recent colonoscopy experience - page 3

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. Visit  bbarbie1 profile page
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    mshulz: Do you also have dental work without analgesia? A root canal without pain meds might be an interesting experience.

    I guess I don't understand why, with modern methods for pain relief, why anyone would chose to do something like colonoscopy without sedation or pain medication, especially after reading the previous posts. Why would anyone voluntarily undergo a routine screening procedure that causes the person to scream with pain? Am I missing something? And why would anyone ever have a repeat procedure? After all, this is not the Spanish Inquisition or Nazi Germany, this is the USA in 2004. Yes, there are certain risks involved with all anesthesia--even with novocaine for dental work. There are a small but significant number of cases in which the needle used to deliver novocaine damages a nerve in the mandible and causes permanent damage, but I'll take my chances.

    With the understandable emphasis on getting people in to be tested, I feel that it is important to make the experience as comfortable for the patient as possible or they will not repeat the procedure. Inform the person of all the risks and let them make the choice about sedation, but try to be as honest about potential pain as possible. It is a disservice to patients to gloss over this aspect and subject them to unbearable pain. And a rethink of the use of the word "tolerable" with respect to -oscopy procedures might be called for. Does tolerable mean you will survive but experience horrible pain? Or does it mean something else? I personally have a great distrust for procedures termed tolerable after reading the posts above.
  2. Visit  mshultz profile page
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    bbarbie1:
    Thanks for the reply. I do in fact have dental work done without analgesia. As one who grew up before fluoridated water became common, my childhood visits to a "child-unfriendly" dentist were often unpleasant. I was a teenager the first time I received Novocaine. By then, I found the lingering numbness more unpleasant than the pain. I have had two root canals with Novocaine. Prodding an exposed tooth nerve is quite unpleasant, let alone a root canal. Although Dr. Hadley emphasizes the risks of sedation on his website, this was not a factor in my decision, as the risks are relatively low. I had noticed that Dr. Hadley seemed a bit fanatic in his belief. Certainly, no one in this thread is saying that a colonoscopy without sedation is not that bad, including me.

    What are the patients saying when they fill out their post colonoscopy surveys? This thread is almost surely biased in favor of bad experiences. I agree with you about giving patients informed consent. A local newspaper columnist with concerns about her upcoming colonoscopy said that her doctor promised that she would not feel a thing. While this is probably the case most of the time, we know that it is not always true, and I would have trouble trusting a doctor willing to make this promise.

    The current Crankshaft comic strip is about Crankshaft getting a colonoscopy. Do you suppose he will feel anything?

    In order to understand why I would choose to undergo a painful procedure without sedation, you have to understand my personality. I am a control freak. I have never consumed alcohol, or taken mind-altering drugs (no tobacco use either). A good part of the reason is that I fear losing control. May 6, 2003, I was taken by squad to the ED, and then transferred to the CCU due to a duodenal ulcer hemorrhage that resulted in the loss of about 4 units of blood. The worst part of the experience was not regaining consciousness to find myself surrounded by a huge puddle of blood and fecal matter, nor was it finding myself unable to sit or stand, and too weak to clean myself up. I was concerned, but not scared, even though my heartbeat was weaker than normal. The worst part was the realization in the ED that they could do anything they wanted to me, no matter how unpleasant. I was over my head medically, and checking out AMA was not a realistic option. Part of the reason that I tried so hard to be the perfect little patient is that while I could not control my body or what they did to me, I could control my behavior. One of the CCU nurses called me a low maintenance patient, so I guess I did alright. I knew that I could be different in my reactions and desires, and would have to accept that the hospital would be geared toward the average patient. The emphasis is on relieving patient anxiety, and since I never questioned the need for any procedures, and refused only to watch television, they probably had no idea that I considered my condition serious, but not life-threatening.

    Since I left the hospital, I have been reading everything I can in order to understand my condition and treatment. Nursing books are good because they explain the rationale for treatment and procedures. This forum has also helped a lot. What continues to puzzle me is how normal people react. It has taken me over 7 months to begin to understand why amnesia is a desirable sedative property (normal people do not want to remember unpleasant procedures). I got an advertisement in the mail a couple of days ago from a dental clinic offering dentistry under sedation so that you would remember little or nothing of the procedure. My first thought was "Why would anyone want that?"
  3. Visit  bbarbie1 profile page
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    mshultz: In answer to your question about why anyone would want amnesia--let's think about the procedure. Someone I don't know, and who doesn't know me or care about me as a person (except to be concerned about whether my check will clear), is going to force a 6-foot-long lighted garden hose up my backside, all the while driving it around with his little joystick. That's not an image I want to remember, it's the stuff of nightmares and sleepless nights. I find the whole procedure demeaning and humiliating. During my flex sig I craned my head around to see the doc hunched over with his head near my rear, peering into his scope (too cheap to get the monitor), feeding tubing into my body--it literally made me so nauseous I nearly threw up (but there was nothing in my stomach except acid). So I'm glad for amnesia, thank you.
  4. Visit  mshultz profile page
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    bbarbie1:

    So, another reason that a person would want to be sedated is to avoid remembering a humiliating procedure. Thanks for the insight.
  5. Visit  bbarbie1 profile page
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    Crud. It looks like I get to have another colon inspection, yuck, yuck, yuck. I had a major cancer scare this week: a CT scan looking for the cause of back pain found instead things that looked like bony metastesies, and a 1.3 cm thing in my liver. After a bone scan, ultrasound and an MRI and various other insepctions, the cancer is mostly out of the picture (one more result to get in), but my doc wants to be aggressive about prevention and have me get the colonoscopy. After being relatively calm about potential bone cancer and all the other stuff, this procedure has me in major panic mode. Doesn't make a lot of sense, does it? I guess the memory of the flex sig, disgusting thing, it still too fresh. I hate the thought of giving up all control of my body to someone who will most likely cause significant pain that I just conveniently won't remember. I do think that's the best way, not that it gives me any comfort.

    Does anyone have an opinion on whether it's better to have an old experienced doc or a younger one, given that the training is equal? One older guy here was trained at Mayo, but one of the younger guys is also good, with the added benefit that he actually has a personality. And what would be a suitable pharmacological agent that can help keep me calm up to the procedure? I have to be able to function, can't afford to be a vegetable (I teach).

    I really, really hate this procedure. It's personally offensive, demeaning, and humilitating. (Maybe if I say it enough I'll get desensitized.)
  6. Visit  mshultz profile page
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    bbarbie1:

    I wish you the best of luck with your health problems.
  7. Visit  bbarbie1 profile page
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    Quote from patsue53
    I'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.
    To all endoscopy nurses, I could use some reassurance please. In trying to prepare myself for an upcoming colonoscopy, I have been browsing the web for other people's experiences. Some are comforting, some terrifying. Great. How do you get a realistic idea of what to expect? Also, if you are really in pain, will the doc stop if asked? The big question--I came across a very disturbing site, Gastro-Pro.org. I don't know if this is a demo for an instrument or a demo of the procedure, but now I'm really worried. It really seemed like the doc was being very harsh in moving the "thing" around in this poor lady. Several times it seemed like he pushed it into her very rapidly and a long ways, more that would seem safe. I noticed that the attendant kept patting her on the shoulder, so my bet is that she wasn't very comfortable. It this "gentle" treatment? I have never observed a real procedure, and would like the opinion of those who have. It sure seemed like he was more interested in pushing and pulling on her (showing off for the camera) than in being gentle. I'm really beginning to distrust the stuff I read about "gentle insertion of the scope", and all other superficial statements intended to lure people in for screening. I would appreciate any input. Thanks.
  8. Visit  athomas91 profile page
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    it is a fine line .... sedating someone enough to keep them breathing, providing enough analgesia for the procedure...and having them wide awake after....
    the bowel is a funny thing... you can cut it w/ a knife and it won't hurt...but you dilate it and it has been referred to as the worst pain imaginable...
    and after the dilation is done and the air dissipates you are pain free...so ....
    the problem is alot of doc's give a certain amt of sedation and analgesia to start...they chase the pain w/ narcs when the pt c/o's of pain...

    i am sorry that your experience was so painful...
  9. Visit  Chrislynn2003 profile page
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    I had my first colonoscopy done when I was 11 when I was diagnosed with ulcerative colitis. I was sedated pretty heavily; do not remember hardly anything. My UC kept getting worse, so the only option was a total colectomy, which I had done 5 years ago. A colonoscopy is not the worst thing in life.
  10. Visit  bbarbie1 profile page
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    Quote from Chrislynn2003
    I had my first colonoscopy done when I was 11 when I was diagnosed with ulcerative colitis. I was sedated pretty heavily; do not remember hardly anything. My UC kept getting worse, so the only option was a total colectomy, which I had done 5 years ago. A colonoscopy is not the worst thing in life.
    I'm sure it is not, but since I haven't had one yet I really have no way of knowing that. After spending 3 days in testing and another 2 waiting for results about possible bone and liver cancer, this is the last test I have to do, and I hope it dispells once and for all the diagnosis of cancer. I'm worn out, stressed out, and the idea of having that thing stuck up my butt is not exactly appealling. All I was asking for was some information.
  11. Visit  beyondword profile page
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    I am not a nurse but I think this forum would be the best chance I have of solving my dilemma.

    I had my first colonoscopy 5 years ago. The doctor told me I would be sedated, that I'd "know what was happening but not care", as he put it. OK, that sounded fine to me.

    It was not until I was on the table that the nurse, honest woman that she was, told me that "one of the meds in the IV" (that I now figure, having done some research, was Versed) would give me amnesia for the procedure.

    I almost jumped off the table. He had not told me that!!! When he came in I confronted him. At first he started to scold the nurse for telling me. Then he tried to say that he HAD told me, that he'd said it would be like taking Valium. Well, that was news to me, that Valium has an amnesiac effect.

    He finally said he'd give me only a little of the Versed. I agreed (I didn't have too many options at that point, really). I remember the start of the procedure; I saw the inside of my colon on the screen. I also remember saying "ow" a few times, but not being in real agony, just some discomfort. I suspect he upped the Versed at that point because I recall nothing after that.

    When I woke up he asked me "You remember it, don't you?" and I said yes, mostly to get rid of him.

    I swore I'd never go back to this man. So now it's time for the next one, and my doctor seems honest, reasonable and accommodating. He also doesn't seem to want to hurt me (nice man).

    He told me there are 3 options:
    Propofil (sp?), which will put me to sleep.
    Versed + painkiller, which will leave me conscious but give me amnesia.
    Painkiller alone, which might or might not be enough to make the procedure tolerable.



    Versed is NOT an option. I will not voluntarily suffer amnesia again. Propofil is an option, because if I'm asleep while it's happening, I have no need to remember it. It's being awake, aware, and possibly in pain during the procedure and not being allowed to remember it that I can't accept.

    He suggested I go with the Propofil this time, and if he sees that my colon isn't too twisted or kinky, then I go with just painkiller for the next time.

    Now, the problem is this. Versed vs. propofil depends on where the procedure is done. And the day of the week depends on where the procedure is done. Long story short, my schedule is such that if I go to the place where I can have the Propofil, I can't get it done for several months. But if I go to the other place, I can have this over with in a few weeks. And I want to get it over with.

    So. Any opinions? Does the fact that I remember some of the first time, and it wasn't too painful, suggest that I'll manage OK with just the painkiller? Or does the fact that I said "ow" suggest that it will hurt? I'd say I have at least an average tolerance for pain, having had 2 babies without pain meds. But I've never had a broken bone or major surgery, so I don't know how I'd react to severe sustained pain. I tend to grin and bear it when I slam my finger in a drawer but I doubt that's comparable <grin>... Oh, and the reason I had this done in the first place was that my sister had colon cancer (she's fine now, thanks) - and she said the doctors found that HER colon turns in an unusual way - maybe that means mine's not too straight either, so it will hurt more?

    Thanks in advance.

    Barb
  12. Visit  bbarbie1 profile page
    0
    Quote from beyondword
    I am not a nurse but I think this forum would be the best chance I have of solving my dilemma.

    I had my first colonoscopy 5 years ago. The doctor told me I would be sedated, that I'd "know what was happening but not care", as he put it. OK, that sounded fine to me.

    It was not until I was on the table that the nurse, honest woman that she was, told me that "one of the meds in the IV" (that I now figure, having done some research, was Versed) would give me amnesia for the procedure.

    I almost jumped off the table. He had not told me that!!! When he came in I confronted him. At first he started to scold the nurse for telling me. Then he tried to say that he HAD told me, that he'd said it would be like taking Valium. Well, that was news to me, that Valium has an amnesiac effect.

    He finally said he'd give me only a little of the Versed. I agreed (I didn't have too many options at that point, really). I remember the start of the procedure; I saw the inside of my colon on the screen. I also remember saying "ow" a few times, but not being in real agony, just some discomfort. I suspect he upped the Versed at that point because I recall nothing after that.

    When I woke up he asked me "You remember it, don't you?" and I said yes, mostly to get rid of him.

    I swore I'd never go back to this man. So now it's time for the next one, and my doctor seems honest, reasonable and accommodating. He also doesn't seem to want to hurt me (nice man).

    He told me there are 3 options:
    Propofil (sp?), which will put me to sleep.
    Versed + painkiller, which will leave me conscious but give me amnesia.
    Painkiller alone, which might or might not be enough to make the procedure tolerable.



    Versed is NOT an option. I will not voluntarily suffer amnesia again. Propofil is an option, because if I'm asleep while it's happening, I have no need to remember it. It's being awake, aware, and possibly in pain during the procedure and not being allowed to remember it that I can't accept.

    He suggested I go with the Propofil this time, and if he sees that my colon isn't too twisted or kinky, then I go with just painkiller for the next time.

    Now, the problem is this. Versed vs. propofil depends on where the procedure is done. And the day of the week depends on where the procedure is done. Long story short, my schedule is such that if I go to the place where I can have the Propofil, I can't get it done for several months. But if I go to the other place, I can have this over with in a few weeks. And I want to get it over with.

    So. Any opinions? Does the fact that I remember some of the first time, and it wasn't too painful, suggest that I'll manage OK with just the painkiller? Or does the fact that I said "ow" suggest that it will hurt? I'd say I have at least an average tolerance for pain, having had 2 babies without pain meds. But I've never had a broken bone or major surgery, so I don't know how I'd react to severe sustained pain. I tend to grin and bear it when I slam my finger in a drawer but I doubt that's comparable <grin>... Oh, and the reason I had this done in the first place was that my sister had colon cancer (she's fine now, thanks) - and she said the doctors found that HER colon turns in an unusual way - maybe that means mine's not too straight either, so it will hurt more?

    Thanks in advance.

    Barb
    Barb:
    Sorry you had such an upsetting experience!! However, I'm proud of you for standing your ground and trying to make him understand your point of view. A good for you in changing docs. The only way, sometimes, we have of making our point is to hurt them in their wallets--take your business away. It's too bad, but often true.

    I've had one C and had a pretty good consult beforehand, and that is the thing to do whenever possible, at least in my opinion. I was OK with the Versed, but wanted to make it clear that I DID NOT want to be aware of the goings-on during the procdure!!! He took me at my word. I had 100 mg of Demerol in 2 doses, and 10 mg versed (50-10-50). The second dose of Demerol did exactly what I want. However, the Versed did not grant complete amnesia--I remember what we talked about before I went to "sleep", and I also remember rousing a bit twice and groaning, but going immediately back to sleep. I do not remember it at painful, just a sensation. This was fine for me and I would do it again.

    I have read several very positive things about the Propofol. My own doctor, who I like and trust, told me that in my state the GI docs are trying to get the regulatory stiffs to let them use another drug, that would be used alone, and I think he was referring to Proprol. That means he thinks it is a good drug. I would try it next time if it were offered, but I would also be OK with the combo we used the first time. I guess, for me, the amnesia is not a big issue, but certainly, you are the one undergoing the procedure, and you need to decide what you are comfortable with.

    Is this a routine exam? Would it hurt to wait the few months to get the Propofol procedure? For me, I get so anxious (it's my little phobia, this procedure--I think it's disgusting and humiliating, and would want to get it over with ASAP, but that's just me, and my issue to deal with) that waiting would be worse than anything else, but if you're OK with waiting, why not try for it? Your first procedure wasn't that satisfactory, so you don't really have much to lose, and you might gain a much more "pleasing" outcome. Or, state to the doctor that you don't want to be aware, and maybe they can up the dose of Demerol to increase the pain threshold. I think I would have been OK without the Versed. Sometimes the Versed is a security blanket for the docs, I think--since they don't know ahead of time what the anatomy of the colon is, they want to patient to forget if there's more pain than they anticipate. My demerol was 100 mg but everyone's different, and I'm not a small person--5'11" and 170. My doc also said he could give me more if I asked for it, so apparently I was not at the max yet. I'm not a nurse either, so I don't know these values from a professional standpoint, please understand!

    I hope this helps. Try to get enough info ahead of time that you are comfortable--gut feelings are important. Be careful reading messages boards and other posts, though--sometimes they can be really scary!! But you've done it once, and know what your issues are, so you're much better off!! When you're done, make sure you let us know how it went--best wishes, good luck, and God be with you!
  13. Visit  MattLloyd profile page
    0
    I am an auxiliary nurse and work in the endoscopy department at a acute NHS hospital in the UK. If you could wait for the propofol that might be the best idea. I am not a trained nurse, and we use different drug names over here in the UK. All I can say is that the procedure may not always be painful, but can be very uncomfortable - especially when trying to get the scope around some tight bends within the colon. Personally, if I were having a colonoscopy, I would rather be sedated and not able to remember the procedure - especially when you hear the comments and language some of the doctors use when having problems progressing further into the colon with the scope.
    If it is just a routine examination, it may be better to wait for the few months and go somewhere else.
    I hope this helps.

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