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Thread: *** OFFICIAL *** Colonoscopy Thread

  1. #121
    Silver IamGreek's Avatar
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    I think he got it started but we don't know the rest of his family to find out. He had moved to Arizona and just had contact by text telling us the bad shape he was in.
    Last text we got said he was moving back so daughter could take care of him. A mutual friend told us he died about 6 months ago. No funeral cuz of Covid. So sad.

  2. #122
    Owner Dan Druff's Avatar
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    Five months after the procedure, these fuckers send me a new bill of $200 for the propofol.

    Here I thought I wasn't going to have to pay for it. Apparently the insurance deemed it unnecessary and refused to cough up the $.

    As I mentioned, this is a common issue, and in fact they had me sign an agreement to pay the $200 if this happened. So obviously I'm not in a very strong position here.

    I attempted to call the insurance and ask for them to make an exception and pay it anyway. I told them I have documented anxiety issues which made the propofol sedation essential, not just a luxury. They are considering it, and I'll find out (supposedly) next month.

    Pretty dumb how this isn't covered by most insurance, given that propofol usage for colonoscopies has become standard over the past 10 years or so.

  3. #123
    Owner Dan Druff's Avatar
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    Quote Originally Posted by IamGreek View Post
    I think he got it started but we don't know the rest of his family to find out. He had moved to Arizona and just had contact by text telling us the bad shape he was in.
    Last text we got said he was moving back so daughter could take care of him. A mutual friend told us he died about 6 months ago. No funeral cuz of Covid. So sad.
    BTW, I just saw this. Sorry about your friend.

    This is actually why they don't recommend colonoscopies unless you're in a high enough risk category to justify the small risk of the procedure itself. Basically that means you're either 40+ with a family history, or 45+ without a family history (some say 50+ if no family history, though).

    Also, they halt the colonoscopies for older people if they've never had any polyps. So my mom, who is in her mid-70s and never had a polyp in her life, was told to stop getting them done, as the risk outweighs the utility of them.

    My dad, however, who has had polyps for the past 25+ years, will be doing them for life, as will I.

    I know you and your wife are around my parents' age, so if you have no family history, and if Cologuard came back negative for the two of you, you're probably fine. Keep in mind that colon cancer also takes awhile to develop, so even if a cancerous polyp were to start growing today, it would probably be over 5 years before you'd see any issues, possibly 10. This is another reason that it's not as useful for people who are older.

     
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  4. #124
    Hurricane Expert tgull's Avatar
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    Colon Cancer is impossible to get without polyps. Druff is correct, it takes generally 5 years for polyps to get to cancer stage. Colon Cancer is the easiest to diagnose, it's also the most difficult to treat outside of pancreatic and lung cancer. It truly is fascinating why people avoid what is a simple procedure. People will not want to get a rod up their ass unconscious, but will readily risk a colonoscopy bag for life or fatal tumors in their ass. Makes sense. Called thinning the herd, AMIRITE?

  5. #125
    Owner Dan Druff's Avatar
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    Got a response to my lol "grievance" regarding the $200 for the propofol. I didn't want to file a grievance, but they told me it was the only way to get this covered.

    Dear Todd Witteles,

    Thank you for contacting us.

    We are responding to the grievance we received on July 1, 2021, regarding the denial for services referenced below. We are happy to inform you that we are able to approve the services.



    I ended up batting 1.000 regarding re-rating of my colonoscopy, and have effectively turned $700 worth of bills into zero point zero.

    GREAT SUCCESS

  6. #126
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    I haven't read any of this thread but I am sure they found the asshole in you.

  7. #127
    Owner Dan Druff's Avatar
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    BUMP

    It has been 28 months since the colonoscopy described in this thead. Recall that they found four polyps in me:

    - One big tubulovillous adenoma polyp (1.5 cm), which probably had about a 30% chance of turning cancerous

    - One small tubulovillous adenoma polyp, which probably had about a 20% chance of turning cancerous

    - One small tubular adenoma polyp, which probably had about a 5% chance of turning cancerous

    - One hyperplastic polyp, which was mostly harmless

    All four were removed, and fortunately none were found to have turned cancerous yet. This was my first colonoscopy, just a very short time before I turned 49. I do have a family history, with my paternal grandmother dying of colon cancer, and my father having numerous adenoma polyps since he started getting colonoscopies in the 1990s.

    Obviously I was going to need a follow up colonoscopy within 3 years, and could not take the 5-10 years that people can do in between when they have a clear result. With my results, it was clear I would be doing colonoscopies for the rest of my life.


    I thought I had until January 2024 to get this done, but it has since been recommended to me to get it done a little sooner, given both the family history and the not-so-good results of my first one.

    I wanted to continue with the same doctor, as I had a good experience with her and she is well regarded. Unfortunately, she switched medical groups. However, I saw my insurance covers her new group, so switching wasn't going to be a problem.

    I called last week about it and got a bad surprise cost-wise, and it turns out that follow-up colonoscopies are subject to what is kind of a billing scam. I will explain in my next post. Very disappointing.

  8. #128
    Owner Dan Druff's Avatar
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    I was expecting all of my colonoscopies to be free, as this is supposedly one of the "benefits" of Obamacare individual plans. Note that anyone with an individual plan falls under the Obamacare umbrella, even if you're like me and don't qualify for any cost subsidy.

    Well, I was wrong about them all being free.

    Only the "preventative" colonoscopies are free, and you can do these at most once every decade. Once polyps are found, all future colonoscopies are billed one of two ways: Either "colonoscopy with polyp removal" or "high risk colonoscopy".

    What is the difference in these two procedures?

    Absolutely nothing!

    What is the difference in out-of-pocket cost for these two procedures?

    About 3x more for the "high risk" colonoscopy!


    So as you might imagine, many of these colonoscopy centers, which are run like a mill, will bill it as "high risk" simply to make 3x the money (both out of pocket and from insurance), because why the fuck wouldn't they?

    I haven't looked into why these two different categories exist in such a fashion to where it can be abused like this, but I've seen this situation many times before in medical billing. This is why the US needs major medical billing reform, and I don't mean socialized medicine. Socialized medicine would simply pass on these same fucked up bills to the taxpayer.

    I have an e-appointment with a different doctor at the same center. The one who will do my colonoscopy (the doctor from 2021) doesn't do Zoom appointments, so I will do the largely useless (but required) first Zoom visit with a different doctor. I was told that if I can convince him to code it as the first category (colonoscopy with polyp removal), then I will get the cheaper rate. Otherwise I will get the more expensive rate.

    Total bullshit to have to hassle with this type of crap. I don't even know what the other centers do. It's very possible they all pull this trick. If they refuse to code it the cheaper way, I will consider going elsewhere. The actual procedure won't be until September or October, so I have some time to look around.

    Note that I am not trying to go the frugal route. I'm not trying to convince them to do a lesser procedure when I need a more involved one. I wouldn't fuck around with my health like that. Here both categories are the identical procedure, just one costs three times as much as the other.


    MEDICAL BILLING = JOKE

  9. #129
    Platinum ftpjesus's Avatar
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    Quote Originally Posted by Dan Druff View Post
    Five months after the procedure, these fuckers send me a new bill of $200 for the propofol.

    Here I thought I wasn't going to have to pay for it. Apparently the insurance deemed it unnecessary and refused to cough up the $.

    As I mentioned, this is a common issue, and in fact they had me sign an agreement to pay the $200 if this happened. So obviously I'm not in a very strong position here.

    I attempted to call the insurance and ask for them to make an exception and pay it anyway. I told them I have documented anxiety issues which made the propofol sedation essential, not just a luxury. They are considering it, and I'll find out (supposedly) next month.

    Pretty dumb how this isn't covered by most insurance, given that propofol usage for colonoscopies has become standard over the past 10 years or so.
    So your insurance thought you should be awake through the entire hose job up your ass?? Your insurance are a bunch of morons. Its standard procedure now. Used to be a demerol Valium cocktail years ago till they discovered the body doesnt clear Demerol at a proper rate.

  10. #130
    Platinum ftpjesus's Avatar
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    Quote Originally Posted by Dan Druff View Post
    BUMP

    It has been 28 months since the colonoscopy described in this thead. Recall that they found four polyps in me:

    - One big tubulovillous adenoma polyp (1.5 cm), which probably had about a 30% chance of turning cancerous

    - One small tubulovillous adenoma polyp, which probably had about a 20% chance of turning cancerous

    - One small tubular adenoma polyp, which probably had about a 5% chance of turning cancerous

    - One hyperplastic polyp, which was mostly harmless

    All four were removed, and fortunately none were found to have turned cancerous yet. This was my first colonoscopy, just a very short time before I turned 49. I do have a family history, with my paternal grandmother dying of colon cancer, and my father having numerous adenoma polyps since he started getting colonoscopies in the 1990s.

    Obviously I was going to need a follow up colonoscopy within 3 years, and could not take the 5-10 years that people can do in between when they have a clear result. With my results, it was clear I would be doing colonoscopies for the rest of my life.


    I thought I had until January 2024 to get this done, but it has since been recommended to me to get it done a little sooner, given both the family history and the not-so-good results of my first one.

    I wanted to continue with the same doctor, as I had a good experience with her and she is well regarded. Unfortunately, she switched medical groups. However, I saw my insurance covers her new group, so switching wasn't going to be a problem.

    I called last week about it and got a bad surprise cost-wise, and it turns out that follow-up colonoscopies are subject to what is kind of a billing scam. I will explain in my next post. Very disappointing.

    Due to my wifes mother having had colon cancer and her own history of polyps ever exam she as to get the hose job every year now as everytime they remove 2-4 polyps. Whats scary is I keep hearing more about cases of folks under 40 showing up with colon cancer. They mistake the blood in their stool for hemorrhoids alot of the time and just assume its a gas or bloating issue from bad food if they have periodic pain. One case I read about the assumption was that the person had poss diverticulitis or crohns turned out not to be the case.. Prime example was barely over 40 Chadwick Boseman who clearly had had problems for awhile before they found it unfortunately it still killed him

  11. #131
    Platinum ftpjesus's Avatar
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    Quote Originally Posted by Dan Druff View Post
    I was expecting all of my colonoscopies to be free, as this is supposedly one of the "benefits" of Obamacare individual plans. Note that anyone with an individual plan falls under the Obamacare umbrella, even if you're like me and don't qualify for any cost subsidy.

    Well, I was wrong about them all being free.

    Only the "preventative" colonoscopies are free, and you can do these at most once every decade. Once polyps are found, all future colonoscopies are billed one of two ways: Either "colonoscopy with polyp removal" or "high risk colonoscopy".

    What is the difference in these two procedures?

    Absolutely nothing!

    What is the difference in out-of-pocket cost for these two procedures?

    About 3x more for the "high risk" colonoscopy!


    So as you might imagine, many of these colonoscopy centers, which are run like a mill, will bill it as "high risk" simply to make 3x the money (both out of pocket and from insurance), because why the fuck wouldn't they?

    I haven't looked into why these two different categories exist in such a fashion to where it can be abused like this, but I've seen this situation many times before in medical billing. This is why the US needs major medical billing reform, and I don't mean socialized medicine. Socialized medicine would simply pass on these same fucked up bills to the taxpayer.

    I have an e-appointment with a different doctor at the same center. The one who will do my colonoscopy (the doctor from 2021) doesn't do Zoom appointments, so I will do the largely useless (but required) first Zoom visit with a different doctor. I was told that if I can convince him to code it as the first category (colonoscopy with polyp removal), then I will get the cheaper rate. Otherwise I will get the more expensive rate.

    Total bullshit to have to hassle with this type of crap. I don't even know what the other centers do. It's very possible they all pull this trick. If they refuse to code it the cheaper way, I will consider going elsewhere. The actual procedure won't be until September or October, so I have some time to look around.

    Note that I am not trying to go the frugal route. I'm not trying to convince them to do a lesser procedure when I need a more involved one. I wouldn't fuck around with my health like that. Here both categories are the identical procedure, just one costs three times as much as the other.


    MEDICAL BILLING = JOKE
    Agreed billing is a farce took over a year to get the billing for my 2 week stint in the rehab/nursing facility after my hospital discharge fixed and billed as my insurance kept kicking it out when I had full coverage for 30 days and was there only 13 i twas there damn BS that I ended up so they couldnt claim it was out of network either.

    I will say this though your insurance as some obvious issues if you have a family history and there has been previous polyps found your insurance should be eating the bill under preventative care almost entirely. I kinda assume you have one of those HDCP though which might change things (where you have to pay pretty much everything yourself until ya hit the cap and then they pay 100% beyond the 13k limit or whatever it is they set it at).

  12. #132
    Owner Dan Druff's Avatar
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    Quote Originally Posted by ftpjesus View Post
    Quote Originally Posted by Dan Druff View Post
    Five months after the procedure, these fuckers send me a new bill of $200 for the propofol.

    Here I thought I wasn't going to have to pay for it. Apparently the insurance deemed it unnecessary and refused to cough up the $.

    As I mentioned, this is a common issue, and in fact they had me sign an agreement to pay the $200 if this happened. So obviously I'm not in a very strong position here.

    I attempted to call the insurance and ask for them to make an exception and pay it anyway. I told them I have documented anxiety issues which made the propofol sedation essential, not just a luxury. They are considering it, and I'll find out (supposedly) next month.

    Pretty dumb how this isn't covered by most insurance, given that propofol usage for colonoscopies has become standard over the past 10 years or so.
    So your insurance thought you should be awake through the entire hose job up your ass?? Your insurance are a bunch of morons. Its standard procedure now. Used to be a demerol Valium cocktail years ago till they discovered the body doesnt clear Demerol at a proper rate.
    Yes, insurance is way behind the times on this one. It's funny how they will snap pay out expensive and scammy tests without batting an eye, but something standard like propofol sedation during colonoscopy they don't cover!

    Presumably I will have to fight this battle again when I get the bill for my procedure this fall.

  13. #133
    Owner Dan Druff's Avatar
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    Quote Originally Posted by ftpjesus View Post
    Quote Originally Posted by Dan Druff View Post
    I was expecting all of my colonoscopies to be free, as this is supposedly one of the "benefits" of Obamacare individual plans. Note that anyone with an individual plan falls under the Obamacare umbrella, even if you're like me and don't qualify for any cost subsidy.

    Well, I was wrong about them all being free.

    Only the "preventative" colonoscopies are free, and you can do these at most once every decade. Once polyps are found, all future colonoscopies are billed one of two ways: Either "colonoscopy with polyp removal" or "high risk colonoscopy".

    What is the difference in these two procedures?

    Absolutely nothing!

    What is the difference in out-of-pocket cost for these two procedures?

    About 3x more for the "high risk" colonoscopy!


    So as you might imagine, many of these colonoscopy centers, which are run like a mill, will bill it as "high risk" simply to make 3x the money (both out of pocket and from insurance), because why the fuck wouldn't they?

    I haven't looked into why these two different categories exist in such a fashion to where it can be abused like this, but I've seen this situation many times before in medical billing. This is why the US needs major medical billing reform, and I don't mean socialized medicine. Socialized medicine would simply pass on these same fucked up bills to the taxpayer.

    I have an e-appointment with a different doctor at the same center. The one who will do my colonoscopy (the doctor from 2021) doesn't do Zoom appointments, so I will do the largely useless (but required) first Zoom visit with a different doctor. I was told that if I can convince him to code it as the first category (colonoscopy with polyp removal), then I will get the cheaper rate. Otherwise I will get the more expensive rate.

    Total bullshit to have to hassle with this type of crap. I don't even know what the other centers do. It's very possible they all pull this trick. If they refuse to code it the cheaper way, I will consider going elsewhere. The actual procedure won't be until September or October, so I have some time to look around.

    Note that I am not trying to go the frugal route. I'm not trying to convince them to do a lesser procedure when I need a more involved one. I wouldn't fuck around with my health like that. Here both categories are the identical procedure, just one costs three times as much as the other.


    MEDICAL BILLING = JOKE
    Agreed billing is a farce took over a year to get the billing for my 2 week stint in the rehab/nursing facility after my hospital discharge fixed and billed as my insurance kept kicking it out when I had full coverage for 30 days and was there only 13 i twas there damn BS that I ended up so they couldnt claim it was out of network either.

    I will say this though your insurance as some obvious issues if you have a family history and there has been previous polyps found your insurance should be eating the bill under preventative care almost entirely. I kinda assume you have one of those HDCP though which might change things (where you have to pay pretty much everything yourself until ya hit the cap and then they pay 100% beyond the 13k limit or whatever it is they set it at).
    As I mentioned earlier in the thread, they have this backwards.

    "Preventative" in their eyes means nothing has been found wrong yet.

    "Diagnostic" means they have found adenomas or cancer in your colon -- either currently or in the past.

    I asked them last time, "If nothing has been found, what is it preventing?", and of course nobody could answer that.

    Anyway I have already conceded that I'll be paying 4-figures out of pocket for this upcoming procedure, but I'm not gonna pay that tripled "high risk" bullshit rate if I can help it.

  14. #134
    Silver Mission146's Avatar
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    You should start a GoFundMe; I bet you could pull at least 50k.

    In all seriousness, I hope everything goes well for you.

  15. #135
    Plutonium Sanlmar's Avatar
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    Propofal is the nuts. I wish I had a guy. Not kidding.

    Name:  325F84D6-CDEC-4B46-920B-016C45D41D92.jpeg
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  16. #136
    Owner Dan Druff's Avatar
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    Quote Originally Posted by Sanlmar View Post
    Propofal is the nuts. I wish I had a guy. Not kidding.

    Name:  325F84D6-CDEC-4B46-920B-016C45D41D92.jpeg
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    I despise the idea of being put out of consciousness. Fortunately I have only had that done to me twice in my life -- for oral surgery in 2002, and for my 2021 colonoscopy.

    Some people love the propofol and say that it's "relaxing", "euphoric", and "the best sleep they ever had". I do not like it. In fact, I had such a black, super-unconscious sleep that it kind of freaked me out when I woke up and thought about it. Seemed like that's what death would feel like -- just nothingness. It was different than normal, dreamless deep sleep, where I don't wake up with the same sensation.

    I have them use the propofol out of necessity, because there's no way I want to be awake during that uncomfortable shit, and any sedation would be even more unpleasant, as I do not like the feeling of being sedated.

    I will say that it's nice that I have whatever hereditary factor which prevents the burning sensation that most people seem to get from its administration.

  17. #137
    Owner Dan Druff's Avatar
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    BUMP

    Approximately 2 weeks away from my next colonoscopy. I loved the facility I was in last time, but sadly that doctor left the medical group, and now I'm going to a new facility to keep the continuity with the same doctor.

    I originally had an appointment for mid-October, but I changed it because I had a Vegas trip I didn't want to cancel (not kidding). If these 2 months caused me cancer, I'm going to feel really stupid.

    I did have a blood test about 2 weeks ago and did not see any signs of anemia, unlike last time. This makes it less likely I have a big or cancerous polyp, but it is likely polyps will be found again. My dad has had them at every single colonoscopy he's done, including this year.

    Not looking forward to it. In order of things I dislike about it, from worst to lesser:

    1) Being put under. Some people love it. I hate it, but it's necessary because the alternative is worse.

    2) The prep. I do the Gatorade one, so no terrible taste, but I do have to down 64oz of a Gatorade-Miralax mix which has a bit of a strange consistency. And then there's all the watery diarrhea, and finally a water guzzling session prior to cessation of all water ingestion for 4 hours prior to the procedure.

    3) The risk. Small, but real. One of those things where complications are uncommon, but can be deadly if they occur. That's why I'm sticking with the same doctor who has a good reputation.

    4) The aftermath. Last time I had pain which lasted for a week, which is uncommon and was potentially worrisome, but turned out to be nothing harmful. I attributed it to the large polyp being removed from the very end of my colon. The doctor could not explain the week of pain, as that usually indicates complications, but I didn't have any.

    5) The billing. I'm definitely going to be 4 figures lighter this time, as the "free" one only applies once per decade, and only if no polyps were previously found. I still could not get a straight answer as to what I'm going to pay at this new office. I gave up and will fight it out later.


    Would've been nice if I inherited my mom's genes on this and only had to do it once per decade, but that's not how it landed.

    At least no COVID test idiocy is required like last time.

     
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    Owner Dan Druff's Avatar
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    Quote Originally Posted by desertrunner View Post
    Druff- Would Gatorade Ice work?

    I'm going the desertrunner method this time and buying this today. Blue one kinda sucked 3 years ago, so I'm trying this instead.

  19. #139
    Flashlight Master desertrunner's Avatar
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    Quote Originally Posted by Dan Druff View Post
    I'm going the desertrunner method this time and buying this today. Blue one kinda sucked 3 years ago, so I'm trying this instead.
    Yes! I do like the red, orange and yellow flavors.

    Side note- Leaving for Vegas today, too bad we can’t meet up this trip.

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    Owner Dan Druff's Avatar
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    I am getting it with the same doctor, who unfortunately moved from a good facility to a crappy, disorganized medical group. Almost said fuck it and went elsewhere. Every time you call them, they transfer you to a "procedure line" where nobody ever answers the phone -- you just wait on hold endlessly until you hang up. Nobody calls you back if you leave a message. If you ask why this is the case, they claim "short staffed", but there are tons of complaints about this on review sites going back years, so it's bullshit.

    Only reason I'm going to this place is because I liked the doctor, and also want the continuity of doing it with the same doctor as last time. Really wish she hadn't left the last group, which had a great facility with very nice staff. A little disorganized too, but nothing compared to this fail facility.

    I got e-mailed the prep instructions today. Extremely different from last time, despite it being the same prep with the same doctor!

    I called today for clarification, and they couldn't explain it. I got some office employee without real medical knowledge, and they couldn't transfer me to a nurse.

    Most bothersome was the claim that you can't drink anything "after midnight", which is bullshit because my procedure is late morning. I asked how they can instruct "after midnight" when the premade instruction sheet doesn't know the specific time of my procedure, and they didn't have an answer for that (people can have them as early as 7am).

    Finally I got out of them that you can actually drink up to 4 hours before the procedure, which is exactly what I was told last time, and consistent with other stuff I found online.

    I'm basically trashing their prep instructions and doing the identical thing to last time, which worked great. I probably did over-drink water 4 hours beforehand last time, and apparently that's a little dangerous during the sedation to have done so, so I'll cut back this time on that. But everything else I'll do the same. It's the same doctor and the same prep type, and she was happy with my prep results last time, so why do anything differently?

    My prediction is 3 polyps, 2 being precancerous, but none being large, and none being worse than low-grade precancerous (tubular). Last time two were mid-grade precancerous, one of which was quite large. But that had a lot more time to grow, as my last colonoscopy was 35 months ago, so they should be smaller this time.

    Low chance they'll find it totally clear.

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