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Friday, January 23, 2009

Colonoscopies Are a Pain in the Ass


This falls squarely into the “Too Freakin’ Much Information” category, and for that I offer an apology. But it’s my site and I’ll write about what I want to write.

So there.

For reasons best left undiscussed in a family forum, but directly related to my trip to India, and at the relatively tender age of 38, I had to undergo a colonoscopy about a month ago. Anyone with an overdeveloped worry reflex can put their mind at ease because everything came out alright. In the end. I didn’t want to write that last part, but there’s a Federal law covering jokes in this situation and I would have been in violation without that bit of boilerplate colonoscopy humor.

Anyway, while there is much hilarity to be found in the actual procedure and in watching a video of a camera marching its way through your tender, pink innards, grabbing bits and pieces of your intestine for later testing, this isn’t actually about the procedure. In fact, I didn’t actually have a colonoscopy, so I didn’t get the good drugs; I had something with a much longer name that is ridiculously harder to type, that still involves cameras being shoved up your butt, that comes without the good drugs but with all of the bad, stomach nuking drugs that make the day and night before a near-colonoscopy such a treat for everyone involved.

From what I’ve heard, I’d actually have enjoyed a real colonoscopy a bit more than its supposedly easier-going little brother. My advice to everyone is this: always go for the procedure that gets you the best drugs. I digress: this post is actually about the aftermath. The financial aftermath.

My insurance has a regular office visit co-pay of $30 and a specialist co-pay of $50. Cynic that I am, I expected the higher co-pay.

Which is why I was shocked (shocked) to get the bill from the service provider (rhymes, in part, with “miser,” if you catch my drift) for $200.

I rushed to find the hefty booklet that covered all the fees, limitations, services, and costs associated with my coverage and found that the bill wasn’t wrong. It was right. I owed $200 for the privilege of having someone shove a camera up my ass. Which made me feel cheap on the one hand and cranky about the unexpected expense on the other. Of course, to be fair, I really should consider the feelings of the nurse and the doctor who actually performed the procedure in the financial and emotional calculus of the event.

I know I should look at the bright side since the actual procedure cost was a bit under $400. I suppose that half off is actually quite a deal. The problem is that I’m not sure I should ever have to pay for the simple joys of having a complete stranger and his assistant shove a camera up my ass. I’m not sure who should pay, and a government bailout seems a little far-fetched, but it still seems a steep price for the indignity involved.*

What really gets me is that there were only a handful of procedures that had the extra-special cost associated. That got me wondering: why charge extra for something like this? Are they afraid of roaming hordes of folks who might go in for extra innings if the price was lowered? They want to discourage that sort of thing?

Because, trust me, I’m not going back for seconds if I don’t have to.

* For the record, I’m a good little conservative and I’m not really complaining about the cost. If it helps keep me healthy, it’s worth the entry fee. I was surprised that the real cost of the procedure was as low as it was and marvel at the technology and skills of the people that make it all possible. And the doctor and nurse combo made the experience as unpleasant as possible; not unpleasant by any means, but it could have been much worse.

The price was a bit of a surprise, though, on top of a month with a lot of surprising expenses.

Image brazenly stolen from here, just in case anyone was searching for the home colonoscopy kit.

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Many years ago, I spent five days in the hospital getting intravenous antibiotics for an infection on my foot that wouldn’t respond otherwise.  The bill came out to a hair above $6K if memory serves.  My insurance at the time had a $2,000 deductible.  After getting the hospital to recalculate the bill using the insurance discount rates, it came out to $1990.  Exactly.

Still and all, I was happy.

Spending five days in a hospital when you are not in pain, not on pain killers, not woozy from the illness etc., ie., fully conscious, alert and bored silly, is really more unpleasant than you’d think.

on Jan 23 2009 @ 01:56 PM

The night before stuff is great, isn’t it?  I hope you got the unflavored and not the sweetened stuff.

on Jan 23 2009 @ 02:48 PM

Wait, wait, wait…

The sweetened stuff is worse? How can that possibly be?

Robin, I have a feeling that if the hospital were presenting the bill to me (no insurance involved) that the price would have been much higher. Much.

on Jan 23 2009 @ 02:57 PM

I had one some years ago. I did get the good drugs, but apparently I had a slightly different reaction to them. Marion said that for the first half-hour or so after I first woke up, I’d look at her, say the exact same thing I’d said the first time, and fall back asleep.

The nurses kept me in the recovery area until they felt I was lucid. According to Marion, I was holding conversations with the nurses and told several jokes. I didn’t remember much of anything, even of the rest of the day.

Dave Barry, in his inimitable way, wrote about his colonoscopy. It’s worth a read.

on Jan 23 2009 @ 03:56 PM

If you had a real colonoscopy, you would have been put to sleep. An anesthesiologist would administer the anesthesia. No drugs and you would have to tell him emphatically that you didn’t want to get sick afterward and you want to wake up right away. You do not want a day of throwing up.

It is considered a short procedure so no hospital stay or use of hospital facilities. I had this done three times, my HMO sees this the same as surgery, so no copay. The last time I got nice pictures.


on Jan 23 2009 @ 03:57 PM

Good Lord, no. No barium enemas for me.

What I had was a flexible endo-something-or-other. They only go a portion of the way up your innards, so you don’t get the general anesthetic. In fact, no drugs at all--which, for me at least, made the first moment of penetration rather shocking.

On the plus side, I got to watch the video as it went along and was quite pleased by the overall healthy appearance of my intestines. I’d seriously rather have been asleep for it, though. The embarrassment factor was off the charts for me.

I’m a bit of a wuss about embarrassment. Pain is usually easy by comparison--not always, but usually.

Wheels, could you send me an email with your phone number? I need to give you a call this weekend.

on Jan 23 2009 @ 04:07 PM

Yeah, I’ve heard about Moviprep.

Glad to hear everything came out alright.

on Jan 23 2009 @ 04:46 PM

And boobies.

I really have nothing else to add…

on Jan 24 2009 @ 07:19 AM

Ooh, barium enema! I got one of those when I got out of the Navy. Normally, I’d have been considered too young, but I had some symptoms that made it advisable. Turned out to be nothing, but best to be safe.

It wasn’t a really good experience, but I suppose parts of it make a good enough story. Again, you need to cleanse the system. Then, they pump the barium in and let it drain out - you only need enough to coat the intestines, not to fill them. Then, they pump you full of air, so they can get better detail in the images.

While all this is going on, you’re on a tilting table. At one point, I told the nurse that my face and hands were starting to tingle. The response was, “Oh, that’s because you’re hungry and dehydrated from the preparation, so you’re close to passing out. Why don’t you keep talking so we’ll know when it happens?”

As it happens, I didn’t pass out. When it was done, they took me across the hall to a restroom reserved for barium enema patients. Someone not getting a barium enema had decided to use it, though, so I couldn’t. The only other restroom on the floor was for enlisted, so they led me halfway around the building and up a flight of stairs to get to an officer’s restroom. Only then could I unpressurize my intestines with a 40-second fart.

Ah, yes, I remember it well.

on Jan 24 2009 @ 03:47 PM

A 40-second fart?

That alone is worth a memory or two. I have to eat a full plate refried beans and two bowls of ham-and-bean soup just to make it to 10 seconds.


That was probably just too much information. Never mind.

on Jan 25 2009 @ 10:38 PM

I had drugs for mine just a few weeks ago.

Thank goodness, I was all clean.

But I really got tired of the butt geysers by the end of the preparation process.

on Jan 27 2009 @ 11:31 AM

What’s worse, up your ass or up your nose?  Since they left you awake while they went up your ass, I’m guessing that’s the less invasive procedure…

on Feb 01 2009 @ 12:19 PM
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