Dr. Hall graduated from Indiana University School of Medicine in 1984 and completed her Family medicine Residency in 1987. During her residency she spent time at Kendrick Hospital (now St.Francis of Mooresville), learning how to do colonoscopies. She was one of the founding members of Kendrick Colon and Rectal Associates p.c. From there she left to help form American Health Network, a large group of primary care and specialty physicians practicing in Indiana and Ohio. In addition to her clinical practice, she has served on numerous local, state, and national medical organizations. Currently she is the President of the Indianapolis Medical Society Foundation.
Before you or a loved one undergo a colonoscopy you should ask your doctor 3 questions.
Most polyp detection and removal occurs when the colonosccope is being withdrawn from the patient. The “Exit Time” describes how much time the doctor spends actually looking for polyps. This is a specifically measured time. If they do not quote a number greater than 6 minutes, I would consider looking elsewhere for my colonoscopy. Remember you do not want to pay for a “fast” colonoscopy you want to pay for a “good” colonoscopy. An adequate Exit Time does not guarantee a good colonoscopy but an inadequate Exit Time may rob you of a good colonoscopy! Dr Hall’s average Exit Time is 11 minutes and 20 seconds.
At a very minimum, Twenty-five percent of men and fifteen percent of women will have precancerous polyps (adenomas) on a screening colonoscopy. If your doctor is not finding adenomatous polyps at this minimum then you need to look elsewhere. Dr Hall's precancerous polyp detection rate for screening colonoscopies is 73%. This statistic was calculated using the last three years of insurance data and is not simply a self reported figure. When doctors quote their adenoma detection rate make sure that they are giving you a true value and not just a self reported figure. Dr. Hall's detection rate is almost triple the minimal standard! Dr. Hall attributes her extraordinarly high adenoma detection rate to several factors. Foremost, when she is examining your colon she does not rush. She studiously looks at your colon like she wanted her colon examined. Secondly, her patients understand the importance of the colon prep. The colon prep is routinely described as the worse part of the exam. However, if the prep is poor the exam is substandard and polyps can go undetected. As unpleasant as the prep is, it is as important as the doctor you choose to perform your colonoscopy.
Unarguably the worse part of a colonoscopy is the colon preparation! However, if it is not done correctly the whole exam is a waste! New literature suggests that the colon clean-out needs to be in 2 divided doses. The second dose acts like the rinse cycle. Recently, there has been discussion that flat lesions were being missed in the right colon. The divided prep rinses mucous off the right colon; so, these lesions are easier to see and remove. Splitting the dose does not require the patient to drink more. It is just a better use of the prep that the patient is already going to take. Your doctor is not doing you any favor if they do not split the dose!
These questions signal to your doctor that you are an informed consumer. The goal of a screening colonoscopy is to find and remove pre cancerous polyps before they develop symptoms and cancer. Assuming you are not at increased risk for colon cancer, the time frame for colonoscopy is every 10 years. So when you have a colonoscopy you want to make sure that your physician is serious about doing a good job because it may be a decade before you get your colon examined again.
There are many options for colon health and Colorectal Cancer screening. Dr. Hall will discuss those choices with you and help you determine the best method to examine your colon. We believe that most Colorectal cancer is preventable. It appears that Colorectal Cancer requires a non-cancerous abnormality like a polyp or Ulcerative Colitis before cancer develops. Because Colorectal Cancer is so common, (the second leading cause of cancer death), the American Cancer Society recommends people get screened for the PRE-cancer. The goal is to catch every patient before cancer begins growing in the pre-cancerous lesion.
A slender flexible tube is inserted in your rectum and your colon is examined under direct visualization. Polyps or abnormalities are removed at the time of the exam.
|PROS:||Direct visualization of the colon. Polyps can be removed the day of the exam. If normal exam, then it does not need to be repeated for 10 years.|
|CONS:||Complete colon prep required. Preformed with sedation.|
A slender tube is inserted into your rectum and the lower 1/3 of your colon is examined in the office without sedation. If abnormalities are found, then a colonoscopy will be scheduled on a different day.
|PROS:||Does not require a complete colon prep|
|CONS:||Does not examine the entire colon. No sedation is used. If pathology is found, a colonoscopy will be required at a later date|
White chalky liquid and air are pumped into your rectum and multiple x-rays are taken. If abnormalities are found, then a colonoscopy will be scheduled on a different day.
|PROS:||Usually views the entire colon|
|CONS:||Not good at finding small abnormalities. No sedation is used. Patients usually find this to be the most uncomfortable exam. Complete colon prep required. If pathology is found, a colonoscopy will be required at a later date|
Air is pumped into your rectum and a CAT scan is taken. If abnormalities are found, then a colonoscopy will be scheduled on a different day.
|PROS:||Usually views entire colon. Does not require sedation.|
|CONS:||Can miss small or flat abnormalities. Complete colon prep required. If pathology is found a colonoscopy will be required at a later date. Insurance may not cover the procedure.|
A home stool test, done yearly, to detect blood in the feces. If blood is found a colonoscopy is indicated.
A new home stool test that actually looks for DNA that a cancer sheds in the feces. If this test is positive then a colonoscopy is indicated.