[n577450]

hi methylene and thanks for your response. Unless sedation is used, or if the patient is dehydrated from the prep (some are), the IV is not necessary. Othewise everyone geting a flex (same prep as colonoscopy at my hospital) and they sure don't administer oxygen and go thru the excessive monitoring that is usually done for colonoscopy. Most, if notall of this is due to the sedation, And most "adverse events" associated with routine colonoscopy are due to the drugs. If a patint's has a vaso-vagal episode, any nurse can respond. no patient needs a pulseox since the only reason that they are going to desaturate is from the drugs. I respect your opinion and you are obviously a skilled, caring practitioner. So am I (or at least I have been told that I am), but from what I have seen of colonoscopy sedation, I am scared to death..............

[n577450]

I thought that I was home free with getting thid colonoscopy without sedation; here in pittsbugh, I worked with an anesthesia doc whom I really trusted and he said that sedation was optional and that propofol for most people was indeed overkill. He called me a few months ago to remind me that I needed to get the exam and that he would talk to the GI dept and tell them that he was willing to "stand by" and basically do nothing as far as sedation was concerned. A real friend; I finally got up the courage to schedule the exam and go the same BS about conscious sedation; when I told them that the head of the anes dept at a major hospital here in Pittsburgh PA said that no sedation was O.K., everyone got cooperative. Then mentioned his name and they told me "he's no longer available"...so like an idiot, I called his home (he gave me his number.....)..he comitted suicide las month...........somehow, someone is trying to tell me that this colonoscopy is a bad idea........I lost my only advocate,

[CrohnieToo]

I went thru similar my first colonoscopy. I had been adamant for a couple of years that I would NOT undergo colonoscopy w/sedation. No sedation or no scope. My gastro finally consented when I provided her w/two articles found thru PubMed regarding pain during colonoscopy verified via real time imaging during the scope.

Yet when I got into the procedure room the nurse insisted on the IV and we got into a pretty heated discussion so I cancelled the procedure and started to get off the table. My gastro was brought in and convinced me to allow the IV for the fluids alone and agreed there would be no sedation. We proceeded w/the upper endoscopy first. No pain but the gagging was MOST unpleasant.

However, when we "reversed" to do the colonoscopy we again got into a heated discussion regarding sedation and again I told them I was outta there and proceeded to get off the table, IV and all. My gastro returned and after further discussion I agreed to the procedure WITHOUT sedation.

It was somewhat uncomfortable thru the sigmoid, then fine up the descending colon, a bit uncomfortable again at the splenic flexure, then okay to about midway thru the transverse colon. Each time we encountered the discomfort the nurse and my gastro were "on me" strongly encourging me to accept sedation, interrupting my concentration both on the monitor and in trying to relax.

I finally made the mistake of agreeing to "some" sedation just to shut them up and let me concentrate, I was quite adamant, only a little bit, I want to watch. I felt a bit of a sting at the IV - and then all h*ll broke loose. This colonoscopy was an incomplete.

To this day when I see that nurse in the hospital hallways my antagonism returns. I detest her w/a passion. I fight the urge to stick my foot out and trip her. There was no excuse for her pushing the full dose so fast. None! And yes, I had the feeling I'd been "kicked in the gut" for 2-3 days after the procedure. To say nothing of the anger I felt. It was years before I would agree to another colonoscopy.

When I did finally agree to another, it was to be w/o sedation. I'm so dehydrated from the prep each time that I "have" to have the IV fluids but I've not been bashful about telling each and every person who comes anyhere near me IF I receive ANY sedation at all I will sue. Now, we all know, I would have no grounds to sue unless I were to experience severe complications. But I could and would make life mighty darn miserable for all involved including the facility.

My gastro deliberately went thru an upper and lower scope w/o sedation and agrees w/me now that the upper is the worse w/o sedation due to the gag reflex. My scopes are now done w/o sedation. The scopes are discomfort free until we hit the mid to distal transverse colon. I swear mine must flex down to the bladder!!! My vagus nerve gets into a twit and I start gagging and they have to give me a little phenergan, the gagging stops and we proceed. It is time consuming and uncomfortable getting around that hepatic flexure and then we are home free until the ileocecal valve where it is again somewhat painful but, stop and relax for a minute, a few deep breaths and we continue. And I get to see it all on the monitor and am fascinated by what I see.

Now - if we could just figure out how to do a "virtual" prep!!! Most definitely the worst part of the colonoscopy!!!

But bear in mind - I do NOT have any colon involvement! My Crohn's is confined to the mid-ileum and a new area just out of the reach of the scope a bit closer to the ICV. IF one does have colon or rectal involvement then I would strongly suggest one give serious consideration to propofol or some form of sedation. Understand that the interior of the colon has no pain nerves, one would not feel polyp removal, BUT the air stretching the circumference of the colon, the scope shaft looping back on itself stretching the circumference of the colon CAN be painful. A doctor in a hurry or lacking the skill and patience to use as little air as possible and sensitve to the shaft looping back on itself can be guilty of performing a very painful colonoscopy.

Endoscopy 2002 Jun;34(6):435-40
Patient pain during colonoscopy: an analysis using real-time magnetic
endoscope imaging.
Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP.
Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, London, United Kingdom.
PMID: 12048623 [PubMed - indexed for MEDLINE]

Gastrointest Endosc 1996 Feb;43(2 Pt 1):124-6
Why is colonoscopy more difficult in women?
Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, Williams
CB.
Department of Endoscopy, St. Mark's Hospital, London, England.
PMID: 8635705 [PubMed - indexed for MEDLINE]

[SeaGirl]

I read this forum over the weekend--I had my first colonoscopy on Monday. I just want to thank everyone here for the information!

I'm 35, but with a family history of colon cancer and several troubling symptoms (anemia, visible blood in stool), I finally quit stalling and had the procedure done. The dr. found several small polyps and one big, scary looking one that she's fairly certain is pre-cancerous (I'm waiting for lab results).

My biggest fear was having to take versed--I hate, hate, hate amnesiac type drugs. They cause me to be severely depressed afterwards. Thanks to this discussion thread, I was able to ask for pain medicine only--an option that I didn't know existed.

I was polite but firm with my dr. (a woman by the way) and the nurses, and they were totally cool with me doing fentanyl but not versed. They even made a allergy bracelet for versed, and voluntarily took it out of the procedure room to reassure me. They were clear to me--this was my procedure and they would do it however it worked best for me.

I'm glad I had the fentanyl. The first part, where they guided the 'scope up through my colon, hurt pretty badly, but then I was relaxed and okay. It was cool watching the procedure and being able to talk to the dr. about what she was doing.

I also had regular fluids delivered via IV during the procedure--a good thing, since I was mildly dehydrated.

Afterwards, both the dr. and nurses were super-nice to me. The doctor said that if I'd waited until I was 50, or even 40, to get screened, I likely would have full-blown colon cancer. I feel like I got a free pass.

For the person on this forum who's having a hard time finding a good dr.--I hope you keep trying.

[CrohnieToo]

Congratulations, SeaGirl, on sticking to your guns, on encountering a good gastro and great endoscopy staff and mostly on getting that scope done in time!

[n577450]

Too many people are harmed by Versed; it's a memory (mistake) eraser and the amnesia haunts many people for a long time. I am shocked by how many times anesthesia or procedure docs try to sneak this terrible garbage into the IV mix. DO NOT sign the anesthesia consent agreeing to "anything"; write in NO VERSED" and make the MD (not a nurse) sign, date and print his/her name.

[tntrn]

I'll be having my 4th colonscopy in September; Had my first at age 45, as my mother had just been diagnosed with colon cancer. My doc knows that he's not allowed to touch me until I have as much medication as is necessary to make sure that I don't remember a thing. He also knows he can play music, even bad music, tell jokes, even jokes about me, and that's perfectly okay, as long as I don't remember any of it. No drugs, no scope.

[hypocaffeinemia]

Originally Posted by n577450

Too many people are harmed by Versed; it's a memory (mistake) eraser and the amnesia haunts many people for a long time. I am shocked by how many times anesthesia or procedure docs try to sneak this terrible garbage into the IV mix. DO NOT sign the anesthesia consent agreeing to "anything"; write in NO VERSED" and make the MD (not a nurse) sign, date and print his/her name.

Versed isn't "terrible garbage"--it's an incredibly useful drug. If you don't like it or can't tolerate it, that's fine-- list it as an allergy; but it works effectively for the majority of people and is wonderful at what it does.

When you use langauge like "try to sneak into the IV mix" I can only assume you do not work in a healthcare profession as this is quite a distorted view of what happens and how decisions are made.

[CrohnieToo]

I have to agree w/you, Methylene. And I'm one who has had an adverse reaction to Versed. Nothing really serious, I get agitated and then HOSTILE. But I've seen it work for my husband and for two friends who I've driven for when they had their scopes. The one is a REAL WORRIER and would be a basket case w/o the Versed. She also has a very low threshold for pain. She has problems w/many meds but she sure does love that Versed for her scopes and has no problems w/it at all.

[n577450]

Originally Posted by CrohnieToo

I have to agree w/you, Methylene. And I'm one who has had an adverse reaction to Versed. Nothing really serious, I get agitated and then HOSTILE. But I've seen it work for my husband and for two friends who I've driven for when they had their scopes. The one is a REAL WORRIER and would be a basket case w/o the Versed. She also has a very low threshold for pain. She has problems w/many meds but she sure does love that Versed for her scopes and has no problems w/it at all.

hey-read a few responses:midazolam is either given to patient's as a memory eraser or even if they are told that it won't be used, it is indeed "snuck into the mix". read Versed Busters.com. my credentials: considerable, at least involving conscious sedation and I trusted every CRNA and anesthesia doc that I have met over the last 53 years..until now. Versed is terrible, if you like it fine: some people like the amnesia of drinking until they pass out..trouble is.. with versed the amnesia may be perm...if you want versed, get it, son't get lied to. My doc said that she "would never consent to Versed"..her job is "too important as far as short and long-term memory"...............just the facts............