Going for endo with dilitation, meds they gave me before didn't work,Im petrified

[unite911]

Hi, I'll try to be short. I had nissen with HSV done in 1995,severe Gerd,.Have had severe nausea, diarrhea, lost about 100 lbs, I'm dehydrated most of the time because I can't eat much d/t the nausea and some times I just loose the drive to drink,that's when it gets bad, I've passed out several times and ended up with concussions,broke my nose, knocked a few teeth out seems like no end in site either. I'm on phenergan p.r.n.(tried everything for the nausea).Also take donnatalES because I get severe chest pain(esophageal/digestive tract spasms).Even with all that I have to go in for another dilitation next week and I am petrified because this last one done in september 2004, I was totally awake, aware,dry heaving through the whole procedure,trying to pull that dam tube out to tell him to stop. I was told they gave me 100mg demerol and 5mg of versed. The last time they gave me the same but it knocked me out in a few seconds. I also take Klonipin.I'm a nurse but don't really see why the meds worked great before and not this last time( I've even thought that maybe the nurse that gave it to me last was keeping a little for herself,if you know what I mean.)but I hate to think that! I've talked to my GI Dr.'s nurse practioner about my concerns about how traumatized I felt because I was wide awake and they just kept going.She put on my chart to increase sedation.I think this time I have to insist that thay make sure I'm out of it enough before they stick that tube down!Heaven forbid if my doc has to wait 2 minutes or whatever for the meds to take effect before he begins the procedure.what's the limit of what they can give you,and if they've given you the limit ....can thay still increase it if your still wide awake and pulling at the tube and wretching !? Oh and the next wonderful thing is, I have to have a colonoscopy 2 days later(same doc).....needless to say I'm not having a good week worring about next weeks procedures.Any advice would be GREATLY appreciated.

Thanks, Marilyn

[Chuckie]

No limit really as to what they give you. At some point you may ask for an anesthesia consult, for deeper sedation. A lot depends on your stress and other medications you may be on. If I were you I wouldn't accuse the nurse of taking the drugs from you. It just wouldn't happen. I believe it takes one to know one. Try fentenyl instead of Demerol it is quicker acting and will not cause the nausea like Demerol.

[fotografe]

I just had an upper endo with Fentanyl yesterday (vs the demerol I had with an ERCP a few years ago) and it is the best. You go out fast, Know nothing during, wake up quickly and are out of the hospital sooner with no lasting effects. I was in recovery with the demerol almost the whole day with the ERCP as they gave me the max dose and I still tried to pull the camera out and run away! I don't know what happens when fentanyl goes wrong, but for me it went quite right. Call ahead and ask if it is an option.

No limit really as to what they give you. At some point you may ask for an anesthesia consult, for deeper sedation. A lot depends on your stress and other medications you may be on. If I were you I wouldn't accuse the nurse of taking the drugs from you. It just wouldn't happen. I believe it takes one to know one. Try fentenyl instead of Demerol it is quicker acting and will not cause the nausea like Demerol.

[rn29306]

Thing to watch out for with rapid dosing of Fentanyl is chest wall rigidity, requiring positive pressure ventilation, either this breaks it or the resulting hypoxia does. A rare but potential problem may occur with the rigidity is the need for chemical paralysis with succinylcholine in order to ventilate.

Have only seen it one time on my cousin, he turned absolutely purple. Don't know his sat at the time because he was bundled up going to CT scan, the RN rushed in and IV pushed the fentanyl and he locked up. Luckily it passed after about a minute.

While your MD may not utilize anesthesia, perhaps you should find one that does and then you will be introduced to propofol and the wonderful characteristics of this drug, especially the benefits of it for outpatient diagnostic procedures. WARNING: while some GI docs and staff RNs are going toward the trend of letting staff RNs push propofol, I would strongly urge against this. Propofol is a general anesthetic and should be treated as such. This has been discussed elsewhere in the GI thread.

I feel your pain about being awake. I have had my esophagus dilated several times under CS. I only remember going for the tube one time. Think one hand was on the tube and the other hand was on the doc. Not good. The last time I was given nothing but a can of lidocaine and was dilated with the bougies and the butthole doc saying "take a deep breath 'cause you won't be able to breathe on these last two". That is the last time that will ever happen. I don't know who had more KY on them, he or I. I emptied the can of lido on the back of my throat, I'm surprised that I didn't go into methemoglobinemia...:)

Let us know how it goes. Stick with fentanyl. Demerol is for the birds. If they don't listen to you about not wanting demerol:

1. pick another doc (pref one that uses anesthesia services)

2. you could always tell them you take a MAOI (contraindication to demerol usage).....but that would be lying and on your medical record then so take that with a grain of salt...#2 is a joke by the way..