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Thread: Colonoscopy: Preparation and Dysreflexia

  1. #1

    Colonoscopy: Preparation and Dysreflexia

    My colon-rectal doctor has suggested that I have a colonoscopy but needs more information on how to handle autonomic dysreflexia should it occur. He suggested that I have my neurologist contact him, which I will do, but I figured that the SCI-Nurses here would probably be even more knowledgable. I am a T4 level injury and have never had a critical bout with AD, but it remains an issue nonetheless.

    I would also appreciate the best tried-and-true means of preparing for the procedure.

    Thanks.

  2. #2

    AD and colonoscopy

    Stephen - It was good of you to talk with your GI doctor about the possibility of an AD occurrence during your colonoscopy procedure. Even though you state that you haven't had any major episodes it is still a concern for you. During the procedure the nurse/MD will need to monitor you closely including frequent blood pressure and heart rate checks. This is usually the norm during this procedure anyway. What the MD might want to consider doing is instilling some Nupercainal or Lidocaine jelly into your rectum a few minutes before proceeding. Do you currently experience AD when your rectum is stimulated? If so, then, it might be a good idea to numb the rectum first before proceeding.

    You will also be given a mild sedative before and during the procedure. This may also help to prevent an occurrence of AD. I suggest you let the MD and nurse know in advance what your typical symptoms are and what works best to relieve them. If these measures are practical during the procedure then that would work best. If not, if you go into AD, the MD may want to hold the procedure for a couple of minutes, elevate your head if possible, and then resume once it subsides. KLD our SCI Nurse expert on AD may have further thoughts on this. I will check with her. You also may want your MD to have some immediate release Nifedipine on hand for high BP just in case. Good luck with your procedure. PLG

  3. #3
    Super Moderator Sue Pendleton's Avatar
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    I'm headed in that direction too Stephen. I see my GI doc again on Friday and will schedule it then. I spoke with my insurance company yesterday about getting a day inpatient stay for the prep work because of AD. I've never had huge bouts of it either but just what I had when I banged up my leg and sprained my ankle convinced me to play it safe. I've gone through bowel prep once for an Xray when I was AB and by the time I was done I was soooo sore! If my memory is half right then AD during the prep itself is possible. The company said to have the doc call them for pre-approval but said it shouldn't be a problem to get 1 day due to quadriplegia, AD and possible ducubiti problems if done at home without a lot of help.

    Has anyone been through one of these tests? I'm hoping to be knocked out for the entire 24 hours! No pain, no embarassment!!

  4. #4
    Senior Member martha's Avatar
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    ...

    [This message was edited by martha on May 19, 2002 at 11:09 PM.]

  5. #5
    I've had the unfortunate pleasure post injury. The procedure is fairly painless, they sedate you during it. The worst part is the horrible gallon of paint thinner they make you drink prior to the procedure to clean you out. And boy does it...

  6. #6
    Senior Member smokey's Avatar
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    I was ok

    I had a colonoscopy done 2 yrs. ago with no dysreflexia. I'm a c6-7 quad. No pain or anything. After swilling down a gallon of "Colon Blow" (some joker named it "Go-lightly"), I oozed shit for days. Fortunately, I was in the hospital for the prep but I still drooled stool for days afterwards. It is a cruel procedure for those with a SCI. They jacked me up on Midazolam 5mg. IV and Meperidine 100mg. IV for the procedure. I had a good buzz on but no way can you drive. We never even discussed dysreflexia-shame on me.

  7. #7

    Smokey

    Do you think you could've gotten away with a 1/2 gallon of Colon Blow?

  8. #8
    Senior Member smokey's Avatar
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    1/2 Gallon...

    I was a patient in the hospital when the colonoscopy was performed. The nurses have specific instructions to make sure the whole gallon was consumed by ANY patient prepping for a colonoscopy. Apparently, sometimes the prep is not done according to protocol and the colonoscopy procedure is aborted part way through it (if the GI Doc can't see well because of excess stool or mucous in your pipes) or is rescheduled completely if you don't shit out clear, watery stool after drinking the Colon Blow. The Doc's will go bananas because the O.R. time set aside for the procedure is wasted, they don't get paid, then you have to do the prep again at some future point. They will monitor your blood pressure, pulse and oxygen saturations and can tell if something is going wrong. Do the gallon, do it once, do it right and then they won't call you back to do it again.

  9. #9
    Super Moderator Sue Pendleton's Avatar
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    I was totally cleaned out as an AB on one bottle of Citrate of Magnesium. There ain't no way in hell I'd try to drink a gallon of roto-rooter. I mean that kind of stuff really does a number on me. My idea of a strong laxative is ONE Senekot tablet. I was a buck sergeant at the time and I let the major who prescribed that sh*t have it! I think I used words he'd never heard before to describe that sadistic procedure. I mean I was living in the barracks at the time and the john was down the hall. That stuff didn't let me stop for 12 hours. What is GoLyghtly made of anyway? I bet Drano, right?

  10. #10
    Senior Member TD's Avatar
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    Over 50 and having to do this every two years

    is not my idea of fun. But that is what the MD recommends. Last time I had one I had them take care of some bad hemmorhoids too. I spent four hours on my bowel care chair after drinking "the gallon". And they wanted me to take two senecotes after that!!!

    I would definitely recommend a stay in the hospital for this prep. Let somebody else clean up the mess you are going to make.

    "And so it begins."

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