recent colonoscopy experience

[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!

[BSN74]

I have had Ulcerative Colitis for 32 Years. I am supposed to have colonoscopies every year or two for the rest of my life. I was so scared it took me 20 years to ever have a colonoscopy. Back then, the doctors all refused to do anything other than light sedation. They said I would be awake. I knew I could not stand this. I was terrified. I went from MD to MD and got the same information. I finally got so distraught because I had to have them for the rest of my life because of the cancer risk, but I could not stand it, but I had to have it, but I could not stand it etc.etc.etc.

Finally, I went to a Psychiatrist. I knew she was paid to listen to me. I told her all about it. She immediatly said "why don't they just put you to sleep?" I said "Yeah, why don't they? I've been trying to get them to for 10 years." She called a collegue who was a GI. He saw me the next day, and did the scope two days later. I knew NOTHING.

Today, they seem to care more. At my every-other-year scope last week, I just mentioned past trauma in the holding room and I could see them thinking about how to help me.

Here is what I do:

Ask for MAC (Monitored Anesthesia Care)

Ask for something (about 2mg Versed) in the IV as soon as they get it in.

I tell then I don't need to see the endoscopy room.

Last week, a CRNA with a college do-rag on his head showed up in the holding room and WHOMP it was over and they were telling me to get up and get dressed. Thanks to short-acting Propophol, I could. We stopped off at Chili's on the way home. The next week, all biopsies came back negative.

I feel cheated because of the 10 years I lost being terrified. It was on my mind almost every day. That was when my children were little. I remember them missing the fair one year because of an insensitive doctor.

Just some words from a long time Ulcerative Colitis sufferer who has had many colonoscopies every other year and will for the rest of my life.

[careerchoices]

It is not so much a matter of "pansy" Americans needing sedation and analgesia as it is a matter of US doctors not taking the TIME to properly do a colonoscopy. It takes considerably more time to use less air, to proceed slowly w/the scope and to stop when the scope shaft loops back on itself to pull it back and straighten it. I have my colonoscopies w/o sedation by choice.

I would rather NOT be sedated; I am allergic to Fentanyl (not a full anaphylactic rxn yet, but I've done vomiting, been told that I am allergic by an anesthesiologist and ended up in the ER twice after procedures on a nebulizer) and I get bad post-procedural depression from Versed. But my doc (colorectal surgeon) always forgets, and then argues with me because he is afraid if I'm not sedated, it will slow him down too much. He does not say that outright, but makes comments about the "tight schedule" until I give in.

[CrohnieToo]

... But my doc (colorectal surgeon) always forgets, and then argues with me because he is afraid if I'm not sedated, it will slow him down too much. He does not say that outright, but makes comments about the "tight schedule" until I give in.

Tell him T++++H S++T! and to H++L w/his precious schedule!! Get another doctor, and probably better to get a gastro than a colorectal surgeon. YOU are the one who endures the benefits and/or consequences of any procedure, test or treatment. WHY give in to some egotistical, insenstive surgeon?? YOU are paying HIM whether out of pocket or thru your insurance. The doctors I've ever encountered who thought they walked on water, fell flat on their faces when walking on ice.

[mshultz]

I would rather NOT be sedated; I am allergic to Fentanyl (not a full anaphylactic rxn yet, but I've done vomiting, been told that I am allergic by an anesthesiologist and ended up in the ER twice after procedures on a nebulizer) and I get bad post-procedural depression from Versed. But my doc (colorectal surgeon) always forgets, and then argues with me because he is afraid if I'm not sedated, it will slow him down too much. He does not say that outright, but makes comments about the "tight schedule" until I give in.

I agree with CrohnieToo's advice. My doctor, a general surgeon, did not use abdominal compression, nor did he withdraw the scope a bit to resolve looping. It was really painful, but the pain was not nearly as bad as the creepy amnesia after I requested more drugs (I had asked to watch).

In addition, I have a concern about your doctor "forgetting" your request. This sounds like passive-aggressive behavior to me. My rules on passive-aggressive behavior:

1. Never, never, never, ever engage in passive-aggressive behavior.

2. To the greatest extent possible, avoid people who do engage in passive-aggressive behavior.

[CrohnieToo]

Another alternative you might want to discuss w/your NEW doctor who will be doing your scopes is the use of Propofol (Diprivan) for your scopes. Whilst you won't be awake to watch as you'd like to be, it is short acting and you wake up ALERT and AWARE and NOT so confused you can't remember a thing the doctor said to you after the scope.

Whenever my gastro and I have agreed on "sedation" for an endoscopy (the upper endoscopy is the worst of the two w/o sedation due to my STRONG gag reflex) my gastro has allowed me to bring my video cam and one of the staff videos just the monitor during the scope from insertion to withdrawal. Its almost as good as being awake and alert during the scope - except you can't ask questions during the scope. My gastro is great about pointing something out, like the psychodelic "yeastie beasties" I had once after using a steroid inhaler; an internal hemmorrhoidal skin tag or a diverticulum, etc. during the lower scope, whatever.

My last upper endoscopy my gastro w/her neat sense of humor (and the staff) took a quick video of me laying there w/my mouth open w/the "dumb" sedated look and the staff all around my head grinning and waving and saying "hi, we're ready to start". I haven't figured out yet what I'm gonna do to "get even" w/those clowns! But I'll think of something before my next scope.

[myschief1]

Most of our GI docs are using NAPS (nurse administered propofol sedation) and it has decreased our patient complications and increased patient satisfaction. It is still controversial, but NAPS is gaining approval as we collect more and more evidence supporting this practice.

[careerchoices]

Thanks for the suggestion; I don't really want the Propofol as I really don't care for the amnesic properties of those drugs. I'm just paranoid enough to want to remember that I acted appropriately...this is a hangup of mine after one bad experience with a rude doc.

That being said, yeah, I want zero recall of an EGD.

[CrohnieToo]

Pardon me while I'm confused. You really don't want Propofol as you really don't care for the amnesic properties of those drugs - yet you want zero recall of an EGD??

How do you propose you are going to reconcile this?

[careerchoices]

Point taken...sorry if I was unclear.

I can tolerate a colonoscopy awake (had a couple very-undermedicated ones where I just kept my mouth shut) and I would rather remember. A friend pointed out that she suspects this doctor is more worried about patients suing if they see something they don't like. He gets annoyed if patients want to keep their glasses on or look at the monitor.

An EGD is a whole different thing. I remember about 2/3 of my first EGD and it was horrid; like I was suffocating while being deeply violated, total gagging and gasping while Cxxxx Txxxxx yelled at me (different doc, I fired him for that). I want to be out for that. I would almost accept a whack on the head.

[CrohnieToo]

THAT I CAN understand! The gagging during an EGD is ..... ugh, don't wanna think about it! Even my gastro says EGD w/o sedation is WAY WORSE than a colonoscopy w/o sedation! She's gone thru both w/o sedation to find out for herself.

[careerchoices]

My other issue--silly as it is--is that if I am awake during a colonoscopy, I can control myself and keep from moaning or complaining. Too many times I have come out of the sedation to find myself moaning as they round the turn at the splenic flexure.

At least with an EGD, I have my mouth full.

[CrohnieToo]

Giggle. I have no problems w/the splenic flexure, its when they get to the far end of the transverse colon approaching the heptaic flexure that the vagus nerve says enough and it gets darn uncomfortable and I start GAGGING bad, but a little phenergan in the IV puts the vagus nerve back in "standby mode" and we can continue.