Colonoscopy w/o sedative or anesthesia

I've done literally thousands of colonoscopy anesthetics. When done by anesthesia, your recovery should be extremely fast. I typically give a couple mg of versed and then only propofol. Patients are awake at the end and literally are able to dress and leave within a few minutes. Note that I said "usually".

I also have my colonoscopy with a touch of fentanyl(pain reliever). Wide awake through out and I thought the gas cramps afterwards were worse than the actual colonoscopy. Not bad at all.

Much depends on the patient's pain tolerance and endoscopists skills.

Bottom line is propofol is very safe, short acting drug(in the right hands).
 
I had two of these in my late twenties and no drugs used. I said then and I say today at 52..I will NEVER do this again..I will die first...
 
Matthew said:
Can't remember what they gave me. My wife gave me a ride home and we stopped for a sandwich along the way. About every half hour for most of the afternoon I kept asking her if we had stopped for lunch. By evening my head was clear and I was back to what's normal for me.
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My wife kept laughing at me when I'd tell or ask her anything... I was puzzled, but she swore it was the Nth time I'd said the same thing. Apparently I became a "conversational goldfish", with apologies to Kimberly. My mid-evening it was better.
 
I remember passing huge amounts of air. The nurse said don't be ashamed. I said I am not in the least this feels great. I was still kind a out of it at that point.
 
Before my wife's knee replacement two weeks ago I told her I didn't want to answer her questions right after because I knew she wouldn't remember the answers. She got upset with me and told me I should answer anyway. I did and she asked again and again and ......... :D
 
DaleB said:
My wife kept laughing at me when I'd tell or ask her anything... I was puzzled, but she swore it was the Nth time I'd said the same thing. Apparently I became a "conversational goldfish", with apologies to Kimberly. My mid-evening it was better.
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Yeah.

"Did we stop at Backyard Burger on the way home and get lunch?"
"YES! For the n-th time!"

Repeat every 30 minutes.

I have no memory at all of the recovery or getting dressed. I had a vague recollection of getting in the car.
 
My driver told me I was "Space Cadetting" on the way home. I think I took a nap and was fine when I woke up. I found the preparation more of a problem than the aftermath.

I recently had about three hours of general anesthesia and I felt fine when I woke up. I can remember the two doctors being there. One of them asked how many fingers he was holding up, what the year was and where I was. He told me a little about what he had done and made the comment about the fat graft I mentioned in the "fat gene" thread. I was amazed I could breath through my nose.

I think they are getting better at anesthesia these days. When I spoke to the anesthesiologist right before the procedure, I said that the only complaint I had about previous anesthesia was waking up intubated when I was a teen. He told me he would take it out before I woke up unless absolutely necessary and he did. It just felt like I was waking up from sleep.
 
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I am a Registered Nurse who administers the "Moderate Sedation" for Colonoscopies and Endoscopies. I have never personally had the procedure done to me but have been in the room for hundreds and hundreds of procedures, I would also highly recomment the Medication,

Most patients are pretty uncomfortable even with the meds the benefit of the meds is that you will not remember the procedure, most people do not remember their ride home either, even when they leave the clininc they are walking and talking.

I can NOT administer Propofol (As a R.N. I am not licensed to do so)

The medicines I use are a combination of Midizolan also know as "Versed" and Fentanyl. Versed is a benzodiazapine (similar to valium) but the medicine is short acting and also has the benefit of Anterograde amnesia meaning you do not remember what just happened :)
The Fentanyl is a Narcotic Pain medication (100x more potent than Morphine) which acts in conjunction with the VERSED to kind of put you in a Twilight like Sleep State.
The benefit of these medication when used as described is that there is a realitively lower risk of Respritory system compromise and Blood Pressure fluctuations. You can still follow commands, i.e. "Take a deep Breath....etc.
Propofol is a wonderful Medication, and it is pretty short acting, but you will be Knocked OUT so as long as they have the proper monitoring in place it is safe to use . We always tell the patients no driving, operating dangerous machinery for 24hrs I will have to add Flying a Plane to that List..
Hope this helps.
 
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iamgregh said:
I am a Registered Nurse who administers the "Moderate Sedation" for Colonoscopies and Endoscopies. I have never personally had the procedure done to me but have been in the room for hundreds and hundreds of procedures, I would also highly recomment the Medication,

Most patients are pretty uncomfortable even with the meds the benefit of the meds is that you will not remember the procedure, most people do not remember their ride home either, even when they leave the clininc they are walking and talking.

I can NOT administer Propofol (As a R.N. I am not licensed to do so)

The medicines I use are a combination of Midizolan also know as "Versed" and Fentanyl. Versed is a benzodiazapine (similar to valium) but the medicine is short acting and also has the benefit of Retro-Grade Amnesia meaning you do not remember what just happened :)
The Fentanyl is a Narcotic Pain medication (100x more potent than Morphine) which acts in conjunction with the VERSED to kind of put you in a Twilight like Sleep State.
The benefit of these medication when used as described is that there is a realitively lower risk of Respritory system compromise and Blood Pressure fluctuations. You can still follow commands, i.e. "Take a deep Breath....etc.
Propofol is a wonderful Medication, and it is pretty short acting, but you will be Knocked OUT so as long as they have the proper monitoring in place it is safe to use . We always tell the patients no driving, operating dangerous machinery for 24hrs I will have to add Flying a Plane to that List..
Hope this helps.
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Thanks for the insight.

Maybe it's me, but I do find myself wondering why so many people consider the amnesia to be a good thing. I guess it depends on one's experiences. In the big scheme of things and given my life experiences, a colonoscopy isn't even a blip on the radar in terms of things I wish I could forget. Not that it's something I especially want to remember, either; but that part of it is not something that bothers me at all.

Maybe it's the anal thing that bothers people about it. I never had a colonoscopy before, but I know that the proctosigmoidoscopy I had years ago was nothing like the horror stories I'd heard about it. I had guys telling me it was so terrible that they were crying, and that the humiliation was the worst part of it. What humiliation? It's just a medical procedure.

Frankly, of everything about this upcoming procedure, the sedation is still the thing that bothers me the most. I've agreed to it because of the advice I've gotten from, well, pretty much everyone; but truth be told, I still don't think I need it. I've been through worse pain, and I'm not the kind of person who worries about things once they're over.

Hell, I was cleaning out the medicine cabinet the other day and I found the Vicodin they gave me after my gall bladder surgery about seven or eight years ago. (I'm a bit of a pack rat...) I remember that I took one pill and decided that the painkiller was worse than the pain. At least without it, I could think clearly.

So frankly, I don't think I need the sedation, and part of me is leaning toward asking if they can start the IV but not medicate me unless I ask for it. That may or may not be reasonable: I doubt the doctor and whoever is assisting him want to stop in the middle of the procedure and wait for me to zone out. But if they have no issue with that, I may do it that way. I have the pre-surgical physical thingy tomorrow, so I can ask them then.

In the end, though, I've learned that when everyone is telling me the same thing, they're probably right; so if my idea's unacceptable, I'll just let them drug me and be done with it.

Thanks,

-Rich
 
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RJM62 said:
Thanks for the insight.
part of me is leaning toward asking if they can start the IV but not medicate me unless I ask for it. That may or may not be reasonable: I doubt the doctor and whoever is assisting him want to stop in the middle of the procedure and wait for me to zone out.
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This is a good plan, and I wouldnt worry too much about inconveniencing the doctor, as far as having to wait The medication literally takes 20-30 seconds (1 minute tops) to kick in, so if you are wanting to go that route, I would ask for the IV and just have the meds on standby.
 
iamgregh said:
This is a good plan, and I wouldnt worry too much about inconveniencing the doctor, as far as having to wait The medication literally takes 20-30 seconds (1 minute tops) to kick in, so if you are wanting to go that route, I would ask for the IV and just have the meds on standby.
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Well, thank you very much for that information!

-Rich
 
RJM62 said:
Maybe it's me, but I do find myself wondering why so many people consider the amnesia to be a good thing.
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Me too. I had the procedure done a few weeks ago. I had propofol only, the least amount needed to keep me out for the event, and bring me to ASAP after it's done. I remember very clearly coming out of it with a fleeting bit of optical nonconvergence, the doctor telling me I had a clean exam, me asking whether there were any polyps, him saying no, then adding "good job on the prep", me asking for and getting two cups of apple juice, and getting dressed to leave. The only thing I don't remember is the walk from the office through the hallway until we were outside, but that might just be because I so relieved it was over that I wasn't paying attention.

As far as I'm concerned, though I don't mind being unaware of whatever they're doing while they're inside, I definitely want to be able to remember what the doctor tells me afterward and for that reason, I always tell them NO versed or any other specifically amnesia-inducing drug. My team was great, they did everything I asked, and the experience was as good as anything like that can be.
 
RJM62 said:
Frankly, of everything about this upcoming procedure, the sedation is still the thing that bothers me the most. I've agreed to it because of the advice I've gotten from, well, pretty much everyone; but truth be told, I still don't think I need it. I've been through worse pain, and I'm not the kind of person who worries about things once they're over.
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But why would you want to put yourself through more pain than necessary? I can understand not wanting to be groggy but why not take advantage of the miracles of modern medicine?
 
Everskyward said:
But why would you want to put yourself through more pain than necessary? I can understand not wanting to be groggy but why not take advantage of the miracles of modern medicine?
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I can think of practical reasons (wanting to get right back to work, etc.). But I suspect that the deeper truth is that I just don't like being sedated, dependent, or restricted, even for a little while.

You have to understand that I left home when I was 17 -- for good reasons -- and have been on my own ever since. Of necessity, I've learned to be very independent, and I don't like anyone messing with that.

That's probably the truth of the issue.

I do, nonetheless, have a pain tolerance that a few doctors have told me is "dangerously" high, meaning that I tend to ignore problems because the pain just doesn't seem all that bad to me.

For example, the surgeon who did my cholecystectomy told me that my gall bladder was one of the most diseased he'd ever removed. He described it as resembling a dirty sweat sock full of marbles, and estimated that I'd been living with the problem for at least 15 years, which seems about right in retrospect.

He couldn't believe that I hadn't seen a doctor about it before then -- especially seeing as how I was a paramedic who should have recognized the symptoms. By the time the last attack happened, significant damage to my pancreas had already occurred (which may have something to do with why I developed diabetes). The doctor couldn't believe I ignored the pain for that long.

But the truth of the matter is that except for the last attack, I never for a moment suspected that I was having gall bladder attacks at all. The pain seemed mild to me, so I would just take an Alka-Seltzer, thinking it was indigestion, and the pain would go away within ten or twenty minutes.

Even after learning that the problem was my gall bladder, I still researched every possible alternative to surgery -- some of which seem downright scary to me, in retrospect. Again, it was the anesthesia and being "laid up" that scared me more than the surgery itself. But the anesthesiologist turned out to be the Mozart of anesthesia. When I came to I was ready to run the mile in four flat. I could have kissed him. In fact, I think I did.

In the end, I guess what it really comes down to is that I'm a stubborn, fiercely independent SOB, who fears any sort of dependency or restriction more than I fear pain. That's most likely the truth of the matter.

Not that I'm saying that's "normal," mind you. I'm just saying that that's what it comes down to.

-Rich
 
RJM62 said:
In the end, I guess what it really comes down to is that I'm a stubborn, fiercely independent SOB, who fears any sort of dependency or restriction more than I fear pain. That's most likely the truth of the matter.
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I can relate to that, to a point... I don't like being dependent either. When my cousin volunteered to come and stay with me for about 10 days I almost turned her down. No one has stayed at my house for a 10-day stretch, ever, unless they were living here, and that was a long time ago. But I had a driving restriction and you need to drive to get anywhere around here. Anyway, it all worked out with her visit. She and her husband entertained themselves and mostly left me alone unless I felt like participating.

When I was at the pre-op interview I must have asked some stupid questions because the interviewer said, "You haven't been in a hospital recently have you?" That was true, not since I was a teen, at least not myself.

But as far as anesthesia was concerned I have no problem with it. As I mentioned earlier, I remember before and after pretty clearly.
 
'had one this morning. Walked in at 7:30am, procedure at 8:00, done at 8:30. Friend arrived at 9 to "drive me home" (wink wink), as they wouldn't let me leave without him showing his face. I was fine, totally lucid and sharp at 9am.
 
CT4ME said:
'had one this morning. Walked in at 7:30am, procedure at 8:00, done at 8:30. Friend arrived at 9 to "drive me home" (wink wink), as they wouldn't let me leave without him showing his face. I was fine, totally lucid and sharp at 9am.
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Thank you. I'll count that as another vote for the juice. :)

-Rich
 
I'm another that's on the 5 year schedule due to family history. The prep is more annoying than the actual procedure. In at 7:30 am, hang around for a bit, get rolled in and someone in scrubs says "count backwards from 100" and I replied "why? I never get to 99!" This time I started singing 99 Bottles of Beer - didn't even get thru the first chorus.

Next thing I know is the overhead lights in the recovery area are annoying me. Friend picks me up, we go have lunch, then take my dog for a walk. By then it's about 1 pm and I'm back in front of the computer trying to get some work done.

Next time, I think I'll grab a marking pen and write "insert tab A into slot B" on the tuchas.
 
Bill Watson said:
Was it painful? No. Uncomfortable? At turns, yes. The key point is that I don't think this was not what is normally given as a full colonoscopy. It was a shorter scope. It has a specific name that I don't recall but I'll call it the short form exam.
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Flexible Sigmoidoscopy. Usually shortened by medical folks to "FlexSig".

BTDT. Way shorter than a Colonoscopy instrument. Not the funnest day at the beach, but not particularly bad either.

Having an ingrown toenail removed with the Doc having missed one of the nerves on either side of your big toe with the local anesthesia was far worse than the FlexSig ;)
 
From my experience, Propofol yes, but I will always skip the Versed. It affects my memory for days. Supposed to be short acting, but I have a hard time remembering a short list of things for at least a couple of days. My wife has had the same experience.

The prep is by far the worst.
 
Bill Watson said:
Way OT!

However, I have had doctors poke me with and without anesthesia.

In the no anesthesia case, I had made an appointment for a completely unrelated matter. Before I saw the doctor that had been recommended to me, his partner offered to screen me for whatever with a 'colonoscopy'. I agreed and found myself laying on my side. During the procedure, I asked whether this was standard procedure. He said no but that he was invovled in a study or something and was giving all office patients over 40, this exam, at no cost. "Oh, do you know I'm only 36?"

"hmm, No... this is going to be a bit uncomfortable when I go around the bend of your colon"

Was it painful? No. Uncomfortable? At turns, yes. The key point is that I don't think this was not what is normally given as a full colonoscopy. It was a shorter scope. It has a specific name that I don't recall but I'll call it the short form exam. The 'discomfort' beyond initial entry has to do with the mechanical interference between the hardward and the bend(s) in you colon. I think he only hit one on this particular exam.

Since then I've had 1 'standard' colonoscopy that is probably the type you are getting. Frankly the anesthesia is so effective that I don't remember a thing. But I think this is what I'll call a long form exam but I don't really know.

I wouldn't mind getting the short form without anesthesia... but the anesthesia would be a nice luxury. Assuming the second exam was different and deeper and possibly longer, I would definitely prefer some help. However, if I really just got the same thing both times, it's an unnecessary luxury and exposure to more drugs.

Hopefully some medical people can pipe in. Good Luck.
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Are you sure this wasn't a date?
 
I had a friend who recently had a total knee replacement. They hit him with every drug in the hospital. He was seeing all kinds of things that nobody else could see, such as a log flume running through his room, a space capsule containing his hospital bed, and things he could only describe as 'awesome screen savers'.
 
denverpilot said:
So Rich, did everything come out alright in the end? ;) ;) ;)
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Actually, it's been postponed until some time in September or October.

At that time, however, I may postpone it again based upon whether or not it makes financial sense to wait until BC/BS rolls me into whatever new plan I have to select under Obamacare. I spoke to them on the phone and they said there was a "good chance" that I would pay less out of pocket by waiting until the replacement policy goes into effect.

Basically, under my present plan, the routine colonoscopy is covered one way or the other, but I still have to pay for the pre-op, and I have to pay for any biopsy if polyps are found under the deductible, because at that point it ceases to be "routine." Because I've only satisfied $55.00 of the deductible this year, it could be a couple of grand if they find a polyp.

Apparently, however, this may not be the case under the new plan -- which is only right, since they estimate that I'll be paying twice as much as I am now.

I already knew about part of the cost coming under the deductible, of course. But now that I've been postponed anyway, I figure I'll check the details of the new plan I'm being rolled into and make a decision whether to do it on the tail end of this policy or wait until the new one kicks in.

I have zero symptoms and zero family history, so I checked with my doc, and she was okay with deciding in October.

-Rich
 
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