Please read: NEED colonoscopy input

[CBLACK]

My husband just found out that his HMO (in Illinois) is no longer covering colonoscopies in-hospital with anesthesia, and instead they are only covering ones done in-office with mild sedation. This means that his surgeon who has been with him since the beginning can no longer do the procedure. So we have two options...go to a new doctor (gastro but not a surgeon) that will do the procedure in-office or pay out of pocket to have it done by the doctor he has been with all along.

PLEASE give any input you can. If you have had a colonoscopy done in-office with mild sedation let me know how the experience was for you.
Thank you for your help!

[missjv]

AS OF APRIL 1, 2008 MOST MAJOR INSURANCE COMPANIES ARE DOING THE SAME THING AND REFUSING TO PAY FOR ANESTHESIA BECAUSE THE INSURANCE COMPANIES DECIDED THAT COLONOSCOPIES ARE NOT A PAINFUL PROCEDURE THEREFORE COMPLETE SEDATION IS NOT NEEDED. I WILL PAY OUT OF POCKET TO BE KNOCKED OUT FOR SURE CAUSE I COULD NOT STAND A SIGMOIDOSCOPY AWAKE SO I KNOW DAMN WELL A COLONOSCOPY WITHOUT BEING ASLEEP IS OUT OF THE QUESTION FOR ME. IT IS A SHAME BECAUSE IT IS ALREADY HARD ENOUGH TO GET FOLKS TO GO IN FOR A COLONOSCOPY NOW TRYING TO CONVINCE PEOPLE TO DO IT WILL BE HARDER IF THEY THINK THEY WILL BE AWAKE THE WHOLE TIME. WHAT A CROCK.

MISSJV

[CBLACK]

The colonoscopies alone aren't even being covered at the hospital. That is our dilemma.

[weisssoccermom]

I am not sure about the wording, however, many many people (the majority) have their colonoscopies done in outpatient settings-gastro labs, etc. that aren't connected to the hospital. These procedures are usually done with versed and demerol or some other sedatives that while not totally knocking you out, do put you into a deep enough sleep that you usually do NOT remember or feel anything. This is totally different than being awake with a sigmoid.

I just got off of the phone with my insurance company (Regence-BC/BS WA State) and they are not doing what you are describing. When I have mine done in the hospital, because of allergies, an anesthesiologist must be present to administer propofol. While this drug does not totally knock me out -say like when I am having surgery- it does nevertheless put me under enough that I do not have any idea what is going on. I would ask CBLACK if when you had your colonoscopy, did you also have a bill from an anesthesiologist? If not, then your surgeon administered the anesthesia and they almost certainly gave you the same drugs that you would get in the in office/ outpatient setting. When I have my colonoscopy done in the hospital GI lab, it is an ordeal because I have to coordinate the anethesiologist (who usually does not work in the GI lab) the surgeon, and the GI lab. (I don't actually do the coordinating-someone else does) The anesthesiologists are usually assigned to in hospital surgery or the same day surgery center, so I usually have to book this quite a ways out to make sure that an anestiologist is available for me. Do you remember who administered the sedation to you? If it was your surgeon, then you were not knocked out, just given mild sedation and you would probably be just fine with the gastro. Keep in mind it IS a different doctor doing the scope and interpreting the results, so should you decide to go that way, I would find out from my surgeon which gastro he/she recommends.

Just remember this. Most people are not completely sedated during colonoscopies anyway. Most people are just given mild sedation and the insurance companies are just trying to cut costs by cutting out all the extra costs associated with the hospitals. I also verified that if, like myself, you would have to be hospitalized because of another medical condition (ie heart problem) or drug allergies, then it would be considered medically necessary to be monitored by an anesthesologist and you would be allowed to go the hospital route.

Hope I explained that well. Good luck. I think that you will be fine in an outpatient gastro lab.

Jaynee

[missjv]

well propofol will no longer be covered from what i was told by my gastro doc. my colonoscopies have always been done at an out patient endoscopy center with an anesthesiologist on board. maybe other places do it differently. everytime i have had one done i have been in a pretty good sleep and i do not wake until i am in a recovery room and out of the procedure room and don't remember a damn thing. i guess it depends on where you go???

missjv

[klryder02]

CBLACK-

I had two colonoscopies, same doctor, same place, same drugs...13 months apart.

First time, I was out..don't remember anything.

Second time, (earlier this month) I was kinda in and out of it. I remember a few particular sections, and don't remember others.

I remember being uncomfortable for a few minutes. During the procedure, I mentioned that my stomach hurt. The nurse came over, did something, and the uncomfortable feeling went away. For some reason, I think she pushed on my stomach...but like I said, I was in and out of it, so who knows what exactly happened.

In all honesty, being partly awake wasn't a big deal for me. If I was told that I couldn't be put out 100% again, it wouldn't bother me that much.

Just this girls experience...

[Guest]

I have had 2 colonoscopies with mild sedation because that’s how they do it here in the UK. The first one was uncomfortable and a little painful as they needed to get past my blockage to inspect the rest of the colon. The second one year later was a walk in the park and I didn’t really feel a thing.

Stop being a baby, after my resection it was very painful and if you’ve been through that a little colonoscopy not such a big deal

[helen098]

I have had 4 colonoscopies 3 in the office and 1 in the hospital.
I love it in the office it takes less time (all I have to do is sign the consent/insurance info) Not as much waiting as there is only one person a head of you then I go home after I can stand up. My colon rectal doctor (in Queens NY the best email me if you want his info) makes it very
comfortable is always joking before they put me out and when I wake up gives me the results. I don’t know what drugs they give but I am usually talking to the doc/nurse next thing I know I wake up and it’s over. I feel nothing and am less stressed than in the hospital As long as you feel comfortable with the doc (I know it is hard to change) it is very simple

[Ron50]

Hi ,
I have had 8 scopes over the last ten years all done under mild sedation. I have woken up during most of them. It does not worry me most of the mild discomfort comes from the amount of air they use to expand the colon to get better vision. My lady GI and I have had some wonderful conversations during scopes. Once she took me for a guided tour of my colon and on another time I cracked her up completely. She thought I was asleep when I suddenly announced that we had to stop meeting like this ,my wife is getting suspicious. Strange thing is that I can never remember the trip home,cheers.
Ron.

[GO BLUE Girl]

Hi, have had 4 scopes last 4 years.........piece of cake. Was somewhat awake through most of them because after the first one where I was able to see the tumor I wanted to see what was going on in there.
It's the PREP that sucks for me My colorectal surgeon does mine the conscience sedation route. If you have to change to "out patient" scopes talk to your friends, coworkers etc. and see who they use. Beth