Another colonoscopy thread

[Magic8Ball]

Well, been told i need one, family history and slight bleeding so got to bite the bullet....

Anyway, just wanted to summarise the other threads out there and prepare myself for the first visit to the GI doc so i can be confident and stand my ground with regards the anticoagulation stance....

The general advise seems to be is....

1. Do a virtual colonoscopy unless there are greater signs of issues to solve. As i have a family history and slight beed's i guess i'm not really a candidate for this option. I get the impression its not widely used here in Australia as my GP did not know of it.....anyone disagree that i should ignore this option in light of my particular circumstances?

2. Do a standard colonoscopy.

a. Primary option (with AVR)

do it fully anti co-agulated but perhaps drop the INR to closer to 2.2ish. This should alow a colonoscopy to happen and small pollups removed (larger ones sampled).

If there are larger ones a second visit may be required using 2b.

b. Secondary option.

Do it by bridging on heparin? now here i'm not sure how this works....do i reduce my inr a bit, then visit a clinic to get injections (how many how often?) or do i get admitted to hospital a couple of days before?

I think i remember getting injections post surger in my stomach twice a day? or was it three times a day? If twice a day is this an option to do as an out patient? Self injections?

I suppose i need someone to give the lowdown on herapin bridging.....

c. Variation on 2b.

What is lovenox? never heard of it over here but everyone seems to dislike that as an option for bridging...would like to know why. Would hate to be offered this as the option and not be able to stand my ground.


Any other pointers would be helpful....cheers

 

[catwoman]

You may want to talk to several gastroenterologists' offices to learn how they handle mechanical valvers.

Virtual colonoscopy -- you'll need to find out if your insurance plans covers it. From what Aetna has told me, it does not, and I don't care to foot the entire bill.
Other carriers/plans may cover a virtual.
Bear in mind: The doctor will probably have to schedule a traditional colonoscopy if he/she finds polyps.

I would bite the bullet and go traditional, with your history & symptom of bleeding.

 

[Bina]

I agree with going for a traditional colonoscopy and aiming for the INR of 2-2.2
Otherwise, they may have you stop Coumadin 2-3 days before and start Lovenox injections when your INR is below 2.0
The shots are no big deal, twice a day in the belly fat.
You can do a "search" of this site for the details.

 

[Ross]

I had mine done fully anticoagulated and two polyps removed. There is no need to stop coumadin unless they find some really really large polyps that need to be taken out, then they can go back and do it again once your bridged with Heparin.

They'll have you stop Coumadin 3 to 5 days before the procedure and place you on either a Heparin IV which requires hospitalization, or Lovenox shots in the belly every 12 hours, which doesn't require hospitalization here in the U.S., but not sure about your country.

 

[Magic8Ball]

ok, so its a heparin drip or lovenox injections.


There's is no issue with lovenox injections? obvously i had those after surgery so probably not....but i seem to have picked up comments about it being a bit dogy to get back in range using this?

What would everyone think was the acceptable process for the injections.....do you just start the injections one day and stop the warfarin tablets or do you stop the tablets a day or two before and then start the injections?


I remember starting after surgery, they kept injecting me while i was taking warfarin until my inr was close to 3 then stopped the injections....is that the same thing that should happen post surgery now?