A safer colonoscopy

March 8, 2017 3:04 PM

As a health consumer, I don't have a lot of control over the outcome of medical procedures. I have a colonoscopy coming up and have some questions about what, if anything, I can do to reduce the risk of an injury.

Soonish I'm getting a colonoscopy at Kaiser in Northern California. This is a standard procedure (yay), that might result in getting a hole punched in my colon (boo). I'd like to minimise the (fairly low already) risk of a bad outcome. When I asked to see the most experienced doctor, the appointment staffer told me she didn't have that information. When I suggested getting the procedure done in Oakland because the facility there does more procedures than in Richmond (and more experience equals better outcomes usually), she told me it didn't matter because both places use the same doctors. Dearest hive mind, is there a way to find out who the most experienced Kaiser doctor is in my area or, conversely, if there's are Kaiser docs with higher-than-expected rates of poor outcomes so I can avoid those docs?

posted by Bella Donna to Health & Fitness (9 answers total)

Best answer: There's nothing you can do except relax. I think you have a much higher chance of being injured in a car accident on your way to your appointment than you do of suffering a perforation during your colonoscopy. People with extremely weakened/ulcerated/swollen colons are at risk for perforations but they still have colonoscopies before having ostomy surgeries. If you've done some basic research on the facility you'll be going to and if you've read reviews of other people's experiences there and everything is legit then you should be fine.
posted by Avosunspin at 4:10 PM on March 8, 2017 [12 favorites]

It's anecdotal and I'm reluctant to be too specific about health issues on the internet, but I'm chiming in to say that I tried the Richmond KP for about a year and found the quality of care to be significantly lower than I had experienced for years in Oakland. My partner had a similar experience with completely different doctors and different health issues.

Who knows if it's just luck of the draw with doctors or if there's an institutional issue, but either way I'm glad to be back at the Oakland KP.

Good luck with the colonoscopy!
posted by quarterframer at 4:39 PM on March 8, 2017

Sometimes the bios of the physicians on the website will show you when they finished gastroenterology fellowship. GIs learn how to do colonoscopies in fellowship, so the person who finished fellowship the earliest is likely to be the most experienced. Realistically, though, they do so many endoscopies that anyone who is more than a few years out of fellowship is likely to be adequately experienced.
posted by The Elusive Architeuthis at 7:41 PM on March 8, 2017

Also consider the prep before the procedure and which laxative solution the doc will give you. My colonoscopy revealed I had internal hemorrhoids (I was largely asymptomatic), and I think the colonoscopy in combination with the longer prep irritated them to the point where I ended up in the ER because the bleeding and clots were WAY beyond what I was told to expect.

I have to get another colonoscopy in a year and am opting for the shorter (if more disgusting) prep in hopes it won't be as rough on my hemorrhoids. (Before this freaks you out, bear in mind I had several large polyps removed, so that added to the irritation.)
posted by Wossname at 8:35 PM on March 8, 2017

i think you're probably more likely to slip and fall in a pool of your own exploded vile filth on the bathroom floor during the prep than you are to be injured during the actual procedure.

i personally have elected to die in the future rather than ever have one done again
posted by poffin boffin at 11:40 PM on March 8, 2017 [4 favorites]

More and more insurance plans are covering the ColoGuard test as an alternative to a colonoscopy. You poop in a box and mail it in for testing. Done and done. No sedation, no messy prep. Ask if it's available.
posted by DaveP at 3:02 AM on March 9, 2017 [4 favorites]

Best answer: In addition to the doctor's skill, there's the skill of the cleaning/sanitizing technicians. I can't find the link, but Monday's and Fridays are more likely to be short-staffed for people taking vacation from a long weekend, or possibly hungover. During short staffing periods, people need to make up time somewhere, or people need to do jobs that they don't normally do. Hep C (among other diseases) can be spread by improperly cleaned equipment. Aim for a Tue,Wed,Thur appointment, not near a holiday.
posted by nobeagle at 7:10 AM on March 9, 2017 [3 favorites]

Best answer: I think the best thing you can do to maximize your chances of safety is to be ABSOLUTELY RELIGIOUS about the prep to minimize the chance that you'll have to have a second one! I recall having seen some prep-related Asks here in the past, and it might behoove you to look them up. For example, certain colors of Jell-o can ruin the whole thing - so be informed about that and don't cut any corners on the prep.
posted by telepanda at 7:13 AM on March 9, 2017 [1 favorite]

More and more insurance plans are covering the ColoGuard test as an alternative to a colonoscopy. You poop in a box and mail it in for testing. Done and done. No sedation, no messy prep. Ask if it's available.

SoCal KP is technically a different org than NorCal KP for some reason, but down here in LA my father went in for his colonoscopy as a result of his ColoGuard test.

"Cheaper test you do first before the expensive test" is part of Southern Californian Kaiser's MO, so I'm assuming Northern Californian Kaiser has the same strategy.

As an aside: His colonoscopy results were almost 100% perfect, so not sure why ColoGuard results had him come in for more involved test.
posted by sideshow at 10:29 AM on March 13, 2017