recent colonoscopy experience recent colonoscopy experience - pg.9 | allnurses

recent colonoscopy experience - page 9

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  CrohnieToo profile page
    1
    Actually, Mike, I can't take all the communication skills credit. My gastro has been a saint putting up with me at times. And we have had our "differences"! It was fortunate that I first met her BEFORE I needed a gastro. My stepmother was bleeding out from unrecognized stomach ulcers and we were in ER. My gastro was heading home for the day and was virtually grabbed by the arm and asked to do an emergency endoscopy. She was so patient w/my stepmother and so gentle, she didn't kick me out of the treatment room, I was able to watch on the monitor as she found the three large areas of bleeding and "zapped" them and stopped them from bleeding. It was fascinating to watch and she was so gentle and aplogetic to my stepmom that she wasn't able to sedate her before or during the procedure. I knew then that when and if I needed a local gastro this would be the one.

    Actually, our relationship hasn't always gone smoothly! I had attempted a long reply to your post regarding my first two colonoscopies but it got lost in cyberland and I didn't feel like re-typing the entire thing again.

    My gastro does her procedures at our local hospital's outpatient Endoscopy unit and I think, other than an exceptionally large gastro clinic w/many gastros in practice, that that is a positive thing as they have more and better equipment, etc. available.

    Frankly, I've never been quite sure WHY they administer Demerol for the Endoscopy. Are they sometimes painful for people? I wouldnt think so except in the case of a dilatation. But what do I know? I can understand the use of the Versed due to the gagging reflex that occurs. However, as much as I HATE gagging and dry heaving I still prefer my upper scopes w/o sedation as well.

    I don't remember if I mentioned it or not, but my gastro actually underwent both the upper and lower scopes w/o sedation herself after I gave her those two articles and she now agrees with me, the upper scope is the worst due to the gagging.

    I never request or suggest a specific amount of sedation or analgesic. That is rather overstepping the bounds as they are the doctor. BUT certainly providing them with the doses and meds used in previous comfortable and satisfactory scopes as well as the doses and meds used in previous unsuccessful or unsatisfactory/incomplete scopes is well within good taste AND good common sense.

    You said: [Quote - A month later, I realized she had to have known in advance, since she injected a portion of both syringes without checking with the doctor about the dosage. - Quote]

    Not necessarily so, nor likely. They are given written orders included right in your chart. The forms in the chart are in order used, i.e. your written consent to sign, the procedure being done, written orders, etc. thru to your recovery vitals, etc. and take home instructions plus charge sheets for materials, meds, etc. used during the procedure as the last form.

    You also said: [Quote - Perhaps the best approach would be to say up front that while the treatment of my bad GI bleed was perfect, we need to work on patient information and scope technique. This gives everyone another chance, and I can always go elsewhere if this approach is not well-received. - Quote]

    I agree. One step at a time. As I said, my gastro and I have had our ups and downs. Its a wonder she has put up with me at times. On the other hand, I have threatened to cancel and walk out on a procedure whilst in my hospital gown on the table. I even went to Mayo Clinic in MN when I "knew" my Crohn's had returned after a long remission when she was convinced I had IBS and I had my Mayo report sent to my family doctor, not her, and ignored her for months until SHE approached me at the hospital. She just asked me how I was doing, but had to leave the elevator she had been waiting for to do so, and I told her I had been to Mayo and was doing well. She said she would like to see the Mayo report and that ended my "twit" and everything was fine between us again. (The Mayo report verifying my Crohn's had returned provided me with an "I told you so" w/o my having to say a word - wicked, satisfied smile). I do think, tho, that my gastro is an unusually good and considerate doctor as well as a gastro. She was a very well loved family practioner before deciding to go into gastroenterology. I've told her more than once she is too good and caring doctor to be "wasted" in a specialty and SHOULD still be a family doctor. At Christmas time I usually take a shrimp cocktail plate or Jimmy John's sub platter or cracker, beef stick and cheese platter to her office for her and her desk dragons to enjoy to show my appreciation.
    MaudKennedy likes this.
  2. Visit  CrohnieToo profile page
    0
    Mike, I knew there was something else I wanted to mention and forgot: I'm glad you took the time to read the "How I Do It" article as well as the two abstracts. We really don't know what questions to ask sometimes, at least those of us who are really interested and want to know about the "mechanics" of what can be expected during a procedure unless we have done our research and have a fairly good idea of just what is involved. Then we have a tendency to blame the doctor for not explaining things to us when something doesn't go quite as expected. Not every patient, in fact, few patients, want to know almost every little detail. Most are satisfied with a broad overview of a procedure. For those of us who are nosey enough to want to know exactly what to expect or be prepared for it becomes our responsiblity to search for and find as detailed descriptions of the procedure we will be undergoing as we can so that we can formulate the appropriate questions for our doctors to answer.
  3. Visit  RN2Bn2006 profile page
    1
    Quote from curleysue
    Spaniel-

    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
    I'm sorry, but this is not true in all cases. I've had two colonoscopies, felt them both, had versed/demerol. I Remember the burning of the cauterizing from removing a polyp. I was crying out and begging them to stop, They did NOT stop, they just keep saying "you're doing fine, we're almost done" , etc.

    I am going back in 2 weeks to schedule my 3rd one, but we are going to talk about different route of sedation.

    I am only 35, but due to my medical hx, I have to have a colonoscope done every year.:uhoh21:
    MaudKennedy likes this.
  4. Visit  CrohnieToo profile page
    0
    Quote from RN2Bn2006
    I'm sorry, but this is not true in all cases. I've had two colonoscopies, felt them both, had versed/demerol. I Remember the burning of the cauterizing from removing a polyp. I was crying out and begging them to stop, They did NOT stop, they just keep saying "you're doing fine, we're almost done" , etc.

    I am going back in 2 weeks to schedule my 3rd one, but we are going to talk about different route of sedation.:uhoh21:
    I would agree that you insist on another form of sedation for future colonoscopies. BUT - just as important, or even more so, I would find myself another gastro (assuming you are using a gastro and not a general or colorectal surgeon). When I say "stop" the sheister darn well better stop! There is the old saying: screw me once, shame on you; screw me twice, shame on me. WHY on earth would you give this inconsiderate, totally uncompassionate doctor a third chance to do your colonoscopy????????????
    That's masochistic! Surely you must be aware of the increased risk of perforation, etc. when a patient is struggling with pain during a scope! I would dump this dolt in a heartbeat!!
  5. Visit  RN2Bn2006 profile page
    0
    She is a gastro, and was highly recommended. To tell you the truth - i felt like that all scopes are probably painful if people were aware of them - I was just one of the unlucky people who the demerol/versed did not work and was aware of what was going on. She said during the last one that my BP had dropped, so they could not give me a larger dose. I think they probably thought I would not remember the pain. I have been in with a patient during a procedure, that hollered out, but did not remember anything once she fully awoke. I on the other hand remember alot! As for having it done the second time, I talked to her about the pain during the 1st one, and she said they would give me more medication - then when it actually came down to it - they couldn't. I still think she is a good doc, just I am a difficult case, and need to be approached differently! Either that or maybe I'm just stupid! :uhoh21:





    Quote from CrohnieToo
    I would agree that you insist on another form of sedation for future colonoscopies. BUT - just as important, or even more so, I would find myself another gastro (assuming you are using a gastro and not a general or colorectal surgeon). When I say "stop" the sheister darn well better stop! There is the old saying: screw me once, shame on you; screw me twice, shame on me. WHY on earth would you give this inconsiderate, totally uncompassionate doctor a third chance to do your colonoscopy????????????
    That's masochistic! Surely you must be aware of the increased risk of perforation, etc. when a patient is struggling with pain during a scope! I would dump this dolt in a heartbeat!!
  6. Visit  CrohnieToo profile page
    0
    No, you're not stupid. If you have that much faith in your gastro then she can't be all bad nor as bad as I pictured her given your first description of your experience.

    I would seriously discuss with her using propofol (diprovan) for your next procedure. At our hospital outpatient endoscopy unit that is considered general anesthesia and an anesthesiologist must be called in to administer it. It is short acting so recovery is quick. They also use either fentanyl or alfentanyl for the analgesic in our unit if they use propofol, I've forgotten which. From reading posts in this forum, evidently in some states nurse anesthetists are allowed to administer propofol.

    I would just be sure to discuss alternative sedation/anesthesia and analgesia with your gastro now and come to an agreement what will be used next time AND THEN BE SURE to remind her when scheduling EACH future procedure and the staff prior to the procedure, especially the day of the procedure, what was agreed upon and why.

    Good luck and God bless.
  7. Visit  lisa bear rn profile page
    0
    Quote from RN-PA
    No can do-- fret, that is. Ask anyone who knows me and they'll tell you: "Fret" is my middle name! I've always said that when my time comes for a colonoscopy, they'll have to hit me over the head with a large rubber mallet-- and ~THEN~ fire up the Versed and Demerol. :stone
    I used to work at a surgical hospital that also had endoscopy. The endo suite at this particular facility had a CRNA do the sedation for the case and they were able to use diprivan or propofol, the patients did not have to be intubated, they also went to sleep very quickly and the diprivan wears off very quickly, so most people were awake and not even groggy within 10 minutes. I dont know how many facilities use diprivan for colonoscopies or EGD's or really how feasible it is that they use that, but after comparing experiences from patients and seeing it first hand Milk of Anesthesia is the way to go!!!!
  8. Visit  CrohnieToo profile page
    0
    Lisa Bear RN, I have to tell you, your nickname of Milk of Anesthesia for Diprivan did tickle my funny bone.
  9. Visit  bbarbie1 profile page
    0
    Quote from RN2Bn2006
    I'm sorry, but this is not true in all cases. I've had two colonoscopies, felt them both, had versed/demerol. I Remember the burning of the cauterizing from removing a polyp. I was crying out and begging them to stop, They did NOT stop, they just keep saying "you're doing fine, we're almost done" , etc.

    I am going back in 2 weeks to schedule my 3rd one, but we are going to talk about different route of sedation.

    I am only 35, but due to my medical hx, I have to have a colonoscope done every year.:uhoh21:
    WHY would you go back to the same doc and facility that ignored your pain the first two times? Records can be sent to other facilities. Continuing to allow that doc to work on you when he ignored your pain earlier just reinforces his tendency to commit the same "crimes" over and over again.
  10. Visit  theplugger profile page
    1
    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!

    In going back and rereading this thread from the beginning, I discover that this first post sounds amazingly (and sadly) similar to my experience as related in my post of June 11, 2005. The more I thought of it, the more infuriated I became, and related the horrid experience to the nurse here at my local clinic. Interestingly, she told me that a couple other of their patients (it's a small rural clinic that refers it's patients to city clinics for procedures) had complained of rude and shabby behavior from the same GI doc who did my colonoscopy. Determined to try to save others from this guy's barbaric treatment I wrote a very strong letter of complaint to all clinics involved expressing my disappointment in the treatment I got from him during my colonoscopy, (being very explicit that the complaint was only about the doc, that the other staff had all been excellent) and recommending that my local clinic no longer refer any of their patients to him. I got a reply from all 3 (clinics involved) that this matter would be investigated and felt better for having espressed myself.
    About a month later during my annual physical, this subject came up and was discussed, and it turns out that the doc (who performed that horrid colonoscopy) has decided to retire.

    I feel like he got off pretty easy, but at least he'll no longer be out there torturing others.

    One moral of the story: If you have what seems like a legitimate complaint, document it. You never can tell, it just might add to the stack and tip the scales toward affirmative action!
    MaudKennedy likes this.
  11. Visit  RN2Bn2006 profile page
    0
    Quote from bbarbie1
    WHY would you go back to the same doc and facility that ignored your pain the first two times? Records can be sent to other facilities. Continuing to allow that doc to work on you when he ignored your pain earlier just reinforces his tendency to commit the same "crimes" over and over again.
    Well the 1st time was unexpected, so we discussed plan for heavier meds next time - but because my BP dropped 2nd time (during procedure) they could not give me anymore. To be honest, what exactly are they supposed to do? The procedure has to be done, what happens if they stop in the middle of it? They could not increase my pain meds due to bp -- I've already had the prep - and I SURE ain't going do to that again any time soon, so It was just a matter of trying to comfort me until it was over. Fast forward to last month........... I had my 3rd scope, and after talking with (same) doc, we decided on propofol (sp?) and it worked out wonderfully! I was out like a light, only slightly became aware once during procedure, and it was just like for 2 seconds, and I was back out. Woke up with no groggy hang-over. So to me - this is the ONLY way to go. I do not know why demerol/versed works for some and not for others. All I know is I have found the way that works for me, and I'm sticking to it.
    I feel like we should have done the propofol the 2nd time, and would have saved myself a bad experience.
  12. Visit  teeituptom profile page
    0
    Quote from RN2Bn2006
    Well the 1st time was unexpected, so we discussed plan for heavier meds next time - but because my BP dropped 2nd time (during procedure) they could not give me anymore. To be honest, what exactly are they supposed to do? The procedure has to be done, what happens if they stop in the middle of it? They could not increase my pain meds due to bp -- I've already had the prep - and I SURE ain't going do to that again any time soon, so It was just a matter of trying to comfort me until it was over. Fast forward to last month........... I had my 3rd scope, and after talking with (same) doc, we decided on propofol (sp?) and it worked out wonderfully! I was out like a light, only slightly became aware once during procedure, and it was just like for 2 seconds, and I was back out. Woke up with no groggy hang-over. So to me - this is the ONLY way to go. I do not know why demerol/versed works for some and not for others. All I know is I have found the way that works for me, and I'm sticking to it.
    I feel like we should have done the propofol the 2nd time, and would have saved myself a bad experience.


    Sounds like a major P.I.A. anyway you do it to me
  13. Visit  CrohnieToo profile page
    1
    Quote from theplugger
    .... Determined to try to save others from this guy's barbaric treatment I wrote a very strong letter of complaint to all clinics involved expressing my disappointment in the treatment I got from him during my colonoscopy, (being very explicit that the complaint was only about the doc, that the other staff had all been excellent) and recommending that my local clinic no longer refer any of their patients to him. I got a reply from all 3 (clinics involved) that this matter would be investigated and felt better for having espressed myself.
    About a month later during my annual physical, this subject came up and was discussed, and it turns out that the doc (who performed that horrid colonoscopy) has decided to retire.

    I feel like he got off pretty easy, but at least he'll no longer be out there torturing others.

    One moral of the story: If you have what seems like a legitimate complaint, document it. You never can tell, it just might add to the stack and tip the scales toward affirmative action!
    AMEN, Plugger!!!! More patients should take such action when they receive rude, abusive or incompetent treatment!! And on the other hand, it doesn't hurt to also send a note of thanks when someone goes above and beyond for you or gives you especially good care and treatment. I've done both and will continue to do so.
    MaudKennedy likes this.

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