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Colonoscopy prep

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Irritable Bowel Syndrome
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Posted 8/22/2007 1:16 PM (GMT -7)
Hello: I have to have a colonoscopy the day after tomorrow - My Doctor has prescribed "GoLitely". My sister had the procedure done last week, and was prescribed Pico-Salax, which she said wasn't nearly as bad as she thought. I've used "golitely" like products, and found it very unpleasant. I phoned the doctor's office, and his receptionist said he says golitely does a better job of cleaning you out. However, any research I've been able to find on the Internet says they're both as effective, but that the Pico-Salax is much more gentle and tolerable. The web site for the Rudd clinic actually recommends the Pico-Salax, but says to follow their (the Rudd Clinic - http://www.ruddclinic.com/patientcare03.html) instructions, which is what I'd like to do.

Will my doctor know if I disregard his instructions, and use the the Pico-Salax using the Rudd Clinic instructions? Or should I follow his instructions?

Thanks
Posted 8/22/2007 2:04 PM (GMT -7)
Welcome reluctantpatient :-)

Hmm, thats a tough call... the good patient in me says that you have to follow his instructions. I have taken Golytly before and I feel for you. My doc allows me to take the pills (Visicol) so I'm much happier about that now. Some people here will tell you that they have done the prep that makes them feel comfortable with or without their docs blessing so I can't steer you one way or the other. My advice would be to personally talk to your doctor (not the nurse or receptionist) and tell him that you had a previous bad experience with the Golytely and would like some more suggestions. Some docs won't waiver and some give you 3-4 different options which mine does. Good luck
Posted 8/22/2007 2:40 PM (GMT -7)
And one GI I went to said that the Fleets Phospho Soda cleans people out better than the pills that Lil's doctor prescribes her.

In short, it all boils down to doctors having a personal preference (or is that prejudice?) for whatever reason. As I am the anti-christ of patients (I demand information from my doctor and demand that what they prescribe me in meds or tests sounds reasonable and logical to me), I've already sworn that the next scope I get is either pills or Pico-Salax (I've also heard that it tastes good--like Tang). I get those or I don't get a scope. Period. No discussion. I will never, ever drink that Golyghtly garbage ever again, for as long as I live.

But that's just me. I'm a militant patient. LOL.
Posted 8/22/2007 4:48 PM (GMT -7)
I had a colonoscope two times and the first time

I had to drink this stuff that tasted like jolly ranchers and then do an anema

the second time i have to take all these pills and i couldnt eat anything!
Posted 8/22/2007 6:15 PM (GMT -7)
REluctant, where do you live? I assume not in the US. I have one coming due in January and am thinking of ordering the Pico from Canada and using it anyway. I have used the Fleets phosph soda the last two times and hated it but it has got to be better than GoLightly from what I heard. I don't think your Dr will know unless for some reason the Pico doesn't work and you tell him you used it. That can happen with any of them though. I know my Dr. don't like the pills but I am going to beg them this time. My Dr. is pretty progressive so maybe he will go for it.
Posted 8/22/2007 7:25 PM (GMT -7)
I'm in Canada... I've seen all sorts of clinics here that prescribe the Pico... I'm beginning to think that my doctor either has stock in the dreaded GoLitely, or just isn't up on the latest - Or maybe the pico doesn't do an adequate job, and I just haven't been able to access the info on-line.

Still not sure what to do; I bought both preps. I'm such a worry-wart that my bet is that if I go with the pico, it will cause so much stress that the whole prep experience will be equally unpleasant. I must admit, the whole thing is stressful - the last time I had a colonoscopy, I received no pain killers or relaxants... It was the most painful procedure (and I've had a few) I've ever experienced. I know that this doctor does use some anesthetic, so I'm not too worried about the procedure itself.

Best of luck to you (Canyonbabe711) - From my research and my sister's account, get the Pico.
Posted 8/22/2007 9:59 PM (GMT -7)
I really feel for you because I too had my first colonscopy without sedation. I had the IV but he really didn't use it as I hollered and screamed almost the whole way thru. Another couple minutes and he would have been dead meat. He said he was afraid because I have lung problem but that didn't stop him the month before putting me out for an endo which is not nearly as painful. I switched Dr. so my last one was painless. There is no reason not to sedate a patient unless they have a really bad problem. They automatically give oxygen anytime they sedate here in the US also, at least at my hospital or out patient and they have a dedicated nurse or anesthetist on hand. I think you need to use both of the Pico's as I noticed it comes in a 2 pak. I have really heard good things about it. I know I will not use Golightly
Posted 8/23/2007 7:16 AM (GMT -7)
Just remember, that you do not have to just lay there and take something that is so painful that you are screaming; tell them to stop. They are legally obligated (in the US, although I'm sure in Canada too) to stop the procedure. You can withdraw consent for a procedure any time you are conscious. If they refuse to stop, start screaming that you'll get a lawyer. That'll stop a doctor quicker than anything in the US, lol.

That's why I'm a militant patient: I won't accept abuse anymore. I've been abused and I won't put up with it again.
Posted 8/23/2007 10:54 PM (GMT -7)
I really was ready to kill him. Of course the spasms would stop for a second and he had the nurse pushing on my abdomen and then they would come again. I really told him off when he saw me afterwards. He is very patronizing to women especially which is odd since his wife is a Dr. also. I might add this is the most highly respected gastro dr. in our town and is head of the California Physicians Society or whatever they call it. However this was totally uncalled for and I had an IV in so there was no reason not to give me some sedation especially since he had earlier for endo. I was about ready to get off table, not easy with that thing in you but I will remember your words should that ever happen again.
Posted 8/26/2007 2:13 PM (GMT -7)
Just thought you'd be interested to know...
I ended up taking the pico salax, and it was pretty much the worst prep I've ever done. I drank 24 oz of water before taking it (1 package with 5 oz water), and then every hour I drank 8 oz of gatorade and 16 oz of water.

Diarrhea started within 15 minutes. My fingers and toes went numb. I experienced nausea, chills, very bad throbbing head ache, confusion, etc. I was pretty much incapacitated. It was bad enough that I phoned the pharmacist to make sure I was OK. He said to hold off on the second dose, and not to take it if the symptoms didn't subside, which they didn't.
I also phoned a telehealth number, and the nurse there recommended going to the doctor. I was concerned because I didn't know if I was suffering from dehydration, or perhaps had over hydrated myself. Anyhow, doctor's office was closed at this point, so I stayed home and endured.

Next day I went to the appointment, told the Doctor about what happened, and that I hadn't taken the second dose. Apparently, I was cleaned out enough (phew). Procedure itself was a walk through the park compared to the one I had without sedation - I didn't feel a thing, and woke up to the news that all was clear.

Anyhow, I guess the moral of the story is that everyone reacts differently, and that pico salax isn't for everyone. Now the big question is is how will I prepare for the next one. Ahhhhhhhhgggghhhhhh!
Posted 8/26/2007 2:39 PM (GMT -7)
Oh, that sounds pretty bad. I didn't realize you had to drink so much liquid with it. I guess i will stick with the Fleets phospho soda unless he will let me use the pills. If I called the pharmacy here with the Pico they wouldn't know what I was talking about. That does sound like an awful lot of water in a very short time but since it started so fast it probably wasn't from that.
Posted 8/27/2007 5:00 AM (GMT -7)
The instructions actually say 8 ozs per hour - I drank so much because the instructions from a reputable clinic (not my Doctor - he didn't have any!) I was also concerned about dehydration - When my sister used it, she just drank 1 cup or so an hour, and she had no trouble at all. I am curious what happened to me - allergic reaction perhaps?

I guess my point is that I did all sorts of research on the Internet, and found no negative comments about the pico, quite the contrary. I wouldn't let my experience influence you too much. My doctor actually said that the pico is easier (usually!!!) for patients, but in his opinion doesn't quite clean you out as well (I wonder if he's ever done a blind "taste test". I do wonder if any else experienced my type of reaction.

Cheers,
RP
Posted 8/27/2007 5:26 AM (GMT -7)

Sounds like you might have had the beginning stages of hyponatremia.  This occurs when people over-hydrate themselves (happens to marathoners a lot).  It's an electrolyte imbalance resulting from the inability of your kidneys from excreting so much excess fluid.  Essentially, your body doesn't know what to do with so much excess fluid at once.

Regular ol' 8 oz servings of fluids every half hour or so would probably be sufficient for next time!  I'm glad it worked out okay!

Posted 8/27/2007 10:27 PM (GMT -7)
Ithink Sarita may be right. You said you drank a lot of water before you even started. I know that I could never consume as much water as you did as you did. That is 24 oz every hour. Not too many people can handle that but it seems your reaction was extreme from the beginning. I just wonder if someone gave you the wrong directions.
Posted 9/4/2007 3:31 PM (GMT -7)
I've had 5 colonoscopies over the last 15 or so years and 4 times have had to take take the Go-lightly stuff. Last time I was allowed to drink a glass of something in the morning, drink water all day and spend half of it on the loo and then drink another glass early evening, drink lots of water and then spend the night on the loo.   I think I'd rather put up with the Go-Lightly for two hours in the morning and a bit of time on the loo than what I went through.  

Regards

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