina]

Hi everyone, I hope I am posting this right, but maybe someone there can help me out there in computer land. I am suppose to have a colonoscopy done soon, the doctor that is doing it says for me to stop coumadin for 3 days before the proceedure and to use lovenox to bridge, however he also says" lovenox is short acting in can be held 12 hours beofre your procedure so there is very little time where your boold would not be thin and a procedure can be done safely. He says the risk of a clot is very small. I have to have this done for my mom died of colon cancer, however I am so so so afraid of having a clot and having a stroke. Ugh, but at the same time I am also afraid of injecting a needle in my stomach...I know I am a baby!!
So there would be a period of time that I would not be protected from a clot, I take coumadin for a st. jude valve and the maze. I would so appreciate a reply to this. Thank you all so much...Jen

When I needed a belly shot at home, my hubby wouldn't do it.
My daughter is a nurse.....and said she would LOVE to stab me!!!
So, I lay on the bed and started whining about her putting it in a good spot, bla, bla, bla; and she says "shut up, it's done".

 

[Cooker]

I am pretty sure that my PP will want me to get the old scope this year as part of my anual physical. He put it off last year do to ACT....which makes me now think that we need to have a talk. I plan on finding a gastro man/gal that will do it without bridging.

I am so pleased with my St Jude mechanical and my INR is super stable and never been an issue. I think the deciding factor for going mechanical was to avoid future surgery. But in hindsight, the AVR was a piece of cake and if I had to do it again well, no problem. But with aging and more and more invasive procedures maybe I should have gone tissue. I don't think I am second guessing but maybe I am.....

Tom

 

[Bina]

......... But with aging and more and more invasive procedures maybe I should have gone tissue. I don't think I am second guessing but maybe I am.....

Tom

NO, you are NOT second guessing!!!!! Don't go there.

 

[Cooker]

NO, you are NOT second guessing!!!!! Don't go there.

Yes ma'am

 

[geebee]

I am pretty sure that my PP will want me to get the old scope this year as part of my anual physical. He put it off last year do to ACT....which makes me now think that we need to have a talk. I plan on finding a gastro man/gal that will do it without bridging.

I am so pleased with my St Jude mechanical and my INR is super stable and never been an issue. I think the deciding factor for going mechanical was to avoid future surgery. But in hindsight, the AVR was a piece of cake and if I had to do it again well, no problem. But with aging and more and more invasive procedures maybe I should have gone tissue. I don't think I am second guessing but maybe I am.....

Tom

You just need to keep those people out of your "invasive procedures areas".

 

[Cooker]

You just need to keep those people out of your "invasive procedures areas".

Kill Joy!!!!!!

 

[jenny]

Colonoscopy

Colonoscopy

Thank you so much for answering me...I have one more question and that is if I do go with lovenox will it make me sick in anyway...Ughhh I hate this, ok once again thank you, )) Jen