Scope timing question

[pdx]

E's calprotectin has been sitting at 250 for a while (after being in the 400's while flaring last spring), so her doctor wants to do a scope. E really doesn't want to miss school for the scope, and the only Monday holiday in the next few months happens to be just 3 days after her Remicade infusion. Her doctor says that's fine, but it seems like it would be better to scope later in the cycle, when inflammation might be at its worst. We could wait one more month until Thanksgiving week, and then she would be 4 weeks post-Remicade, but that means waiting longer to find out what's going on.

Do your kids' doctors pay attention to medication timing when scheduling scopes?

 

[my little penguin]

It’s only one day
If she preps on Sunday
That said typically you don’t get that much choice in scope dates
At least we don’t unless it’s inpatient
Otherwise it’s 4-8 weeks out from when we try schedule
Add in holidays means staff is basically the
Younger staff who couldn’t get off to stay with family
No thank you


We had our last scope days before the next shot so we could see what was what

 

[crohnsinct]

Our old practice didn't pay any attention to days after or before infusion. Basically their theory was "if there is inflammation, there will be inflammation". 3 days of Remicade won't miraculously clear everything up.

Don't even get me started on the new practice which hardly ever scopes! They do keep tight control with cal pro so at least there is that I guess.

 

[Maya142]

I would guess that if Remicade is not working well, then there is likely to be inflammation whenever you scope.

We typically can get a scope scheduled within a couple weeks if it's not with M's GI. Sometimes she says that's ok and gives us a few names of other GIs in the practice that specialize in IBD, and other times she really wants to see for herself.

I think all GIs have different preferences about scoping, so that might be worth asking about. If she doesn't mind who scopes E then you may have more flexibility with scheduling.

My daughters hated missing school and did everything they could to get there - even if it was just for a few classes. M even went to school on a prep day for the first half of the day.

 

[Lady Organic]

I did read stories of people on biologics who observe return of symptoms at the end of the cycle. It can be frustrating to go for a scope and not find anything when we feel, know or suspect something is going on. THe risk, even if minimal, for this happen and having to repeat a scope is not worth it imo. Some patients also exibit a pattern of very fast change in remission-flare status. I know a patient like that. I'd personnally chose a date of scope when I would be most certain to see the suspected disease activity.

 

[Tesscorm]

I don't think the timing of the scope has ever come up with S?? But, yes, I can understand why having it before remicade might provide more info (although, as crohnsinct said, if inflammation is there, I don't think 3 days would make a significant difference).

Scopes are hard to reschedule but would it be possible to reschedule her remicade to the day after the scopes? Do you or her GI feel that a 4 day delay on remi could create problems?

 

[pdx]

Thanks all, for your insights. This scope is not urgent, so we gave E the choice on the date, and she chose the Monday before Thanksgiving. That way she won't have any worries about missing school or even homework time over the weekend, since she has the whole week off.

MLP--I hadn't even thought about the whole holiday/less experienced staff thing, but I'm just hoping that not too many people take off the Monday before Thanksgiving.

 

[Tesscorm]

FWIW, as I said, this question had never come up for S (or I never questioned it??)... until now.

Iin any case, his next infusion was scheduled for two days before his scope so I did email his GI asking about increased infection risk or the masking of symptoms. I was told there were no issues with the timing of his infusion and his scope. However, keep in mind, S has been in remission for a long time... this answer may not apply if there's been ongoing inflammation or if there's a question as to whether remicade is working 'full cycle'.

Just thought I'd post as it was brought up here.

 

[pdx]

Thanks for asking and reporting back!