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flex sig or colonscopy?

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Posted 5/28/2014 8:39 PM (GMT -5)
agreed with hateuc.
Most of these docs will tell you that they do 10 to 15 per day. They are very good at it and the risk is minimal in the right hands. That being said... let me tell you:
My colon was in the worst shape that my GI had seen in 20 years. He was sure I would lose it soon.
When he did the colonscopy, he didn't "finish it" for a few reasons. First, I wasn't able to get the whole thing cleaned. Secondly, it wasn't necessary, he could see that it was really inflamed all the way through, both from the CAT scans and from the part he did scope. Thirdly, there was danger of perforation because the colon was sooooo inflamed. So he retracted the scope at some point.

BUT, then I went to see another GI, after my release. I had to move and this doc was closer. When he saw that the first GI didn't finish, he said, "some doctors won't continue if they think that the risk of perforation is too much, but I will keep going anyway." ***?

And he told me he thought I needed another colonoscopy (2 months after my first). Needless to say I traveled the 80 miles BACK to my old GI and am going to stay with him.

It's ALL about picking the right doctor and it sounds like you did.
Posted 5/28/2014 8:50 PM (GMT -5)
Yikes, seakyline, that's scary. yes making the trip to the right one (finding the right one) is everything!!!

I travel quite a distance to 2 of my docs, i was just thinking about that today. When you find a good keeper... keep him or her! even if you do have to drive a little.

my GI said that i might as well do the colonoscopy because in 3 years i will need my ten year checkup anyway, so knock it off early if i have to.

i was thinking to myself, "i have no plans of repeating this!"

do people really go every ten years? anyone?
Posted 5/28/2014 8:55 PM (GMT -5)
Yeah, seaskyline, gotta love when the new GI has to "see for themselves". Like the notes and biopsies from the scope 2 months ago aren't good enough. That's the problem when u want to change docs...you need to put up with that see for myself foolishness. And as far as the doc that would push through and risk perforation...glad you ran away from that loser.
Posted 5/28/2014 9:43 PM (GMT -5)
BUT, then I went to see another GI, after my release. I had to move and this doc was closer. When he saw that the first GI didn't finish, he said, "some doctors won't continue if they think that the risk of perforation is too much, but I will keep going anyway." ***?

This is why some doctors have no place practicing medicine. There should be a litmus test and a psychological evaluation for these clowns. Just because they are rich and privileged enough to go to medical school, doesn't mean they have the license to mess around with lives like that.

Any in case, I'd like to see the code of hammurabi enacted for every patient they harm. An eye for an eye and a tooth for a tooh. There is little justice in the realm of medicine.
Posted 5/28/2014 9:55 PM (GMT -5)
Guardian, to be honest, I had a sense for him being a narcissist because he had been reported for inappropriate conduct and it made the papers last year. (I googled him). Basically it was determined that he showed "bad boundaries".

After he said that, it occurred to me that he was just testing my boundaries, trying to see how I would react to such a bizarre statement.

There is little justice in any realm. These freaks are everywhere.
Posted 5/28/2014 10:05 PM (GMT -5)
" These freaks are everywhere."

geez, you can say that again !
Posted 5/28/2014 11:43 PM (GMT -5)
here is a link to someone's account of a perforation... very scary! and the statistics he found.

ps i read all three links to "wolverine"

http://roarofwolverine.com/archives/2772

(think i'll be seeking out the flex sig if need be. pray that the cortisone works!)
Posted 5/29/2014 12:02 AM (GMT -5)
you certainly have the right to say no to your doc -
Posted 5/29/2014 8:01 AM (GMT -5)

Lotusrising said...
here is a link to someone's account of a perforation... very scary! and the statistics he found.

ps i read all three links to "wolverine"

http://roarofwolverine.com/archives/2772

(think i'll be seeking out the flex sig if need be. pray that the cortisone works!)

Wolverine was initially the one who sparked my research on it (as well as on raw milk), after my last colonoscopy in May of 2013.

There's no way there aren't complications. Something happens after the prep and procedure, at least on the microbiome level. Though people may not show anything afterwards, I'd love for them to take stool samples before and after and do comparisons of the bacteria present (or absent).

Quite honestly, the colon cancer screening thing is a joke to me. It's not going to do anything on the prevention front if the patients continue their lifestyle habits.

A large-scale investigation of colonoscopy screening demonstrated its complete futility. The eighteen-years-long Minnesota Colon Cancer Control Study included 46,000+ patients between the ages of 50 and 80. It demonstrated only a 0.6% reduction in the incidence of colorectal cancer. Statistically speaking, this difference is even less than the chance outcome of one thousand coin flips.

In his particular case, it cost him his colon and it was for nothing at all.
Posted 5/29/2014 8:12 AM (GMT -5)

seaskyline said...
Guardian, to be honest, I had a sense for him being a narcissist because he had been reported for inappropriate conduct and it made the papers last year. (I googled him). Basically it was determined that he showed "bad boundaries".

After he said that, it occurred to me that he was just testing my boundaries, trying to see how I would react to such a bizarre statement.

There is little justice in any realm. These freaks are everywhere.

Yes, he wouldn't the first to test someone's boundaries. Most doctors I know have a god complex mentality and I'm pretty sure it's not different anywhere else. Maybe it's from all the indoctrination that happens in medical school.

Too bad they as aren't invincible as they think and die like the rest of us.
Posted 5/29/2014 8:15 AM (GMT -5)
C-scopes for colon cancer screening aren't to prevent colon cancer, it's to catch it early enough that it's treatable. And stats support that screening is a big reason mortality due to colon cancer is declining.

From Colorectal cancer statistics, 2014
http://onlinelibrary.wiley.com/doi/10.3322/caac.21220/full
"Colorectal cancer death rates have been decreasing since 1980 in men and since 1947 in women (Fig. 4). Declines since 1975 have been attributed to improvements in treatment (12%), changing patterns in colorectal cancer risk factors (35%), and screening uptake (53%)"
Posted 5/29/2014 8:33 AM (GMT -5)
I also don't agree with having so many colonoscopies or flexsigs, especially in the first few years. I also think they are way overdone and am a little afraid myself that the prep and biopsies taken can actually make things worse on some occasions. Like anything else there can be complications. But, if you need them done you need them done. And, I must say that there are a lot of extremist views in this thread regarding the procedures and the medical profession in general. You can always pull up a horror story or two on anything. My mother died because of this thought process. She badly needed a heart cath or baloon angioplasty or whatever you want to call it. She had heard of some horror stories and refused. She then developed bad gall bladder problems. Once again they warned her that she had to do the heart cath thing so that she wouldn't be so high risk for gall bladder surgery. She still refused and died during gall bladder surgery. Would she have had complications from the heart cath? We'll never know but the odds are very much in her favor that it would have been no big deal and she would most likely not have died during gall bladder surgery and lived another 10 years. Lotusrising is using everything they can to justify their irrational fears. As I said before, you can find horror stories about everything.
Posted 5/29/2014 9:00 AM (GMT -5)
so gar, you've mentioned many, many, many times that you were "afraid" of something or other - what were those fears based on ?

how bout jumping out of an airplane ? ever studied up on the death statistics ? last I heard, it was much, much safer than driving a car - I'm assuming you drive ?

are those rational fears ?
Posted 5/29/2014 9:20 AM (GMT -5)

fruitgirl said...
C-scopes for colon cancer screening aren't to prevent colon cancer, it's to catch it early enough that it's treatable. And stats support that screening is a big reason mortality due to colon cancer is declining.

From Colorectal cancer statistics, 2014
http://onlinelibrary.wiley.com/doi/10.3322/caac.21220/full
"Colorectal cancer death rates have been decreasing since 1980 in men and since 1947 in women (Fig. 4). Declines since 1975 have been attributed to improvements in treatment (12%), changing patterns in colorectal cancer risk factors (35%), and screening uptake (53%)"


1) Colon cancer deaths have stayed roughly on course, with minor declines throughout the years. The link you gave me showed 2% every year, which isn't a statistically significant number.

This isn't due to the fact that they are being prevented or "caught" early on, but because of more elaborate chemo measures to extend life. The deaths are still as miserable, except chemo just shifts the cause of death due to complications down the road.

See the graph here on the minor decreases each year.

Going by the CDC data, it still remains the third leading cause of cancer deaths in men and women.

2) Colonoscopies are touted as preventative measures, not to "catch" it early on. Screening is recommended to find the polyps before they become cancerous, so it IS prevention they are talking about. Except most polyps never turn cancerous, so it's useless to remove them in the first place:

An estimated 95% of all polyps are benign. They will never become cancers, so removing them makes just as much sense as zapping the moles off your buttocks to prevent melanoma.

Again, the large scale Minnesota study also showed no almost decrease (.6%) in colon cancer rates for those who under went colonoscopies for screening purposes.

Post Edited (Guardian7) : 5/29/2014 8:23:12 AM (GMT-6)

Posted 5/29/2014 9:30 AM (GMT -5)
Since soystud brought it up:

According to the United States Parachuting Association, there are an estimated 3 million jumps per year, and the fatality count is only 21 (for 2010). That’s a 0.0007% chance of dying from a skydive, compared to a 0.0167% chance of dying in a car accident (based on driving 10,000 miles). In layman’s terms, you are about 24 times more likely to die in a car accident than in a skydiving one.
Posted 5/29/2014 9:32 AM (GMT -5)
The link to the graph doesn't work.

You can't just say that 2% isn't statistically insignificant because it's a small number. The article I linked to unfortunately doesn't say if it is or is not (and it's actually 3%). Here is another link which says that the decrease in mortality rates IS significant, from 2001 to 2010.
http://www.cdc.gov/cancer/colorectal/statistics/trends.htm
Posted 5/29/2014 9:33 AM (GMT -5)
As far as skydiving being less risky than driving:

I can easily go about my life w/o jumping out of an airplane. Is it fun? Absolutely, if you're into that sort of thing. However, I can't easily go about my life w/o driving a car, because public transportation in my area is basically nil.
Posted 5/29/2014 9:46 AM (GMT -5)
risk vs fear --------- driving is obviously way, way more riskier, but much, much less fear inducing than plane exiting - that's cuz we're conditioned -

then there is risk vs benefit - how much risk is there, and is it worth it ? in terms of pred, it's all over the map as far as both questions -

if I couldn't get my uc under control to my satisfaction, I would try low dose pred before the other scarier and scarier drugs, like weed :-) j/k ......... I would get me a supply of 1 m/grammers and see what I need to take up to 5 m/g/day to find the happy colon zone - maybe I could get by on 2.5 every other day ?

I would give that a month to see how it worked or not -

and then I'd go find me one o them planes turn
Posted 5/29/2014 9:53 AM (GMT -5)
To me, it's not statistically significant if they are catching it and then putting patients on chemo to "reduce" death rates. The statistics are based on survival rates, not on whether the cancer comes back in the long term:
These are the latest survival rate figures:
Stage I – 74 percent
Stage IIA – 67 percent
Stage IIB – 59 percent
Stage IIC – 37 percent
Stage IIIA – 73 percent
Stage IIIB – 46 percent
Stage IIIC – 28 percent
Stage IV – 6 percent

And why not just tell us how to prevent it in the first place? Eating something like mung beans have shown to decrease colon cancer risk by 42%:

In one study, daily bean intake was associated with an up to 42% reduction in colon cancer risk after researchers adjusted for several potential confounding factors including age and gender.

That is far more valuable than getting a colonoscopy and then seeing if someone has cancer or not. This is valuable info they should be telling us, and not subjecting us to chemo and hoping that will "cure" the cancer.
Posted 5/29/2014 10:24 AM (GMT -5)
Instead of calming people down about procedures that carry small risks, some try to alarm people as much as possible, using absurd nonsense and distraction (soydud).

There's a reason there is no link to that graph, fruitgirl...

Garbling7, who seems to live her whole life on this forum, has again sought to mislead people with bogus excerpts. The quote she uses is NOT from the actual Minnesota study, which can be found here:
http://www.nejm.org/doi/full/10.1056/NEJM199305133281901#t=articleTop

Instead, it is taken from a personal statement made by the very questionable author Monatyrsky, as part of his attempts to sell his often ridiculed book - and it is a complete distortion of the truth. (The Minnesota study is actually about the use of fecal occult-blood screening to detect cancer.)

There seems to be no limit to the contorting of information done by some. And no-one has the time to unravel all the nonsense, let alone to go through all the dodgy links that look so real. (The study on mung beans is another embarrassing example.)

Thank goodness for people like Gary and fruitgirl, and others (like DBwithUC) who occasionally step in to try and balance out the nonsense.
Posted 5/29/2014 10:33 AM (GMT -5)
pay attention rambling -

garylooville posts = 5393 since 2012

guardian posts = 1557 since 2006


huh ?
Posted 5/29/2014 10:38 AM (GMT -5)
I suspected it would be a matter of time before you responded to perpetuate your own nonsense.

1) Here are the conclusions to the Minnesota study, as clear as day. That's where he got .6 the number from.

Through 30 years of follow-up, 33,020 participants (70.9%) died. A total of 732 deaths were attributed to colorectal cancer: 200 of the 11,072 deaths (1.8%) in the annual-screening group, 237 of the 11,004 deaths (2.2%) in the biennial-screening group, and 295 of the 10,944 deaths (2.7%) in the control group. Screening reduced colorectal-cancer mortality (relative risk with annual screening, 0.68; 95% confidence interval [CI], 0.56 to 0.82; relative risk with biennial screening, 0.78; 95% CI, 0.65 to 0.93) through 30 years of follow-up. No reduction was observed in all-cause mortality (relative risk with annual screening, 1.00; 95% CI, 0.99 to 1.01; relative risk with biennial screening, 0.99; 95% CI, 0.98 to 1.01). The reduction in colorectal-cancer mortality was larger for men than for women in the biennial-screening group (P=0.04 for interaction).

Link here

2) You don't even have to buy Konstantin's book to understand what he's saying. All the information is on his site gutsense, with sections detailing what constitutes good bowel health. He makes everything pretty darn clear and anyone with a grade-school education should be able to understand it.

3) Ok bro - go get your colonoscopy and then see if helps you not succumb to cancer. I choose not to get anymore because it's useless to me. It was a complete waste of my money and time. Did it help my UC one bit in the last 11 years? Not even close. I choose to prevent cancer with other means.

4) You want information contortion, go talk to your doctor and he'll be happy to contort information for you and tell you that drugs are good for your body.

Better yet, go subject yourself to chemo and see if you survive.

I'm glad that people like Michael Hurst exist so they can shred your hopelessness and drug pushing on these forums to the bounds of oblivion.
Posted 5/29/2014 11:15 AM (GMT -5)
Well, obviously it's an individual decision, colonoscopy or flex sig or not. Personally if i could get away with "not" that's what i'd pick... why not just try more aggressive measures, since he already knows what i have?

his (GI) whole argument is that i will need the col. anyway in 3 years for screening. I don't want one in 3 years for screening, either~. If anything i'll choose a flex sig for that, too, if need be.

The research i choose to follow (NY Times, McDougall as cited in earlier post of mine) shows that a flex sig is just as good for screening and has half the risk.

I think therefore there is no medical justification for doing one now. I should use this 6 week window to find someone who is more aligned with my values.

Being here has helped me understand more clearly what i want. I am beholden to this doc for further care via the col. even though it is not medically necessary. Wow. something smells fishy. Like, his group spent $$$ on their machines and they need to pay for them.

how much can a flex sig cost? that's what docs used forever, isn't it, till fancy stuff came along?

Your old time doc had one in his drawer, probably!

Risk is a very personal thing. I have had permanent damage to my body already in two places from medical procedures that have altered my life. I am not blaming, it's just what happened... but still i am sad and injured, and understandably older and wiser. So... um... no thank you, unless i am at life's edge or there is no other method available.

having said that, i completely understand, especially now, how individual this choice is.

again, thank you all for your comments. ~
Posted 5/29/2014 11:48 AM (GMT -5)
Every human being has irrational fears to one thing or another. I can actually completely understand Lotus's fear of colonoscopies. I actually had them myself. My family doc had been trying to talk me into a colonoscopy for years and years and then just about the time I was seriously considering it (due to my age, pre UC) a friend of mine almost died from a colonoscopy gone wrong (at the VA). But, when I started having UC symptoms I realized that the odds of something going wrong were probably lower than dying in a car accident and I took the big plunge. Was I nervous and apprehensive about it? Sure!!!!!!! But my fears were basically irrational and I hope Lotus hasn't taken any of my posts too personal but I have been trying to convince them that their irrational fears are clouding good judgment. My UC has been doing fairly well now and I am actually afraid that a colonoscopy might possibly wreck the progress I have made but if I get worse and the doc suggests a look see to figure out what is going on I would rather do the colonoscopy rather than a flex sig because I would want to know what is going on in order to decide what the best course of treatment should be.
Posted 5/29/2014 11:58 AM (GMT -5)
Just FYI - I'm the one who actually wanted some of the my colonoscopies done.

My doc just rolled his eyes when he saw the results, which was the same thing as the prior year's colonoscopy.

Also, a top university doc in the country I visited basically echoed Lotus' sentiment on a flex sig being a far safer bet. If I had to do something, it would be that.

The other thing that one can do is an MRI with volumen on the small intestine to rule out crohns. You'll have to drink a nasty tasting white liquid, but it's better than any prep out there.

Disease progression does not happen rapidly, but stressful circumstances, poor diets, lack of compliance with medications can worsen some circumstances. In that case, it's really up to the patient and the doctor should just stay the hell out of it. Who the hell is he to determine what to do to your body? Just another human being who is capable of making the same mistakes as anyone else.

Be your own advocate and come to your own conclusions. I presented a viewpoint that is different and goes against the river, but someone has to say it.
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