Colonoscopy question

SuzyP

Hello All,

I have a question about whether it is wise to schedule my H for a colonoscopy, which he is due for this year.  He is 70 years old, diagnosed in 2014 with MCI, changed to probably Alz after a spinal tap in 2016.  He is still relatively functional (can dress himself, feed himself, etc.) but has very poor short term memory (asks same question multiple times per hour), doesn't recall historical events correctly (claims to have travelled to locations that he has never been to), etc.  His primary care doc mentioned that he is due, then in a later conversation with the NP at the Brain Wellness Center, it was suggested that we may consider skipping, due to the potential issues following anesthesia.  My mom with Alz had to have a hip replacement last spring following a fall, and she was very badly impacted by the anesthesia.  Any thoughts on the pros/cons of undergoing this procedure at this point?  Thanks.

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harshedbuzz

Suzy-

I would not schedule a screening colonoscopy for a person beyond the earliest stages of MCI. Aside from the concern about the prep Victoria mentioned-- even if the procedure was done under conscious sedation rather than general anesthesia, there's the matter of what you would do with the information obtained. If something was revealed to need follow-up treatment-- a second colonoscopy or chemo/radiation-- what choice would you make?

HB

Ed1937

It would be hard to disagree with the last two posts, so I'll take the easy way out. Even though he probably would not be under complete sedation, the prep is no fun in itself, although not as bad as in previous years. So mine is the third vote against having it done.

Lills

Mine would make the 4th vote against having a colonoscopy.  

M1

Make that five.  Screening tests of any sort are really for those who are functioning well in other areas.

JJ401

DH's PCP said he was due for a colonoscopy. I put off making the arrangements as I was dreading the prep. Then when I met with the gastroenterologist about mine, I talked to him about DH (who has never even had a polyp).  After hearing DH's diagnosis and my concerns, my gastroenterologist said he would not recommend one for DH. That ended my thinking about making the appointment. Next PCP visit I told the PCP it was not happening.

blues

Here's a different view, as I was wondering the same thing when it came time for my LO, who sounds to be at about the same stage of dementia as yours though a few years younger, to have a screening (had a previous screening with a benign polyp, so not going into this with "no record"). I discussed the wisdom of proceeding with the neurologist, who thought it was important to carry out the screening to be able to avoid the pain and suffering of cancer should something be found and easily removable (e.g. a polyp), which is probably more likely than finding invasive cancer. Clearly there are risks either way, so everyone has to make their own choice. Speaking with the GI doctor (and/or anesthesiologist) also sounds like a great idea, and I think I'll follow up on that myself.

easy23

My PWD stage 5, with a colostomy, had a colonscopy where they removed a benign polyp. The prep was not bad and there were no ill effects from the anesthesia.

Pat6177

My DH is early stage 5 and is 78. His PCP said he’s due for a colonoscopy. DH said no. Of course, he says no to everything! He has had benign polyps and has diverticulosis. I think he would rather have colon cancer and die from that than to keep going with dementia. But thank you Subversive Vegan. A stool test or even cologuard might be options.

Joe C.

When DW wad due for a colonoscopy a couple of years ago she was probably mid stage 5 and I knew there was no way she could handle the prep, even just getting her to drink the magic elixir would have been impossible. I also consider what I would do if we somehow made it through the procedure and they found something, then what, she would not be able to handle the treatment. I did ask her PCP if we could just use cologuard but was informed if a person has had polyps in the past they were not candidates for these noninvasive test.

aconite

DH is 79, has severe memory loss, but is able to do most of the activities of daily living on his own.  I don't usually need to monitor his hour to hour activities. He was scheduled for a colonoscopy this fall with his prep being the new one where one takes tablets followed by lots of water.  So we went ahead with it - with me being really not aware of the potential downsides of anesthesia and not thinking about what we would do if something were found.

The day of the prep was stressful to say the least.  It wasn't the toileting - it was keeping him on the prescribed diet.   I managed the schedule of prep activities and giving him prescribed foods as allowed. We had many options of allowable drinks - things he liked - but that didn't matter. He was hungry and couldn't remember that his diet was restricted. And during the last prep in the middle of the night, I fell asleep before he was finished with the water & toileting.  He found a banana and consumed it.  It took consultation with the doctors to see if it was safe to go ahead with anesthesia given that he had eaten. The results indicated that he had an incomplete prep as well.

If I had it to do over, I definitely would not go ahead with it.  I can't definitely say how the anesthesia affected him since any doctor's visit (change from routine at home) brings on periods of confusion and more noticeable memory problems for a day or so. 

ghphotog

Same thing here. Our PCP sent us the cologuard kit. Mine was fine but it's been a challenge getting her to poop in that bucket without peeing in it but we got er done. Not sure what I will do if the test is positive and she has to have a colonoscopy. She's had two before and some polyps removed if I remember right. Heard that would prevent her from doing a home test but too late. It's already sent. Removing polyps or even early cancer would be easier for her than to let the cancer run it's course.