recent colonoscopy experience - page 5
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
Oct 24, '04 by ClassySince 2001, I've had 3 colonoscopies and 3 upper endoscopies. With my 1st and 2nd upper endoscopy and 1st colonoscopy, I remember very little. For my 2nd colonoscopy, I was fully awake but felt no pain. I watched the whole thing including the taking of biopsies during that one. Because of my level of consciousness with that colonoscopy and the greater risk involved with an ERCP, they used general anesthesia for that. With my next upper endoscopy, I was fully conscious. It was painful. I was gagging the entire time and they held me down to do the procedure. The doctor said he "used a boatload of sedation" but couldn't get me out. For all those procedures, I am not sure what was used. I then needed a colonoscopy so he totally changed the sedation medications. He used Fentanyl 200 mcg, Midazolam 6 mg, and Droperidol 5 mg. I remember hearing voices occassionally but that is it.
Oct 24, '04 by SuperSGirlYou did not receive enough sedation! Next time find a doctor who is more generous with the medication. None of my patient's remember a thing about the procedure!
Quote from mat/childnurseI 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!
Oct 24, '04 by Classy[QUOTE=bbarbie1]mshulz: Do you also have dental work without analgesia?
I've never have had novocaine or any analgesia for dental work. That discomfort is nothing compared to what I experience with the -oscopy procedures without proper sedation.
I also am one who has been raped. So when they held me down to perform the upper endoscopy which I posted about earlier, that revived those memories. I had many flashbacks and nightmares following that procedure and had to deal with those in therapy. My family doctor told me that many people who have similar traumas in the past describe not being sedated enough similarly to being raped.
Oct 24, '04 by CHATSDALEthank you all for your input...i have been advised oncollogist to have a colonoscopy but primary p has not scheduled it... i am going to bite the bullet and call his office and get this thing done and over with...don't tell any one but i am chicken,,,i can give advise to family and friends but i bury my head in the sand when it comes to myself i hope i have a better experience than OP
Oct 28, '04 by jewelcuttI'm absolutely terrified. I'm a former ICU nurse, now in anesthesia school. I have to get a colonoscopy because of recent problems and my very cool doc wants it done this week, so I'm getting it done saturday because, if anyone knows about anesthesia school, I can't take anytime off school. So anesthesia isn't available on weekends for some reason so I'm getting demerol and versed. Every scope I have helped out with in ICU was somewhat awake and moaning, have seen some in real pain, it just never seemed fair. I will not have this! I don't want to be awake, don't care if I obstruct my airway, don't want to cooperate, watch the video, or be in any sort of pain at all. What I'm wondering is what would you Endo nurse say are standard doses of Demerol and Versed (btw, I'm a 25 year old redhead, great!!) and what are the higher end of standard does you have given. I plan on having an indepth discussion with my doc before I'm wheeled in. I'm so scared after reading this board it's almost making me cry. Of course, that's why I went into anesthesia school, so I could take people's pain away during difficult times. I would so much rather get propofol, but this has to be done in two days so I'll suck it up. I'd really appreciate any Endo nurses responses, thanks in advance!
Oct 28, '04 by bbarbie1When I had mine, I was also terrified! I was "lucky" enough to have to wait 3 weeks, though, which was not fun in any way, shape or form. My GP prescribed me enough Xanax (spelling?) to get me through, and that helped a lot. Ask for some! Even for one day!
The day of my procedure I had a consult with the GI doc before the procedure. I stressed that I did not want to be awake, did not want to be aware, did not want to watch, and that I was terribly worried because I had heard numerous horror stories about patients in terrible pain, the doctor ignoring patient requests for meds, begging to stop, etc. He assured me that he would either make me comfortable or he would stop and get me a virtual C that same day. I am brunette, 5'11", 170 lbs (hey, not too many people get to know that!), had 100 mg demerol and 10 mg versed. I "napped" through almost all of it, rousing twice for sensations that were probably pain but I did not perceive them as such. And he indicated that I could ask for more meds if needed, so I don't think I had reached the max "allowable" for my size. If you can come to this kind of understanding with the doc, the chances of making it through with reasonable comfort are good. I think the knowledge that he would pay attention to my comfort-distress was very reassuring. (BTW, the versed and the memory thing always makes me nervous--I don't like the idea of writhing in pain and not remembering.) On the whole, the actual experience was not as awful as the anticipation, not that I would ever do it for fun!
The one thing people seem to agree on is that it's nice/wonderful/exhiliarating to have it over with! Like a one-ton weight being lifted from your shoulders. The best part for me was walking out of that chamber of horrors and knowing I don't have to go back for 10 years!
Good luck, best wishes, God be with you!! Write back when it's over!
Oct 29, '04 by bbarbie1Jewelcutt:
A couple of things, actually, occured to me on the drive home:
1. someone in ICU is likely to have many complicating issues the might preclude adequate medication, right? It should be easier (less worrisome?) to medicate someone who is in overall good health and in their 20's?
2. Demerol and Versed are standard for this area and seem to be effective for most people
3. Get a doc who is not afraid to use enough meds to achieve adequate levels of sedation
4. Is there truly a hurry to do this? Is there another facility that can deliver the type of sedation/anesthesia you feel comfortable with, and on a Saturday?
5. You might check out some of the other posts about levels of drugs used. Cecumseeker says that there is no such thing as average levels of meds, that everyone is different (hope I paraphrased him somewhat accurately! Read his post to be sure.). Certainly you should make sure the doc will be responsive to your requests for more meds if you are in a lot of pain!
Again--best wishes for a smooth, minimal-trauma, procedure!
Oct 29, '04 by mshultzQuote from bbarbie1That's a good point. When I was in the Critical Care Unit, I was given a reduced amount of sedation for the EGD due to my condition (2mg Versed and 50 mg Demerol, plus the Cetacaine throat spray). I am 5' 7.5", and weighed about 175 pounds at the time. This amount of sedation had no perceptible effect on me. However, I found the EGD to be surprisingly tolerable.1. someone in ICU is likely to have many complicating issues the might preclude adequate medication, right? It should be easier (less worrisome?) to medicate someone who is in overall good health and in their 20's?
At my request, for the first part of my colonoscopy, I was given 1mg Versed and 50mg Demerol. I asked for additional medication when the scope was going from the transverse colon to the ascending colon, and was given 2mg Versed and 25mg Demerol. Unfortunately, I was unable to remember what happened after that, but the doctor said that I fell asleep half-way through, so presumably I was no longer in pain.
Chronic use of alcohol and/or benzodiazapines (Valium, etc.) results in a tolerance to Versed, while chronic use of narcotics results in a tolerance to Demerol. As a result, these people will be more difficult to adequately medicate.
Since I am determined to get through my next colonoscopy without sedation, I spend a lot of time reading about the procedure. The more colonoscopies the doctor has done, the easier the exam. Note that studies done on the tolerability of colonoscopies are limited to doctors with extensive experience (say >2000 exams). Also, the use of abdominal pressure during the exam helps. The Olympus ScopeGuide sounds promising:
http://www.medscape.com/viewarticle/473215 (registration required but free). It can be assumed that a doctor good enough to use this technique on awake patients is going to be better with sedated patients than a doctor without such experience.
Oct 29, '04 by jaimealmostRNI had my first colonoscopy last week (had a sigmoidoscopy 10yrs ago). While I remember saying "oww" during the actual proceedure, I don't remember the pain (thank you versed). The WORST part is the prep. I did NOT feel "clean and free" as someone described to me. I have much for empathy for my pts with excoriated backsides now!
Nov 5, '04 by jewelcuttHey everyone. I had to get my colonoscopy done last saturday because it had to be done this past week and I had to have it at my hospital because that's where my insurance is through. Anyways, it was great!!! Saturday mornings are very quiet and slow. I was so scared I almost cried but my doctor is the best so he took really good care of me. I ended up getting 6 of versed and 75 of demerol. he gave me the initial two of versed and 50 of demerol and asked me how if I felt anything, so I lied and said maybe a little even though I could really feel the drug. The last thing I remember saying is that there was no way I was eating a low residue diet and going straight for a cheeseburger! He laughed at me. I think I remember saying ouch but no pain or recall. I woke up in recovery after like a half an hour and threw up, got some zofran, never felt so great in my life. I slept for hours when getting home. The prep was awful. I couldn't drink even one glass of the golytely so I got fleets phospho soda from the store, found online instructions at other GI centers, and used that instead. Anyway, I think the main point to any story is that if you are very afraid, there is no reason you can't have anesthesia, and you need to communicate very well with your doctor. For those who don't want to be sedated or forget I don't quite understand the logic. I give versed all the time to prevent you having recall or nightmares about the operating room, usually people have so much stress from having to get a procedure they don't need anymore from us. We aren't barbaric, if you are in pain we will give you pain medicine. I understand no-one likes losing control but you just have to place yourself in the good hands of anesthetists, nurses, and doctors. We are really there to help you.
Nov 5, '04 by CHATSDALEI am glad that you came thru with flying colors...maybe you gave me the strength to have mine done...i will call md monday before i chicken out ... i hope that your results were good
Nov 6, '04 by mshultzQuote from jaimealmostRNThe worst part for me was the restricted diet prior to the prep. NutraPrep: http://www.ezem.com/vc/nutra.asp?action=vc sounds much better than the three cans of pop that I had as my meals.I had my first colonoscopy last week (had a sigmoidoscopy 10yrs ago). While I remember saying "oww" during the actual proceedure, I don't remember the pain (thank you versed). The WORST part is the prep. I did NOT feel "clean and free" as someone described to me. I have much for empathy for my pts with excoriated backsides now!
I was not "clean and free" either. In fact, the morning of the exam, I was still expelling light brown fluid. There was a lot of fluid visible during the part of the colonoscopy that I watched, as well as the occasional fecal particle. The nurse told me that the doctor would suction out the excess fluid and gas on the way out. I had no problems with flatulence or fluids in my colon when I regained awareness.
Nov 6, '04 by mshultzQuote from jewelcuttThe best explanation I can give for avoiding sedation and amnesia is that there is no one method that works to reduce stress for all people. From reading this forum, it is apparent that many nurses feel their medical knowledge would make their own hospital stays more stressful. As a result, patients tend to be insulated from the details as much as possible. Although well-intentioned, and quite probably best for most patients, this approach has the unfortunate effect of greatly increasing my stress. The best approach for me is to treat me like a medical or nursing student and to provide me with detailed, comprehensive written information, thereby indulging my insatiable curiosity.For those who don't want to be sedated or forget I don't quite understand the logic. I give versed all the time to prevent you having recall or nightmares about the operating room, usually people have so much stress from having to get a procedure they don't need anymore from us. We aren't barbaric, if you are in pain we will give you pain medicine. I understand no-one likes losing control but you just have to place yourself in the good hands of anesthetists, nurses, and doctors. We are really there to help you.
According to my medical records, reducing my anxiety was part of my treatment plan while I was in the Critical Care Unit. The irony of the situation was that because I was not given any written information and had no way of taking notes (no pen or paper either), the effort of trying to remember what little information I was told, along with trying to be the perfect little patient when I was not told how to be the perfect little patient, resulted in more anxiety for me.
The challenge for me in the future will be how to convey my preferences to the medical staff without causing an adversarial relationship. The best I can think of so far is to tell them up front that I am greatly interested in the procedure, and will be requesting my complete records so that I can learn as much as possible. I can only hope they understand, and not think I do not trust them, or am looking to file a lawsuit.
As far as avoiding sedation, my response will be: "I want this procedure done without sedation, by someone who is experienced and comfortable with performing it without sedation. Can I get this here, or do I need to be referred to a teaching hospital somewhere else?"