Steerpike

Time flies when you are having fun! Almost 7 years ago I posted this: http://britishexpats.com/forum/trail...e-cake-637093/ . Today I had my next scheduled event (should have been 5 years but I got lazy).


This time, it was even better - rather than drink 4 liters of the salty, sickly liquid for hours and hours, I was given a buch of tablets to take - OsmoPrep. All I had to do was take 20 tablets over a 1 hour period the day before (5-6pm), then take 12 more over a 30 minute period at 5am the day of. You get to wash them down with Apple Juice, or some other pleasant drink, and keep your taste buds happy.


Insurance rejected the prescription at first, since the liquid is OTC and dirt cheap, while the tablets are about $200, but I called the doc's office and they pushed back on the ins. co. and they agreed to cover it.


The procedure itself was the same as last time - show up, lie down, get looked after by friendly nurses, get an IV, then take some deep breaths of some magic potion, drift off into LaLa land for 45 minutes, then wake up in the recovery room with everything done. No pain.


Interestingly, they found no polyps this time (last time found 2) so I guess that means things are doing OK down there! They did mention diverticulosis again, but must not be bad enough to do anything about.


As before, I'm posting this to encourage all those over 50 to go get it done, as it is the #1 way of detecting certain cancers in men over 50 (and covered by insurance as a preventive procedure, not subject to any deductible).

robin1234

When I had my last one, maybe six years ago, I ended up with significant charges, even though it was supposedly a preventative procedure, covered 100% with no copay or deductible. First, the anaesthesiologist charged me $600 or so. Small print with the insurance policy was that the procedure was covered, not the anaesthetic - supposedly you could have the procedure without anaesthetic. Second, they found polyps & removed them. This meant the procedure was no longer preventative, but an actual procedure, so normal copay and deductible came in to play. Another $600 or so.

My HR director was appalled at this, we went back and forth for two years with the insurance company. I don't really have the stomach for this stupidity, I ended up paying both bills. End result, HR stopped promoting and encouraging colonoscopies, and I was more determined than ever NOT to grow old in America.

Davita

For those who reject a colonoscopy because of the cost, or the idea it is painful or unnecessary, please read on.....

I'm a 79 year old Canadian currently living in Bali. I've never had a colonoscopy although, under Canada's (BC) Medical Services Plan (MSP), I've had free annual medical and prostate checks (paid US$60 for the PSA)...but at no time was a colonoscopy advised.

Over Xmas I had some stomach discomfort and my Bali doctor prescribed a colonoscopy. The procedure under a general anesthetic, one night in private hospital room and purging (2x45mL Fleet phospho-soda) and enema needed, prior to the procedure, cost around US$550.

I'd hoped the result would be so I could boast in my local pub that I was a 'perfect asshole.' Sadly, they found a large tumor at the top of my colon. Further CT scan suggested it had migrated to my liver.

A professor surgeon was introduced and, after scanning my prognosis said..."The only thing to do is surgically remove the tumor and cauterize the spot on the liver."
I said "when?" and he replied he had a surgery available in 4 days...I accepted.

Suffice to say that was 6 months ago. I was operated and the tumor and about 15 inches of colon removed. It had metastasized but my liver was clean...I suggested to my surgeon that was because I had cleaned it with alcohol for over 50 years...
I've been on 6 cycles of oral chem-therapy (420 pills costing US$4 each) till last Saturday and my blood tests say I'm clean....but I'll have another CT scan tomorrow and a colonoscopy in a couple of months to confirm.

The moral of this is...if I'd had a colonoscopy, say 10 years ago, the polyps would have been removed and I wouldn't go thru' this painful and expensive treatment...so far about US$20,000. At my age no insurance company would cover me and a return to Canada (MSP) would entail a waiting period.

As others here advised...and I'd also concur, if over 50, get a colonoscopy. If no problem get another in 5 years...if defective polypses are detected they can be removed with the colonoscopy tool during the process.

scot47

I had an American colleague in Saudi who got one done in Bangkok every year. We used to joke that he must have enjoyed it. Hey-ho, I suppose if it catches colon cancer it must be worth it.

robin1234

Nothing wrong with the procedure, just the very nature of the prep is no fun .... since prep takes about 24 hours ....

Anian

If you are going to have doctors sticking their fingers up your bum, going to a country where they have a lot of small-handed doctors is a good idea.

robin1234

The practice where I go is 70 year old dad and 35 year old daughter in law. I always seem to get the dad.

lansbury

When I had mine done earlier this year I was given a different liquid to take. Drink about a pint 24 hours before and another pint either 5 or 6 hours before. It didn't taste that bad and I had no trouble drinking it. Better than the old stuff they used.

Don't forget the Vaseline and baby wipes to reduce soreness.

Steerpike

My g/f had one a few years ago and she also got hit with a charge for the anesthesia service. Based on this experience, I made sure this time that both the procedure and the anesthesia were covered ahead of time. Sad that you have to deal with all this bureaucracy, but still worth it.


They found / removed polyps during my procedure 7 years ago but it was still considered preventive. I believe this all comes down to 'coding' - how they coded the procedure. I specifically discussed the coding with the doctor prior to the procedure to ensure it would be covered. Now, I'll have to wait 6 months before I can be sure there are no charges, but I've been assured there won't be any.


I understand the sentiment that you don't want to grow old here - I have the same fears - but on the other hand, I've heard that in the UK no one ever gets a colonoscopy checkup as a preventive procedure so early detection does not occur. In fact one friend of mine in UK did have colon cancer, and said in retrospect it would have been detected much earlier had he had the procedure. My brother (5 years older than me, also in UK) won't even entertain the concept because he's never heard of it and thinks it 'odd' (he'd generally have to be at death's door before he'd see any doctor about anything, that's just his way).

The prep is no fun, but as I mentioned in my post this time, there are better products available if you ask for them, as I did (the OsmoPrep). The prep 7 years ago involved drinking 4 liters of icky salty liquid, this time I just drank apple juice - a world of difference. Yes, you need to form a close relationship with your toilet (you poop/squirt as if you ate the worst curry of your life, although with no stomach pain) but that part wasn't as bad as I expected.

Steerpike

Any chance you can remember / find out the name? I'm keeping notes for the next time . The product I used this time was 'perfect' as I got to drink apple juice and take pills, but in case I can't get it, I'd like to know what else to ask for!


I have absolutely no pain ... it's now 24 hours after the procedure and the expected soreness hasn't manifested itself!

mrken30

You need to ask for a lot of things both in the UK and US. I has a preventative sigmoidoscopy when I was back in England. The latest thing is the US that seems to vary is vitamin D deficiency testing. Some places this is covered , others it is not.

Steerpike

This article discusses the whole subject of whether or not the 'screening' is still free if they discover and remove polyps. Seems like a big topic, and seems like insurance companies are falling into line.


Coverage of Colonoscopies Under the Affordable Care Act’s Prevention Benefit – Report – 8351 | The Henry J. Kaiser Family Foundation


ETA: Another article that discusses the polyp issue:
http://khn.org/news/health-law-colonoscopy/

mrken30

This is what one insurance company decided

The committee agreed to move forward with Medicare PDT’s recommendation to cover colonoscopies in full and offset the cost by increasing the OP surgery copay by $15.

mrken30

This may be of interest to you.

Despite not being covered by Medicare, use of computed tomographic colonography (CTC), commonly referred to as virtual
colonoscopy, is on the rise, according to the Journal of the American College of Radiology. Researchers found that in 2008, 17 percent
of hospitals offered CTC, up from 13 percent in 2005. xxxxx Healthcare, the only hospital in the region to offer the service,
started its program in May 2008 and has since conducted more than 130 procedures.

lansbury

Suprep Bowel Prep Solution. Two bottles in the kit. You add water to make up each one to 16 ounces. FAQs - Bowel Prep Kit - SUPREP

Not after I meant to use while the prep is taking effect.