7 day colonoscopy

[djacq]

Hello all,

4 day in the hospital for ohs on 12/02 and just got home from a 7 day colonoscopy. All those days were bridging coumadin to heparin and visa versa.

I had a dropping hemaglobin (9.1) and a low potassium level and they did a colonoscopy, an endoscopy and small intestine check.

Nothing showed except small diverticuli, hiatal hernia and some hemorrhoids. A remote possibility is the bleeding from the hemorrhoids in conjunction with the coumadin caused the low hemaglobin (but 9.1!!).

I had kiddingly asked the X RAY Doc to check my heart out while he was doing the small intestine scope. He did and showed me the St Judes valve and the wires and that was that.

The surprise came in when the nurse gave me my hospital record to read last night. I had expressed an interest in seeing my labs as the PT and INR were all over the place.

In the record, the x ray Doc reported an enlarged heart!!!! From a small intestine x ray?

Then, I read a report in the chart from my PCP that I had a murmer.

Also, it was the first I had heard that I had a hiatal hernia

How does one keep up advocating and coordinating care?

I don't know how Nancy and all the others do it.


I have my yearly cardiac app't next week and hope there is a clarification.

Does OHS enlarge a heart?

I would be anxious to hear if any of the above rings familar with anyone?

It was so great to catch up on the posts and to know I am not alone no matter what happens.

I hope everyone is enjoying the Memorial Day week end. It just gave my heart a wrench to see my father all dressed up in his WWII uniform. He is a Pearl Harbor Vet and is in his 80s' and just got home from the parade.

Best to all,
Donna

 

[Ross]

Glad to hear there isn't anything to be concerned about.

Sounds like the goofy Doctors I had look at me. One wrote down that I was showing early male pattern baldness. WTH? I have no baldness whatsoever. I think they write their notes on a note pad and then later confuse what patient is what and write the wrong stuff on the wrong charts!

Now that my friends is quality U.S. Medical Care!

 

[Nancy]

Hi Donna-

Well, I guess that's why our parents say "be careful what you wish for", in your case, be careful what you ask for. LOL.

Quite a few people have enlarged hearts and do well with them, remember there are all degrees of enlargement. It doesn't necessarily mean a disaster. That and the murmur thing, have to be discussed with your cardiologist next visit just to set your mind to rest. Joe has a murmur and his is from his mechanical valves. He'll always have it. Those doctors who aren't used to hearing it always comment on it.

I have a hiatal hernia, and it never gives me any problem whatsoever. I wouldn't have ever known I had it except I had a look-see for some other things. In my opinion, if I didn't know I had it and it isn't bothering me, why worry about it?? I did have a doctor in the distant past that wanted to make a big deal of it. He confused my gallbladder attacks with hiatal hernia problems and wanted to treat the wrong thing. We had some words of clarification about that one, and I had my gallbladder out, no more problems. The surgeon asked me how much I thought the hiatal hernia had contributed to my symptoms, and I gave him the big goose egg sign. He smiled and agreed.

It is a real eye-opener to read hospital records. I once had to bring a very large set of records to a new doctor for Joe. It took me two nights to go through all of them. There were pages missing, and very important information missing. They were all out of sequence and some of the copies were illegible. I wrote my own notes to the new doctor and did it on different colored paper so they would be distinguishable from the hospital records, and then I numbered all the pages and put them in order.

Sometimes I wonder how anything ever gets done correctly.

You just have to stay on top of everything, even the most benign things.

That's why I'm so glad that we have the HIPAA law that allows us to be able to get copies of our records. There are way too many people involved in record keeping. Too many chances for error.

Now Ross-- Male pattern baldness??
good grief

 

[tobagotwo]

You have no idea how that "Seven-Day Colonoscopy" title frightened me. I thought the doctors had come up with yet another unending, unendurable test that they would be recommending for everyone soon. Ye gads - just disembowel me and be done with it!

I gather the Coumadin bridging was part of the time and the other tests you went through as well. That's a lot for a person to handle anyway. My hat's off to you for getting through it without performing bodily harm on someone. That must have been a real trial.

For an gastrointestinal doctor, he sure did come up with a lot of heart comments. Maybe he secretly yearns to change specialties. I can see downsides to doing colonoscopies day after day. The view never changes...

The murmur could just be his interpretation of hearing your valve. And we don't know what his criteria are for "enlarged," so it's early to be too concerned. Did he even recommend having it checked out?

Hiatal hernias are very common, too. One familiar home remedy is to eat heavy foods (literally), like mashed potatoes (but watch out for sodium). The weight sometimes helps pull that bit of intestine back under the diaphragm. Also, not eating in a reclined or semireclined position, where the stomach is not vertical. My dad had a hiatal hernia. For all I know, I may have one. However, I'm definitely not planning a 7-day rectal field trip extravaganza to find out.

I hope that whatever first ailed you has an answer now, and is treatable. It better be, after all that aggravation for you. And I hope the doctor's other comments were just misunderstandings from viewing your repaired heart.

Best wishes,

 

[ALCapshaw2]

4 day in the hospital for ohs on 12/02 and just got home from a 7 day colonoscopy. All those days were bridging coumadin to heparin and visa versa.

..... they did a colonoscopy, an endoscopy and small intestine check.

SNIP

Donna

Hello Donna,

Did they do the upper endoscopy and colonoscopy sequentially on the same day (back to back so to speak) ?

IF I agree to have them done, I would certainly like to do them sequentially so I only have to go off Coumadin ONCE for both procedures. I'm certainly NOT looking forward to a 7 day hospital stay just to do the heparin drip thing. YUCK! Glad you got those tests out of the way.

'AL'

 

[tommy]

Yikes

Yikes

Could the enlarged heart be left over from symptoms prior to AVR. How long does it take for the heart to return to "normal" size? Seems like 6 months is long enough if it is going to shrink, but don't know.

I'm due for a colonoscopy. I was planning to schedule it for a time when I can afford a week off if necessary. You just validated my plan. I thank you.

The tentative plan is to use a Lovenox bridge, but the cardio and gastro docs haven't spoken directly yet. I've had Lovenox bridges before, but not with the potential of bleeding where the sun doesn't shine.

Hope you get full understanding and full recovery.

 

[hensylee]

HIatal hernia - Mine was discovered about 10 yrs ago. Mother had one - they had to stretch her whatever every few months. My doctor has one - he's about 5 feet tall - very tiny man. His weight is perfect. My elderly neighbor had one - she was in her 90s and a beanpole. Brother has one.....doctor tells me many, many people have one but it doesn't necessarily bother them, like Nancy says.

Treatment - eat several small meals a day and chew the food well, avoid acidy foods, use antacids like the liquid one for instant relief, pills for longer relief, raise the head of your bed about 6 inches (but you slide out the bottom). Stop smoking. Lose weight.

 

[djacq]

Hello Again,

Thank you for the replies and info.

To elaborate further, I begged for Lovenox. I was told it was too unsafe as it was too difficult to control.

Instead, I stopped Coumadin last Sunday night. I was admitted Monday and a heparin iv was started.

I read, watched tv, tried to use my laptop, walked the halls with an IV pump with a ton of iv bags...heparin, potassium and antibiotics to protect my valve through these prcedures.

Thursday, they stopped the coumadin for 4 hours and did the enoscopy and colonoscopy "back to back". The Doc and I were both agresssive with the nurses to start the heparin immediately after the procedure. You know how busy the nurses can get and seemed to forget a lot of things including medications! They started me on higher doses of coumadin than I usually take that night. I am waiting for it to hit me now. I am getting broccoli today!!

If anyone is having this done, please be careful and advocate loudly for yourself. The nusing shortage is really not good.

Anyway, the procedure took about 2 hours and I was given Vercid (sp) and it just made me not care as I was awake looking at all the pictures.

Friday, I was given an upper GI x-ray without coming off the heparin.

By Saturday, my INR was 1.9 and they wanted it 2.5 for discharge. Well, guess what? It went up to 3.6 the next day Sunday and I came home.

I didn't believe the 3.6 and tested on my ProTime and again it came through at 2.9 which is where I thought it would be. This is the second time this hospital has made errors with my INR. Last one was a 6.0 when I was a 2.9!!!!!

It is great to be able to trust your machine. It has always come through for me.

Also, it seems difficult to get any information until you have a follow up at the Docs' 4 weeks later. If I hadn't accidently read my chart I would be still waiting for info. Maybe it was because of the holiday week end the Docs' were off. Again, you have to be pushy and I guess request to read your chart?

Do you read the charts Nancy? Would you push for this?

Is the above the standard protocol? Cause if not, I am changing providers.

I had venipunctures done every 6 hours for the PT, INR's and frequent IV site changes for seven days.

Every FIVE years????? Doc told me every 10 if no colon cancer history in the family.

Thanks for the pratical info on the "enlarged heart" and the hiatal hernia.

I wonder if that pushes against the heart?

Donna

 

[Nancy]

Yes, I certainly would ask to see the chart if I had any suspicions that something wasn't right. I had a recent situation for myself, when I knew there was a BIG mistake, and I said to the nurse as I reached for the chart, "give me that thing", and when I found the error, I asked, "who wrote that?". Got it straightened out on the spot.


I don't want to have to say, "I'll fight you for it", but if something's wrong, I might.

 

[Lorraine]

Very interesting thread. I just saw my cardio last Monday for my 3 year checkup (yeah, it was a couple of months late). He reviewed everything with me and mentioned since I'm over 50 , I should get a colonoscopy done. I just looked at him in fright. The thought of going off of my coumadin, and the doctors regulating (actually my doctor said they would use Lovenox) in a timely manner to do the procedure scares me. I metabolize fast. I also drop very quickly. He told me I should see my family doctor and have him recommend a doctor to do the procedure. I haven't made a appointment with my MD yet, as I still need time to digest this. He said they could do it while I'm still on coumadin, but then if they found something, they would have to stop and I'd have to have the procedure done again going off coumadin and getting the injections. Reading I see Lovenox is not the drug of choice anymore for this procedure but it obviousely must still be used by some doctors. My question is which one is more effective with regulating the clotting factor while your under the knife? I know I won't get it done for a while (at least not this summer but probably sometime during winter break after finals. I go back for my 4 year checkup on March 8, 2004 so I know I had better have it done before I see him. I made sure this time I'd have my checkup and stress echo done on the anniversary of my surgery. Any information would be gratefully appreciated.

 

[Guest]

I've heard a lot of criticism of Lovenox, but this is the first time that I ever heard that it was too difficult to control. The main reason that it is used is that there is nothing to control. You take your weight in pounds and multiply by 2.2. The answer is the number of mg you need every 12 hours. No testing. No venipunctures. No need to be in the hospital. It is given like an insulin shot at home.

Besides that the colonoscopy uses a camera that is inside your intestine. There is no way that it could see your heart.

I tease the nurses that do colonoscopies with this line. You know how some people say that they can't remember names but they never forget a face. Do you say I can't remember your name but I never forget a ______!!!

 

[djacq]

Sorry for the confusion,,,,

they saw my heart in a floroscope (sp) of the small intestine.

Thanks to the posts, I am reserving my panic of an enlarged heart and murmers when I see my cardio.

My understanding of the resistence to using lovenox (especially given the belief of a gi bleed) was that heparin could be stopped and started on a dime.

I hope this isn't true for my own future reference and future procedures.

Donna

 

[Robbyn]

7 day colonoscopy too

7 day colonoscopy too

Hi Donna,

I was reading your post and I too, have to go in for a 7 day colonoscopy. For exactly the same reason as you. My hemoglobin is very low 84. So I needed a blood transfusion to bring it up. I also take 3 iron pills a day. YUK! Did they ever find a reason for the low hemo. How did you make out with your cardio - the enlarged heart business. I have hypertrophic cardiomyopathy (enlarged heart) which shows up as a heart murmur. I always wondered if there was any correlation between that and the low hemo.

Take care,
Robbyn

 

[djacq]

Hi Robbyn,

Interesting that there maybe a connection with low hgb and enlarged heart. There seems to be a lot of odd connections with OHS.

Do you have Restless Leg Syndrome. I acquired that as soon as my hgb dropped but it was not recognized until recently it is a symptom of low hgb.

Yes, I am still low and on iron (yuk, yuk) and no known cause as yet.

Now I have to test for my hgb as well as INRs'.

They thought it was hemolytic anemia from the valve but the tests were negative. Did you get that checked out???

Isn't it awful how tired you feel. It is like pre valve times that you can barely breathe and move around. Don't you wonder about the damage it can do to your body. I understand that it can enlarge your ventricles. Probably the lack of oxygen to the heart?

At least it an inpt colonoscopy is a nice 7 day rest, albeit an expensive one. The food was good, I had a private room and it was a luxury to have the prep in house and not have to drive to the hospital in the early hours..

Keep me informed as I am looking for any clue to resolve this.

Good luck,
Donna

 

[tobagotwo]

Not quite colonoscopy

Not quite colonoscopy

Something for consideration...

From CCF: http://www.clevelandclinic.org/healthextra/default.asp?index=11733

Colorectal Cancer: New Screening Method Available

Colorectal cancer is one of the leading causes of cancer deaths in American men and women. A newer, noninvasive screening method now makes prevention easier than ever. Called a fecal DNA test, the new method just became commercially available.

Detecting mutations
Genetic material called DNA is present in every cell of the body, explains Carol Burke, M.D., director of the Cleveland Clinic?s Center for Colon Polyp and Cancer Prevention.

Normal colon cells and their DNA are passed into bowel movements every day. Abnormalities, or mutations, in the DNA suggest that a colorectal polyp or cancer is present. These mutations can be detected by processing the stool. "If mutations are found, a colonoscopy is warranted," she says.

More accurate than fecal occult testing
The results of a recent study comparing the accuracy of the fecal DNA test to traditional fecal occult blood testing found that the fecal DNA test was positive in patients with colon polyps and cancers 53 percent of the time. Fecal occult blood testing was positive only 14 percent of the time.

Clearly fecal DNA testing is much more accurate than fecal occult blood testing, says Dr. Burke. Although colonoscopy is the best colon cancer screening test, people that will not or cannot have colonoscopy may benefit from fecal DNA testing.

Don?t wait for symptoms!
Colorectal cancer screening should begin at age 50 (or younger if you have a first-degree relative (parent, sibling or child) with colorectal cancer. The key is not to wait until you have symptoms to get screened.