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CT Scan with Rectal Contrast Fears

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CT Scan with Rectal Contrast Fears

Postby kitty,rn » Fri Oct 24, 2008 12:17 pm

I'm scheduled for my first follow-up CT scan on Monday, 10/27. My GI doc ordered a CT of abdomen, pelvis, (and chest-- after I mentioned that I'd learned on this forum that CRC metastasizes to the lungs). He also ordered rectal contrast and I'm stressing about that aspect of the scan. I have around 1/3 of my rectum remaining and since my ileostomy reversal the end of February, I sometimes have trouble holding back stool, so I'm afraid of having the barium instilled and not being able to retain it in the CT scanner as well as possibly causing a "Code Brown" in the CT scan room :oops: .

I spoke to one of the CT techs when I went to pick up my barium drinks the other day and made her aware of my concerns. I asked her about how long I was expected to "hold" the barium and asked whether it would be administered near the end of the scan so I'd be able to go to the bathroom-- I even asked where the bathroom was located in relation to the scanner. She said I'd have to hold the barium for 5 minutes or so and it wasn't clear if that would be in the beginning or the end of the CT scan. (Whether they let me out to pass the contrast and then get back in the scanner or what.)

I had a gastrografin enema to check for anastamosis leaks after my LAR in January before my ileo. reversal was done, and they instilled a lot of fluid in my bowels that I was able to retain, but it was on an open table and a bedpan-type container was available near me if I needed it. But in the "tube" of a CT scanner, a bedpan is of course impossible.

I figure the techs have had to deal with patients with continence issues in the past, but I'm getting stressed enough over the rectal contrast that I'm considering refusing it, but going ahead with the oral barium. I have a colonoscopy scheduled for 11/17. Wouldn't that give enough information to my GI doc without my having to have the rectal contrast? Any advice or words of wisdom or your own experiences would be appreciated.
Stage I rectal cancer 2/07, age 51, found during colonoscopy
Laparoscopic LAR 4/07
Rectovag fistula caused by anastamosis staple; loop ileostomy 5/07
Flap repair of fistula 7/07; Failed 8/07
Open LAR for takedown of fistula 1/08
Ileostomy reversal 2/08
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Re: CT Scan with Rectal Contrast Fears

Postby Lee » Sat Oct 25, 2008 8:57 pm

Hi Kitty,

Sorry no one has responded to your question yet. I will try my best.

When I do a scan with a contrast, I have to drink 2 bottles of that chalk type drink, about 45 prior to my scan. About 1/2 way thru the scans, I am then injected with the contrast (via a needle), so I'm not totally sure if it's the same as your procedure.

I'm sure, the tech(s) have had to deal with your problem before, so I'm surprised the tech was not more helpful. If you are unsure of your bowel control, wear depends, they should help until you get to the bathroom if you have an accident. Bring a change of clothes if it will help. There should be a bathroom near by, chances are they will not want you to leave the x-ray room until you are finished.

Please don't consider refusing a part of the procedure. As scary, uncomfortable as it may be, it is better that they have all the data to make a correct diagnoses.

Hope this helps, and all of it goes well for you. Please let us know how it goes.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!
Lee
 
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Re: CT Scan with Rectal Contrast Fears

Postby Luv2Run » Sat Oct 25, 2008 9:11 pm

I have an ileostomy due to rectal cancer. When I have to do my yearly CT scan, I tell the staff of my situation and instead of the hour I half to wait, I need to be scanned in half the time. I also make sure I have a plastic bag in the car for the trip home - my bag fills quite quickly with the contrast. Not good when you are on the expressway in rush hour traffic. I have had to empty my bag while driving to prevent a blow out.
dx ulcerative colitis @ 22 yrs
partial colectomy @ 41 yrs
dx Stage III rectal cancer -July 2005 - 46 yrs old
Ileostomy
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Re: CT Scan with Rectal Contrast Fears

Postby kitty,rn » Sun Oct 26, 2008 4:16 am

Thank you, Lee and Luv2Run for your responses. :) It's not the oral contrast that concerns me. It's the rectal contrast, instilled sort of like an enema, and it has to be "held" at least 5 minutes while you're in the scanner. What's left of my rectum is still easily stimulated since my reversal in February and I don't have much capacity to hold stool for very long (I still battle urgency with my bowels), and that was why I've been stressing over the procedure. I hate being a wuss about it and know how important the entire CT scan is. I was wondering whether what can be seen with contrast in the rectum might also be visualized as well during colonoscopy (which I have scheduled for 11/17).
Stage I rectal cancer 2/07, age 51, found during colonoscopy
Laparoscopic LAR 4/07
Rectovag fistula caused by anastamosis staple; loop ileostomy 5/07
Flap repair of fistula 7/07; Failed 8/07
Open LAR for takedown of fistula 1/08
Ileostomy reversal 2/08
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Re: CT Scan with Rectal Contrast Fears

Postby renee2u » Sun Oct 26, 2008 8:36 am

Hello Kitty....

My schedule for scans now is to have CT scans every other 6 months... and then the OTHER 6 month scan is a PET scan.

The Dr orders 3 CT scans... chest/abdominal/pelvic.

Just after treatments my scan schedule was every 3 months... My first CT scan after treatments was in January and I've had 2 other CT scans. I have to have the rectal contrast. The techs know that I can not hold the contrast. They push the contrast up as far as it will go and leave it in for a few seconds and then allow it to wash right back out! The contrast coating that is left is plenty for my Drs to see everything they need. All of my scans have been considered successful... showing everything that was needed...

The scan room with the machine... has it's own bathroom... the minute the scan was done I make a BREAK for the bathroom even though all the dye washed right back out... it is a lot like getting an enema and I have to go to the bathroom a lot right after the scans... but it's not so bad! It's really worth it to get the scans!

Hope this helps you...
Renee :-)

Dxed 8/10/2007
Stage IV Squamous Cell Carcinoma Anal.. mets to Sacrum.
30 Radiation Treatments. 2 rounds of Mitomycin and 2 - 96 hour 5FU Treatments...
Completed Treatments 11/2/2007.
NEG and NED Feb 1st.
Port Removed Feb 7th
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Re: CT Scan with Rectal Contrast Fears

Postby renee2u » Sun Oct 26, 2008 8:38 am

Kitty... just so you know... the first time I had the CT scans after my treatments the tech said I'd have to hold the rectal contrast for several minutes during the scans and I informed her that was a joke... that's when she decided to do the enema type wash...
Renee :-)

Dxed 8/10/2007
Stage IV Squamous Cell Carcinoma Anal.. mets to Sacrum.
30 Radiation Treatments. 2 rounds of Mitomycin and 2 - 96 hour 5FU Treatments...
Completed Treatments 11/2/2007.
NEG and NED Feb 1st.
Port Removed Feb 7th
User avatar
renee2u
 
Posts: 97
Joined: Sat Apr 19, 2008 12:13 am
Location: SWMO

Re: CT Scan with Rectal Contrast Fears

Postby kitty,rn » Sun Oct 26, 2008 5:05 pm

Thanks for your response, Renee-- I don't know if you'll see a question I have before I have to go for my CT scan tomorrow, but I wondered how your techs did a "rectal wash". You said: "The techs know that I can not hold the contrast. They push the contrast up as far as it will go and leave it in for a few seconds and then allow it to wash right back out!" How does it wash back out? Are you on a bedpan that allows the contrast to drain from your rectum?

I'll mention what you said about the rectal wash to the techs tomorrow and warn them I won't be able to hold the contrast for very long. I think the tech said the bathroom is across the hall from the scan room, too. I can imagine making a lovely trail all the way from the scanner to the toilet... :(
Stage I rectal cancer 2/07, age 51, found during colonoscopy
Laparoscopic LAR 4/07
Rectovag fistula caused by anastamosis staple; loop ileostomy 5/07
Flap repair of fistula 7/07; Failed 8/07
Open LAR for takedown of fistula 1/08
Ileostomy reversal 2/08
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kitty,rn
 
Posts: 98
Joined: Mon Jul 21, 2008 3:13 pm

Re: CT Scan with Rectal Contrast Fears

Postby Lee » Sun Oct 26, 2008 5:48 pm

kitty,rn wrote:Thank you, Lee and Luv2Run for your responses. :) It's not the oral contrast that concerns me. It's the rectal contrast, instilled sort of like an enema, and it has to be "held" at least 5 minutes while you're in the scanner. What's left of my rectum is still easily stimulated since my reversal in February and I don't have much capacity to hold stool for very long (I still battle urgency with my bowels), and that was why I've been stressing over the procedure. I hate being a wuss about it and know how important the entire CT scan is. I was wondering whether what can be seen with contrast in the rectum might also be visualized as well during colonoscopy (which I have scheduled for 11/17).


Kitty,

Now I understand your fears and concerns. My rectum is 100% gone, so I don't have that problem anymore. I believe Renee2u has given you perfect advice. I would REALLY STRESS to the tech the problems that will happen if they are unable to assist you, and again I would bring a change of clothes just in case.

Best of luck, hope it is an uneventful procedure and results are clean. Please let us know.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!
Lee
 
Posts: 2966
Joined: Sun Apr 16, 2006 4:09 pm

Re: CT Scan with Rectal Contrast Fears

Postby living skies » Sun Oct 26, 2008 5:56 pm

Kitty,

When I had a barium contrast the tech inflated a small balloon in my anus to hold the contrast in....no problem. Good luck.

J
living skies
caregiver to husband
stage 1 rectal cancer 06/06
resection, permanent colostomy
mets to lungs 04/08, stage 4
folfiri,leucovorin and avastin started 10/08 , 52 rounds
10/11 progression in lung mets, change chemo to folfox
age 62
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living skies
 
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Re: CT Scan with Rectal Contrast Fears

Postby DeeDee » Sun Oct 26, 2008 6:10 pm

I had a barium enema test prior to my ileo take down surgery. I ended up with my ileo because the surgeon was having trouble finding the source of a leak during the surgery. My test was done to make sure the leak had healed before doing the reversal surgery. I think the contrast provides a better look at the surface of the rectum. Some things can be hidden by the folds in the rectum or colon during a colonoscopy.

The scan room had its own bathroom which was really good because I would never have made it any farther. They did the first part of the scanning without the enema. It wasn't as hard to hold the contrast as I thought it might be. It was a challenge but I managed to do it. Where I had my biggest challenge was after the test. Once I released the contrast I thought it would be done. It wasn't. I almost had 2 accidents leaving the medical center. I guess it just took my body a bit longer to settle down afterwards. You may want to hang around for a little while after the test just to make sure you won't have a problem with the contrast.
Hugs,

Dee
Stage 2 Rectal Cancer
Tomo Radiation and resection 12/06
Folfox stopped after 3 due to toxicity
Ileostomy reversal 04/07
NED
DeeDee
 
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Re: CT Scan with Rectal Contrast Fears

Postby kitty,rn » Sun Oct 26, 2008 8:00 pm

Thanks, Lee--I'll definitely be warning the techs and will be asking to wear a hospital gown for the scan. J, that's reassuring to hear about the small balloon inflated to hold the contrast in. When I mentioned my concerns to the CT tech the other day when I was picking up the oral contrast, she said nothing about a balloon to hold things in. Dee-Dee, the procedure you had pre-reversal sounds like the gastrografin enema I had to check for leaks before my ileostomy reversal.They instilled a lot of contrast and I also was thankful a bathroom was in the same room! I hung around the hospital after the procedure for a while before heading home for the reason you mentioned-- I had to keep running to the bathroom a number of times before I could leave, so I'll make sure to hang around for a while until I feel like my bowels have settled down tomorrow. I'm planning to bring a Depends to wear in the car for the drive home. I can't imagine that they haven't had patients with continence problems before, so they must have a way to deal with us. I'll check in sometime tomorrow to report on how it went. Thanks to everyone for your caring and input!
Stage I rectal cancer 2/07, age 51, found during colonoscopy
Laparoscopic LAR 4/07
Rectovag fistula caused by anastamosis staple; loop ileostomy 5/07
Flap repair of fistula 7/07; Failed 8/07
Open LAR for takedown of fistula 1/08
Ileostomy reversal 2/08
User avatar
kitty,rn
 
Posts: 98
Joined: Mon Jul 21, 2008 3:13 pm

Re: CT Scan with Rectal Contrast Fears

Postby renee2u » Sun Oct 26, 2008 8:04 pm

Kitty.... I am not sure where the wasted dye went... It didn't seem to make a mess on the pads that were on the sheets... but they did put out a lot of pads on the bedding...
Renee :-)

Dxed 8/10/2007
Stage IV Squamous Cell Carcinoma Anal.. mets to Sacrum.
30 Radiation Treatments. 2 rounds of Mitomycin and 2 - 96 hour 5FU Treatments...
Completed Treatments 11/2/2007.
NEG and NED Feb 1st.
Port Removed Feb 7th
User avatar
renee2u
 
Posts: 97
Joined: Sat Apr 19, 2008 12:13 am
Location: SWMO

Re: CT Scan with Rectal Contrast Fears

Postby kitty,rn » Mon Oct 27, 2008 7:43 am

Hi again, Renee-- I wonder if there's a way that the tube or catheter inserted in the rectum to instill the contrast could also be used to withdraw some of the contrast? Oh well... I'll be finding out in around 4 1/2 hours. I just drank my first container of "berry-flavored" contrast and it's not sitting too well on my earlier bowl of Cheerios... :|
Stage I rectal cancer 2/07, age 51, found during colonoscopy
Laparoscopic LAR 4/07
Rectovag fistula caused by anastamosis staple; loop ileostomy 5/07
Flap repair of fistula 7/07; Failed 8/07
Open LAR for takedown of fistula 1/08
Ileostomy reversal 2/08
User avatar
kitty,rn
 
Posts: 98
Joined: Mon Jul 21, 2008 3:13 pm

Re: CT Scan with Rectal Contrast Fears

Postby Lee » Mon Oct 27, 2008 9:09 am

Hi Kitty,

Just to let you know I am thinking of you, hoping the procedure is a success without fuss and problems. Please let us know how it went, and know that we care.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!
Lee
 
Posts: 2966
Joined: Sun Apr 16, 2006 4:09 pm

Re: CT Scan with Rectal Contrast Fears

Postby renee2u » Mon Oct 27, 2008 11:51 am

Kitty... I agree with Lee... please let us know how things went! I know what you're going to be going thru... and I'm pulling for you big time!

Hugs...
Renee :-)

Dxed 8/10/2007
Stage IV Squamous Cell Carcinoma Anal.. mets to Sacrum.
30 Radiation Treatments. 2 rounds of Mitomycin and 2 - 96 hour 5FU Treatments...
Completed Treatments 11/2/2007.
NEG and NED Feb 1st.
Port Removed Feb 7th
User avatar
renee2u
 
Posts: 97
Joined: Sat Apr 19, 2008 12:13 am
Location: SWMO

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