After a colonoscopy two years ago, Patti Damare felt so delirious and weak that she couldn鈥檛 stand on her own.
That was on a Friday, and she chalked up her symptoms to lingering effects of anesthesia. On Saturday, the San Marcos, Calif., woman wondered if she had contracted a killer flu or urinary tract infection.
The next day, she couldn鈥檛 get out of bed.
By Monday, it was almost as if her body had been beaten with a baseball bat, she recalls. 鈥淚t felt like what you imagine dying feels like,鈥 says Damare, 53, a retired flight attendant.
That night, emergency room doctors diagnosed her with a raging E. coli infection and , a potentially . Her doctors told her the infection likely stemmed from her colonoscopy, she says.
鈥淭he doctor in the ER told me that if I had waited one more day, I would have died,鈥 she says.
Physicians use a variety of reusable medical scopes to peer into the body 鈥 and they can pose a deadly infection risk when not cleaned properly.
Complicated scopes called , used to in the bile and pancreatic ducts, to at least 35 deaths in the U.S. since 2013, including three at the UCLA Ronald Reagan Medical Center.
But less complex scopes also pose contamination risks 鈥 and they鈥檙e used on far more people: Each year in the United States, doctors perform colonoscopies and 7 million endoscopies of the upper GI tract.
Two recent studies underscore the threat: published in March found that 71 percent of reusable medical scopes deemed ready for use on patients for bacteria at three major U.S. hospitals.
Then a May study concluded that infection rates are far higher than previously believed after colonoscopies and upper GI endoscopies. For instance, the infection rate within seven days of a routine colonoscopy at an outpatient surgery center is roughly 1 in 1,000, the determined.
It was previously thought to be about 1 in a million.
Susan Hutfless, senior author of the May study and an assistant professor at Johns Hopkins, says she was 鈥渧ery surprised鈥 by the findings, adding that patients must start grilling doctors about treatment options and the cleanliness of the scopes.
You shouldn鈥檛 do it as I did at my first colonoscopy in January: I was on the gurney, waiting to be rolled into the operating room when I asked the doctor, 鈥淵our scopes are clean, right?鈥
You can guess what he said.
I might have asked earlier but, as Hutfless says, 鈥渢he more people ask, the more cleanliness will improve.鈥
No matter which scope procedure your doctor recommends, start by applying a risk-benefit analysis to your situation, experts say.
In the case of colonoscopies, which can detect colon cancer, many experts believe the benefit outweighs the risk of infection.
鈥 saves lives,鈥 says Dr. James McKinnell, assistant professor of infectious disease at UCLA and the research institute. 鈥淭he benefit is a reduction in the risk of death.鈥
Besides, most infections related to scopes are treatable and short-lived, adds Sylvia Garcia-Houchins, director of infection control for the , which accredits many U.S. hospitals and surgery centers.
As part of your deliberations, consider discussing potential alternatives with your doctor, says Lisa McGiffert, former director of Consumers Union鈥檚 Safe Patient Project and now a member of the . 鈥淚 would say, 鈥業s there another procedure that you could identify that鈥檚 not invasive?鈥欌
If there isn鈥檛, start asking questions.
First, make sure you鈥檙e seeing a reputable provider with lots of experience. Ask how many procedures he has performed. If yours is the first, or among the first few, consider going elsewhere or asking for someone to supervise the procedure.
You can also ask your doctor if she knows the facility鈥檚 infection rates, says McGiffert, who is based in Austin, Texas. 鈥淚f they say no, I would say 鈥榃hy not? Why aren鈥檛 you keeping track of this?鈥欌
If your doctor gives you an infection rate but it鈥檚 confusing, remember: 鈥淭he closer to zero the better,鈥 McGiffert says.
Next, ask about . McKinnell offers some questions: Do you clean and reprocess your scopes? Do you hang them to dry in a place that is clean? After they鈥檝e been cleaned, do you check them for contamination?
Without wading into every scientific detail, you want to get a general sense that the doctor or facility has an established cleaning process.
鈥淚 want to know there鈥檚 a person cleaning the scopes who鈥檚 dedicated to cleaning the scopes. If they are, they鈥檝e got the system down pat,鈥 Garcia-Houchins says.
You can also research whether a hospital or surgery center in your area uses single-use endoscopes, which are becoming more accepted and prevalent.
Ultimately, trust your gut.
鈥淚f you don鈥檛 feel comfortable and those alarms are going off, you need to stop the bus,鈥 Garcia-Houchins says. 鈥淵ou just have to do it.鈥
Damare agrees. After her bout with sepsis in August 2016, which she says sucked the life out of her for a year, she doesn鈥檛 plan on getting a colonoscopy again.
But if you do, remember that you 鈥 not the doctor 鈥 are in charge, she advises.
鈥淭his is your whole life,鈥 she cautions. 鈥淵ou have to feel really good about what your choice is.鈥
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