recent colonoscopy experience

jnette, ASN, EMT-I · Feb 17, 2005

Oh crap... (guess that's kinda fitting for this thread, eh? )

Just got done reading ALL of this thread, and now I'm horrified. :eek:

Yes.. I'm in definate need of a colonoscopy.. not only due to age, but due to bowel concerns. Had it on my agenda, and never gave it a second thought.. until now. I had NO idea these were so "iffy" and painful.

Maybe I'll just wait. :uhoh21:

curleysue · Feb 17, 2005

Thank you for the post- I too am up for a colonoscopy but I am too concerned about having Propofol without anesthesia backup. (there was a huge debate on this in the Propofol section.) I'd worked many years ICU/CCU and the CRNA's do seem to know what they are talking about. Any other advice regarding the feasability and safety of having Propofol WITH a seasoned CRNA/anesthesiologist right near the bed? I am really wondering if even that is safe if not done in the proper setting/backup.
While I'm at it, what are some of the higher doses of Versed/Demerol used? I know my prior doses were 50 mg. Demerol and once 3 mg. of Versed and I believe another time 5 mg. of Versed. Didn't do the trick> I too have a torturous bowel , and I have endometiorsis with adhesions.
I've wondered and researched the Virtual Colonoscopy as well- anyone know if the pain is significantly less with this?

Spaniel-

50mg of demerol and 3mg of versed is hardly anything, at least for me. It is common though for people to need like 5-10mg versed and up to 150mg demerol, I asked my sis who is a nurse in a colonoscopy clinic. She says is kinda rare that they give more than that but it does happen. Like in my case. That one time I got like 23mg versed and 150 demerol and I still wasn't really relaxed so that is why they did the propofol.

My opinion: I think propofol is rather safe. In fact when I was going through a pain clinic I was having sympathetic nerve block for my foot injury. They would sedate me with versed, then propofol roll my on my back and inject the medications into my spine. There was no anesthesiologist or CRNA in the room. It was just nurses and the pain doctor. They said since the propofol has such a short half life than its okay to give it. So I guess its different in different hospitals and clinics but I know for sure in the future if I ever need concious sedation I will request propofol even though that drug it really an anesthetic, if needed they can just do the procedure in the OR like I had done last endoscopy.

I think the main thing when giving propofol in a non operating room setting. Is to make sure a nurse is standing by with a bag valve mask ready to take over respirations when needed if the patient goes deep under and sats dip. Or have a CRNA or anesthesiologist stand by with intubation equipment if needed but really propofol given in a pretty small dose has a short half life. So when I got my procedure for my pain they gave me the propofol and the procedure only lasted like 5-10 min and by that time I was awake (groggy) but maintaining my airway with supplemental oxygen.

I know if one of the CRNA looks at my posts they might think otherwise but that is just my experience and my opinion. Curleysue

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 :)

bbarbie1 · Feb 17, 2005

I had 100 mg demerol and 10 versed--female, 5'11", 170 lbs, 51 years--it was just fine. People react very differently though, metabolic I guess. But I definitely think your earlier doses were pretty small.

Why would you do a VC? Same prep, but the indignity of being awake while someone stuffs tubes up your butt then blows up your gut like a beach ball. Pretty uncomfortable/painful I hear, but I haven't had one. Then if they find something, you have to do the prep all over again for a real colonoscopy--more money, something the docs probably really like. Not for me, thanks. Put me out so I don't know I'm being violated, do it once, and then not again for a decade.

denverasking · Feb 17, 2005

Oh crap... (guess that's kinda fitting for this thread, eh? )
Just got done reading ALL of this thread, and now I'm horrified.
Yes.. I'm in definate need of a colonoscopy.. not only due to age, but due to bowel concerns. Had it on my agenda, and never gave it a second thought.. until now. I had NO idea these were so "iffy" and painful.
Maybe I'll just wait. :uhoh21:

I'm speaking from the patient perspective. There's a wide variety of experiences and I think that's good to know. Absolutely do not let anything keep you from making an appointment and getting it done. I went because since I nagged my husband to go last year, I kind of had to follow suit. I also didn't want to find anything later and feel incredibly stupid that I had waited.

Find a doctor and staff that you feel comfortable with and express your concerns before the procedure.

Wicket16 · Feb 17, 2005

I'm speaking from the patient perspective. There's a wide variety of experiences and I think that's good to know. Absolutely do not let anything keep you from making an appointment and getting it done. I went because since I nagged my husband to go last year, I kind of had to follow suit. I also didn't want to find anything later and feel incredibly stupid that I had waited.
Find a doctor and staff that you feel comfortable with and express your concerns before the procedure.

When my husband had his colonoscopy a couple of weeks ago and we were waiting for him to come around after the procedure the nurse mentioned in passing something about waiting for the paralysis medicine to wear off. I've never heard anyone mention that in here and am wondering what it is?

bbarbie1 · Feb 17, 2005

Hi this is my first post. I am not a nurse, but very concerned about having to have a colonoscopy in about a month. My husband just had one and said it was "a piece of cake", but then it doesn't take much to put him completely out...Me, on the other hand need a lot more medication. Can you tell me where in Gastro-Pro.org did you find the information about the woman getting the colonoscopy you mentioned. I am trying to get all the information on this that I can. Thanks!!

After I saw that video, I emailed the people that sponsored it and complained. I told them that it terrified me, and that I thought it should be pulled from the web (and that I would be glad when there is a DNA test that puts all GI docs that do colonoscopies out of business!). They responded that the site is only for professionals. I never went back to the site until recently, just out of curiosity, and they have made it a register-only site so those of us unsuspecting terrified types can't accidentally get in and get more terrified. I think that's OK.

Really, as much as I hate the thought of the whole undignified, humiliating procedure, mine was about as painless as it could have been. I woke up twice with sensations that could not be described as pain, then went right back to sleep and woke up at the end when it was done. But I had made it absolutely clear to the doc that I did not want to know ANYTHING that was going on, that I was to be out BEFORE he started, etc. And he could see that I was totally freaked, and confirmed that if I was in pain I could ask for the procedure to stop, or ask for more drugs. I didn't need to do either. I am convinced that making your wishes clear up front is an absolute must-do. And go with your "gut" (no pun intended) feelings--if you don't think he will do as you ask, cancel and get another doc. The best way to make it clear what you want is to talk with your feet and get the hell out of there if you feel uneasy.

Good luck. You know, most of these are just fine. Preparation and understanding between you and the doc is critical.

PACU R/N · Feb 23, 2005

Hi there, hmm paralysis medicine. From an Australian view point, seems like your husband may have had a general anaesthetic without muscle relaxant - as this causes central nervous system depression - leading to relaxation of the gastrointestinal system.

The term 'paralysis' means that your husband was given a muscle relaxant and had to be intubated and mechanically ventilated during the procedure. Not done unless a patient has a bleed from the GIT system and emergency endoscopy has to be done to arrest bleeding.

Hope this has clarified your query. With no medical/nurse training, I would be putting the question to your Doctors who took care of him.

Cheers Elva

When my husband had his colonoscopy a couple of weeks ago and we were waiting for him to come around after the procedure the nurse mentioned in passing something about waiting for the paralysis medicine to wear off. I've never heard anyone mention that in here and am wondering what it is?

blue chips · Mar 17, 2005

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!

I am not a nurse but have worked in a GI lab for 4 years and most and i say most people do not remember there procedures due to the versed. A lot of times if the doctor does not allow you to be sedated before he starts then you become more anxious and not sedate as well. dont be afraid take deep breaths and try very hard not to bear down during the procedure.

bbarbie1 · Mar 17, 2005

I am not a nurse but have worked in a GI lab for 4 years and most and i say most people do not remember there procedures due to the versed. A lot of times if the doctor does not allow you to be sedated before he starts then you become more anxious and not sedate as well. dont be afraid take deep breaths and try very hard not to bear down during the procedure.

If the doc did not allow me to be sedated before he starts, I would cancel. Why would he/she want an anxious, tense patient? That certains does not bode well for a smooth procedure. Such a doctor must have his own interests well before those of the patient. I'm tired of docs with the God complex that don't treat patients with respect. I want to be so sedated that not bearing down is not something I even have to consider.

curleysue · Mar 17, 2005

Hi all-

I just had a colonoscopy and endoscopy yesterday due to my hemoglobin and hematocrit falling rapidly for reasons that we don't know. So my doc said he wanted to find out if I was bleeding from an ulcer or other spots in my GI tract. Because of my chronic pain and daily use of narcotics for it, I am very tolerant to versed and demerol. SO the procedure was done in the OR where I was given 10 of versed at first and then followed by propofol. I don't remember a thing. I just remember waking up in recovery room. It was very easy and I had an awsome anesthesiologist!

However I am a different case. I don't think they do it with propofol in the OR too many times. BUt everything turned out okay. They didn't find any bleeding what so ever. Which I was rather disapointed about. I wish they found a source of my low hemaglobin but now I have to have a CT scan and possible exploritory laporotomy?!! I am getting two units of blood tomarrow cause I am so low. They tested my iron levels and so forth and everything was normal. SO we have no idea where my bleeding is coming from. I am really scared! I don't know what it is?!

Anyways, just thought I would share my experience. Take care. Amy

spaniel · Mar 18, 2005

Cannot thank you enough CurleySue,for your reply. Despite your own troubles, you are taking the time out to tell us of what I think really might be a good option for some of us who tolerate the colonoscopy poorly. I also would want the Propofol only with an anesthesiologsit or CRNA available.

Please keep us posted on your health. Thoughts and prayers with you.

curleysue · Mar 19, 2005

Spaniel--

You welcome for the post. Actually I think propofol is an excellent drug to use for scope procedures cause it has a short half life and patients who are on a lot of pain meds for chronic pain are usually tolerant to versed or other drugs given.

My first endoscopy was done in a procedure room with the surgeon and a nurse. They kept giving me 5mg Versed increments and I would still say "i am still awake". All in all they ended up giving me 25mg versed!! Enough to kill a person if I wasn't so tolerant. That surgeon said it was really important for me the next procedure I had done to tell the doctors that experience and request to have it done in the OR with propofol.

I think in some hospitals nursing are getting delegated to give propofol or at least they are trying to convince the hospital that they can give it safely. As long as oxygen equipment is nearby and so forth.

All I can say is propofol is a wonderful medication! Puts you out right away!

Oh by the way my CBC levels have dropped even more after yesterday's infusion. I am super scared! Where am I bleeding? My doctor suggested that there is a small chance that my body has stopped making blood cells?! How can that be? I am so confused and worried. This morning I was so so pale and so weak is was horrible. Maybe there is something wrong with my bone marrow?

Take care, Culeysue. :crying2: