What To Expect During a Colonoscopy

Amy Long, an endoscopy nurse navigator, explains the process of getting a colonoscopy, and when you should schedule one.
Featuring:
Amy Long, RN
Amy Long, RN Graduated with BSN from the University of Indianapolis in 1995. Came to Franciscan Health January 2001. Started in Endoscopy January 2012 and worked in the preop and postop department. Became the GI Nurse Navigator in 2016.
Transcription:

Scott Webb: My son had to have a colonoscopy when he was 16. And if a 16-year-old can handle the prep and the procedure, you can too. And joining me today to discuss all things colonoscopies and especially the importance of early detection of colorectal cancer is registered nurse Amy Long. She's an endoscopy nurse navigator with Franciscan Health.

This is the Franciscan Health Doc Pod. I'm Scott Webb. So Amy, thanks so much for your time today. We're talking about colonoscopies and let's just start upfront here. Why should people get colonoscopies?

Amy Long: Well, people really need to get a colonoscopy because colorectal cancer is the second leading cause of cancer-related deaths in America. Early detection is the key here. It can take 10 to 20 years for a small polyp to become cancer. So if they can find that polyp in the beginning and remove it, then you don't have to worry about it growing.

Scott Webb: Yeah, it does sound like early detection is key. So let's talk about that. Some questions here about scheduling. How do we schedule a colonoscopy? What's the process like? Do we need a referral? How old do you have to be?

Amy Long: So we try to make it as easy as we can. I have a really cool phone number. You can call me if you don't know how to schedule and my number is (317) 528-ENDO, E-N-D-O, it's 3636 if you don't know what to do. So if you've been told by your family physician to get a colonoscopy and they know where to send it, that's great. If not, have them to call me. I'm really easy to work with. I do answer my phone. If you don't get me, leave me a message and I'll call you back.

You may have worked with a colorectal or a GI guy before or gal. And if you've been to Franciscan, I'm able to see that. So if you call me, we can look you up and we can do some investigating. I can get in touch with one of the providers and we can get that ball rolling.

So how old do you have to be? Forty-five to fifty. They've changed the guidelines. You need to call your insurance company. Now, Scott, what we have learned is that if you've got a family history of colorectal cancer, you need to start and get a colonoscopy for yourself 10 years before your family. So say, your father had colorectal cancer at 50, you need to be screened at 40.

Scott Webb: Yeah. And I know they've changed the recommendations and that's such a great tip you had about making sure you contact your insurance, right? Because 50 was always the marker for most people. And if you're trying to get one at 45, you definitely want to clear that with insurance, you know, before you go through this whole process only to find out later, that they're not going to pay for it.

And I've been through this myself, I'm 52. So I know that the prep was probably my least favorite part of the colonoscopy, but take people through this. What's the prep like? Are there different kinds? And how long is the prep process?

Amy Long: So the prep is the worst part of it, I agree with you. There's different kinds of prep. The physician that's going to do your procedure will order your prep. There's too many to mention here. They will pick what is best for you.

Typically, what your prep time will look like, the day before your procedure, you can't have any solid food or dairy products the whole day. So when you wake up, no solid food or dairy. You will have your clear liquids that day. They will give you a list of what you can have and what you cannot have. And then you will be given times of when to start the actual prep.

Most likely, there'll be two times. You'll be given, for instance, five o'clock that evening and then you'll do another prep. So then the next day, when you wake up, when it's colonoscopy day, you won't have anything so many hours before the procedure because of the anesthesia or your sedation that will be involved.

Scott Webb: Yeah. And I just remember, I don't know if this helps people or not, but I ate a lot of Jell-O. I ate a lot of blue raspberry Jell-O, I believe it was. And if you're a fan of Jell-O, that goes along nicely with the prep and so I definitely enjoyed all the Jell-O I got to eat. I don't think I've had any since, but I ate a lot of Jell-O 24 hours and that was good. And I didn't have to take any time off of work, but do some people need to do that?

Amy Long: So it depends on your schedule. So you wouldn't want to work the day of your procedure. Because of the sedation, you can't drive yourself home. You will be kind of down and out for the day. If you're going to be sedated, you can't do any physical or mental task for the remainder of the day following your procedure. So, if you had it done on a Friday and you don't work Fridays, that works for you. It just depends on your schedule.

Scott Webb: Yeah, I think that's so right. It depends on everyone's schedules. And definitely, don't try to drive yourself and make sure that you have somebody drive you there, drive you back, and there may be some, you know, COVID complications there in terms of whether people can walk you in and wearing masks and those types of things, but generally just make sure that you have a ride home, that's the most important thing for sure. And we've kind of covered this already about insurance. But generally speaking, does insurance cover the cost of the procedure and the prep?

Amy Long: Yes. Most insurance covers the procedure. especially if it's a screening colonoscopy. Those are covered under your wellness visit. So when you call to check, that's what you're going to ask. "I'm going to have a screening colonoscopy. Is this covered under my wellness plan?"

Scott Webb: You know, in addition to the prep, which definitely is one of the reasons why people are leery about getting colonoscopies, let's talk about the actual procedure, right? Now, I know that you're sedated and you wake up and you often say, "Wait, did you already do it? Am I done?"

Amy Long: That's exactly what they say.

Scott Webb: Yeah, that that's generally the reaction, but take folks through this a little bit. How long does the procedure last? And is that pretty common where people wake up and they are sort of surprised to find that it's over?

Amy Long: That's what most of our patients say, "What do you mean? We haven't started yet. Have we?" Well, "Yeah, you're finished." Typically, we schedule the colonoscopy procedure for just 30 minutes.

Scott Webb: Yeah. And I know it's so common. Everybody says the same thing. They just can't believe how easy this was. And it was really like the prep leading up to it is much more, I don't know, time-consuming, if you will. The actual procedure is quite fast. And it may vary, of course, if there are more polyps for people or whatever it might be. But, when we talk about getting the results, how soon are the results available? Will the doctors generally schedule an appointment to go over the results?

Amy Long: So it depends on your doctor. Some of them will personally call you. Some of them will send you a letter. Typically, if there's any kind of pathology sent, which would be a polyp, they would want to send off and just have it looked at, that can take five to seven days for those results to come back. And whoever did your procedure will be the one to get you those results. Whether they call you on the phone, have you come in, they will discuss that with you for follow-up before you leave for your procedure.

Scott Webb: Gotcha. And is there any reason for people to be concerned about the anesthesia? Unless of course people have had issues with it before, is there any reason for anyone to be worried about being put under for this?

Amy Long: Not at all. We take very good care of our patients. It's very super quick. Unless they've had concerns or problems before, it should go smoothly.

Scott Webb: Yeah. And maybe we could just talk about what are some of the common complications, if you will? Is there anything that people really need to be worried about or concerned about, or any reason not to have a colonoscopy? Because obviously the downside of not getting a colonoscopy, not being screened, we know what that can mean, that could be cancers, that could mean death. So are the complications, really anything, for people to worry about?

Amy Long: So the doctor will go over complications with you when you sign your consent. Most likely all they're going to experience afterwards would be gas because sometimes they put air in the colon so that they can inflate it, if you will, to see the lining, to notice any kind of polyps that are there. So you might be a little gassy after your procedure.

Scott Webb: Yeah, that was my experience. Just a little bit gassy for a while. Got a nice ride home, relaxed when I got home and it really wasn't a big deal. And we talked about them changing some of the guidelines and, of course, if you have a family history or genetic predisposition, but how often do people need to get colonoscopies?

Amy Long: So it's about every 10 years, unless you were told by your doctor, "We did find a polyp. I want to bring you back in five." Typically, they will tell you that right after, "Hey, everything looked great. We don't need to see you for 10 years." So typically 10 years, unless they tell you otherwise.

Scott Webb: Yeah, unless you hear otherwise, that sounds right. Well, Amy, this has been so helpful today. As we wrap up here, anything else you want to tell people about colonoscopies? There seems to be a big fear factor when it comes to these things, whether it's the prep, the anesthesia, the procedure itself. We know there's really no reason for people to be concerned, but maybe in your own words as an expert, tell them again, tell listeners again why they need to do this.

Amy Long: You need to put this in your own hands and you need to help yourself. Early detection is the key and we can remove a polyp and save you from developing one of the most treatable cancers that is out there.

Scott Webb: That sounds right. And a great way to finish. Amy, thanks so much for your time today. You stay well.

Amy Long: Thank you, Scott. You as well.

Scott Webb: Visit Franciscan health.org/colon care. To learn more about colonoscopies.

and take a colon cancer health risk assessment, or schedule a colonoscopy appointment. And we hope you found this podcast to be helpful and informative. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.