recent colonoscopy experience

Mersa59 · May 26, 2008

Mychief 1

I am a RN, had to be scoped last week, was anxious about it. However everyone insisted I would not feel anything.

They Lied.

I had Propofol

Remember nothing from the EGD, However I was very sore and raw from the prep, and when I told the doc this, I heard her say to someone get me some lidocaine.

I asked myself why would they need lidocaine?

well.....I was not so sedated for the colonoscopy.

I felt the insertion of the tube, and it hurt and I remember yelling out. I also felt the tube being advanced and this was painful, along with this I felt the removal, and the doc told me there was a hematoma that occured from the tube.

I was yelling OWE-OWe!! at different times, and while I was wheeled into recovery. I was AWAKE, but had still enough sedation, not to be able to move and stop this proceedure.

I was in terrible pain after ward,I felt like a horse had kicked me upper and lower abdomen, had pain for days now, although with each day it is a little less.

I did have biospies taken with the endoscopic part.

I am not a wooz, have had 3 c-sections, a shoulder dislocation and more. Never wanted to get the 5-6 foot hose however, and found myself with a very low crit and HG/ iron levels.

I did not think I had a bleed, but you know they have to do their own thing about ruling out the cause.

I feel they could of had me out as deeply for the colonoscopy as they did for the endo.

I do not know why they did not.

I felt lied too, and misserable, and felt that this test was not necessary. I had asked for a virtual and capsule but was told It was better to go this route.

sitting here with my upper abdome still hurting I can honestly say, This was the First, and the Last.

I will never be put thru this one again.

It is totaly nuts, that they do not give many patients enough anesthesia. To have to feel all that and with my insides already raw, which I am sure made it worse, is totaly barberic.So If you are working for GI docs, let them know, that this patient/RN

says, make sure the patient is OUT, and not yelling. yelling is a sign of not being medicated enough, and should :no:never be happening!!!!!

Mersa

CrohnieToo · May 26, 2008

If you are still in pain from this colonoscopy you can credit that DIRECTLY to the lack of skill or consideration of the person doing the scope. Whether the doctor advanced the scope or had a nurse advancing the scope the residual pain at this late date was caused by the extreme and unnecessary stretching of the colon as the scope was advanced and the shaft looped back on itself and the person advancing the scope not using proper and considerate procedure.

If I'm understanding correctly you had the EGD and then immediately following you had the colonoscopy. Most certainly you SHOULD ask WHY you were NOT adequately sedated for the colonoscopy. There may have been a MEDICAL reason why they couldn't provide more or enough propofol for the colonoscopy.

I sure would NOT have another colonoscopy w/this particular doctor and I would ask point blank WHO was advancing the scope, the doctor or the nurse.

Mersa59 · May 27, 2008

I do believe it was the doc that had hands on with the scope.

I was left with a hematoma also, they were upfront about it, said it probably happened from the scope, and that they rinsed throughly with saline, and it appeared to have stopped bleeding.

If they were concerned about any medical problem, they should have told me. after all they sedated me enough with the EGD, so why not the colonoscopy?

I had been told not to worry that I would be out and not feel anything as I was getting the catalac of drugs for this. But that was not what happend. I think they knew ahead of time, as when I told the doc about how sore I was from the prep, I heard her say to one of the other staff, go get me lidocaine. if a person is sedated enough, why would you need lidocaine.?

I was going to ask her this, but then I thought no they promised I would be out.

oh well it is over and done with now, was set up as a urgent sort of thing, as I had dropping crit and hg, iron levels. had to have 4 units of blood several days before the proceedure. I had to have my crit back up to non dangerous levels in order to be sedated. It was up to 32 from 14.

thanks for responding.

If I see her again, the doc, I will make sure I say something about all this.(she was a 4th year resident)

Mersa

CrohnieToo · May 27, 2008

Check out these articles:

Endoscopy 2002 Jun;34(6):435-40

Patient pain during colonoscopy: an analysis using real-time magnetic

endoscope imaging.

Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP.

Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, London, United Kingdom.

PMID: 12048623 [PubMed - indexed for MEDLINE]

Gastrointest Endosc 1996 Feb;43(2 Pt 1):124-6

Why is colonoscopy more difficult in women?

Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, Williams

CB. Department of Endoscopy, St. Mark's Hospital, London, England.

PMID: 8635705 [PubMed - indexed for MEDLINE]

Especially try to get the full article of that first abstract. Its an eye opener.

CrohnieToo · May 27, 2008

Since you had been having some problems in the days immediately preceding the colonoscopy that might account for both the less than satisfactory sedation AND for some of the prolonged pain you are encountering. There might well have been something going on in the colon to contribute to the sensitivity and pain you are still encountering. Your scope report should answer some of this. I would certainly get a copy of the report from Medical Records/Health Information Management.

I'd be inclined to ask for the full record, including Nurse's Notes, etc. Curiosity killed the cat and I like to have the full recorded info on hand when I talk to the doctor about something I wasn't happy with.

nursebabygirl 08 · Jul 23, 2008

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!

Mat i am a GI nurse and your experince is NOT normal!!! do you take narcotics? sleeping meds? anxiety meds, or meds for depression? All the meds i just listed can effect how "well" you tolerate sedation. At my office we use fentanel standard dose 50-100 mcg and benadryl (for those hard to sedate). Oh yeah and do you drink alcohol on a daily basis? We have noticed that people who drink daily are unlikely to have desired effects from sedation. Did your doc wait before sticking that colonoscope up your butt? recommended time lapse from drug administration to scope entrance is 2-3 mins. (some docs don't give the meds time to work).I'm sorry that you had such a horrible experince. Maybe you should have your next procedure done at you local hospital; that way you could recieve propofol. You may have Min discomfort from the air used within the colon, but from what your saying something is not right, i hope that your next experince is a better one. :nurse:

Mersa59 · Jul 23, 2008

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!

Mat do not let anyone tell you what you felt was secondary to you doing something. I have combed thru the research, the reason most folks get sedation of some sort, is because the colonoscopy is not a comfortable test. I have read that many patients complain of pain and do not feel like they were adequately sedated. some even call versed the worst drug and are telling folks not to have it.

My Gi told me the best thing to have is Propofol.

I believe her, after reading about patients who write in and complain of the pain they felt with other forms of sedation.

first of all women are harder to scope.

if you have had abdomiinal surgery it is even harder.

the pressure of the streatching of the bowel causes pain and if the scope is advanced and coils, or hits the wall of the intestine, especially at the bends and curves...it causes pain.

I am no wimp, I have been thru more than I can put in here and without meds.

If I woke up with propofol, in pain, and found myself moaning and hollering out, I will tell you, it is painful. I do not use narcs, benzos and I do not have a drinking problem or history.

neither did many of the patients who wrote in about their experiences.

they too were made to feel they did something wrong. or the problem was theres, not the doc, not the proceedure, not the sedation or pain med they were given.

something aint right in Demark......too many complaints of similar to the same sort of thing,

if you plan to have another one. ask for propofol, you may still wake up and feel discomfort/pain.

some folks do and some do not.

My brother claimed he slept all the way thru.

I did not.

Other follks I know who have had these proceedures, also say they hurt, there is pain without adequate sedation. They too are not useing meds, alcolhol and so on.

best wishes to you if and when you have another one down the road.

mersa

hot flasher · Jul 29, 2008

Perhaps you can request having MAC anesthesia. The GI Lab where I work are doing more and more cases every day utilizing an anesthesia provider that will administer Propofol and I can assure you, you would not feel or remember anything. This drug is amazing...patients are "out" but maintain their own airway. The beauty of it is that it has a very short half life and patients awaken very quickly after. It is extremely rare for a patient to have any memory of the procedure and I have not heard any complain of pain. We still do one day a week without anesthesia assistance, where an RN administers Fentanyl and Versed, and even with that, depending on the skill of the GI practitioner, we have rare complaints of discomfort. While I realize that everyone has an individual pain tolerance, and reaction to drugs, it still has as much to do with the skill and technique of the doctor, as it does any of those other factors. I have been doing this for a very long time and know this to be true.

CrohnieToo · Jul 29, 2008

... While I realize that everyone has an individual pain tolerance, and reaction to drugs, it still has as much to do with the skill and technique of the doctor, as it does any of those other factors. ...

Amen! That is soooooo true, HotFlasher! Thank you.

Mersa59 · Jul 29, 2008

Perhaps you can request having MAC anesthesia. The GI Lab where I work are doing more and more cases every day utilizing an anesthesia provider that will administer Propofol and I can assure you, you would not feel or remember anything. This drug is
Flasher,
they used Propofol. I was out and remember nothing about the endoscopy.
I woke up however during the colonoscopy, at various times.
so it may work if enough of it is given to keep one out the entire time.
but that is not what occured.
thanks.
mersa

theofour · Jul 30, 2008

I had a colonoscopy and upper endoscopy on June 25th. The Versed they gave me had very little effect as I have a high tolerance to Valium. They took me into the procedure room and hooked up my IV. The doctor had previously decided to use "MAC" monitored anesthetic care where they knock you out completely using Propofol. he didn't even give me a choice. :confused:

Thinking back on it, he probably did it to make the procedure easier for himself rather than me. No having to listen to moans and groans or dealing with the patient squirming around. I hear these procedures under conscious sedation can be very painful. But they want more people to go for the test so no matter where you read about it they always say that that it's "somewhat uncomfortable". That's why they use Versed. To wipe your memory of the procedure and the pain. It helps protect the doctor from being sued.

They didn't even warn me that they were about to knock me out. I was awake one second and then I was awakened by motion of the gurney. The nurse saw me open my eyes and said in a cold, uncaring, indifferent, I say this a hundred times a day manner, "the procedure is over and you're in recovery." Then she walked away.

I felt like nothing had been done. I suppose that's a good thing. No throat pain from the upper endoscopy in which they took one biopsy from my stomach and one in my duodenum, although later when I read the nurses report "gagging" was noted. No pain in my butt area. No passing gas. No burping or bloating. No nothing. The only evidence that something had been gong on around my butt area was when I reached back there and felt some lube around my orifice.

The main thing I regret is not being conscious to witness the procedure on the monitor. I think I am going to ask for conscious sedation next time WITHOUT the Versed for wiping your memory. I want pain killers only. Will they do this? Am I making a big mistake about this? I have an insatiable curiosity and feel that I WANT to experience the procedure and see my innards "live". Pictures later just don't do it. Can't they have the IV set up so that if I am in too much pain I can say, "I give up! Knock me out!"?

I don't like the idea that I was completely gone for 45 minutes and feel as though I have been intimately violated. I feel like the 45 minutes that I was gone was just like being dead. If I HAD died, I never would have known the difference! I sure hope there's more to death than that "nothingness"!

To sleep, to sleep, perchance to dream. :bow:

CrohnieToo · Jul 30, 2008

If you weren't passing gas I'd say your doctor was probably very conscientious! Not only must he have not gotten carried away w/insufflating the colon during the scope, he must have been very conscientious about "sucking out" as much of the air as he could.

I agree it would have been nicer if they had advised you, "We are going to start your anesthetic now". But you can mention you'd like to be advised next time.

Yes, you can request that your procedure(s) be done next time w/o conscious sedation and request just analgesia for discomfort or pain. It is your right as a patient to make that request. BUT you should discuss this w/your doctor before hand.

No one can determine before hand whether it would be a mistake to ask for pain control only and no sedation. You won't know until you try it. Your doctor should be made aware of your tolerance for Valium as that could well apply to Versed as well since they are related drugs. I'm not sure how long it takes for propofol to take effect should it turn out that you need more than just analgesia. Nor am I sure about the willingness to have an anesthesiologist "standing by" just in case he/she might be needed. On the other hand, some states don't require an anesthesiologist for the administration of propofol. This is all something that needs to be discussed and decided and arranged for ahead of time since it is not the usual procedure for scopes.

I will tell you that the upper endoscopy is MUCH WORSE than the colonoscopy w/o sedation. NOT because of pain but because of the extreme gagging. It WILL bring tears to your eyes!

I totally understand your resentment of having 45 minutes of your life just taken, stolen, from you. And I understand your curiosity and wanting to see for yourself. We are kindred spirits!!!

One thing you could consider that might be more comfortable: if you have a video camera, ask if the MONITOR can be videoed during your procedure(s) from start to finish. That would require consent by both your doctor AND the hospital or facility. But some do allow it upon patient request, doctor approval and the patient providing the camera and tape or disk. There are even a few progressive facilities that have the equipment to provide a video if the patient provides the disk. But they are few and far between. I've done this as well as had both upper and lower procedures w/o sedation and just analgesia for the colonoscopy.