Transplant tests?

[dyannalw]

I am considering getting evaluated for a transplant and I heard you have to have a colonoscopy. Can someone tell me how that is. Is it painful or just uncomfortable? Thank you.

[Angiepkd]

I just had a colonoscopy for my transplant work up. The worst part is drinking all the prep liquid. The actual procedure is a piece of cake, no pain and I don't remember a thing. The thought is way worse than the reality. Good luck!

[jeannea]

I agree with Angie. For the actual procedure, the worst part is getting the IV in to get your anaesthesia. The afterward someone drives you home and I always go back to sleep.

Unfortunately the prep is quite unpleasant. You have to drink large amounts of prep liquid and spend lots of time in the bathroom. You are allowed to have other liquids to chase the taste like sprite, ginger ale, white grape juice. Don't worry about your liquid restrictions. You won't retain the liquid. It's something to just get through.

[Poppylicious]

Is this an American thing?  In the UK we don't have to have a colonoscopy when being evaluated.  I hope your evaluation is smooth and all the testing isn't as bad as you think it might be!

[Simon Dog]

A colonoscopy is a good idea if you are over 50, even if there is no xplant in your future.  Colon cancer is a killer, and a colonoscopy can nip it in the bud (getting polyps out before they even start to go cancerous).    Here in the US the guideline is typically every 10 years post 10 w/o polyps; every 5 years if hyperplastic polyps; every 3 if adenoma.

The worst part is going 24 hours w/o food.  The second worst part is shitting your brains out the night before.  The actual procedure is a piece of cake if they give you sufficient fentanyl/versed/benadryl and they don't puncture your colon or spleen (rare, but it happens).   I slept through mine.    When you wake up, you may tell the doctor you just had a dream you had been abducted by aliens and probed .

[cattlekid]

Having been diagnosed with ulcerative colitis 24 years ago, needless to say, I have had my share of colonoscopies over the years.  Here are my patented colonoscopy prep steps.  Feel free to borrow them and share them with your friends.

Supplies: 
A cup that you will never want to see again (I prefer plastic so I can write on it)
Your chaser of choice (Sprite, ginger ale, other clear liquid)
A timer
Other liquids to drink in between (I like hot broth, tea, popsicles – no orange or cherry, Jello – again no orange or cherry)
Soft toilet tissue (you’ll use a lot of it)
Something to read or otherwise occupy yourself in the washroom (hello, iPad!)

Steps:
1.    Get your prep ready the night before.  You want it to be ICE COLD.  It’s usually gritty as all get-out and warm grit is worse than cold grit.  If your doctor allows it, you can toss in a pack of Jello (no orange or cherry), it’s usually better than those little flavor packets that they give you from the pharmacy.
2.   Before starting your prep, do some math.  Figure out how many ounces you need to drink over how many hours.  This will give you your ounces per hour.  I like to break mine down into 15 minute increments.  Mark this on your cup somehow.
3.   At the appointed time, start chugging.  I like to have the glass of prep ready with the chaser right next to it.  This is the time to embrace your inner barfly.  Chug the prep, follow with the chaser.  Don’t sip, it just makes it worse. As soon as you chug your ounces, then set the timer for the next round.
4.   Keep going.  You’ll feel like you slosh from side to side when you walk.  Don’t stray too far from the washroom as at some point, your gut will rebel and the dam will be released. 
5.   That’s when the soft toilet tissue and reading material come into play.  You may need to start having a friend or loved one bring your prep to you in the washroom to keep on schedule.

Be prepared not to get a lot of sleep the night before.  I usually schedule my tests on a Monday morning if possible so I can do the prep on Sunday afternoon. 

The test itself is a piece of cake.  I’ve been awake for some and out for others.  Versed is my personal friend.  I look at it like a restorative nap, followed by a nice lunch afterwards. 

I got out of my last colonoscopy last year because I had my transplant, but this year, I’ll be on the colonoscopy train sometime this spring.  As my gastroenterologist says, don’t skip your colonoscopies, especially if you have a personal or family history.  We have a bad history of colon issues in my family, so I am religious about it.  Not all sunshine and lollipops, but I’d rather be safe than sorry.

[Angiepkd]

You are cracking me up Cattlekid!     I don't have to go back for 5 years, but I will remember your tips. Here's one to add.  Don't use sprite or 7up as your chaser if you are diabetic. I know this is a "duh" thing to say, but my father-in-law couldn't have his colonoscopy because his sugar was sky high.  He told them the instructions said he could use 7up as his chaser.  Sounds crazy to me, but you would be surprised at how well some follow those instructions.  Worst of all, he had to go back to have the colonoscopy a week or so later, and do that awful prep again.  One thing I know I do not want to do is repeat in a week!  Good luck Dyannalw!  It will be over before you know it!

[obsidianom]

My first colonoscopy saved my life. I was 52 and healthy and athletic. I was playing softball as one of the oldest in the league. Then I had the colonoscopy that I put off from age 50 as I hated the prep. I was so shocked when the doctor came out after and said "we have a problem"  ( I LOVE THE TERM WE). Yes, I had a large almost 2 inch diameter tumor in my rectum. It already was though the wall and almost into the space outside the rectum . Another few months and it may have been in the lymph nodes and I would have had a hard time beating it. If I had a colonoscopy at age 50 as recommended I would have a much easier time treating it. I just barely avoided a colostomy.
So the moral is DO IT!!!!   It is painless. Yes the prep is horrible. My last one I did the prep in my wifes hospital room where I was staying with her while she was ill form the kidney disease 2 years ago. The nurses got a kick out of my doing it in her room and walking down the hall to the room to do it in the same hospital. I didnt need a ride at least as I was staying in the hospital with her. We always get a private room so I can take care of her in the hospital too.
I am surprised in England you dont require a colonoscopy. It is so simple and there is so much risk of colon cancer. Also the prep can be hard on kidneys so it is better to do it BEFORE you get a new kidney. Any polyps need to be excised before going on anti rejection meds.

[cariad]

I am surprised in England you dont require a colonoscopy.

It really depends on the hospital in the US. I think these assessments are much more homogenous in England than the US because you are looking at such a substantial size and population difference. However, I would imagine that they do require a colonoscopy in England if you are over age 50 or have certain risk factors.

I had 5 evals in the US before my second transplant, plus contacted another dozen hospitals by phone. Only one of those required that I have a colonoscopy, but it was the one that was going to let me in to their clinical trial so I (very reluctantly) agreed. The surgeon said that it was my long history of taking prednisone, plus I stupidly mentioned that my grandfather died of colon cancer (when he was well into his 70s! And he was a borderline alcoholic!)

When the local hospital personnel kept asking me why I was there for a colonoscopy, I would briefly explain and then always add "I *don't* have colon cancer!" I made them put me under general anaethesia. They wanted to give me an amnesiac (versed) but no painkiller because of my intolerance of opioids. I have had a lifetime to build up a mistrust of doctors and this was one of the worst ideas I'd ever heard. In the end they had to do it my way or not do it at all, and I was right, no colon cancer.

[obsidianom]

I am surprised in England you dont require a colonoscopy.

It really depends on the hospital in the US. I think these assessments are much more homogenous in England than the US because you are looking at such a substantial size and population difference. However, I would imagine that they do require a colonoscopy in England if you are over age 50 or have certain risk factors.

I had 5 evals in the US before my second transplant, plus contacted another dozen hospitals by phone. Only one of those required that I have a colonoscopy, but it was the one that was going to let me in to their clinical trial so I (very reluctantly) agreed. The surgeon said that it was my long history of taking prednisone, plus I stupidly mentioned that my grandfather died of colon cancer (when he was well into his 70s! And he was a borderline alcoholic!)

When the local hospital personnel kept asking me why I was there for a colonoscopy, I would briefly explain and then always add "I *don't* have colon cancer!" I made them put me under general anaethesia. They wanted to give me an amnesiac (versed) but no painkiller because of my intolerance of opioids. I have had a lifetime to build up a mistrust of doctors and this was one of the worst ideas I'd ever heard. In the end they had to do it my way or not do it at all, and I was right, no colon cancer.

I agree on the anesthesia. I always have Propofol which is an anesthetic rather than versed. I hate versed . It lasts for hours after and is not always that effective. Propofol wears off very quickly and in a few minutes I can walk out with no after effects.

[cariad]

I agree on the anesthesia. I always have Propofol which is an anesthetic rather than versed. I hate versed . It lasts for hours after and is not always that effective. Propofol wears off very quickly and in a few minutes I can walk out with no after effects.

How fab to hear that a bona fide doctor agrees with me. They treated me like I was the biggest princess that had ever darkened their doorstep. I felt uneasy about versed not only because it was tampering with something as delicate and poorly understood as one's memory, but also because of the attitude that I detected from them that they could just drop the painkiller and so long as I couldn't remember anything, it didn't matter how much pain I was in. That meets my definition of abuse.

Thanks for relating your experience. (Propofol - isn't that what did Michael Jackson in?)

[obsidianom]

Unfortunatly Michael Jackson abused propofol for sleep and without the proper monitering. What he did was like giving yourself general anesthetic without anesthesiologist controlling it and hoping for the best. Propofol is one of the safest anesthetics as long as it is used properly with monitering devices . It is quick onset and quick off.  Even my oral surgeon uses it in his office with all the proper monitering devices hooked up. I have had several teeth pulled this way. 

[SooMK]

I avoided a colonoscopy for my transplant eval because my first one was just under the wire--10 years next year. The prep,as everyone has said, was the worst. I am nervous about having another one because they said they had "trouble waking me up" (is that like nearly dying?). My husband had to wait two hours past the time I was expected to be released. I never received any other explanation. And then when the specialist contacted me to have it repeated five years later for no reason ("that's Dr. X's standard") I was having none of it and got my GP to confirm there was no reason not to wait for the ten year mark. But it's just another miserable test and I am a big whiner. Another rite of passage. Best of luck.

[jeannea]

I had propofol given during my bad bout of encephalitis when I was also intubated. I had seizures and hallucinations and a lot of bad stuff. I was in ICU with good doctors and nurses who controlled the propofol. MJ died because he abused propofol and had a bad doctor. For the rest of us it can be a good anaesthetic.