[CrohnieToo]

CONGRATULATIONS, dbmc, and GOOD ON YOU for lodging the complaint! Thank you for doing so. I only wish more patients would do so when the encounter such an experience!!

[dbmc]

How could I not report it? I didn't want anyone else to go through what I did! I'm not one to hold a grudge, but to this day I would love for those nurses to look me in the eye and tell me why they didn't stop that doctor...

[suanna]

Its amazing how many replies are posted to this question- do all nurses have a colonoscopy? My doc wants me to be scoped every 2-3 years-I've had 4 so far. The posters that say the trick is to find a doc that isn't afraid of medicating are right- I don't remember a thing. It helps to tell your doc your expectations- for me "more narcotics less benzos" I dont want to forget the pain I don't want to feel it to start with. Besides narcotics are easier to reverse if they do knock me too far out. Interesting to note, in most of the world a colonoscopy is not a sedated proceedure. We are spoiled in the USA in that we "waste" all that money sedating patients for this proceedure. All I can I'g glad I live in a wasefull country.

[CrohnieToo]

Originally Posted by suanna

... Interesting to note, in most of the world a colonoscopy is not a sedated proceedure. We are spoiled in the USA in that we "waste" all that money sedating patients for this proceedure. ...

It is not so much a matter of "pansy" Americans needing sedation and analgesia as it is a matter of US doctors not taking the TIME to properly do a colonoscopy. It takes considerably more time to use less air, to proceed slowly w/the scope and to stop when the scope shaft loops back on itself to pull it back and straighten it. I have my colonoscopies w/o sedation by choice. I do have a light dose of Demerol. But my gastro is caring and considerate of my wishes in this respect. It also takes her considerably longer to do my scopes because of no sedation. I enjoy watching the monitor and REMEMBERING what I saw. "Our" problem area is the transverse colon, I never have even discomfort at the sigmoid colon or the splenic flexure. Due some Crohn's disease scarring the ileocecal valve can be a bit of a challenge but no more than discomfort.

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.
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum


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.
http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus

Colonoscopy How To
http://www.rcsed.ac.uk/journal/vol47_2/4720010.html

[BSN74]

I have had Ulcerative Colitis for 32 Years. I am supposed to have colonoscopies every year or two for the rest of my life. I was so scared it took me 20 years to ever have a colonoscopy. Back then, the doctors all refused to do anything other than light sedation. They said I would be awake. I knew I could not stand this. I was terrified. I went from MD to MD and got the same information. I finally got so distraught because I had to have them for the rest of my life because of the cancer risk, but I could not stand it, but I had to have it, but I could not stand it etc.etc.etc.

Finally, I went to a Psychiatrist. I knew she was paid to listen to me. I told her all about it. She immediatly said "why don't they just put you to sleep?" I said "Yeah, why don't they? I've been trying to get them to for 10 years." She called a collegue who was a GI. He saw me the next day, and did the scope two days later. I knew NOTHING.

Today, they seem to care more. At my every-other-year scope last week, I just mentioned past trauma in the holding room and I could see them thinking about how to help me.

Here is what I do:

Ask for MAC (Monitored Anesthesia Care)

Ask for something (about 2mg Versed) in the IV as soon as they get it in.

I tell then I don't need to see the endoscopy room.

Last week, a CRNA with a college do-rag on his head showed up in the holding room and WHOMP it was over and they were telling me to get up and get dressed. Thanks to short-acting Propophol, I could. We stopped off at Chili's on the way home. The next week, all biopsies came back negative.

I feel cheated because of the 10 years I lost being terrified. It was on my mind almost every day. That was when my children were little. I remember them missing the fair one year because of an insensitive doctor.

Just some words from a long time Ulcerative Colitis sufferer who has had many colonoscopies every other year and will for the rest of my life.

[careerchoices]

Originally Posted by CrohnieToo

It is not so much a matter of "pansy" Americans needing sedation and analgesia as it is a matter of US doctors not taking the TIME to properly do a colonoscopy. It takes considerably more time to use less air, to proceed slowly w/the scope and to stop when the scope shaft loops back on itself to pull it back and straighten it. I have my colonoscopies w/o sedation by choice.

I would rather NOT be sedated; I am allergic to Fentanyl (not a full anaphylactic rxn yet, but I've done vomiting, been told that I am allergic by an anesthesiologist and ended up in the ER twice after procedures on a nebulizer) and I get bad post-procedural depression from Versed. But my doc (colorectal surgeon) always forgets, and then argues with me because he is afraid if I'm not sedated, it will slow him down too much. He does not say that outright, but makes comments about the "tight schedule" until I give in.

[CrohnieToo]

Originally Posted by careerchoices

... But my doc (colorectal surgeon) always forgets, and then argues with me because he is afraid if I'm not sedated, it will slow him down too much. He does not say that outright, but makes comments about the "tight schedule" until I give in.

Tell him T++++H S++T! and to H++L w/his precious schedule!! Get another doctor, and probably better to get a gastro than a colorectal surgeon. YOU are the one who endures the benefits and/or consequences of any procedure, test or treatment. WHY give in to some egotistical, insenstive surgeon?? YOU are paying HIM whether out of pocket or thru your insurance. The doctors I've ever encountered who thought they walked on water, fell flat on their faces when walking on ice.

[mshultz]

Originally Posted by careerchoices

I would rather NOT be sedated; I am allergic to Fentanyl (not a full anaphylactic rxn yet, but I've done vomiting, been told that I am allergic by an anesthesiologist and ended up in the ER twice after procedures on a nebulizer) and I get bad post-procedural depression from Versed. But my doc (colorectal surgeon) always forgets, and then argues with me because he is afraid if I'm not sedated, it will slow him down too much. He does not say that outright, but makes comments about the "tight schedule" until I give in.

I agree with CrohnieToo's advice. My doctor, a general surgeon, did not use abdominal compression, nor did he withdraw the scope a bit to resolve looping. It was really painful, but the pain was not nearly as bad as the creepy amnesia after I requested more drugs (I had asked to watch).

In addition, I have a concern about your doctor "forgetting" your request. This sounds like passive-aggressive behavior to me. My rules on passive-aggressive behavior:
1. Never, never, never, ever engage in passive-aggressive behavior.
2. To the greatest extent possible, avoid people who do engage in passive-aggressive behavior.

[CrohnieToo]

Another alternative you might want to discuss w/your NEW doctor who will be doing your scopes is the use of Propofol (Diprivan) for your scopes. Whilst you won't be awake to watch as you'd like to be, it is short acting and you wake up ALERT and AWARE and NOT so confused you can't remember a thing the doctor said to you after the scope.

Whenever my gastro and I have agreed on "sedation" for an endoscopy (the upper endoscopy is the worst of the two w/o sedation due to my STRONG gag reflex) my gastro has allowed me to bring my video cam and one of the staff videos just the monitor during the scope from insertion to withdrawal. Its almost as good as being awake and alert during the scope - except you can't ask questions during the scope. My gastro is great about pointing something out, like the psychodelic "yeastie beasties" I had once after using a steroid inhaler; an internal hemmorrhoidal skin tag or a diverticulum, etc. during the lower scope, whatever.

My last upper endoscopy my gastro w/her neat sense of humor (and the staff) took a quick video of me laying there w/my mouth open w/the "dumb" sedated look and the staff all around my head grinning and waving and saying "hi, we're ready to start". I haven't figured out yet what I'm gonna do to "get even" w/those clowns! But I'll think of something before my next scope.

[myschief1]

Most of our GI docs are using NAPS (nurse administered propofol sedation) and it has decreased our patient complications and increased patient satisfaction. It is still controversial, but NAPS is gaining approval as we collect more and more evidence supporting this practice.