in 2009, when dick was due for a colonoscopy, I told my doctor, no.... we were not doing it, and he understood. At this point, he is very anemic, and the doc has put him on iron pills and Folate. Meanwhile, he wanted a stool sample to see if there was blood. Well, he finally pooped in his depends, so I was able to get the stool sample, but no way in h..l I'll be able to put him through the prep for a colonoscopy.... can you just imagine. There will be poop on the ceiling. Anyway, obviously, i don't want to do it. And for what??? if there's anything there, we're not going to do anything about it. He's 87 yrs old and he has DEMNTIA!!! what life would be saved. Anyway, I'd just like some feedback from my dear friends here. Thanks.
YOU ARE ABSOLUTELY RIGHT, CHRIS!!! NO COLONOSCOPY. I assume that this is a gastro guy, not the PCP or neurologist. It's like the prostate/bladder exams (scope up the penis) that the urologist wanted to do after finding a polyp a few years ago. NO!! Just don't go back! and tell your PCP.
colonoscopy prep is hard on one who doesnt suffer dementia. i would not choose this for my spouse either. let hospice come in and do comfort care if the time comes if he gets worse.
I agree with the comments above. Nope. don't do it. Dick would have to be in hospital for the prep if they were to do such a thing.. But more importantly, to what purpose would this be? They are treating the anemia. Area there other underlying conditions that could contribute to the anemia..kidney, diabetes etc? No I would not go forward. Tell your PCP.
Agree with above....as long as he is comfortable, what purpose will be served. Plus sedation for test, coupled with prep and add in procedure room, sounds like a lot of trauma for what? Increased agitation. You did not mention if stool sample was positive? Even if it was..vote for no!
Oh Chris, your post reminds me of a moment a long time ago when a young doctor who was my husband's PCP said that since he was over 50 years old he needed a colonoscopy....I looked at the doctor and said..."I can't get him to change clothes, shower, sleep in a bed or take his meds...but you want me to get him to drink gallons of foul tasting stuff, have him crap all over the house and then tell him he has to crawl up on a table and that someone is going to put a camera up his backside." Well, the doc looked at me busted out laughing and said he would never make that suggestion again.
Don't go looking for trouble, especially in that area because you may just find that the trip can be pretty messy. Prostrate cancer takes years and years to progress...If it is not broken, do not fix it./
My DH should have had on 10 years ago (when he was in his right mind) but he is doctor phobic so he refused. There is no reason why you should put him through that. So it is unanimous so far……..no colonoscopy
DH has pernicious anaemia and the consultant wanted to do a colonoscopy ,I refused as I said what if you found cancer he couldnt go through an op in his state so why upset him with all these tests ,he gets treatment for the anaemia and thats all thats going to happen . Rosie
We spoke with the primary care doctors who writes the scripts for DW. He suggested that we do not run any test or go looking for anything that might be terminal. We both agree, that we hope for some other disease to be the cause of death.
Thank you all, you have cemented my opinion. I haven't gotten a result yet on the stool sample, but no matter what, I won't subect him to that. And you re exactly right, he already had a terminal disease. Thank God if something else takes him first.
Since diagnosis my hb primary has given him the card to do the stool samples and each time they get put behind the toilet and I eventually throw them away. I am assuming my hb forgot about them. My feelings is same as above: why? I would much rather him get colon cancer and die sooner than go through this disease.
Sandi* Your answer is so on target and the funniest thing I have read in a long time. I don't mean to make light of this at all but heaven help me if some fool doctor wants to do something like that to my dh I hope I am as quick at the draw as you were.!
This is actually not an easy decision if the stool sample comes back positive. Hopefully it will be negative and the anemia is due to something else. Someone mentioned bladder cancer as one possible cause which can cause anemia. Dying from bladder cancer is apparently not terribly painful and there are medications to control the discomfort. At least that is what I was told and have observed (in a family member). However, colon cancer is apparently quite a painful cancer to die from because (according to the specialist who described it to me) there are no effective medications to deal with the pain of end stage colon cancer. Because the colon's function is to basically expell, it does not have a lot of absorptive qualities and therefore medications cannot target that area well. I am not a medical person so have no observational knowledge if that is true or not (maybe Marsh could comment here).
Colonoscopy prep is no picnic for anyone and would be awful for any person in later stages of dementia. But if a stool sample came back positive, I would want to dialogue further with both the family doctor and a specialist to weigh all the options in order to make as fully informed a decision as possible.
Here is an article I found that might interest some of you trying to make this decision. http://www.nytimes.com/2009/10/20/health/20well.html?_r=3&ref=science
I don't know what I would do, however if pain from colon cancer cannot be controlled that is something to consider. Also, I would want to know the affects of treatment of the cancer on his Alz. If the treatment would speed up the decline and avoid pain I might consider it. None of us would want our loved ones to have pain.
I have a friend and her husband had colon cancer and had alz. I often wondered why she had him have the surgery. He died within a year of the surgery. She had him at home taking care of him and she told me it was terrible and if she had to do it over she wouldn't do it. I don't think she knew alot about alz at the time.
Tank you Faye Bay for that excellent article. What I am afraid of is pain. My mom died of colon cancer. She was 71. dick is 87. but when they operated there was an actual blockage. What pain that must have caused, so that's what I fear. 'm all for palliative care, believe me. Just afraid for him to be in pain. I'm praying the sample is negative o I don't have to make thisdecision.
Tough decision but my first reaction was "don't" then the subject of pain gave me reason to doubt my first thought. I'm praying the test is negative so you won't have to make a decision.
I agree with NO colonoscopy, I told his dr. the same as you told you DH's. He totally understood, didn't even flinch an inch. I don't even know why he suggested it in the first place! Come on, really! I can go along with the poop sample but he would have to be bleeding uncontrolably before I would let him(and me) go through this. Also if his dr. did wanted him to go through it I would be tempted to ask him ,or tell him, to be with him during the prep instead of me.lol See how long it will take before he decides he doesn't need it after all.
Rachelle, There are 2 main problems with colon cancer. The first is bleeding, which does not cause any pain. Actually, extensive bleeding is not a bad way to die. The other problem is bowel obstruction, which can be very painful. However, the pain can be controlled with narcotics as long as the doctor is willing to do what is needed and not worry about the "feds". Years ago my father, also a doctor, got a letter from the "feds" wanting him to explain why he was giving so much narcotic to a certain patient. He wrote "Cancer" across the letter and sent it back. He never heard from them again. With cancer the correct dose of narcotics for pain is "enough" to do the job. There can also be pain from metastases, but these also can be controlled with narcotics. With cancer patients you don't worry about addiction.
Given the situation you describe I would not do a colonoscopy or the stool samples for blood. There's no point in getting information you are not going to act on. I like Deb's suggestion that the doctor who is insisting on a colonoscopy in a patient with AD be the one to administer the prep.
You guys are great. thanks marsh for your assurance that pain can be controlled. I don't want him to be uncomfortable, but I can't see the point of doin this stuff to an 87 yr old who has a terminal disease. i don't think the doctors think of it that way, but that's what it is. Just a very slow termindal disease.
I agree no colonoscopy. I do have a question for my DW. Should I continue normal/yearly exams for my DW (PAP Smear, etc)? She is 51 years old and is at stage 5/6.
aalferio, although my wife is older than yours, we (her PCP and I) have decided no more paps or mammograms. Given the AD diagnosis, what would we do about a positive report? Nothing!
aalferio the one diagnostic test I would continue is a mammogram. Your wife is still young. Breast cancer caught early is easily treatable. If not it can spread and cause a great deal of pain.
I agree with the other posters - no colonoscopy. DH's PCP asked in 2009 if he's ever has a baseline colonoscopy. I advised him that he never had and said I really didn't think we could manage the prep and the actual procedure. So this year when DH had his physical his PCP ordered a blood test which could detect if there were colon cancer problems. He said it's not 100% accurate in some circumstances but given my husband's dementia he thought it might be a viable alternative. BTW, Medicare won't pay for the test and it is somewhat pricey $100.00
LFL, as I have said before, what are you going to do with the information from the test when you get it? If the answer is "nothing", then don't get the test.
Just had it done this summer an when I asked the doc if I had to do it again,he explained its something like the law of diminishing returns,its such a slow growing cancer an at my age,fugget about it an thats exactly what i did
Marsh- you are a wise and faithful doctor, and I would follow your advice without question. I want to start a thread called "Marshisms". 1. What are you going to do with the information from the test when you get it? If the answer is "nothing", then don't get the test.
Absolutely agree w/Marsh. A neurologist wanted to do a PET scan at my expense along w/some other stuff. Hb had already been diagnosed w/vascular dementia years before by a neurologist. New (and last) neurologist said he just wanted to check to see if it might be AD. I asked what big dif it would make. I talked w/PCP and his clinical nurse who is a neurology specialist. No more tests.
Well, the result of the stool sample came back positive. I was hoping it would be negative, so this would not even be discussed. I must ask, If anyone knows, what else does a colonoscopy show besides cancer? Like, if there's a blockage, and he's in pain? And is there any other way? Marsh, you are a doctor, other than cancer, which I will not have him operated on for, what's the good of it? anything?
I would ask the doctor what alternatives are and other than cancer what would they be looking for since the test came back positive. If they are looking for the source of the blood, I would think there are other less invasive things to try first.
I am reminded of when my hb had his surgery for GERDS years ago. There was an elderly man brought in due to blood being found in his stools. They went up from both direction (rectum and down through the mouth) - when we saw him it was the second time they had done it - and both times never found any sign of bleeding. He was anemic and they had no idea why. His wife said he would not put him through it again.
Chris, colonoscopy can also show various inflammatory conditions of the bowel which might cause bleeding, such as ulcerative colitis. However, most of these also have significant diarrhea. If there are no symptoms - pain, diarrhea, constipation - and he is in the later stages of AD, I would be inclined not to do the colonoscopy. I can't imagine going through the prep with my wife in the stage she is in now.
About 5 years ago my dh had black stools..tested for blood..was positive. Did a colonoscopy and it was negative. Then they did the test where they went down into his stomach and found he had some small ulcerations in the stomach. He took medication for a month and everything was fine. Do you think you might want to consider that option first? There wasn't the terrible prep for that test.
I would try antacids or whatever first before even putting him through that. If an ulcer a bland diet, no spicy foods, salt, pop, coffee or things that would irate it. But, I would definitely consider a occurrence of the ulcer before anything else.
Actually, he had bleeding ulcers about 15 yrs ago due to advil.... he takes prilosec every day, even now.... so maybe an endoscopy would be less invasive than the other, and it might actually be what it was previously. thanks.
News... All my worrying is over. The gastro guy came in the room and asked dh who I was what the drs name was & why he was there. No answers. Doc turns to me. I say no colonoscopy!!! Doc says of course not. We'll handle the anemia with LEDs and eventually with a possible transfusion if necessary. I don't know how you got a stool sample. We're on the same side. I'm so relieved that this is not something I have to decide. Thanksto all for being with me in this. I just love you all so much.