Pill Camera Endoscopy Scheduled

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CrohnieToo
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Date Joined May 2003
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   Posted 2/11/2008 12:10 PM (GMT -7)   
Wow! Evidently the gastros in this area are really jumping on the PCE bandwagon! Only one hospital in town is doing them and they are already booked up until 10 March 08. And get this: my appointment is scheduled for 7 AM! Yeah, like 7 AM in the morning! What an unGodly hour to HAVE to be somewhere this time of year!!!! I thought I got out of the risk of early morning bad winter roads when I retired!!! (Yeah, we can STILL have some really bad storms in March, even early April any more).
 
Ah well. So - I'm scheduled 26 February 08 to "do" the Patency Capsule (the dissolvable pill to make sure the PCE will "pass" w/o getting stuck). For the patency capsule I have to do a liquid diet the day before and NPO after 10 PM w/an appointment to swallow the pill at 10 AM on the 26th w/my gastro's PA. 26 hours later I have to go in to an imaging center for an abdominal xray to make sure the patency capsule has passed. If it passes I am good to go for the PCE.
 
The HOSPITAL instructions for the actual PCE are interesting. No iron supplement for 3 days prior as it can darken the intestinal mucosa.
 
No smoking for 24 hours PRIOR to swallowing the PCE AND no smoking for the 8 hours the procedure is taking place as smoking can also stain the mucosa. (I'd swear my gastro put this rule in!!!)
 
Normal lunch by noon the day before swallowing the PCE, clear liquids only until 10 PM. NPO after 10 PM. Morning meds may be taken by 5 AM w/a SIP of water. NOTHING after 5 AM.
 
The day OF the PCE, 7AM at the hospital, review of medical history, sign a consent form. No soap or skin moisturizer on abdomen or groin the morning of the procedure. Male patients (ha! ha! I'm NOT) need to shave abdomen and upper groin areas prior to admission to ensure a secure connection of the sensory pads.
 
After the sensory pads are in place, fitting with a belt to hold the data recorder and battery pack. Then swallowing the PCE w/water (what? some have said they were given something to make it slipperier!). Specific instructions for discharge will be reviewed and then I can leave for 8 hours.
 
BUT - MY gastro also insists on a prep for the PCE. *sigh*. Some luckies I've read haven't had to. *sigh*. However, she did say that since it is the small intestine, and not the colon, I can do a HALF prep rather than the full prep. So I can do either one bottle of PhosphoSoda OR 125 mg of Miralax w/32 oz of Gatorade. This sounds like a good time to try the Miralax prep to see how I do w/it. She said one cup of that every 30 minutes until gone. That's 8 ozs every 1/2 hour. Hmmm. Ha! I'll stretch that out a bit. I'll probably take 1-2 hours longer to get it all down.
 
Duh. You know what tho??? Red-face. I forgot to ask what TIME I start the Miralax!!!
 
Those of you who have done the Miralax prep for a scope or the PCE, what time did they have you start the Miralax prep if you were having a MORNING scope or PCE???
 
Be AT the hospital AT 7 AM??? Barbaric!!! Inhumane!!! Mumble, grumble. Just "ain't" no pleasing me! Watch, we'll have a BLIZZARD that night and morning!!! Whachya wanna bet?


Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Post Edited (CrohnieToo) : 3/21/2008 10:30:37 AM (GMT-6)


wanthealth
Regular Member


Date Joined Feb 2008
Total Posts : 78
   Posted 2/11/2008 4:10 PM (GMT -7)   
Crohnie too,
Can't help you with the prep for the test as I didn't have to have any--can't remember what and when I was allowed to eat or drink. I participated in a study before the patency capsule was approved. But one good change seems to have occurred---I had to retrieve the patency capsule and bring it in. They wanted to see it! As far as the results go, after having had a small bowel study, CT, MRI all which showed no disease, the CPE showed moderate to severe inflammation in a number of places in my small bowel. It was a relief- after whining to the doc for years about pain, I finally got his attention.
Good luck with your exam. It's one of the easier ones especially since you don't have to go "fishing".

gumby44
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Date Joined Nov 2007
Total Posts : 4100
   Posted 2/11/2008 4:23 PM (GMT -7)   
Hi there,
I didn't have to do a prep..just clear liquids the day before, so I can't advise you on the Miralax. They put the camera gadget and electrodes on me in the doc's office, and then I went home and returned about 8 hours later. I felt like the Uni-bomber driving home with the belt and electrodes, and I was hoping I didn't get in an accident or stopped by the cops! I joked about it with my doc afterward, and they said they should have written me a note or something. It isn't a bad test, and you can get good info from it. I found out I had a bleeding ulcer in my small intestine - before the test we couldn't find the source of my anemia.
Where do you live that you are so worried about the snow? I'm in Northern Michigan. Good luck and I hope it all goes well!
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares


schoolgirl
Regular Member


Date Joined Oct 2007
Total Posts : 35
   Posted 2/11/2008 4:46 PM (GMT -7)   
I had to start the "half" prep by 3 pm the afternoon before.  And I had to be there at 7 am because you have to go back to turn in the belt and transmitter/receiver thingy before they close at the end of the day. 
 
Hope all goes well for you.  The pill was very slippery and not hard to swallow even with just water.  mInd over matter I guess!
Dx with Crohn's Aug 2007; celiac sprue July 2003; Type II diabetes Nov 2006.  Current meds: Entocort , Asacol, Levoxyl, Fosomax, various vitamin supplements.


Blue Velvyt
Regular Member


Date Joined Sep 2006
Total Posts : 194
   Posted 2/11/2008 11:29 PM (GMT -7)   
Cant say i remeber doing prep or not when I did the camera pill, so many colite preps, they all just seem to blend together.

However the results of this test showed the inflamation which multipl endoscopies, simodoscopies and colonoscopies missed, along with stomach erosion and ulcers.

This test was at least conclusive for me, I hope it will be for you to.

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 2/11/2008 11:49 PM (GMT -7)   
Hey C2,
I had to get "cleaned out" before my pill cam a couple years ago...better to be safe than sorry as far as that goes, I'm afraid. Believe it or not, there's a whole bunch of nastiness that hangs out in your small intestine (believe me, I've dug my hands through almost every inch of it on the cadavers). Just think...what a great excuse to read horrible things like the National Enquirer (that always cheers me up while I'm having "one of those days"). I am excited that you are getting this done, and the dissolvable camera idea just blows my mind. Keep us updated and GOOD LUCK!
Co-moderator - IBS Forum


CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 2/12/2008 6:33 AM (GMT -7)   
SchoolGirl, thanks so much for the prep start time!!! Just what I needed to know. I'll start at 2 PM then so I can take a little longer getting that much liquid down me. I'm a sipper, not a drinker. I understand WHY I have to be at the hospital at 7 AM for the PCE. Doesn't mean I have to LIKE it tho!!! I'm still in a coma at 7 AM even if I've been awake since 5 AM. Sheesh!

Sarita, thanks to you too. Actually, I've had to "paw" thru some real yuck in 30 years of breeding and showing dogs. And I observed a lot of necropsies thru the years as well. (On dogs, not humans). I was REAL disappointed to learn that Bodies was in Detroit and I didn't learn about it until after it had moved on. I would have been fascinated by and LOVED to have been able to go and SEE!!!

We've talked about the double balloon endoscopy too but the only place in Michigan doing them is U of M and I'm not so sure I wouldn't end up w/a few "practicing" whilst I'm sedated. And for the double balloon I am SURE I would NEED to be sedated despite I don't "do" sedation during my colonoscopies.

BlueVelvet, and all of you, thank you so much for your responses, and the good wishes. Hopefully we will pinpoint the areas of involvement if I'm cleared for the PCE. I'm concerned I won't be because of the TYPE of resection I had. It was a side to end reconnection so there is a loop at the anastomosis rather than "just" a widened area (that is now a partial obstruction). That is WHY I REFUSED to do the PCE until they developed and approved the patency capsule and it became available in our area despite my so much wanting to SEE what is going on WHERE in my small intestine.

Gumby44, I'm in the Saginaw valley area. Do you have sleep apnea too??

MoodIndigo, I was thinking of trying to "catch" the patency capsule w/something just out of curiosity if I don't get a chance to get a good look at it before I swallow it. And I'm DEFINITELY gonna try and catch the PCE if all goes well and I am cleared to do it. Any suggestions on the best way to go about it?
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 2/12/2008 6:38 AM (GMT -7)   
Ha! Gumby! Maybe I'll make it a point to go shopping - in the Mall (which I HATE - both shopping and the Mall) just so I can keep my coat off and see how much excitement I can engender! Maybe I'll even take my camera and catch some salesclerks' faces! Or even shoppers! (Guess I better get that letter your doctor suggested, huh?) Then I can get some security guard faces too, you think? Hey! The 10th could turn out to be a fun day after all!!
 
I don't have much faith in getting TIMELY results from my gastro, tho. *sigh* She's no more "timely" than I am (and I'll be late for my own funeral!)


Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Post Edited (CrohnieToo) : 2/12/2008 6:42:39 AM (GMT-7)


wanthealth
Regular Member


Date Joined Feb 2008
Total Posts : 78
   Posted 2/12/2008 8:18 AM (GMT -7)   
CrohnnieToo,
You have an advantage since you spent many years "pawing" through the yuck.
For the retrieval process they gave me a "hat-like" product---cardboard for the rim with tabs to stick to the rim of the toilet bowl and a filter like material in the center. You can probably get something together that would work.... coffee filter? cheesecloth? stapled to some cardboard. You'll get a chance to examine both capsules before you swallow them in case you change your mind.
Let us know how you make out.
Moodindigo

Trsora1
Regular Member


Date Joined Nov 2007
Total Posts : 111
   Posted 2/12/2008 8:37 AM (GMT -7)   
i had it done. Was on medication when i had it done kinda of a waste. Coulndt find crohns that way. I was all cleaned out from a colonscopy. so i just couldnt eat or drink

gumby44
Veteran Member


Date Joined Nov 2007
Total Posts : 4100
   Posted 2/12/2008 9:46 AM (GMT -7)   
Why do you have to retreive the capsule..just to make sure it passed? They didn't have me retrieve it. In answer to your question, I don't have sleep apnea..what does that have to do with anything??? It wasn't hard at all to swallow the capsule. Compared to the colonoscopy, it was a breeze
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares


wanthealth
Regular Member


Date Joined Feb 2008
Total Posts : 78
   Posted 2/12/2008 10:24 AM (GMT -7)   
Gunby,
I was part of a study to test the patency capsule- a dummy capsule made of a waxlike material to see if any obstructions were present in the bowel. (I've had three resections) It was the same size as the camera capsule and if it got stuck at an obstuction it would disolve. That would indicate that you wouldn't want to go ahead with the camera capsule. Seems to me that it should be used all the time, especially in people with strictures.
Moodindigo

CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 2/12/2008 10:32 AM (GMT -7)   
We have a Gumby in one of our sleep apnea forums and I just thought I'd take a chance if you two were one and the same. We don't "have" to retrieve the patency capsule. I'm just the curious (read that nosey if you like) type.

MoodIndigo, I already have a "hat-like" thig-a-ma-jig" to hold a tub to catch stool for the fecal calprotectin test. I "think" that a Cool Whip container just might fit in it w/some cheese cloth. Thanks for the info and suggestion. (Yeah, I used to make mud pies when I was a kid too!).

Trsora, in my case, I would be rather reluctant to try the PCE when in a flare since we KNOW there is a partial obstruction at the old anastomosis. I'm not saying I would refuse to do so - just that I'd be increasing my chances of a serious problem w/the capsule getting stuck. That is the main reason I refused to do the PCE w/o first trying the patency capsule.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


rootsmith
Veteran Member


Date Joined Jan 2004
Total Posts : 598
   Posted 2/12/2008 10:52 AM (GMT -7)   
I did the Miralax and gatorade prep before a colonoscopy. It wasn't bad at all except that it was winter and drinking all that cold liquid made me very cold. I seem to recall sitting in the living room with my husband in the rocker recliner watching the news on tv while I was drinking this stuff so that would be early evening for a morning (not real early) colonoscopy.

I would give your doctor's office a call and find out the time they recommend.
10 years, many tests, 3 gi doctors, Pentasa 1000mg 3x day
diovan, simvastatin, sertraline, lyrica  


nikki0294
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 3/19/2008 3:37 PM (GMT -7)   
Crohnie Too
How did the patency capsule go? I am scheduled for one Tuesday and the real deal after that. Do you have any areas of narrowing/stricture?? Did it pass??

Thanks
Chris

Keah
Veteran Member


Date Joined Nov 2003
Total Posts : 7314
   Posted 3/20/2008 11:27 PM (GMT -7)   
When my GI and I discussed the CE and the possibility of the camera getting stuck, I decided that if I had a stricture tight enough to block the camera, I'd likely need surgery anyway, so going in for the camera would get me the resection that I'd likely need.

I can understand why someone else might look at this issue differently though. It's all just a matter of what choices we want to make regarding our individual disease process and treatment options.

So CToo, how did it go?
Keah a.k.a. Wormy
 God helps those who help themselves.
Please help us support this invaluable forum.
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MikeB
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Date Joined Mar 2006
Total Posts : 1169
   Posted 3/21/2008 4:53 AM (GMT -7)   
You all might be interested in a recent experience of mine. I arranged for our local CCFA support group to tour the endoscopy clinic at the local hospital. The clinic director met us and conducted a most educational tour for about 15 members. Part of the tour was of the room where the pill camera results are read. She pulled up the video of one pill camera procedure and it was quite fascinating to see the images -- they are very clear and precise and pinpointed, in this case, a very clear area where bleeding was occurring from an AVM (arterio-venous malformation.) She also seconded the opinion of the GI cited -- that if you have a stuck pill, that is not just a clear indication for surgery to remove it, but an equally clear indication that surgery is necessary to remove the narrowed area, since if the pill won't pass, neither will food, if not now, then in the soon-to-be future. Her statement was "it's good news and bad news -- good that you know where you are blocked, bad that yuo have to go in and get it now." Overall, the pill camera tour was a highlight, and it was clear from seeing those images that this is really a very precise and useful diagnostic tool.

CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 3/21/2008 9:28 AM (GMT -7)   
I posted the results in another thread. The PCE is a no-go for me. We did an abdominal xray 26 hours after I swallowed the APC and there it sat, top and bottom off and gone but the center w/the rod in it still sitting there. It looked to me on the film on the CD they gave me that it might have been sitting at the beginning of the sigmoid colon and I was hopeful .... but the radiologist said, NOPE, the APC was stuck in the small intestine, not the colon. It was sitting right there in the left lower quadrant just about even w/the top of the hip done. *sigh*
 
I swallowed the APC on Tuesday, xray Wednesday, Friday the APC had totally dissolved and I passed the tiny rod that was in the APC. No discomfort, no problems.
 
I've got an appt on 14 April at Mayo in MN. NOT going there for surgery. Going there for BETTER IMAGING w/radiologists most experienced w/recognizing Crohn's disease to find out just WHERE there really is Crohn's activity in my small intestine. I'm suspecting 3 areas but hoping for none and that the area where that APC was supposedly stuck is "just" scar tissue from the old resection and NOT active disease.
 
Dr Tremaine suggested probably they would do a CT enterography. He's the gastro I was assigned to when I went back to Mayo in 1999 when my remission ended. It had been 21 years since I was back to Mayo for my Crohn's and my previous gastro was long gone. *sigh* I really liked him, darn it.
 
Ah, MikeB, I would have loved going on that support group tour! Sounds fascinating. No such luck viewing even your own pics at our local facility. This hospital is the only one doing PCEs in our area and they have always been b*st*rds about releasing your medical records to you personally.
 
So, KEAH, did you not have the PCE then, or are you still in the process of insurance approval, etc.?
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


Keah
Veteran Member


Date Joined Nov 2003
Total Posts : 7314
   Posted 3/22/2008 1:34 AM (GMT -7)   
Oh CToo, my CE was done almost 2 years ago. LOL Mom just had one 2 weeks ago though and I'm going to try and get the GI to give me a look see at some of the pics. She's been getting more and more anemic over the last 2 years and her hematocrit is down to 8.4. In early Nov, she had an oozing polyp and 2 AVMs removed and we had hoped to keep her at or above her 9.7, but the repeat CBC in Jan was too low. She's almost on the borderline of needing a transfusion, so they wanted a look at the small bowel.

I'm sorry that your APC didn't go through. Doesn't it just figure that you'd have to go the hard way. SIGH. It would have been so much esaier for you if that darn thing would have fit through. Then you'd know for sure what was in there. I hope the trip to Mayo goes well and that you can get the answers you're looking for. Meanwhile, I'll be hoping for a positive report. (((((HUGS)))))
Keah a.k.a. Wormy
 God helps those who help themselves.
Please help us support this invaluable forum.
Crohn's Forum Moderator

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