Pending Procedure Worries

TheLadySkye

It's been a challenging and somewhat confusing last few weeks.  It's been a year since my diagnosis (and all of the emotions that go with that), and my oncologist suggested that even though my tumor was in the small intestine, a repeat colonoscopy would be a good idea.  She referred me back to the GI doctor who originally found the tumor for the procedure.

In addition to the colonoscopy, he said he would like to also redo the endoscopy, scoping further into the small intestine to check the surgical site and to check for local recurrence.  My oncologist didn't seem to think local recurrence was likely, but did not object to the procedure.  While I assume they would not agree if it was not safe to scope the surgical site, does anyone have any experience with this?  Is it safe to be poking around there?

They will also be performing the procedures two weeks apart.  It seems I would be quite uncomfortable if they use the expansion gas from both ends on the same day.  Which unfortunately means two separate bouts of anesthesia, two weeks apart.  In the past, I've had twilight sedation for the procedures.  However, my GI doctor said he had to use so much sedation last time (whether it was due to anxiety or a developing tolerance he could not say), that he would prefer to use monitored anesthesia this time.  He said he doesn't feel comfortable using the level of sedation required and that anesthesia is actually the common course in a lot of states.  Propofol is the anesthesia to be used.  Does anyone know if anesthesia is often used for these procedures?  Is it safe to have two weeks apart?

As if the concern about the procedures and the anesthesia weren't enough, when I went for my clearance exam, something weird popped up on my EKG.  Since chemo can cause cardiac issues, everyone went into ZOMG WHAT'S GOING ON mode.  Another ekg, an echocardiogram, and a visit with the nice cardiologist later, and I'm assured everything is fine, my second EKG was normal, and there doesn't seem to be anything to worry about but they'll repeat the tests in a year just to be sure.

Anyway, the tests will be next week, and then two weeks after that.  Of course I'm nervous about what they might find, but also about the anesthesia issue and surgical site safety and phantom cardiac issues and...I sure would appreciate prayers, good thoughts, and any insights you all might have.  And hand holding?  Can I humbly ask for that too?

Yolllmbs

Prayers

And lots of cyber hugs. I don't have any experience in the procedures but I sure have experience in the anxiety. 

 

Yolanda

UncleBuddy

Propofol

I've had propofol for both an endoscopy and colonoscopy. I had no issues with that anesthesia at all.

I wonder if your cardiac issues were caused by anxiety because you were nervous. My husbands blood pressure always goes up in the dr's office.

I'm sending good thoughts and cyber hugs. I'm sure everything will be fine.

Lin

Trubrit

Surgeries

I have had many surgeries over the years, and had Propofol a few times Now. The surgeons prefer to use it as it is safe than general anesthetic. i certainly have experienced no problems with it. 

My closest surgeries with Propofol were two months apart. 

I am sure they would not perform any procedure that would put your health in jeapordy, but you could seek a second opinion if you it would make you feel more confident. 

UncleBuddy

BTW

my brother had both scopings in the same procedure. He was fine afterward. I guess everyone is different, but he had no issues either. They also used propofol with him as well. 

Lin

LindaK.

Endoscopy

My husband just had an endoscopy on Thursday and the ercp to put a stent in his bile duct.  The Dr. Said he had to give him more sedation to calm the bowels down while they are poking around down there with the scope and tools.  The procedure was almost 2 hours due to his difficult anatomy because of previous resections and lymph node tumor pressing on bile duct.  He was totally gooned for about 5 hours after the procedure.  I'm not sure exactly which anesthesia they used. But he as come up from his 2 resections talking and awake so this was a very deep anesthsia.

I would ask about having them both in the same day.

Good news for my husband who is still inpatient is that his liver numbers are all coming down and the pancreas seems fine too.  One of the side effects is pancreatitis.

Good luck, Linda

annalexandria

I had quite a lot of local spread,

in both the colon and small intestine, so while rare, it's def not unheard of.

I was told that the small intestine is tricky, and that the scopes simply can't check the entire length of the intestine.  I was given a camera pill to swallow as an alternative, but that didn't work in my case, as I already had tumors in the small intestine that blocked the camera from passing through.  In most cases, tho, this option would allow for more complete scanning.  Might be worth asking about.

I would also ask about having a PET scan.  Is there some reason they aren't using this (ideally PET/CT combo) to track things?

Again, this is just my experience, but the PET did pick things up, even in the sm. intestine, when they were quite small.  Made a big diffference for me, as chemo didn't work and I needed frequent surgery to get stuff out as it popped up.

Good luck!  Let us know how it all goes.

Big hugs~AA

Nana b

annalexandria said:

I had quite a lot of local spread,

in both the colon and small intestine, so while rare, it's def not unheard of.

I was told that the small intestine is tricky, and that the scopes simply can't check the entire length of the intestine.  I was given a camera pill to swallow as an alternative, but that didn't work in my case, as I already had tumors in the small intestine that blocked the camera from passing through.  In most cases, tho, this option would allow for more complete scanning.  Might be worth asking about.

I would also ask about having a PET scan.  Is there some reason they aren't using this (ideally PET/CT combo) to track things?

Again, this is just my experience, but the PET did pick things up, even in the sm. intestine, when they were quite small.  Made a big diffference for me, as chemo didn't work and I needed frequent surgery to get stuff out as it popped up.

Good luck!  Let us know how it all goes.

Big hugs~AA

I've had an endoscopy and

I've had an endoscopy and colonoscopy at the same time.  My ONC stated reacurrance in the colon is rare, wondering also why they aren't doing a pet scan. What is your CEA Level?   Why are they doing one so soon?

 

TheLadySkye

Nana b said:

I've had an endoscopy and

I've had an endoscopy and colonoscopy at the same time.  My ONC stated reacurrance in the colon is rare, wondering also why they aren't doing a pet scan. What is your CEA Level?   Why are they doing one so soon?

 

I honestly don't know why

I honestly don't know why they aren't doing a PET scan.  Every time I ask, they say they see what they're looking for better on the CTs and may follow up with a PET if something looks suspicious.  I'm not sure a PET scan is something I can INSIST on, though I do wonder.

My CEA has been negligible every time it's been tested.  However, for some reason I was not tested BEFORE surgery so I have no idea if it's a good marker for me or not (it isn't always for small intestine cancer).  I guess it's good that it's so low, but I don't know if CEA is even a useful measure for me.

It's been a year since my resection surgery, and I'm told a year out is generally when they want to repeat the colonoscopy.  I've also been having some narrow stool, and so they want to rule out anything in the colon.  They THINK it's probably related to the uterine fibroid I have or a hemerrhoid, but since PROBABLY isn't a word they want to be using, it's best to check under the hood.  So the onc wants the colonscopy.  My GI doc is the one who wanted to repeat the endoscopy as well and check the small intestine surgical site for recurrence.  It's a heck of a hard area to visualize, so I am always hoping and praying they got it all!

Lots of good thoughts on Wednesday (the day of the colonscopy/anoscopy) would be very much appreciated!  The endoscopy will be two weeks after that.

annalexandria

TheLadySkye said:

I honestly don't know why

I honestly don't know why they aren't doing a PET scan.  Every time I ask, they say they see what they're looking for better on the CTs and may follow up with a PET if something looks suspicious.  I'm not sure a PET scan is something I can INSIST on, though I do wonder.

My CEA has been negligible every time it's been tested.  However, for some reason I was not tested BEFORE surgery so I have no idea if it's a good marker for me or not (it isn't always for small intestine cancer).  I guess it's good that it's so low, but I don't know if CEA is even a useful measure for me.

It's been a year since my resection surgery, and I'm told a year out is generally when they want to repeat the colonoscopy.  I've also been having some narrow stool, and so they want to rule out anything in the colon.  They THINK it's probably related to the uterine fibroid I have or a hemerrhoid, but since PROBABLY isn't a word they want to be using, it's best to check under the hood.  So the onc wants the colonscopy.  My GI doc is the one who wanted to repeat the endoscopy as well and check the small intestine surgical site for recurrence.  It's a heck of a hard area to visualize, so I am always hoping and praying they got it all!

Lots of good thoughts on Wednesday (the day of the colonscopy/anoscopy) would be very much appreciated!  The endoscopy will be two weeks after that.

As you say,

hard to visualize in that area.  CT alone misses stuff all the time in the digestive tract.  If it was me, I would ask about the PET, see if you can talk them into using that for future scanning.

Good luck on Wed!

UncleBuddy

TheLadySkye said:

I honestly don't know why

I honestly don't know why they aren't doing a PET scan.  Every time I ask, they say they see what they're looking for better on the CTs and may follow up with a PET if something looks suspicious.  I'm not sure a PET scan is something I can INSIST on, though I do wonder.

My CEA has been negligible every time it's been tested.  However, for some reason I was not tested BEFORE surgery so I have no idea if it's a good marker for me or not (it isn't always for small intestine cancer).  I guess it's good that it's so low, but I don't know if CEA is even a useful measure for me.

It's been a year since my resection surgery, and I'm told a year out is generally when they want to repeat the colonoscopy.  I've also been having some narrow stool, and so they want to rule out anything in the colon.  They THINK it's probably related to the uterine fibroid I have or a hemerrhoid, but since PROBABLY isn't a word they want to be using, it's best to check under the hood.  So the onc wants the colonscopy.  My GI doc is the one who wanted to repeat the endoscopy as well and check the small intestine surgical site for recurrence.  It's a heck of a hard area to visualize, so I am always hoping and praying they got it all!

Lots of good thoughts on Wednesday (the day of the colonscopy/anoscopy) would be very much appreciated!  The endoscopy will be two weeks after that.

I agree!

If you can get a Pet or an MRI, it may show that area better. I know my brother's lung nodules show up easily on the CT but the liver tumor shows up only on an MRI or PET. The CT isn't clear when it comes to his liver and they could have missed it if his onc didn't push for the other test.

Good luck on your scopings. 

Lin