Colonoscopy & BiPap

[StuUnderPressure]

Called to schedule routine Colonoscopy after receiving letter in mail that I was due

Was told that since I am now on BiPap (switched 9-17-17), they would have to do the Colonoscopy in the Hospital - instead of in the "Clinic" where it has always been done.

WHOA ! !

Have never even used my CPAP in prior Colonoscopy - so was shocked to hear that.

Seems like the "Clinic" can handle you if you are on CPAP - but not if you are on BiPap.
Scheduler was not able to give me any real reason as to why.

A quick Google search did not result in relevant information.

Clinic mailing me pre-colonoscopy info. Hopefully, that will provide more information.

Has anyone heard of this?

[SewTired]

They have very specific criteria about when a colonoscopy can be done in the office or needs to be done in a hospital. If you are using a bipap AS a cpap, clarify that with the office. However, with Bipap settings, I think you are SOL and will have to do it in the hospital. They don't make exceptions. Anesthesia given for this procedure causes changes in breathing and if you already have problems breathing laying down, it could result in an unplanned emergency. They prefer those to happen in the hospital.

Chances are that this is something you would find if you had access to the medical journals and newsletters associated with colonoscopy screenings. It would not be something you could google.

Wish I could be more helpful, but neither myself nor any family members (so far) have had this procedure done in an office. We were all excluded because we didn't meet the criteria for an office procedure.

[jnk...]

BPAP, to some medical people, sounds close to using a ventilator, since it reduces work of breathing. Therefore, to some, BPAP carries some connotation of being associated with more serious comorbidities than simple OSA--such as hypoventilation issues or requiring higher pressures than most CPAP users need. So if someone were looking for a way to send some money (oops, I mean, patients) the hospital's way, the CPAP/BPAP line can be an easy line in the sand to draw, since BPAP use sounds a little riskier and makes it seem that it might be nice for an RRT to be nearby just in case of some rare, but possible, complications. Remember, the principles of home-treatment machines still aren't familiar to everyone in medicine, so no logic-based protocols have existed long-term on how to view people who use different forms of them. And like anything, it often boils down to the comfort level of the doc and the sleepy/forgetfulness-juice guy as to whether something simple like colonoscopy should be done at an office or at a hospital for a particular person.

Just my take. And I have no real experience with any of it from the medical end. I will say, though, that my sleep-doc-issued Rx was for bilevel (I also have an Rx for straight CPAP from my primary care), and my colonoscopy was done at an office. (That office just so happened to be about a half mile from a respected hospital, though.) For my comfort level, since I'd never had the juice he was going to use, I asked the sleepy/forgetfulness-juice guy to keep me mostly conscious, and he did a good job of keeping me right on the edge. He says my breathing didn't change at all. I was, uh, on my side, of course, and you aren't really asleep during a normal colonoscopy, so sleep-breathing isn't exactly what they are working with. Before the procedure, I told him that if anything went wrong, I thought 10 cmH2O ought to be enough to keep me safe overnight, if he would please put that in a prominent place in my paperwork. And I told him that if anything ever happened that required intubation, treat my airway like a child's, since it is smaller than my frame might suggest.

[StuUnderPressure]

So if someone were looking for a way to send some money (oops, I mean, patients) the hospital's way, it can be an easy line in the sand to draw, since it sounds BPAP use sounds a little riskier and makes it seem that it might be nice for an RRT to be nearby just in case of some rare, but possible, complications.

Just my take. And I have no real experience with any of it. I will say, though, that my sleep-doc-issued Rx was for bilevel (I also have an Rx for straight CPAP from my primary care), and my colonoscopy was done at an office. That office just so happened to be about a half mile from a respected hospital, though.

This huge clinic consists of eight (8) gastro guys who do the vast majority of Colonoscopies (if not approaching 100%).
They happen to be just across the street from a large regional hospital - but will be doing mine at another large regional hospital way across town from the clinic - but just blocks from me.

I also still have both of my S9 AutoSets & an antique brick.
When I travel, I usually bring only an S9

When they asked me whether I was on CPAP or BiPap, I might have answered CPAP had I known why they were asking.

In retrospect though, I guess I really don't have a problem with doing it in a Hospital - other than it will probably take longer for the procedure.
The colonoscopy will be done by the same gastro guy.

I have done routine lab tests, etc at this hospital, so I am already in their system.
That should cut down on the amount of paperwork - especially since they on are on the "Epic" medical software where you truly have to give them your information only once.

[jnk...]

I know you know your stuff, but if a U.S.A. hospital is involved in any way, make sure everyone from the cleaning staff on up are "in-network," to prevent surprises with any bills.

[StuUnderPressure]

I know you know your stuff, but if a hospital is involved in any way, make sure everyone from the cleaning staff on up are "in-network," to prevent surprises with any bills.

That is a good point!
But, I already know that they are in network from my past use of all involved.

[StuUnderPressure]

I will be sure to bring my own VAuto since I have seen that hospital's "BiPap" used on someone else.
It was the size of a tank!

[jnk...]

I will be sure to bring my own VAuto since I have seen that hospital's "BiPap" used on someone else.
It was the size of a tank!

So THAT'S where you got your avatar!

[chunkyfrog]

Good idea to let them know IN ADVANCE that you will be EXPECTING an itemized statement.
A recent study showed errors in 100% of all the hospital bills they checked.

[SewTired]

It isn't so much that you have cpaps you can bring with you, but the reason you were prescribed a bipap. My gastro can only do 4 colonoscopies at the hospital a week, max. They make more money on it in-house. So not something they will pawn off to hospital easily. I agree with the other poster, that there are a variety of reasons why someone may get a bipap that doesn't increase risk. I'm sure someone with access to the more specific medical journals might come up with reasons why.

[greatunclebill]

most of my doctors are in an office building on the campus of the associated hospital. in the past all of the outpatient procedures like these were done across the street in the hospital outpatient surgery center. recently the doctors started going to a stand alone surgicenter to do routine colonoscpies, etc. my wife on cpap had hers done at the surgicenter. i also am on cpap but mine is scheduled in the hospital outpatient surgery center because of my copd.

[jnk...]

My guess is that if they have a regular number of slots reserved over there at the big house, they will find a way to fill those slots with whomever they deem the riskiest that week. And I'm betting they grade on the curve, depending on who happens to be scheduled for which week. But I'm a conspiracy theorist, so don't listen to me.

[McSleepy]

...or have your colonoscopy without any sedation or drugs, and save yourself the aggravation. viewtopic.php?f=1&t=113703

McSleepy

[salinas212]

BINGO! I wasn't offered so much as a Valium in the 90's and mid 2000's for a colonoscopy. Jus go in, grease up & assume the fetal position. Admittedly not a pleasant or fun experience by any stretch but no root canal either. Lately tho the VA has started a mild dose of Fentanyl (sp?) which while not making it fun, does make it bearable. Its the GoLYTELY prep and near 1.5 gal H2O that makes it so gross and insufferable!

[ChicagoGranny]

In retrospect though, I guess I really don't have a problem with doing it in a Hospital

They won't have to call the ambulance, when they puncture your colon. Just wheel you down the hall.