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Colonoscopy in France


brodie19
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Early last year I posted regarding a colonoscopy which I subsequently underwent whilst resident in France. Having since moved back to the UK, I am not really impressed at the way my nearest hospital would undertake a colonoscopy, compared to what I received in France. The reason for this is that under the NHS, I will not be able to have any future colonoscopy under a general anaesthetic. My French specialist had previously told me I would need a colonoscopy every 3 years ( as my father was diagnosed with bowel cancer), and that in France (as I now know), unless there is a specific medical reason, colonoscopies are not undertaken without general anaesthetic for reasons of patient safety, contrary to what happens in the UK.

My question is of those who have undergone medical treatment in France and then moved permanently back to the UK. I am wondering if anyone has then specifically returned to France to continue treatment (obviously at their own expense), rather than using the NHS. In my case, I would rather have any subsequent colonoscopies done in France under general anaesthetic rather than in the UK without (although I understand that sedatives can be used), however, I would rather be "out of it" when that happens.

Having now "released" myself from CPAM, and now resident in the UK, how easy is it to obtain a procedure such as this again in France, not being resident, and not being able to use EHIC? I suppose it is not as simple as going back to my former French GP, paying him for a consultation, and having him write a "prescription" for a colonoscopy at the same clinic I received mine, and hopefully by the same doctor. As I said, payment is not a problem. I noticed from my last colonoscopy that the French charges were about 900€ for the privelege, a price I would not hesitate to pay for this procedure under GA.

Anyone have any experience of a similar type scenario?

 

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Can't help with the French info but different NHS hospitals handle the procedure in different ways depending on the person carrying it out. At my local hospital Lewisham they use a mild sedative and apart from slight discomfort due to the air used to inflate the bowel it was fine and the pilot was very competent.

The same procedure at St Thomas's the sedation was far heavier and I knew nothing about it until I awoke an hour or so later.

My only criticism of the NHS is far too many office bods who do not know what they are talking about, so get to talk to the person who is actually carrying out the procedure. If you are not happy, use NHS choices to transfer to another hospital where although they still may not use a general as that in itself is not without risk, heavier sedation is safer and has the same benefit from your perspective. It is a lot nicer feeling coming round from heavy sedation ( a nice restful sleep) than the horrible sickness feeling of general anesthetic.

Private is still an option and lets face it, they do pretty much what you want them to do as they are in receipt of your payment.

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I have had this done in France. Their first attempt included giving me a 'sweet' to melt in my mouth which was supposed to relax me and was no good, as that was not working, then they gave me what is probably gas and air and as I was screaming blue murder, they very unhappily had to stop what they were doing and book me in later. As it happens it was six months later, and during that wait, they managed to make me very ill. So yes, I had a general eventually, but I don't think that this is automatic in France either.

During subsequent conversations with friends (in France) I found that those, and there were several friends who had had this done, had not been put under and were surprised I had been. A good french friend had it done recently and she was not put under either. My husband has had this done several times in France and was never put under, and it was never offered.

As you lived in France, you are quite aware that there are Cliniques everywhere and these are 'private'. You could book in with a consultant and anasthesist and pay. It would be what I would consider very expensive, but if you have the money and prefer it, then why not.

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Like Theiere, I have had one done in the UK as day surgery under a mild sedative. Honestly, there was nothing to it. The worst part was the strngent diet to follow beforehand, and the explosive medication to be taken to ensure everything was truly empty for the big day.

In fact, I was preparing to leave my glasses i n my cubicle when the nurse came to collect me, and she said "oh bring them with you; you'll be able to watch the procedure on a TV screen!". Which I did, and it was fascinating...

You are slightly aware of air being puffed in to inflate the passage, but no pain of any sort.

Angela
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Just this week a lady of 35 that I know had this procedure and chose just gas and air rather than heavier sedation, however an older friend is booked in for the same thing and he will be having a general.

I've had it done and like others said it really isn't a problem, but if you really want a general talk to your Doctor and ask about it. But you have to be willing to pay, just as you may hav to pay in France.
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Thanks everyone. I did have had a colonoscopie in France last year under GA. I was just wondering how easy it was, as a now non resident, to go back to my former French GP and arrange a future colonoscopie with the same consultant at the same clinic.
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Unfortunately, posters on here will have different experiences and won't be able to give you a definite answer. You could probably have the procedure privately in France in the same way as in England, but nobody can be certain about whether you would be able to have the smae consultant.

My husband has had a colonoscopy in England with sedation and thoroughly enjoyed watching the procedure. Following his very restrictive diet before it, I was surprised that the exact timings he was given for emptying out were totally correct. He has had endoscopies in England although the sedatives must have been stronger as he couldn't remember anything afterwards, whereas after the colonoscopy he remembered everything. These all happened in the same hospital in England. He had an endoscopy in France and had a general anaesthetic, which we found bizarre.

By the way, my husband also thoroughly enjoyed watching his angiogram and angioplasty.

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No, the easiest is usually to get the information directly from the people concerned and if you think that is wrong, then contact someone else who does the same thing, ie in this case another hospital.

You say you want the same consultant, but if they work in a public hospital then this may not be possible. But I do not know this for sure either. I do know that at a 'clinique' then they will happily take your money. So as was said, this is not the easiest place to ask.

As I didn't even have a phone at home when I first got to France (internet was only in science fiction), I would go and ask if I needed to know anything, or get myself to a phone box and that was with very limited french. As far as I am concerned you cannot beat getting info from the horse's mouth. Asking on here is more or less like asking in the pub. You'll get anecdotes, people's stories and some awful info and thankfully, some excellent info too. Then you have to decortique the good from the bad. The best and most reliable info you'll ever get on here are links to phone numbers and websites where you can get information from the 'source'.

In the past I have seen very respected members post stuff that I know to be absolute tosh. Sometimes I have contacted the OP and made an alternative suggestion, sometimes I have ignored the nonsense, as it is easy to start a bit of a battle on these boards. At the end of the day, we all make choices and when it is important, it is down to us, to sort ourselves out.

Sometimes I suspect that I was very lucky not having alternatives, like a message board. Improved my french and I gathered a great deal of practical knowledge about living in France. And as things change, I never treat my knowledge as written in stone, and do check up on things, even now.

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Just contact the 'cabinet' of the specialist you  saw last time.

The secretary will be able to make an appointment and tell you which hospital or clinic the surgeon uses to perform the procedure.

Then you book a consultation and ask for the appointment.

The nuisance if you are not in France is that you may need to have a prior appointment with the anaesthetist as well so you need to keep a chunk of time available.

Your estimate for the price may be exceeded by the extras (including the anaesthetist's fees and clinic charges)

You will also get a later bill for the analysis of any samples taken

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[quote user="NormanH"]Just contact the 'cabinet' of the specialist you  saw last time.

The secretary will be able to make an appointment and tell you which hospital or clinic the surgeon uses to perform the procedure.

Then you book a consultation and ask for the appointment.

The nuisance if you are not in France is that you may need to have a prior appointment with the anaesthetist as well so you need to keep a chunk of time available.

Your estimate for the price may be exceeded by the extras (including the anaesthetist's fees and clinic charges)

You will also get a later bill for the analysis of any samples taken

[/quote]

Thanks Norman H, the last time I had a colonoscopie, I was able to see the breakdown of charges for everyone and every service involved and that came to about 900€. I just wonder if the charges would be more, given that it is not going via CPAM but out of my own pocket.

I think though it would be easier to email the specialist who did my last colonoscopie as I did this a few weeks ago to obtain a copy of the biopsy report, and his department was very approachable and quick in their replies.

Again, thank you to everyone for their replies and comments, its appreciated.

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Colonoscopies are usually done under sedation and often with an amnesiac drug, so you do not remember anything afterwards. As a result some patients think they have been given a general anaesthetic, because they do not remember anything.

I have had numerous colonoscopies over the years and paid to go privately, so cost was not a consideration. On each occasion I was sedated at my request and told giving a general anaesthetic was discouraged because of the risk of the anaesthetic itself and a higher risk of bowel perforation if the patient was unconscious.

Talking to family members who are doctors, apparently the riskiest part of an operation is the general anaesthetic, especially for older patients whose memory can be permanently adversely effected, and recovery takes a lot longer.
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[quote user="Sprogster"]Colonoscopies are usually done under sedation and often with an amnesiac drug, so you do not remember anything afterwards. As a result some patients think they have been given a general anaesthetic, because they do not remember anything.

I have had numerous colonoscopies over the years and paid to go privately, so cost was not a consideration. On each occasion I was sedated at my request and told giving a general anaesthetic was discouraged because of the risk of the anaesthetic itself and a higher risk of bowel perforation if the patient was unconscious.

Talking to family members who are doctors, apparently the riskiest part of an operation is the general anaesthetic, especially for older patients whose memory can be permanently adversely effected, and recovery takes a lot longer.[/quote]

It must vary considerably in France as my last colonoscopy at a clinic in Saumur (49) was under general anaesthetic. The consultant told me that the clinic always does colonoscopies under GA as it reduced the rick of the patient moving and thus perforating the bowel. I suppose being late 40s, there was a minimised risk of complication which may affect older patients as you say.

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One VERY important point about the General Anaesthetic;  there are growing concerns about the use of GA's for the more 'mature' patient.  

There are indications that GA's can lead to onset of dementia;  we've had personal experience of this in my family, and there are growing number of cases where patients have had GAs and 'not been themselves' after the op.   Please be careful about GAs unless it is absolutely necessary.

I can remember my mother having a hip joint replacement op and the procedure was done with sedation and an epidural - couldn't believe it but that was what happened.    Today's sedation drugs are so good that you can be 'out of it' but not anaesthetised.

Just thought I'd throw this option in for good measure - but whatever the procedure hope everything is 'clear' and continues to be so.

Chessie

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I have just had a relative undergoing a hip replacement privately and they had an epidural with sedation and amnesiac drug. So convinced were they that they had a general anaesthetised I had to double check with the doctor who confirmed that with sedation and the amnesiac drug most patients cannot tell the difference!

The problem with general anaesthesia is that medical science still does not fully understand why or how it works!!

As someone who has had multiple colonoscopies and gastroscopies I have been told that a degree of patient cooperation is helpful ,as if you are able to indicate it is getting uncomfortable the risk of a bowel perforation is reduced.

Cheesie is correct about the memory and confusion dementia related complications that can arise with a GA. Also if you are overweight, smoke, drink frequently, have high blood pressure or lung problems, then a general anaesthetic carries much higher risks.
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I raised this with my anaesthetist last time, and he pointed out that there is a difference between the very light anaesthetic given for the 20 mins or so of a coloscopy and the ones given for much heavier procedures.

I would certainly try to avoid them where possible as each time I have to have one it seems to exacerbate my balance and mobility problems.

As the OP has found they are standard for coloscopies in France.

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I don't necessarily think the "depth"of anaesthesia and the length of procedure are directly related. Mr Betty had a catheter ablation last year to correct a heart problem. He was in surgery for five hours, and watched the whole thing on five TV screens in the theatre. This wasn't an NHS shortcut, by the way. It was done in a private hospital.
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