recent colonoscopy experience

Specialties Gastroenterology

Published

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!

Hi,

I'm a retired RN who has had only a few personal healthcare experiences, most of them very positive. For example, when I needed a rhc and pulmonary angio I was full of anxiety only to find that the procedure was not nearly as horrid as my mind had made it out to be. For years I've been urged to have a screening colonoscopy just because I'm 65. At age 60 I was on coumadin for multiple pe's which had caused pulmonary hypertension, so when the subject of screening colonoscopy came up the surgeon recommended a barium enema instead since I was on coumadin at that time. I have since been pronounced free of pe's and ph so now decided I should go along with my physician's urging to have the screening colonoscopy, especially after my husband had one a few months ago which revealed some pre-cancerous polyps which were removed. He went through the prep and the procedure quite well saying "it wasn't so bad", so this allayed my anxiety considerably. I figured the prep would be the worst part (remembering the horrendous barium enema prep), and even though it was different, it didn't let me down. I was on clears the day before (this was fine), then 3T phosphosoda in 4 oz 7-Up followed by 12 oz clears at 12:30pm. That's when the fun began. I even worked at crocheting on an afghan while seated on the throne for a couple hours. The resulting discharge of cautic liquid scalded my butt raw. I could barely stand the pain of cleaning up between expulsions! A nurse called me around 5pm asking how the prep was going. When I told her of my woes, she recommended Tucks and vaseline to sooth the pain. We had no Tucks. I only wish that recommendation had been included in the colon prep instructions so I would have been prepared, but I did have some vaseline and it did help considerably. The next dose of 3T phosphosoda was ingested at 6:30pm sending me back to the throne, but I was so exhausted by 8pm that I had to lie down. Six pads, a couple soiled towels and 3 pairs of underwear later I finally was able to get a little sleep. Luckily my procedure was scheduled for 12:45pm so I was able to get up and enjoy my (black) decaf before the npo at 8:45a, congratulating myself on surviving the prep and now looking forward to getting on with it, getting it over with. From here on I was feeling like I was "home free"...they would give me conscious sedation, I would still be awake enough to watch the screen during the scope. I guess they gave me some Versed or something, but it didn't cause any amnesia nor did it ease the severe pain! I was in such agony three or four different times that I was ready to climb off that table, and all the while the nurse kept assuring me "you're doing just fine". I was NOT doing fine, I have a pretty high pain threshhold and this was nearly above and beyond my tolerance!! It didn't last long, perhaps 15 minutes, and the pain subsided immediately at the end of the procedure. When I returned to the recovery area the nurse observed "gee, you're not sleepy at all, you're really wide awake". Very astute observance. In retrospect I wonder if I didn't get enough Versed (or whatever), and if the doctor didn't just shove that scope along too fast. Maybe he had not had lunch yet? At any rate, I'm glad the scope came out clean so I don't need another colonoscopy for 10 more years, because I don't think I could go through that again very soon. Maybe in 10 years they'll have better methods so I won't have to suffer so.

The reason I'm posting this here is because I felt the need to vent, to tell of my experience, but I wouldn't/won't pass my experience on to my friends and loved ones so as not to scare them because everyone else's experience has been much more positive and less painful.

Hi,

I'm a retired RN who has had only a few personal healthcare experiences, most of them very positive. For example, when I needed a rhc and pulmonary angio I was full of anxiety only to find that the procedure was not nearly as horrid as my mind had made it out to be. For years I've been urged to have a screening colonoscopy just because I'm 65. At age 60 I was on coumadin for multiple pe's which had caused pulmonary hypertension, so when the subject of screening colonoscopy came up the surgeon recommended a barium enema instead since I was on coumadin at that time. I have since been pronounced free of pe's and ph so now decided I should go along with my physician's urging to have the screening colonoscopy, especially after my husband had one a few months ago which revealed some pre-cancerous polyps which were removed. He went through the prep and the procedure quite well saying "it wasn't so bad", so this allayed my anxiety considerably. I figured the prep would be the worst part (remembering the horrendous barium enema prep), and even though it was different, it didn't let me down. I was on clears the day before (this was fine), then 3T phosphosoda in 4 oz 7-Up followed by 12 oz clears at 12:30pm. That's when the fun began. I even worked at crocheting on an afghan while seated on the throne for a couple hours. The resulting discharge of cautic liquid scalded my butt raw. I could barely stand the pain of cleaning up between expulsions! A nurse called me around 5pm asking how the prep was going. When I told her of my woes, she recommended Tucks and vaseline to sooth the pain. We had no Tucks. I only wish that recommendation had been included in the colon prep instructions so I would have been prepared, but I did have some vaseline and it did help considerably. The next dose of 3T phosphosoda was ingested at 6:30pm sending me back to the throne, but I was so exhausted by 8pm that I had to lie down. Six pads, a couple soiled towels and 3 pairs of underwear later I finally was able to get a little sleep. Luckily my procedure was scheduled for 12:45pm so I was able to get up and enjoy my (black) decaf before the npo at 8:45a, congratulating myself on surviving the prep and now looking forward to getting on with it, getting it over with. From here on I was feeling like I was "home free"...they would give me conscious sedation, I would still be awake enough to watch the screen during the scope. I guess they gave me some Versed or something, but it didn't cause any amnesia nor did it ease the severe pain! I was in such agony three or four different times that I was ready to climb off that table, and all the while the nurse kept assuring me "you're doing just fine". I was NOT doing fine, I have a pretty high pain threshhold and this was nearly above and beyond my tolerance!! It didn't last long, perhaps 15 minutes, and the pain subsided immediately at the end of the procedure. When I returned to the recovery area the nurse observed "gee, you're not sleepy at all, you're really wide awake". Very astute observance. In retrospect I wonder if I didn't get enough Versed (or whatever), and if the doctor didn't just shove that scope along too fast. Maybe he had not had lunch yet? At any rate, I'm glad the scope came out clean so I don't need another colonoscopy for 10 more years, because I don't think I could go through that again very soon. Maybe in 10 years they'll have better methods so I won't have to suffer so.

The reason I'm posting this here is because I felt the need to vent, to tell of my experience, but I wouldn't/won't pass my experience on to my friends and loved ones so as not to scare them because everyone else's experience has been much more positive and less painful.

This is the reason I HATE my job. I am a "moderate sedation" nurse, and at times I have to sit back and watch patients tortured by physicians who do not understand how to use the medications. Versed is not an analgesic. You probably needed more of it, first of all, and also needed an opiate such as Demerol or Fentanyl for pain relief. The doctors seem to think that Versed is always an amnestic; however, if the patient does not get enough, they remember the whole procedure. It does no good to have a patient writhing and bearing down hard when the scope is being advanced.

It takes even more time to do the scope. I have seen patients crying, and I'm asking the doctor to give them more medication and the doctor refuses. The biggest culprits are the surgeons. I work with one of them who starts poking the scope in before I even get the medication in the IV. I feel like asking them if they start to cut before the patient is anesthetized in the OR. Patients need to feel the effect of the medication before the procedure is started; otherwise, it's hard to "catch up" with the Versed and pain medication.

I would advise you to contact your hospital's QI or risk management person and complain! Nobody should have to put up with that.

Specializes in LTC, assisted living, med-surg, psych.

OMG........I just can't wait to NOT do this. :stone

I've put so many people through the bowel prep (whoever named that stuff "GoLytely" must've had a warped sense of humor) that I've never really urged the over-50 members of my family to get a colonoscopy done, even though I know the statistics about colon cancer. Nor am I planning on having the procedure done on myself at any time in the foreseeable future, even though I've had some GI trouble in the past and will be 50 well before this decade is over. It's just like the dentist: I'll go when I have an actual problem that I can't stand anymore.......that's how badly I DON'T want to deal with this :o

You'd think, in the 21st century, that we'd have more humane ways of diagnosing such things.......meanwhile, if I or anybody I care about needs to have this test, I'll be advocating for Propofol! That's what they gave me for my last laser lithotripsy, and I not only didn't get verbal incontinence like I do with Versed, I didn't wake up sick to my stomach either. :) It's good stuff.........now, if they could just do something about that damned bowel prep......... :uhoh3:

:rolleyes: It's been over a week since my traumatic experience and I've done much reflecting on it and on the responces. So now I'd like to add more feelings about my colonoscopy experience and about how I (still) feel about colonscopy in general.

First of all, my main complaint was with the callous treatment I received from one arrogant doc who chose to show absolutely no regard for the patient's comfort or feelings. To me, that's the bottom line which I incorporated into a letter of complaint mailed to the clinics involved.

Since my husband's screening colonoscopy of a few months ago during which, with no symptoms of any kind, they discovered and removed 2 pre-cancerous polyps, I felt more of an urgency that I wanted to have one as well to set my mind at ease, get it over with. I had a cousin who lost a very long and agonizing battle with colon cancer, and definitely did not want to go that path since it can easily be detected early enough for cure.

Thank you for your ears and sympathies :balloons: , and down with heartless sadistic docs :angryfire !!

As for the bowel prep, once in any lifetime is surely enough!!

OMG........I just can't wait to NOT do this. :stone

I've put so many people through the bowel prep (whoever named that stuff "GoLytely" must've had a warped sense of humor) that I've never really urged the over-50 members of my family to get a colonoscopy done, even though I know the statistics about colon cancer. Nor am I planning on having the procedure done on myself at any time in the foreseeable future, even though I've had some GI trouble in the past and will be 50 well before this decade is over. It's just like the dentist: I'll go when I have an actual problem that I can't stand anymore.......that's how badly I DON'T want to deal with this :o

You'd think, in the 21st century, that we'd have more humane ways of diagnosing such things.......meanwhile, if I or anybody I care about needs to have this test, I'll be advocating for Propofol! That's what they gave me for my last laser lithotripsy, and I not only didn't get verbal incontinence like I do with Versed, I didn't wake up sick to my stomach either. :) It's good stuff.........now, if they could just do something about that damned bowel prep......... :uhoh3:

Yep- this is why I asked about the virtual colonoscopy .

Specializes in Oncology/Haemetology/HIV.
Yep- this is why I asked about the virtual colonoscopy .

Unfortunately, virtual colonoscopy is not an option for many of us, since biopsies cannot be done that way.

Due to medical history, I get scoped every two years and biopsies must be done.

Unfortunately, virtual colonoscopy is not an option for many of us, since biopsies cannot be done that way.

Due to medical history, I get scoped every two years and biopsies must be done.

True about it not always being an option, and it also doesn't bypass that "worst" part, THE PREP, which is still a necessary evil with the virtual colonoscopy.

I don't recommend the virtual to my friends, but I do recommend they do not just take their chances with "anyone" as I did, but that they check around and find a kind, caring and compassionate physician to do the job. That's what I feel I learned from my bad experience.

Specializes in Telemetry/Med Surg.

I've had two colonoscopies before in the past--the 1st time showing polyps which were removed & biopsies. I now have to go q3 yrs. I remembering waking up both times during the procedure but only briefly.

The worst bit for me was the prep. Now if I can just convince my sister to go!

For those of you who have encountered pain during colonoscopy, you really should read the two abstracts I've given the URL for below. Then get the full articles and give them to your gastro!!!! I first gave my gastro the abstracts and then later, to reinforce my message, the full articles. Her scoping skills have improved dramatically and she is slicker than snot on a doorknob maneuvering that scope thru my colon now.

I no longer have a bruised feeling in my abdomen for several days after a scope, I do not have sedation or anesthesia for my scope. I have just 25 mg Demerol and, if the vagus nerve gets in a twit at the transverse colon/hepatic flexure area, a little Phenergan to stop the resulting dry heaving. My gastro does use a pediatric scope and frankly, altho I haven't convinced her of it, I think the peds scope is more likely to cause the vagus nerve twit than if she used the adult scope due to the peds scope being more flexible and thus more likely to loop back on itself.

Since our hospital's outpatient endo department equipment doesn't have the capability of producing a video tape of the procedure my gastro has agreed to my bringing my video cam in and videotaping the monitor during the procedure. For those of you who would really like to watch but really doesn't want to endure any discomfort from the procedure this is the ideal solution.

A Study of Pain During Colonoscopy

Why Colonoscopy Is More Difficult In Women

From the Journal of The Royal College of Surgeons of Edinburgh, here's an article by a "teaching colonoscopist" that details the whole procedure, including some of the things that can go wrong. It's called, How I do it, by A. LESLIE and R.J.C. STEELE, University Department of Surgery and Molecular Oncology, Ninewells Hospital, Dundee DD1 9SY, U.K.

For those of you who have encountered pain during colonoscopy, you really should read the two abstracts I've given the URL for below. Then get the full articles and give them to your gastro!!!! I first gave my gastro the abstracts and then later, to reinforce my message, the full articles. Her scoping skills have improved dramatically and she is slicker than snot on a doorknob maneuvering that scope thru my colon now.

I no longer have a bruised feeling in my abdomen for several days after a scope, I do not have sedation or anesthesia for my scope. I have just 25 mg Demerol and, if the vagus nerve gets in a twit at the transverse colon/hepatic flexure area, a little Phenergan to stop the resulting dry heaving. My gastro does use a pediatric scope and frankly, altho I haven't convinced her of it, I think the peds scope is more likely to cause the vagus nerve twit than if she used the adult scope due to the peds scope being more flexible and thus more likely to loop back on itself.

Since our hospital's outpatient endo department equipment doesn't have the capability of producing a video tape of the procedure my gastro has agreed to my bringing my video cam in and videotaping the monitor during the procedure. For those of you who would really like to watch but really doesn't want to endure any discomfort from the procedure this is the ideal solution.

A Study of Pain During Colonoscopy

http://www.e-health-questions.info/html/board/index.php/action=displaythread&forum=boweldisorders&id=12&realm=default

Why Colonoscopy Is More Difficult In Women

http://www.e-health-questions.info/html/board/index.php/action=displaythread&forum=boweldisorders&id=13&realm=default

From the Journal of The Royal College of Surgeons of Edinburgh, here's an article by a "teaching colonoscopist" that details the whole procedure, including some of the things that can go wrong. It's called, How I do it, by A. LESLIE and R.J.C. STEELE, University Department of Surgery and Molecular Oncology, Ninewells Hospital, Dundee DD1 9SY, U.K.

http://www.rcsed.ac.uk/journal/vol47_2/4720010.html

CrohnieToo:

I am in absolute awe of your communication skills with your gastroenterologist! The "How I do it" article seems to have a lot of good advice. His scope appears to be better than what was used on me, which had an eyepiece and was probably not variable stiffness. I doubt that my doctor ever backed out the scope to reduce looping. If this had occurred, I should have noticed a reduction in pain. I was glad to see that suctioning out the excess fluid and gas is a recommended technique. Although my doctor did this, many apparently do not.

My main concern now, is that in retrospect, no one provided me with adequate information, even when I expressed concerns that should have indicated the need for additional information. Informed Consent was never discussed with me. In my letter to the doctor, I requested the same sedation as I had for the EGD, which was 2 mg Versed and 50 mg Demerol. If the doctor had told me the initial dosage for the colonoscopy would be 1 mg Versed and 50 mg Demerol, then I would have had the nerve to just request more Demerol later on, since I still wanted to remember. I only found out about this after I requested my records from the hospital.

Especially troubling to me now is that when the nurse who was assisting the doctor came out to get me, she asked me to remove my glasses. I explained that I had written to the doctor about wanting to watch the procedure, but had not yet heard his answer. She showed no expression at this reply; just indicated I could keep my glasses, but warned they could get bent. 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.

My concern for the future is that even after telling everyone I want to be an informed patient; that I want all of the information to which I am entitled, it will still be an uphill battle to get the necessary information. 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.

Michael E. Shultz

[email protected]

"Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read."

Groucho Marx

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:

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:

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.

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.

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