Q. How long will the procedure take?
A. The time needed for each procedure is somewhat individual for each patient. In general, the time needed for a procedure is usually one to one-and-a-half hours from start to finish. This allows for necessary paperwork to be completed, a brief pre-procedure assessment to be performed, an IV line to be established, the procedure to be done, and a discussion with the doctor after the procedure to discuss results. The actual time the procedure takes is usually between 20 to 30 minutes.
Q. I am nervous about waking up during the procedure; will I be completely "out"?
A. The standard method of sedation for endoscopic procedures is called "conscious sedation". This means that sedatives will be administered through an IV line to make you relaxed and sleepy throughout the procedure. The over-all goal for this type of sedation is not so much to make you sleep, but to make you comfortable throughout the procedure. The sedatives are given in increments, and titrated for each patient to achieve the desired effects. We also have the option available for Monitored Anesthesia Care, which provides deep sedation, to be administered by an anesthesiologist in our center on a case-by-case basis when deemed medically necessary, in which case you would be completely "out". The type of sedation that is planned for a procedure will be decided at the time of scheduling the procedure.
Q. Why do I have to drink so much for the bowel preparation?
A. As the thoroughness and completeness of a colonoscopy is dependent on the quality of the preparation, it is important for the colon to be as clean as possible. The function of the colon is to act as a storage tank for waste, and to absorb water from the waste. As the waste that is in the colon lines and coats the walls of the colon, it is important to completely wash the lining off, to allow for a thorough examination. The volume of fluid necessary in the preparation acts as a wash to loosen, remove, and flush all of the waste from the walls of the colon, allowing for a thorough evaluation. Although it may seem unnecessary to continue taking the laxative after the initial result from the laxative gets the bulk of the waste out of the colon, it is necessary to continue taking the laxative as it will work as a "power wash" to clean off the stool stuck on the walls of the colon, allowing for the best examination possible.
Q. What should I do if I can't finish all of the prep?
A. The thoroughness and completeness of a colonoscopy is largely dependant on the quality of the colon preparation. If you start to experience nausea or bloating during the bowel preparation, you can try to increase the time interval between doses of the laxative — instead of drinking a glass every 10 to 20 minutes, you could stretch it out to every 30 minutes. This will take longer to complete the preparation, but will ease the undesired side effects from it. Also, you could take a "break" from the preparation, if needed. You could stop taking the laxative for an hour to an hour-and-a-half, then restart the laxative once your symptoms have subsided. Either way, it is very important for you to do your best to finish the entire preparation.
Q. When will I know the results?
A. You and your family member/driver (unless you request otherwise) will have a discussion with the doctor after the procedure, before you are discharged to go home. This discussion will include the findings from the procedure and any recommended additional evaluation, follow-up, and treatment needed. If biopsies are taken or polyps are removed during the procedure, it takes about three working days for the results to reach us. In most cases, you will receive a phone call notifying you of the results from the biopsies, but in some cases, a follow-up appointment may be scheduled for you to come to the office and discuss the results with the doctor.
Q. What can/should I eat after having a procedure? Are there any restrictions?
A. For the most part, you can eat whatever you would like following a procedure. There may be specific dietary restrictions after certain procedures that will be discussed following the procedure, if necessary. Most people know their own body well enough to determine the best choice of food for them to start with. While one person may want to start with something light and easy to digest, another may want a full meal with all of the trimmings. It depends on the individual and their preferences.
Q. How long will it take for my bowel habits to return to normal after having a colonoscopy? Will I have diarrhea afterwards ?
A. If you were not experiencing chronic diarrhea as a symptom prior to taking the preparation for a colonoscopy, you will not typically experience further effects of diarrhea from the laxative preparation following the procedure. As each person's digestive habits are unique to them, the return of normal bowel habits will differ from person to person. Be aware that it is not unusual to go several days without having a bowel movement after a colonoscopy as your digestive tract has been completely emptied, and it will take some time for the food that you eat afterwards to go through your entire system.
Q. Why can't I drive or go to work for the rest of the day of the procedure, even if I feel good?
A. The sedatives used can act in your body for up to 24 hours. Part of the effects from the medication used includes an amnesic side effect, altered judgment, and impaired ability and reflexes. Although the majority of the medication's effects usually start to wear off in four to five hours, it is still necessary to refrain from operating motor vehicles, or doing tasks that require alertness for the rest of the day. Should you chose to ignore our restrictions, please be aware that if stopped by a police officer, you will be "driving under the influence", and will be prosecuted by law.
Q. How do I know if my insurance will cover the procedures scheduled?
A. Each insurance carrier offers numerous plans. The plan that you have with your specific carrier is dependant upon what policy you/your employer chose when purchasing the plan. Although we will handle obtaining necessary prior authorization, if required by your insurance, we do not have specific information regarding the coverage you have with your insurance plan. If you have specific questions about coverage or services allowed by your insurance, YOU should call you insurance carrier to ask those questions, and to see if your specific plan allows for the services being performed.
Q. Why are there two charges on my bill for a procedure?
A. When you receive your bill, you will note that there are two charges for your procedure. The first charge is for the doctor's services for performing the procedure. The second charge is the facility fee, which covers the cost of running the facility, the purchase and maintenance of the endoscopes and other equipment, nursing services, IV conscious sedation, and disposable items used during the procedure. The facility fee is in lieu of the bill you would otherwise receive from the hospital if the procedure were done there. Medicare and most other insurance carriers accept, and will pay, the facility charge. The advantage of having procedures done in our facility is that the cost of the facility fee that accompanies the procedure is considerably less than it would be when performed in a hospital setting, providing you and your insurance carrier with substantial cost savings. If you have any questions regarding the facility fee or filing your insurance, our billing department will be glad to assist you.