Colonoscopy & Conscious Sedation - page 4
Help. I am an RN, 51 y/o and family hx of colon cancer. I'm scheduled for next week. GI Doc is insisting on sedation for the procedure. After extensive reading I can find no valid reason for... Read More
1May 20, '09 by mwalsottI just had my first colonoscopy. I am posting because I had been petrified about having one for years due to the sedation everyone said I had to have.
Well, I couldn't convince them to do the procedure without any sedation, so I just hoped for the best. They used propofol and my insurance covers an anesthesiologist. I did much research on propofol and, although there is no reversal agent yet, the reviews were very favorable.
So I had it at 8 this morning and I am here to say that it was a breeze. I was worried and anxious over nothing. I was out for just a few minutes while the doctor went into my colon, then they brought me around to watch the withdrawel of the scope and the cutting of the polyps. (I did have 6 tiny ones.) It was a simple, easy experience, I recovered immediately. Was a little groggy so took a nap for an hour and woke up fine. All in all, I started to undress at about 8:20 and was in the recovery room just before 9.
The prep was absolutely horrible. I would not recommend Golytly. It is vile, repulsive, poison, no matter what you use as a flavor enhancement. Next time I am going just with pills. I also recommend eating very lightly for a few days beforehand because I know my expulsion ran clear faster than had I been eatig as usual.
0Jul 27, '09 by jbmurrayThere are some modest studies, via Google (ask "acupuncture for colonoscopy") that showed some positive results in relief of fear and pain associated with colonoscopies.
I have benefited from Acupuncture with pain reduction for knee problems (and complete relief from seasonal allergies)
Does anyone onboard know if anyone is using Acupuncture as a type of anesthesia for colonoscopies? Thank you
0Aug 3, '09 by jbmurrayAnyone on board have info about the use of acupuncture for pain managemet/anxiety control during a colonoscopy?
Acupuncture has a long history of anesthesia use, esp in China, and is becoming more mainstream for use in certain conditions (personally had good pain relief for knee pain due to torn meniscus).
I am not an acupuncturist...I am due for a colonoscopy, have had prior colonoscopies...I doubt it is done, but am posing the question.
2Aug 4, '09 by darne20JB-I have had acupuncture a number of times for dental surgery in the Far East and it worked great; I'm no expert but I would guess that it could be used for endoscopy as well, but I doubt that you have an easy time finding an endoscopist who will take the time to consider your request. I had a difficult time finding someone who would even do an unsedated colonoscopy (even though this is the safest option and the norm in most parts of the world); it seems like most GI docs are interested in the assembly-line approach to this procedure and do not appreciate a patient who wants to participate in his or her care. Three GI docs whom I spoke with "insisted" on sedation (they usually use midazolam) initially; when I told them that I was a hospital pharmacist they immediately changed their tune and acknowledged that a fair number of patients have fairly terrible experiences with midazolam and that they would personally only have the exam with propofol or even unsedated. And everyone admitted that drugs increase the chance of peroration (you won't get perforated if you are unsedated and probably won't with accupuncture either), but this option is a "secret" because it takes a few minutes longer to do the exam. If this sounds like a dismal assesment of the usual way that colonoscopy is performed in this country, it is. Not a rant against midazolam (versed), which has way too many problems to be so widely used, but it's criticism of a lack of informed consent and cost-containment at the expense of patient care. I did find a wonderful GI doc who did the exam unsedated; I'm sure that she would let you do it with accupuncture if you wanted to bring the acupuncturist...but doctors like her are few and far between. Read the anesthesia section on allexperts, Dr J. Starkman's comments to a colonoscopy sedation with midazolam question..his comments about "weeklong amnesia" etc. ring all too true with the patients whom I talk to. You are not unreasonable in requesting alternatives to the sedation drugs currently being used for colonoscopy. Not by a long shot. Good luck.
0Aug 4, '09 by jbmurraythanks for such a excellent review/response to my query. I am not having much success in matching an acupuncturist with a GI doc, and I am seeking info from both fields...I will keep you informed if I find items of interest.
1Jun 20, '10 by RobertxQuote: "it seems like most GI docs are interested in the assembly-line approach to this procedure and do not appreciate a patient who wants to participate in his or her care. Three GI docs whom I spoke with "insisted" on sedation (they usually use midazolam) initially; when I told them that I was a hospital pharmacist they immediately changed their tune and acknowledged that a fair number of patients have fairly terrible experiences with midazolam and that they would personally only have the exam with propofol or even unsedated. And everyone admitted that drugs increase the chance of peroration (you won't get perforated if you are unsedated and probably won't with accupuncture either), but this option is a "secret" because it takes a few minutes longer to do the exam. "
This is the word that needs to get out. Versed is way over used and barbaric. I wish this drug were outlawed. It has been in a few hospitals and some doctors will no longer use it. It will NEVER be used on me or anyone I care about. As was mentioned, it is so widely used in colonoscopy because the doc wants to rush through it. Its like herding cattle all day.
0Jun 20, '10 by CrohnieTooIn our area our gastros see patients in their office ONE DAY a week! Three days a week they are doing scopes at one of two local hospitals and a free standing endosocpy facility. None are available on Fridays. If they insist on two "well visits" a year w/their patients WHEN does that leave them TIME to ADEQUATELY treat their Crohn's disease patients w/active disease or patients w/other disorders who need attention NOW or at least w/in a reasonable 2-3 days wait???
0Jun 23, '10 by jbmurrayThank you to robert and chronie,
In over a year, I have not been able to find anyone who will allow an acupuncturist to do any treatment during a colonoscopy.
I have refused Versed, after one experience with it, and it was not explained to me that I would lose memory of the procedure. I was home, and had to call the office to ask - how did the scope go? am I ok? When I learned that Versed caused me to be so unknowing - I would not take it again, as I am a single individual who has no family.For a subsequent procedure, I have met with doctors who exclaimed: refuse Versed? you are much stronger than I am...I would never do that, etc.
In one situation where I refused Versed, I asked for Demerol instead...They said they gave it, but it didn't help at all. The doc was angry..."next time we will put you under anesthesia"....And I won't do that, surely...
This bulletin board helps me remain steadfast in my determination to be as much of a self-advocate, as I can be, in this wide world of health care.
0Aug 14, '10 by johnvaljonHi Nurses,
I am not a nurse but read your thread and thought you might be interested in my take on this topic. I'm a 52 year old man who had his first colonoscopy yesterday. I did not know the doctor but as he was about to sedate me I asked if he could give me a low dose so that I might watch part of the procedure on the monitor. I told him I was very interested in being awake and observing. To my surprise, he asked me if I wanted to try the procedure without sedation and that both he and the assisting nurse had done it. I said sure and he assured me all I had to do was ask and he would turn on the IV sedation. While the procedure was quite uncomfortable and at times down right painful, I totally enjoyed the experience. I know it probably took him a little extra time and I thanked him for it. I will also write my primary care doc and tell him how much I appreciate the GI doc and his willingness to work with me. He used CO2 gas and I was very comfortable within a few minutes of the removal of the scope. Both he and his nurse were very supportive throughout the entire experience and I will recommend him to my friends who need the 50 year old checkup.
0Aug 19, '10 by classicdameCongrats! Now you have a clean bill of health (I HOPE!) and bragging rights to boot.
1Sep 24, '10 by peaparamedicI wanted to add my experience from yesterday to the pile. I recently turned 50 so my PCP recommended a screening colonoscopy. No colon CA in my family hx but enough other neoplastic problems to convince me that it was a good idea. I'm a 50 y/o/m RN, EMT-P. I don't like sedation or pain meds stronger than tylenol. Had it for my wisdom teeth extraction years ago and still remeber the nauseated groggy feeling. The center I use doesn't offer propofol. I did a lot of research and decided to do it without any meds.
The 225G miralax and ducolox tab prep was miserable.
I showed up for my appointment and announced that I didn't want the versed/fentanyl. They looked at me like I had three heads. It was way outside of their box. They said it had been done but was very rare. The RN went off to talk to my MD. She came back and told me the Doc would do it but I sould at least have an IV loc in case it was needed during the procedure. I didn't have a problem with that. Other than some cramping and pressure, the procedure was quite tolerable. I worked hard at relaxing. I watched the whole thing on the screen and asked several questions. The staff commented it was odd to have an interactive patient. Lots of bloating cramps when it was over. I obtained instant relief from flatulance that would make a state-fair cow proud. I left the office in two hours feeling great. Don't have to do that again for ten years.
0Sep 24, '10 by FranEMTnurse, LPN, EMT-IAll of you who can tolerate Versed in order to have a colonoscopy performed are fortunate. I'm not even able to have one even though my grandmother had colon cancer.
0Nov 2, '10 by Tess SweeneyI have been in GI nursing sine 1989. Rarely are there sedation problems on a patient in generally good health. Everyone has different anatomy. I have seen a ccum reached in a minute. I have seen a tortuous colon that is difficult to navigate and take longer to reach te cecum. You ultimatly hav the decision. I have had the experience of a GI doctor refusing to do a patient not sedated. Good luck to you! Tess