recent colonoscopy experience - page 14

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... Read More

  1. by   CrohnieToo
    Check out these articles:

    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]

    Especially try to get the full article of that first abstract. Its an eye opener.
  2. by   CrohnieToo
    Since you had been having some problems in the days immediately preceding the colonoscopy that might account for both the less than satisfactory sedation AND for some of the prolonged pain you are encountering. There might well have been something going on in the colon to contribute to the sensitivity and pain you are still encountering. Your scope report should answer some of this. I would certainly get a copy of the report from Medical Records/Health Information Management.

    I'd be inclined to ask for the full record, including Nurse's Notes, etc. Curiosity killed the cat and I like to have the full recorded info on hand when I talk to the doctor about something I wasn't happy with.
  3. by   nursebabygirl 08
    Quote from mat/childnurse
    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 procedure (patient teaching, videos of colonoscopies, personal experiences, etc.) I also spoke to several people who had gone through the procedure recently including my husband and my OB/GYN. I felt very well informed and more than educated about what would happen, what I would see on the screen, and how it would feel.
    I was given Versed 2 mg and Demerol 50 mg IVP and the doctor waited until I assured him that I was groggy. Everythiing went just as I expected until just after insertion when air was instilled into my colon. I experienced some of the worst pain I have ever felt. The doctor immediately instructed the nurse to give me "25 more" which I assumed meant more Demerol. He continued the exam with me moaning in pain. I felt every mm. of my colon being blown up and navigated. I tried to watch the screen because I was
    really interested to see my own colon after viewing so many others in my preparation for the procedure. The pain was practically unbearable. Since then, I have had trouble concentrating and sleeping because I keep reliving this scene. I feel so duped and betrayed. All of the instructions and testimonials I read stated that there is little dicomfort and the Versed gives the patient amnesia to any discomfort that may occur. I have lamazed three children and had I known ahead of time, I would have gotten into a breathing pattern and anticipated the pain. I will know better next time. And as a nurse, I will return in 5 years because of my FH.
    I guess what I want from you guys is some validation that indeed this does occur occasionally and that I'm not alone in this experience.
    Thanks for your input. Sorry about the length of this, but I needed to vent!

    Mat i am a GI nurse and your experince is NOT normal!!! do you take narcotics? sleeping meds? anxiety meds, or meds for depression? All the meds i just listed can effect how "well" you tolerate sedation. At my office we use fentanel standard dose 50-100 mcg and benadryl (for those hard to sedate). Oh yeah and do you drink alcohol on a daily basis? We have noticed that people who drink daily are unlikely to have desired effects from sedation. Did your doc wait before sticking that colonoscope up your butt? recommended time lapse from drug administration to scope entrance is 2-3 mins. (some docs don't give the meds time to work).I'm sorry that you had such a horrible experince. Maybe you should have your next procedure done at you local hospital; that way you could recieve propofol. You may have Min discomfort from the air used within the colon, but from what your saying something is not right, i hope that your next experince is a better one.
  4. by   Mersa59
    Quote from mat/childnurse
    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 procedure (patient teaching, videos of colonoscopies, personal experiences, etc.) I also spoke to several people who had gone through the procedure recently including my husband and my OB/GYN. I felt very well informed and more than educated about what would happen, what I would see on the screen, and how it would feel.
    I was given Versed 2 mg and Demerol 50 mg IVP and the doctor waited until I assured him that I was groggy. Everythiing went just as I expected until just after insertion when air was instilled into my colon. I experienced some of the worst pain I have ever felt. The doctor immediately instructed the nurse to give me "25 more" which I assumed meant more Demerol. He continued the exam with me moaning in pain. I felt every mm. of my colon being blown up and navigated. I tried to watch the screen because I was really interested to see my own colon after viewing so many others in my preparation for the procedure. The pain was practically unbearable. Since then, I have had trouble concentrating and sleeping because I keep reliving this scene. I feel so duped and betrayed. All of the instructions and testimonials I read stated that there is little dicomfort and the Versed gives the patient amnesia to any discomfort that may occur. I have lamazed three children and had I known ahead of time, I would have gotten into a breathing pattern and anticipated the pain. I will know better next time. And as a nurse, I will return in 5 years because of my FH.
    I guess what I want from you guys is some validation that indeed this does occur occasionally and that I'm not alone in this experience.
    Thanks for your input. Sorry about the length of this, but I needed to vent!
    Mat do not let anyone tell you what you felt was secondary to you doing something. I have combed thru the research, the reason most folks get sedation of some sort, is because the colonoscopy is not a comfortable test. I have read that many patients complain of pain and do not feel like they were adequately sedated. some even call versed the worst drug and are telling folks not to have it.
    My Gi told me the best thing to have is Propofol.
    I believe her, after reading about patients who write in and complain of the pain they felt with other forms of sedation.

    first of all women are harder to scope.
    if you have had abdomiinal surgery it is even harder.
    the pressure of the streatching of the bowel causes pain and if the scope is advanced and coils, or hits the wall of the intestine, especially at the bends and curves...it causes pain.
    I am no wimp, I have been thru more than I can put in here and without meds.
    If I woke up with propofol, in pain, and found myself moaning and hollering out, I will tell you, it is painful. I do not use narcs, benzos and I do not have a drinking problem or history.
    neither did many of the patients who wrote in about their experiences.
    they too were made to feel they did something wrong. or the problem was theres, not the doc, not the proceedure, not the sedation or pain med they were given.
    something aint right in Demark......too many complaints of similar to the same sort of thing,
    if you plan to have another one. ask for propofol, you may still wake up and feel discomfort/pain.
    some folks do and some do not.
    My brother claimed he slept all the way thru.
    I did not.
    Other follks I know who have had these proceedures, also say they hurt, there is pain without adequate sedation. They too are not useing meds, alcolhol and so on.
    best wishes to you if and when you have another one down the road.
    mersa
  5. by   hot flasher
    Perhaps you can request having MAC anesthesia. The GI Lab where I work are doing more and more cases every day utilizing an anesthesia provider that will administer Propofol and I can assure you, you would not feel or remember anything. This drug is amazing...patients are "out" but maintain their own airway. The beauty of it is that it has a very short half life and patients awaken very quickly after. It is extremely rare for a patient to have any memory of the procedure and I have not heard any complain of pain. We still do one day a week without anesthesia assistance, where an RN administers Fentanyl and Versed, and even with that, depending on the skill of the GI practitioner, we have rare complaints of discomfort. While I realize that everyone has an individual pain tolerance, and reaction to drugs, it still has as much to do with the skill and technique of the doctor, as it does any of those other factors. I have been doing this for a very long time and know this to be true.
  6. by   CrohnieToo
    Quote from hot flasher
    ... While I realize that everyone has an individual pain tolerance, and reaction to drugs, it still has as much to do with the skill and technique of the doctor, as it does any of those other factors. ...
    Amen! That is soooooo true, HotFlasher! Thank you.
  7. by   Mersa59
    [quote=hot flasher;3002586]Perhaps you can request having MAC anesthesia. The GI Lab where I work are doing more and more cases every day utilizing an anesthesia provider that will administer Propofol and I can assure you, you would not feel or remember anything. This drug is

    Flasher,
    they used Propofol. I was out and remember nothing about the endoscopy.
    I woke up however during the colonoscopy, at various times.
    so it may work if enough of it is given to keep one out the entire time.
    but that is not what occured.
    thanks.
    mersa
  8. by   theofour
    I had a colonoscopy and upper endoscopy on June 25th. The Versed they gave me had very little effect as I have a high tolerance to Valium. They took me into the procedure room and hooked up my IV. The doctor had previously decided to use "MAC" monitored anesthetic care where they knock you out completely using Propofol. he didn't even give me a choice.
    Thinking back on it, he probably did it to make the procedure easier for himself rather than me. No having to listen to moans and groans or dealing with the patient squirming around. I hear these procedures under conscious sedation can be very painful. But they want more people to go for the test so no matter where you read about it they always say that that it's "somewhat uncomfortable". That's why they use Versed. To wipe your memory of the procedure and the pain. It helps protect the doctor from being sued.

    They didn't even warn me that they were about to knock me out. I was awake one second and then I was awakened by motion of the gurney. The nurse saw me open my eyes and said in a cold, uncaring, indifferent, I say this a hundred times a day manner, "the procedure is over and you're in recovery." Then she walked away.

    I felt like nothing had been done. I suppose that's a good thing. No throat pain from the upper endoscopy in which they took one biopsy from my stomach and one in my duodenum, although later when I read the nurses report "gagging" was noted. No pain in my butt area. No passing gas. No burping or bloating. No nothing. The only evidence that something had been gong on around my butt area was when I reached back there and felt some lube around my anus.

    The main thing I regret is not being conscious to witness the procedure on the monitor. I think I am going to ask for conscious sedation next time WITHOUT the Versed for wiping your memory. I want pain killers only. Will they do this? Am I making a big mistake about this? I have an insatiable curiosity and feel that I WANT to experience the procedure and see my innards "live". Pictures later just don't do it. Can't they have the IV set up so that if I am in too much pain I can say, "I give up! Knock me out!"?

    I don't like the idea that I was completely gone for 45 minutes and feel as though I have been intimately violated. I feel like the 45 minutes that I was gone was just like being dead. If I HAD died, I never would have known the difference! I sure hope there's more to death than that "nothingness"!
    To sleep, to sleep, perchance to dream.
  9. by   CrohnieToo
    If you weren't passing gas I'd say your doctor was probably very conscientious! Not only must he have not gotten carried away w/insufflating the colon during the scope, he must have been very conscientious about "sucking out" as much of the air as he could.

    I agree it would have been nicer if they had advised you, "We are going to start your anesthetic now". But you can mention you'd like to be advised next time.

    Yes, you can request that your procedure(s) be done next time w/o conscious sedation and request just analgesia for discomfort or pain. It is your right as a patient to make that request. BUT you should discuss this w/your doctor before hand.

    No one can determine before hand whether it would be a mistake to ask for pain control only and no sedation. You won't know until you try it. Your doctor should be made aware of your tolerance for Valium as that could well apply to Versed as well since they are related drugs. I'm not sure how long it takes for propofol to take effect should it turn out that you need more than just analgesia. Nor am I sure about the willingness to have an anesthesiologist "standing by" just in case he/she might be needed. On the other hand, some states don't require an anesthesiologist for the administration of propofol. This is all something that needs to be discussed and decided and arranged for ahead of time since it is not the usual procedure for scopes.

    I will tell you that the upper endoscopy is MUCH WORSE than the colonoscopy w/o sedation. NOT because of pain but because of the extreme gagging. It WILL bring tears to your eyes!

    I totally understand your resentment of having 45 minutes of your life just taken, stolen, from you. And I understand your curiosity and wanting to see for yourself. We are kindred spirits!!!

    One thing you could consider that might be more comfortable: if you have a video camera, ask if the MONITOR can be videoed during your procedure(s) from start to finish. That would require consent by both your doctor AND the hospital or facility. But some do allow it upon patient request, doctor approval and the patient providing the camera and tape or disk. There are even a few progressive facilities that have the equipment to provide a video if the patient provides the disk. But they are few and far between. I've done this as well as had both upper and lower procedures w/o sedation and just analgesia for the colonoscopy.
    Last edit by CrohnieToo on Jul 30, '08
  10. by   theofour
    Please send the quick reply back to me that I sent about my gastroenterologist and the upper and lower scopes that were done. I replied to the wrong spot. Send it to sparkyfour4@mac.com

    thanks
  11. by   theofour
    Sorry, still learning to use this site.
  12. by   theofour
    I had a colonoscopy and upper endoscopy on June 25th. The Versed they gave me had very little effect as I have a high tolerance to Valium. They took me into the procedure room and hooked up my IV. The doctor had previously decided to use "MAC" monitored anesthetic care where they knock you out completely using Propofol. He didn't even give me a choice.
    Thinking back on it, he probably did it to make the procedure easier for himself rather than me. No having to listen to moans and groans or dealing with the patient squirming around. I hear these procedures under conscious sedation can be very painful. But they want more people to go for the test so no matter where you read about it they always say that that it's "somewhat uncomfortable". That's why they use Versed. To wipe your memory of the procedure and the pain. It helps protect the doctor from being sued.

    They didn't even warn me that they were about to knock me out. I was awake one second and then I was awakened by motion of the gurney. The nurse saw me open my eyes and said in a cold, uncaring, indifferent, I say this a hundred times a day manner, "the procedure is over and you're in recovery." Then she walked away.

    I felt like nothing had been done. I suppose that's a good thing. No throat pain from the upper endoscopy in which they took one biopsy from my stomach and one in my duodenum, although later when I read the nurses report "gagging" was noted. No pain in my butt area. No passing gas. No burping or bloating. No nothing. The only evidence that something had been gong on around my butt area was when I reached back there and felt some lube around my anus.

    The main thing I regret is not being conscious to witness the procedure on the monitor. I think I am going to ask for conscious sedation next time WITHOUT the Versed for wiping your memory. I want painkillers only. Will they do this? Am I making a big mistake about this? I have an insatiable curiosity and feel that I WANT to experience the procedure and see my innards "live". Pictures later just don't do it. Can't they have the IV set up so that if I am in too much pain I can say, "I give up! Knock me out!"?

    I don't like the idea that I was completely gone for 45 minutes and feel as though I have been intimately violated. I feel like the 45 minutes that I was gone was just like being dead. If I HAD died, I never would have known the difference! I sure hope there's more to death than that "nothingness"!

    To sleep, to sleep, perchance to dream.
  13. by   mshultz
    theofour:

    Wow, I could have written your thoughts on amnesia and death myself. I never really expected to find someone who relates to me so well. Your description of the creepy amnesia as a violation is exactly how I interpret it.

    I am a Christian. I do not expect heaven to be a physical place, with physical bodies, but I certainly hope to continue to exist in some manner.

    I described my colonoscopy experience on page 3 of this post. That post is a little out of date, since I have requested my medical records since then, and have a lot more knowledge (courses in addiction, medical terminology, biological aging, gerontology, and pharmacology).

    I was given 2 mg of Versed and 50 mg of Demerol for my EGD, with no effect. The Cetacaine throat spray eliminated any problems with gagging.

    The initial dose for my Colonoscopy was 1 mg Versed and 50 mg Demerol. After I asked for more drugs, I was given the remainder in the syringes, for a total of 3 mg Versed and 75 mg Demerol. There was no pain relief, just that creepy amnesia. I regained the ability to remember a few minutes before I was moved out of the recovery room. The nurse did not speak to me when she moved me. Since my coworkers do not remember the recovery room, I assume she did not think I would remember.

    My doctor, on the other hand, does his best job of providing patient information while the patient is under sedation. He never met with me prior to either procedure, nor was any kind of detailed description of the procedure provided to me. He told me the results immediately after each procedure. Because I was not actually sedated for the EGD, I remembered his talk, and when he asked if I wanted pictures, I of course said Yes. There was no follow up talk about the results.

    I do not remember anything said to me after the colonoscopy, and if he offered to provide a picture, I was too drugged to say Yes. The nurse told him that I wanted to speak to him before I was released. He was apparently surprised that I did not remember. I was not even told that a picture was taken.

    They removed the excess air and fluid from my colon, as the nurse said they would. This was good, because I saw a lot of fluid, along with some fecal matter, during the part I was able to watch. Passing gas might have been a messy and embarrassing experience. Someone did wipe my anus, but I don't remember that part. I hope you washed your hands after you felt your anus

    I believe Versed is given for the following reasons:

    1. Many people do not want to remember. I can accept this, but I will never be able to relate to that.

    2. Versed is supposed to relieve anxiety. If I experienced that, I do not remember due to the creepy amnesia.

    3. There is this belief that pain is not real if it is not remembered. I disagree, and anyway, the creepy amnesia is far worse than the pain, and while the pain is temporary, the creepy amnesia is unfortunately permanent. I do have a lot of sympathy for those suffering PTSD from painful procedures, however.

    A couple of my coworkers described their amnesia as "The best sleep I ever had." To each his own. "Different strokes for different folks. And so on and so on, and scooby dooby dooby."

close