Quote from serialmom12
Yes you can and you SHOULD refuse sedation for a colonoscopy!!!! This is NOT a painful procedure at all. I've had two of them done by two different doctors and I told them both up front that I absolutely refuse to be sedated for this short procedure. Your colon has no nerve endings so how CAN you feel pain? The only uncomfortable thing about the procedure is when the Dr puffs air into your colon, but it's not painful, just uncomfortable. I had a very small amount of Demerol for both procedures like 25-50 mgs, just to take the edge off. I watched both of them on the monitor and even pointed out when I saw something that I wanted my Dr to go back and recheck. The nurses in the room the first time tried to force me to take Versed (I had it once before and it has ruined my life totally, memories are gone...years of memories, and I was left with PTSD from the incident, stopped breathing and almost died.) I wear a medic alert bracelet now at all times stating that I'm allergic to this poison that should be banned for use on humans. I told the nurse finally that if she came near my IV with Versed that both the syrnge and she would be picked up and bodily thrown into the wall....and then sweetly asked "was I making myself clear?" (The Dr then told her...hey don't mess with this one, she means what she says!!)
I even watched as the dr removed a 5mm precancerous polyp...totally painless. That is why I had to go back for another c-word a year later, which came out clear thank god.
If the Dr won't do the procedure w/o sedation, find another Dr. The ones that insist on it, I'm totally suspicious of, they are NOT looking out for their patients, and just want to cover up with a memory loss drug incase they screw up and can rush through the procedure and onto their next victim.
One thing I wanted to inform everyone about this procedure is to ALWAYS insist that your Dr use a pediatric scope for this procedure. Your chances of a colon perforation are quadrupled when the dr uses and adult sized scope, and they're so large that they often miss small polyps. Also ask of their track record. The two dr's that I used in St Pete and Clearwater had perfect records, never perforated anyone's colon during the procedure and both were caring and took their time to be thorough.
I figured if I can have dental work done w/o novocaine and two nine-pound babies w/o any drugs that the c-word procedure would be OK...and it was. Feel free to email me if you'd like the Dr's name or the prep that they used. The one actually allows the patient to eat breakfast AND lunch. Neither one made you drink the Golitely or Nulitely...that stuff tastes like peed in ocean water...you throw up more than you can swallow which totally defeats the purpose.
So much incorrect information:
1. The colon does have nerve endings. The colonic mucosa does not, which is why you do not need additional pain medication for a biopsy or polypectomy. There are tons of studies on pain scales during colonoscopy and comparative studies on colonoscopy vs. CT colonoscopy or BE. The pain ratings go all the way to the top suggesting this is a very painful procedure for some people. Concern over pain or inadequately treated pain is a common reason for people not getting their colonoscopy. To suggest that the colon does not have nerve endings is factually incorrect.
2. Statistically Demerol is a much more dangerous drug than Versed (even if they were in the same class of drugs). It can cause seizures and Serotonin syndrome. As an analgesic it is less effective than virtually all other narcotics. Most hospitals have banned it except in the case of rigors because of these problems. Its main advantage is that it dries up secretions which makes the endoscopy easier.
3. There have been a number of studies on pediatric vs. adult scopes. There is probably some advantage in using long pediatric variable stiffness scopes in female patients (especially if they have had a hysterectomy). For males (especially young males) there are advantages to a long adult scope. For most of the rest it probably doesn't matter. Most GIs are probably using peds scopes for the variable feature not for the diameter. The physician should use the scope that is most appropriate for the situation.
4. Perforations. As a consumer you have no way of independently confirming the perforation rate of a gastroenterologist. Complications from colonoscopy occur between 3 and 5/1000. Perforation rates are around 1/1000. Perforation rates during polypectomy can be as high as 11/1000. Statistically if a gastroenterologist has done more than 10,000 colonoscopies they most likely had a perforation. If someone claimed that they had no perforations they are either very lucky or I would be concerned that they were not recognizing complications.
Colonoscopy is not risk free. Any procedure should have a full explanation of the risks and benefits. If someone has concerns over a part of the procedure that should be brought out into the open. However, the benefits of colonoscopy outweigh the risks in terms of colon cancer prevention.
David Carpenter, PA-C