recent colonoscopy experience - page 11

I had my first colonoscopy last Friday. I am 46 and my mother has had two surgeries for colon CA, so I felt pretty good about being so responsible. I went to every website I could find and researched all aspects of the... Read More

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    Quote from caroladybelle
    Unfortunately, virtual colonoscopy is not an option for many of us, since biopsies cannot be done that way.

    Due to medical history, I get scoped every two years and biopsies must be done.

    True about it not always being an option, and it also doesn't bypass that "worst" part, THE PREP, which is still a necessary evil with the virtual colonoscopy.

    I don't recommend the virtual to my friends, but I do recommend they do not just take their chances with "anyone" as I did, but that they check around and find a kind, caring and compassionate physician to do the job. That's what I feel I learned from my bad experience.

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  2. 0
    I've had two colonoscopies before in the past--the 1st time showing polyps which were removed & biopsies. I now have to go q3 yrs. I remembering waking up both times during the procedure but only briefly.

    The worst bit for me was the prep. Now if I can just convince my sister to go!
  3. 0
    For those of you who have encountered pain during colonoscopy, you really should read the two abstracts I've given the URL for below. Then get the full articles and give them to your gastro!!!! I first gave my gastro the abstracts and then later, to reinforce my message, the full articles. Her scoping skills have improved dramatically and she is slicker than snot on a doorknob maneuvering that scope thru my colon now.

    I no longer have a bruised feeling in my abdomen for several days after a scope, I do not have sedation or anesthesia for my scope. I have just 25 mg Demerol and, if the vagus nerve gets in a twit at the transverse colon/hepatic flexure area, a little Phenergan to stop the resulting dry heaving. My gastro does use a pediatric scope and frankly, altho I haven't convinced her of it, I think the peds scope is more likely to cause the vagus nerve twit than if she used the adult scope due to the peds scope being more flexible and thus more likely to loop back on itself.

    Since our hospital's outpatient endo department equipment doesn't have the capability of producing a video tape of the procedure my gastro has agreed to my bringing my video cam in and videotaping the monitor during the procedure. For those of you who would really like to watch but really doesn't want to endure any discomfort from the procedure this is the ideal solution.

    A Study of Pain During Colonoscopy

    <http://www.e-health-questions.info/html/board/index.php/action=displaythread&forum=boweldisorders&id=12&re alm=default>

    Why Colonoscopy Is More Difficult In Women

    <http://www.e-health-questions.info/html/board/index.php/action=displaythread&forum=boweldisorders&id=13&re alm=default>

    From the Journal of The Royal College of Surgeons of Edinburgh, here's an article by a "teaching colonoscopist" that details the whole procedure, including some of the things that can go wrong. It's called, How I do it, by A. LESLIE and R.J.C. STEELE, University Department of Surgery and Molecular Oncology, Ninewells Hospital, Dundee DD1 9SY, U.K.

    <http://www.rcsed.ac.uk/journal/vol47_2/4720010.html>
  4. 0
    Quote from CrohnieToo
    For those of you who have encountered pain during colonoscopy, you really should read the two abstracts I've given the URL for below. Then get the full articles and give them to your gastro!!!! I first gave my gastro the abstracts and then later, to reinforce my message, the full articles. Her scoping skills have improved dramatically and she is slicker than snot on a doorknob maneuvering that scope thru my colon now.

    I no longer have a bruised feeling in my abdomen for several days after a scope, I do not have sedation or anesthesia for my scope. I have just 25 mg Demerol and, if the vagus nerve gets in a twit at the transverse colon/hepatic flexure area, a little Phenergan to stop the resulting dry heaving. My gastro does use a pediatric scope and frankly, altho I haven't convinced her of it, I think the peds scope is more likely to cause the vagus nerve twit than if she used the adult scope due to the peds scope being more flexible and thus more likely to loop back on itself.

    Since our hospital's outpatient endo department equipment doesn't have the capability of producing a video tape of the procedure my gastro has agreed to my bringing my video cam in and videotaping the monitor during the procedure. For those of you who would really like to watch but really doesn't want to endure any discomfort from the procedure this is the ideal solution.

    A Study of Pain During Colonoscopy

    http://www.e-health-questions.info/h...&realm=default

    Why Colonoscopy Is More Difficult In Women

    http://www.e-health-questions.info/h...&realm=default

    From the Journal of The Royal College of Surgeons of Edinburgh, here's an article by a "teaching colonoscopist" that details the whole procedure, including some of the things that can go wrong. It's called, How I do it, by A. LESLIE and R.J.C. STEELE, University Department of Surgery and Molecular Oncology, Ninewells Hospital, Dundee DD1 9SY, U.K.

    http://www.rcsed.ac.uk/journal/vol47_2/4720010.html
    CrohnieToo:

    I am in absolute awe of your communication skills with your gastroenterologist! The "How I do it" article seems to have a lot of good advice. His scope appears to be better than what was used on me, which had an eyepiece and was probably not variable stiffness. I doubt that my doctor ever backed out the scope to reduce looping. If this had occurred, I should have noticed a reduction in pain. I was glad to see that suctioning out the excess fluid and gas is a recommended technique. Although my doctor did this, many apparently do not.

    My main concern now, is that in retrospect, no one provided me with adequate information, even when I expressed concerns that should have indicated the need for additional information. Informed Consent was never discussed with me. In my letter to the doctor, I requested the same sedation as I had for the EGD, which was 2 mg Versed and 50 mg Demerol. If the doctor had told me the initial dosage for the colonoscopy would be 1 mg Versed and 50 mg Demerol, then I would have had the nerve to just request more Demerol later on, since I still wanted to remember. I only found out about this after I requested my records from the hospital.

    Especially troubling to me now is that when the nurse who was assisting the doctor came out to get me, she asked me to remove my glasses. I explained that I had written to the doctor about wanting to watch the procedure, but had not yet heard his answer. She showed no expression at this reply; just indicated I could keep my glasses, but warned they could get bent. A month later, I realized she had to have known in advance, since she injected a portion of both syringes without checking with the doctor about the dosage.

    My concern for the future is that even after telling everyone I want to be an informed patient; that I want all of the information to which I am entitled, it will still be an uphill battle to get the necessary information. Perhaps the best approach would be to say up front that while the treatment of my bad GI bleed was perfect, we need to work on patient information and scope technique. This gives everyone another chance, and I can always go elsewhere if this approach is not well-received.

    Michael E. Shultz
    mshultz@valkyrie.net

    "Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read."
    Groucho Marx
  5. 0
    Actually, Mike, I can't take all the communication skills credit. My gastro has been a saint putting up with me at times. And we have had our "differences"! It was fortunate that I first met her BEFORE I needed a gastro. My stepmother was bleeding out from unrecognized stomach ulcers and we were in ER. My gastro was heading home for the day and was virtually grabbed by the arm and asked to do an emergency endoscopy. She was so patient w/my stepmother and so gentle, she didn't kick me out of the treatment room, I was able to watch on the monitor as she found the three large areas of bleeding and "zapped" them and stopped them from bleeding. It was fascinating to watch and she was so gentle and aplogetic to my stepmom that she wasn't able to sedate her before or during the procedure. I knew then that when and if I needed a local gastro this would be the one.

    Actually, our relationship hasn't always gone smoothly! I had attempted a long reply to your post regarding my first two colonoscopies but it got lost in cyberland and I didn't feel like re-typing the entire thing again.

    My gastro does her procedures at our local hospital's outpatient Endoscopy unit and I think, other than an exceptionally large gastro clinic w/many gastros in practice, that that is a positive thing as they have more and better equipment, etc. available.

    Frankly, I've never been quite sure WHY they administer Demerol for the Endoscopy. Are they sometimes painful for people? I wouldnt think so except in the case of a dilatation. But what do I know? I can understand the use of the Versed due to the gagging reflex that occurs. However, as much as I HATE gagging and dry heaving I still prefer my upper scopes w/o sedation as well.

    I don't remember if I mentioned it or not, but my gastro actually underwent both the upper and lower scopes w/o sedation herself after I gave her those two articles and she now agrees with me, the upper scope is the worst due to the gagging.

    I never request or suggest a specific amount of sedation or analgesic. That is rather overstepping the bounds as they are the doctor. BUT certainly providing them with the doses and meds used in previous comfortable and satisfactory scopes as well as the doses and meds used in previous unsuccessful or unsatisfactory/incomplete scopes is well within good taste AND good common sense.

    You said: [Quote - A month later, I realized she had to have known in advance, since she injected a portion of both syringes without checking with the doctor about the dosage. - Quote]

    Not necessarily so, nor likely. They are given written orders included right in your chart. The forms in the chart are in order used, i.e. your written consent to sign, the procedure being done, written orders, etc. thru to your recovery vitals, etc. and take home instructions plus charge sheets for materials, meds, etc. used during the procedure as the last form.

    You also said: [Quote - Perhaps the best approach would be to say up front that while the treatment of my bad GI bleed was perfect, we need to work on patient information and scope technique. This gives everyone another chance, and I can always go elsewhere if this approach is not well-received. - Quote]

    I agree. One step at a time. As I said, my gastro and I have had our ups and downs. Its a wonder she has put up with me at times. On the other hand, I have threatened to cancel and walk out on a procedure whilst in my hospital gown on the table. I even went to Mayo Clinic in MN when I "knew" my Crohn's had returned after a long remission when she was convinced I had IBS and I had my Mayo report sent to my family doctor, not her, and ignored her for months until SHE approached me at the hospital. She just asked me how I was doing, but had to leave the elevator she had been waiting for to do so, and I told her I had been to Mayo and was doing well. She said she would like to see the Mayo report and that ended my "twit" and everything was fine between us again. (The Mayo report verifying my Crohn's had returned provided me with an "I told you so" w/o my having to say a word - wicked, satisfied smile). I do think, tho, that my gastro is an unusually good and considerate doctor as well as a gastro. She was a very well loved family practioner before deciding to go into gastroenterology. I've told her more than once she is too good and caring doctor to be "wasted" in a specialty and SHOULD still be a family doctor. At Christmas time I usually take a shrimp cocktail plate or Jimmy John's sub platter or cracker, beef stick and cheese platter to her office for her and her desk dragons to enjoy to show my appreciation.
  6. 0
    Mike, I knew there was something else I wanted to mention and forgot: I'm glad you took the time to read the "How I Do It" article as well as the two abstracts. We really don't know what questions to ask sometimes, at least those of us who are really interested and want to know about the "mechanics" of what can be expected during a procedure unless we have done our research and have a fairly good idea of just what is involved. Then we have a tendency to blame the doctor for not explaining things to us when something doesn't go quite as expected. Not every patient, in fact, few patients, want to know almost every little detail. Most are satisfied with a broad overview of a procedure. For those of us who are nosey enough to want to know exactly what to expect or be prepared for it becomes our responsiblity to search for and find as detailed descriptions of the procedure we will be undergoing as we can so that we can formulate the appropriate questions for our doctors to answer.
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    Quote from curleysue
    Spaniel-

    PS.. Everyone gets nervous before these types of procedures but you should be fully aware that they will not allow you to be uncomfortable. IF you feel pain during the procedure everything will be stopped and you will be medicated. No worries
    I'm sorry, but this is not true in all cases. I've had two colonoscopies, felt them both, had versed/demerol. I Remember the burning of the cauterizing from removing a polyp. I was crying out and begging them to stop, They did NOT stop, they just keep saying "you're doing fine, we're almost done" , etc.

    I am going back in 2 weeks to schedule my 3rd one, but we are going to talk about different route of sedation.

    I am only 35, but due to my medical hx, I have to have a colonoscope done every year.:uhoh21:
  8. 0
    Quote from RN2Bn2006
    I'm sorry, but this is not true in all cases. I've had two colonoscopies, felt them both, had versed/demerol. I Remember the burning of the cauterizing from removing a polyp. I was crying out and begging them to stop, They did NOT stop, they just keep saying "you're doing fine, we're almost done" , etc.

    I am going back in 2 weeks to schedule my 3rd one, but we are going to talk about different route of sedation.:uhoh21:
    I would agree that you insist on another form of sedation for future colonoscopies. BUT - just as important, or even more so, I would find myself another gastro (assuming you are using a gastro and not a general or colorectal surgeon). When I say "stop" the sheister darn well better stop! There is the old saying: screw me once, shame on you; screw me twice, shame on me. WHY on earth would you give this inconsiderate, totally uncompassionate doctor a third chance to do your colonoscopy????????????
    That's masochistic! Surely you must be aware of the increased risk of perforation, etc. when a patient is struggling with pain during a scope! I would dump this dolt in a heartbeat!!
  9. 0
    She is a gastro, and was highly recommended. To tell you the truth - i felt like that all scopes are probably painful if people were aware of them - I was just one of the unlucky people who the demerol/versed did not work and was aware of what was going on. She said during the last one that my BP had dropped, so they could not give me a larger dose. I think they probably thought I would not remember the pain. I have been in with a patient during a procedure, that hollered out, but did not remember anything once she fully awoke. I on the other hand remember alot! As for having it done the second time, I talked to her about the pain during the 1st one, and she said they would give me more medication - then when it actually came down to it - they couldn't. I still think she is a good doc, just I am a difficult case, and need to be approached differently! Either that or maybe I'm just stupid! :uhoh21:





    Quote from CrohnieToo
    I would agree that you insist on another form of sedation for future colonoscopies. BUT - just as important, or even more so, I would find myself another gastro (assuming you are using a gastro and not a general or colorectal surgeon). When I say "stop" the sheister darn well better stop! There is the old saying: screw me once, shame on you; screw me twice, shame on me. WHY on earth would you give this inconsiderate, totally uncompassionate doctor a third chance to do your colonoscopy????????????
    That's masochistic! Surely you must be aware of the increased risk of perforation, etc. when a patient is struggling with pain during a scope! I would dump this dolt in a heartbeat!!
  10. 0
    No, you're not stupid. If you have that much faith in your gastro then she can't be all bad nor as bad as I pictured her given your first description of your experience.

    I would seriously discuss with her using propofol (diprovan) for your next procedure. At our hospital outpatient endoscopy unit that is considered general anesthesia and an anesthesiologist must be called in to administer it. It is short acting so recovery is quick. They also use either fentanyl or alfentanyl for the analgesic in our unit if they use propofol, I've forgotten which. From reading posts in this forum, evidently in some states nurse anesthetists are allowed to administer propofol.

    I would just be sure to discuss alternative sedation/anesthesia and analgesia with your gastro now and come to an agreement what will be used next time AND THEN BE SURE to remind her when scheduling EACH future procedure and the staff prior to the procedure, especially the day of the procedure, what was agreed upon and why.

    Good luck and God bless.


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