recent colonoscopy experience - page 2
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
Aug 21, '03Could have been the versed. Makes me vomit like all get out. So much they told me to write it down as an allergy.
Aug 21, '03Originally posted by LibraSun
Will tell you why later, but I want to ask you :
Are you a redhead?
(NO, I wasn't there at the procedure!)
Thanks for sharing your experience. I usually tell my patients that they may experience mild discomfort with this procedure and that most people tolerate it very well. I will now keep in mind that this procedure can be painful. I am glad you will follow up with your next colonoscopy but am sorry it was such a bad experience. I too would have had nightmares. I had a c-section years ago that was painful and the recoverery full of complications. It was so traumatic and most people report that they were up on their feet with good results shortly after the operation. It stinks to be in the percentage of people in which things do not go well.
Aug 21, '03The topic of redheads and anesthsia has come up before on these boards. (See:[url http://allnurses.com/forums/showthre...light=redheads[/url] )
I did a quick Google search by typing: "Redheads and pain tolerance" and found a number of references and articles about them and anesthesia resistance. Here's one that starts out:
"If you're a natural redhead facing surgery, you may want to have a chat with your anesthesiologist before heading for the operating room.
A new study finds you're likely to need more anesthesia when you go under the knife than do people with other hair colors. Researchers at the University of Louisville discovered that, on average, people born with red hair require about 20 percent more anesthesia to obtain satisfactory sedation."
And here's another article from "Health and Age" website, but the link doesn't work:
Red Hair and Anesthesia?
July 15, 2003
I read your news item on anesthetics with red haired people. I have red hair myself, and eight years ago I had an unpleasant experience: I was having a C-Section and was advised to opt for an epidural, but it wouldn't work properly. I was a full hour with the anesthetist and he could not get me completely numb; the operation went ahead, but they had to put me fully asleep. Can you let me know more on this topic?
If you have red hair, you might want to talk to your anesthesiologist before having surgery - and request more anesthesia! A study has shown that women with naturally red hair require up to 20% more anesthesia than dark-haired women. Researchers administered a commonly used inhalation anesthetic, desflurane, to 20 women (10 redheads and 10 non-redhead controls) between the ages of 19 and 40 years. The researchers then gave small electric shocks to the anesthetized women to measure their pain response. Compared to the non-redheads, the redheads required more anesthesia to reach what the experts judged an "optimum" dose. The optimum dose was determined by the amount of anesthesia needed to suppress movement in response to the small electrical shocks. Because this is a small study and only women were tested, more research needs to be done before generalizations can be made. Everyone has a unique response to pain. Something that is unbearably painful to one person might be only mildly painful to another.
Attention to pain may also influence the perception of that pain. Redheads, however, apparently feel pain more than most other people because of a quirk of genetics that is linked to having red hair. Anesthesiologists had anecdotally noticed for decades that redheads seem to require more anesthesia during surgery, but this is the first study to show it actually is true. The study was done by Daniel Sessler, a professor of anesthesiology at the University of Louisville, USA.
Oct 18, '03Originally posted by 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!
Nov 2, '03I was reading your message and felt so bad for you. I am a Registered Nurse working in an Endoscopy Center. Our patients come in so nervous and leave with a big smile on their face and can not believe what a pleasurable experience they have had. We no longer use Demerol and Versed. We use an anesthetic agent called Propofol (Diprovan). We now have Anesthesiologists on board with us who administer the drug and within seconds, the patient takes a nap. The drug has such a short half life, so is administered prn throughout the procedure to keep the patient comfortable. So, on your next visit for your colonoscopy, ask about Propofol. It works so well for the patients, especially females who have had abdominal surgeries and have many adhesions. Good luck. Any questions, let me know.
Nov 9, '03I work in a GI unit and we use versed and demerol for sedation. by far, most patients report two things: first, they don't recall any discomfort; and second, that the entire expierience was better than what they had expected.
That being said, I have seen patients who had a very uncomfortable expierience. Some were clearly in pain but did not recall it and others recall everything. Your expierience is not very uncommon, but it isn't everyday either. You need to discuss your expierience with your doctor before your next colonoscopy and with the nurse who will be administering the medication immediately before the procedure. Perhaps your doctor and you can opt for general instead of sedation. If sedation is the route that is decided on, letting the nurse know about your expierience will enable him (her) to advocate for increased medication at the begining of and during the procedure.
I hope this helps. You are certainly not alone in your expierience and hopefully you won't have another bad expierience.
Nov 9, '03My doc told me he wanted me to be awake to talk with him. Was awful and I do not plan on having another one.
Good information on the alternative meds/ways to do the test.
Dec 5, '03I have had 2 colonoscopies and both were extremely painful. I was in so much pain they were not able to complete either exam. I had them about 10 years ago when I was experiencing some intestinal problem that tentatively got called Crohn's.
The first time, I figured it was because my bowel was inflamed, but the second time I was a lot better. I don't know what they gave me, but it didn't work. I still have vivid memories of the pain. The second time I was in so much pain, I was screaming. That had to have been a comfort to the patients waiting their turn! I know they turned up whatever it was they were giving me, and the pain eased....but then the nurse started telling me to breathe, remember to breathe, and they turned it back down. The pain and screaming returned.
I know I should have another, due to my age and previous condition, but I fear it on 2 grounds. One I am afraid of going through the agony again, and more importantly, I don't want to die on the table with a glorified light cable up my rear.
I heard recently of the virtual colonoscopy and I may eat the cost if my insurance won't pick it up and my doctor tells me I need to have one.
I am glad to hear that I am not the only one who has had such horrible experiences. Actually I'm sorry anyone else has had to go through it, but I'm glad I ain't crazy.
Dec 25, '03I'm an RN who has worked Endo for 8 years. The vast majority of our patients do very well with Versed and Demerol. I can't tell you how often the patients ask me "when are we going to start?" as I'm removing the blood pressure cuff and ekg patches.
Unfortunately, there are the few who don't respond as well to moderate sedation and experience extreme discomfort and remember the whole thing. I sure don't have any explanation for this. As a general rule, younger patients need more medication for sedation....but not always. I think 2 of Versed is a little on the light side....it's very common for me to get 5 or more of Versed.
For whatever reason, I think nurses are harder to sedate. I can't explain it, but I'm not the only one who has commented on it.
I've noticed that our physicians are using alot more MAC anesthesia in the last few months. Today I had a male patient who had been sexually molested as a child and was a nervous wreck about the procedure. We had an anesthesiologist administer sedation....versed, fentanyl, and diprivan and the guy did great. I don't think this patient would have been adequately sedated with Versed and Demerol.
Anyone who has had extreme pain during a colonoscopy should discuss alternatives with his doc. And if the doc doesn't take you seriously then find a new doc.
Sorry you had such a miserable experience. I hope it's better next time around.
Dec 25, '03I will have to be in serious health trouble to have another procedure like that again LOL.
Very good thread and I am glad it is active again. A split mix of who had horrible pain vs no pain at all.
Jan 23, '04Observation: the propaganda that is offered on flex sig and colonoscopy by the major orgs on their websites or in print (ACS and AMA) would have you believe that neither procedure is stressful or painful in any way. However, if you read the actual experiences of people who submit to them (numerous message boards), the responses are strikingly different. One wonders why the promotion orgs insist on slanting the information so much when the reality is quite different (my flex sig certainly was no picnic--never again).
I can't understand why a doctor who is causing so much pain (see several of the postings) would continue the procedure(?). And why can't the patient say "stop"? My own doctor was hell-bent for "full insertion" and wasn't about to stop for anything. Jeez, even my dentist will stop and let me have a "breather" if things get tough.
I, too, am a fretter. Major. 6 weeks of anxiety before my procedure almost did me in, but I got NO help of any kind from my prescribing doctor (a GP who admits to never having had either one). I don't get it--if these procedures are so important, why won't the docs make any more effort to give them a good reputation?
BTW, neither of the docs I dealt with for my procedure are my docs any longer. And with respect to Katie Couric, of course hers will be good. She's on TV for heaven's sake. They're not going to broadcast her having a bad one. You can bet she had all the good drugs and plenty of them.
Jan 26, '04I am not a nurse, but would like to share my colonoscopy experience. While researching the procedure prior to my exam, I stumbled upon http://www.colonoscopysafety.com by Dr. Jeffrey Hadley, who recommends having a colonoscopy without sedation. Being insatiably curious, the idea of being able to watch the procedure really appealed to me. I got up the nerve to write to my gastroenterologist requesting the reduced dose of sedation that he had given me during a gastroscopy the previous month, which had not affected my memory or mental status (I had lost about 4 units of blood due to a duodenal hemorrhage). Dr. Hadley made the procedure sound relatively easy to bear, and I assumed that a sedative dose too low to affect mental status would still have some anaesthetic properties. When I was wheeled in for the colonoscopy, the gastroenterologist said that he would follow my wishes, and that if I needed more sedation, to just say so. Early in the examination, I asked the doctor if the brown particle I was seeing on the screen was fecal matter. He answered "Yes, but don't concern yourself", and sounded uncomfortable. I was not embarrassed, as I had followed the prep instructions. I just wanted to make sure that I understood what I was watching on the monitor. As he worked his way through the sigmoid colon, the pain increased to where my face broke out in sweat; something that had never happened to me before. Thankfully, the nurse wiped off my face before the sweat could run into my eyes. The cramping sensation from each introduction of air would go away, but with no reduction in pain. The pain seemed to increase linearly as the colonoscope was advanced, leading me to believe that the mere contact of the side of the colonoscope against my colon was painful. As he worked his way through the transverse colon, I was beginning to doubt my ability to endure the pain. With the next increase in pain, I felt like I was on the verge of a complete physical collapse. This feeling scared me, and I stated (in what sounded to me like a calm voice) that I needed more anesthetics. Prior to this, I had twitched once, but had neither cried out in pain nor shed any tears. The nurse reacted so quickly that I wondered what my vital signs looked like. As she was injecting the remaining drugs from both syringes, I was still hoping that I would be able to remember the rest of the procedure. Assuming that forward progress of the colonoscope was paused at this point, I noted that there was no decrease in pain. The nurse asked the doctor "Are you encountering resistance?" This same phrase was used in the ED when I had protested during the insertion of the nasogastric tube. It must be something taught in nursing school. The doctor said that he was having difficulty. My last remembered thought was "This really hurts!"
At my next appointment with the gastroenterologist, I thanked him for allowing me to watch what I could of the procedure. He explained that I had been at the most painful part of the examination when I gave up, and that there were a couple of things that he had wanted to show me (anatomical landmarks; I had no abnormalities). I was greatly disappointed to hear that I had come so close to success, but said nothing, as I had made the best decision with the information that I had at the time, and since I was not complaining, the doctor had no reason to tell me that I was approaching the hardest part, and that it was soon going to be less painful. He said that he was sorry for the pain that I endured. I replied "Don't be sorry for me! It was a choice I made!" When I filled out the customer satisfaction survey from the hospital, I thanked the doctor for letting me watch what I was able to endure. I gave top ratings in every catagory, just as I had for my ED and CCU hospital stay.
A couple of interesting notes about sedation. The doctor was surprised to read that I remembered the gastroscopy. After the colonoscopy, the doctor had to tell me the results twice, since I had no memory of seeing him in the recovery room (I had stated to the nurse that I did not want the doctor to talk to me in front of my parents (too personal and uncomfortable for me)). I had temporarily stopped taking Protonix 24 hours before the colonoscopy. According to a recent Medscape article, H2 blockers slow the breakdown of benzodiazepines, and I had regained awareness only a few minutes prior to being wheeled out of the recovery room. The amnesia caused by the Versed completely blocked any awareness of mental status changes from the Demerol. My legs were wobbly as I followed my parents to the car.
After considering the matter for a couple of months, I have decided that I will watch my next colonoscopy, only without any sedation at all, since it does not seem to do any good in a dose that does not affect memory and mental status. In fact, I am almost looking forward to it. Since my body is undergoing the same abuse whether or not I am sedated, I guess the worst that can happen is passing out from the pain. If so, just monitor vital signs and proceed with the exam. If I want to be sedated when I regain consciousness, I will say so. The pain did not make me nauseous, and since I was able to behave myself, I want to try again. An advantage I have is that while I have unpleasant memories of painful events during childhood, and can empathize with others in pain (like the other posters to this thread), as an adult I can remember painful events without being bothered by the memories. Furthermore, the only mental status I like is alert and oriented. The Versed induced amnesia bothers me. This ability is a mixed blessing. Since I could not see the damage being done by taking 5-6 Anacin a day to control headaches, and the GI discomfort did not affect work or school, I ignored it. I also ignored the significance of having half a dozen ED workers immediately surround me, remove the blanket covering my naked body, introduce themselves, and start working on me without even asking my name. I was convinced that while I needed to be in the hospital, it was not all that serious.