My 1st colonoscopy - draping & pain questions

[carolla]

Last week I had my first colonoscopy. It was recommended because of a positive fecal occult test. My first question has to do with draping. I woke up several times (from the pain). The first time I woke up, I was in a supine position and I found that I was not covered from the waist down. I then was on my right side (also uncovered). Is this typical or is there a way to drape the patient. It's not the worst thing in the world but I felt embarrassed not being covered. Also, at the times I woke up, I was in extreme pain. The pain was a terrible stabbing pain. Is this normal?

After the procedure, I had a good bit of pain in my left side and I passed some blood. I was told not too worry about it and that everything looked good. I thought it was strange because I did not have polyps removed. My lower left side still aches a bit. Is this typical? I'd appreciate any feedback. Thanks

[core0]

chewchabuckala said:

Had my first colonoscopy and endoscopy last month. Several months ago I had been scheduled but the prep put me in the hospital. This new doc I saw did my prep differantly. No laxative pills, and drank the mix with orange drink.....McDonald's! I drank it in small doses over a 12 hour period, and if I was to start vomiting (thank goodness I didn't), I was told to take a fleets before leaving home.

I was sedated to the max. Saw nothing, felt nothing.

Has anyone in cyber space been diagnosed with diverticulitis?

I'd sure appreciate to hear what your S&S are, I'd like as much info as anyone is willing to share. :balloons:

Never had it but treated plenty. It presents like left sided appendicitis. Sharp LLQ abdominal pain usually accompanied by diarrhea with occasional bloody stool.

That being said I am amazed by the number of sub acute cases we see. In my previous job I saw people for pre op eval for colonoscopy. We had more than a few with LLQ tenderness. About half of those had mild diverticulitis that resolved with antibiotics.

David Carpenter, PA-C

[MeganNY]

mrsred said:

I just had my first colonoscopy last week as well. I had researched the procedure and the meds used. My husband had his 2 year screening done in March and while sitting in the recovery area with him, I had heard 2 people scream. One was a woman who cried and hollered just like I remember myself doing at the start of the procedure.

I was uncontrollably crying as they wheeled me into the procedure room. I had a death grip on my husbands hand and was told that when the Dr told him he had to leave the procedure room I would not let go of his hand. He had to literally pry my fingers off of his hand to leave and this was after the sedative.

My blood pressure was 142/102 just after I saw the colonoscope on the nurses arm and I did not do very well in the beginning. I was so upset that the Dr. had a difficult time sedating me and ended up giving me 7 mcg of Versed and 200 mcg of Fentanyl plus oxygen.

I know that I felt pain when they started the colonoscopy, becaue I felt a burning/pain sensation going up my left side and I remember crying and whining Owe, Owe, Owe, and then it stopped and I don't remember anything else until I woke up in recovery and told both the Dr and my husband that they had lied to me, that the procedure hurt!

Thanks for listening and allowing me to vent

Does anyone know if Drs are open to an alternative to Versed? I am having a c-scope in a few weeks and have heard horror stories about amnesia from the Versed, also about inadequate pain management.

Any other benzos being given IV, such as Valium?

thanks

Megan

RN, BSN, disabled; back in school for MT (ASCP)

[caroladybelle, BSN, RN]

MeganNY said:

Does anyone know if Drs are open to an alternative to Versed? I am having a c-scope in a few weeks and have heard horror stories about amnesia from the Versed, also about inadequate pain management.

Any other benzos being given IV, such as Valium?

(ASCP)

Valium and demerol was the combo used the first time I was sedated for the procedure.

(I had the procedure done several times prior, with no sedation whatsoever....back in the old days)

Several problems. As most nurses know, demerol is now rarely used d/t the wellknown issues with it. Valium IV can be very irritating to the vein and there was some phlebitis for about 7-10 days after, each time it was used. It also tends to leave the patient more heavily sedated and for longer than versed does. This decreases pt turnover, and means the GI has to stay longer.

However, for my last two endos, my GI used diprivan (Propofol). While mildly irritating to the vein, it wasn't as problematic as IV valium. It works much faster than traditional concious sedation, it kept me completely out, and wears off rapidly with NO after effects (I get HAs from versed). Within 30 minutes after the endo, I felt completely sober.

It does have to be given with anesthesia personnel (CRNA or anesthesiologist) present. Which means same places cannot safely give it. While propofol has an excellent safety record, if the patient goes bad, there needs to be someone that can intubate if necessary. Unlike most narcs/seds, there are NO antidotes to it other than time.

[MeganNY]

caroladybelle said:

Valium and demerol was the combo used the first time I was sedated for the procedure.

(I had the procedure done several times prior, with no sedation whatsoever....back in the old days)

Several problems. As most nurses know, demerol is now rarely used d/t the wellknown issues with it. Valium IV can be very irritating to the vein and there was some phlebitis for about 7-10 days after, each time it was used. It also tends to leave the patient more heavily sedated and for longer than versed does. This decreases pt turnover, and means the GI has to stay longer.

However, for my last two endos, my GI used diprivan (Propofol). While mildly irritating to the vein, it wasn't as problematic as IV valium. It works much faster than traditional concious sedation, it kept me completely out, and wears off rapidly with NO after effects (I get HAs from versed). Within 30 minutes after the endo, I felt completely sober.

It does have to be given with anesthesia personnel (CRNA or anesthesiologist) present. Which means same places cannot safely give it. While propofol has an excellent safety record, if the patient goes bad, there needs to be someone that can intubate if necessary. Unlike most narcs/seds, there are NO antidotes to it other than time.

How about IM Valium? The GI I was referred to doesn't use an anesthesiologist.

I definiately don't want Versed tho.

Thanks

megan

[genealogymom]

I was being treated with cipro for an UTI for 9 days on the tenth I woke up with LUQ pain, I def had rebound tenderness! They did an x-ray then sent me to get an MRI, I was an immediatel admit. I had an abcess the size of a tennis ball, 7cm. I was treated with cipro, levoquin and flagel via a subclavian line for 6 days. I had my colonoscopy day b4 yesterday, I do not remember a thing except being told to roll over. I am home today but have a pain in my chest that will not go away feels like a poke and a sore knee joint (she said this is common with levoquin) I was diagnosed with diverticulitis. My overall experience was no pain with the colonoscopy but the golytely was horrible. I will def have more empathy when I bring in that jug!

[truern]

Scheduled for an EGD and colonoscopy on the 3rd....I'm paying extra for propofol vs versed and demerol. I want to be OUT!!

Oh, and I'm taking the pills instead of GoLytely. Anybody else take them??

[caroladybelle, BSN, RN]

MeganNY said:

How about IM Valium? The GI I was referred to doesn't use an anesthesiologist.

Very few places use valium IM.

But as a general rule with meds, if a med is very irritating as an IV drug, it is much more so given IM/SQ, potentially necrosing.

Think about the other major irritants/vesicants. Because of the nature of blood vessels vs skin/muscle/fat tissue, there are many drugs that can be given safely IV, that if they extravasate into tissue, can seriously damage tissue (example of vesicant chemo, dopamine, dilantin, potassium).

Chances are if it hurts IV, you will have even more serious problems with the IM/SC.

[MeganNY]

caroladybelle said:

Very few places use valium IM.

But as a general rule with meds, if a med is very irritating as an IV drug, it is much more so given IM/SQ, potentially necrosing.

Think about the other major irritants/vesicants. Because of the nature of blood vessels vs skin/muscle/fat tissue, there are many drugs that can be given safely IV, that if they extravasate into tissue, can seriously damage tissue (example of vesicant chemo, dopamine, dilantin, potassium).

Chances are if it hurts IV, you will have even more serious problems with the IM/SC.

You're right. But I am grasping at straws here because I do not want Versed! Thanks

megan

[core0]

MeganNY said:

You're right. But I am grasping at straws here because I do not want Versed! Thanks

megan

If I am reading the thread right you have never had Versed or a colonoscopy? I don't understand your aversion to Versed. There are more than 10,000 colonoscopies done every day, the great majority of them with Versed and Fentanyl. Most (my estimate would be 99%) have no problems with either pain control or amnesia. Talk about your concerns with the physician, but my thoughts are you are gettting yourself worked up after reading reports from the minority of people that have problems. The other meds that you discussed especially Valium are in my opinion less safe than Versed. I am sure there are plenty of nurses here that remember the Valium Demerol days with the consequences of over and under sedation. Patients taking 5 hours to wake up in PACU etc.

Talk to your physician about your concerns, I am sure that they will be able to allay your fears.

David Carpenter, PA-C

[caroladybelle, BSN, RN]

MeganNY said:

You're right. But I am grasping at straws here because I do not want Versed! Thanks

You could always forgo having any sedation at all.

But as someone that was scoped without any meds at all, I don't recommend it.

[donsterRN, ASN, BSN]

I've had more than my share of colonoscopies, and I've never had a problem with the Fentanyl-Versed combo. I'm kinda grateful for the amnesia! The prep on the day before was much, much worse, IMO.

[MeganNY]

core0 said:

If I am reading the thread right you have never had Versed or a colonoscopy? I don't understand your aversion to Versed. There are more than 10,000 colonoscopies done every day, the great majority of them with Versed and Fentanyl. Most (my estimate would be 99%) have no problems with either pain control or amnesia. Talk about your concerns with the physician, but my thoughts are you are gettting yourself worked up after reading reports from the minority of people that have problems. The other meds that you discussed especially Valium are in my opinion less safe than Versed. I am sure there are plenty of nurses here that remember the Valium Demerol days with the consequences of over and under sedation. Patients taking 5 hours to wake up in PACU etc.

Talk to your physician about your concerns, I am sure that they will be able to allay your fears.

David Carpenter, PA-C

thanks for your response, David

My understanding of Versed (never having had it) is from friends and family members who were unable to converse or communicate with the GI and nurse during the procedure, for example, I am in pain, can I have more pain meds, I have am nauseous, this hurts so bad, please stop.

They were aware, but unable to form a sentence or speak. The procedure was terribly traumatic for that reason.

My feeling is there will be some pain, which I might (?!) be able to handle, but to be unable to communicate during the procedure makes me terrified.

Others have said they had complete amnesia from the procedure and would have preferred to have been relaxed with some mild sedation and some pain meds, but aware enough to communicate.

Maybe not everyone has the same experience. I prefer to keep the horror alive (!) rather than wipe out my memory, but as you said, many people don't have a problem.

Thanks all for your help!

Megan, RN, BSN, disabled, now a future med tech