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Colonoscopy without sedation

I'm 54 and have beeh having dark blood in the stool as well as recent onset change in bowel habits (alternating constipation/diarrhea) as well as a bad family history of colon cancer.  Since I'm a nurse, it seems like a no-brainer that I should get a colonoscopy, althought my doc said not to worry (she's making me feel like a pest for asking) and told me to take metamucil.  I can self-refer fo rthe test, but I want to have it without sedation; after recommending this test to hundreds of patients and seeing a number of them performed, I just won't do the "conscious sedation"; I have seen too many people with long-term memory impairment from Versed to consent to this.  About 10% of these exams are done without sedation (and most other countries don't use sedation), but when I try to schedule one, they "insist" on sedation.  Oh, and of course I'm allergic to eggs, so propofol is out, ut even if I wasn't I would not do the sedation.  Should I keep trying or give up?  What's the big deal with doing the exam without sedation?  I know it's uncomfortable; heck, I have seen a number of patients literally scream for the doc to stop the colonoscopy and this was with Versed; they rely on the amnesia effects to stupify the patient.  What bothers me, is that I see a lot of patients who have a PTSD-type reaction later when they start to remember how they were treated. I would rather experience and remember the discomfort.  My doc says that she would never get this exam, drugs or not........thanks
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Avatar universal
I think everyone should call their doctor's office and ask if they would do a colonoscopy without sedation, even if they want to be sedated. It will give you an indication if the doctor is "patient centered" or cares more about how quickly he/she can finish a procedure and get the next patient in. You can always tell them later that you want it with sedation after all. They will be happy to oblige. I just had my (almost) sedation free colonoscopy. I was just lucky to have a great Dr because I asked for a sedation free procedure  the last moment., when the anesthesiologist talked with me a few minutes before they got started.  My doctor immediately agreed and everybody was fabulous, encouraging and helping me. There was some pressure when the scope went in and when I winced the Dr asked if I want something to help. I said yes and they gave me a tiny bit of sedation that lasted barely a few minutes. No Versed. I was widely awake for the rest of the procedure. It was really neat to see the whole thing on the screen. They found three polyps and I saw how they took them out. (No pain whatsoever, there are no pain receptors on the inside of the colon, as she explained). Except for some pressure, there was no discomfort at all. When I was in the procedure room a couple of nurses came in and told me, all smiling, that they did it without sedation as well. They looked like I was being admitted to some club of the "no sedation" people.  It got me thinking, if medical personnel does it without sedation, what do they know that we don't. Because they found the polyps I will have more colonoscopies and I will not take any sedation at all. The pressure was not too bad and I asked for something to help just because I was a little nervous as this was my first colonoscopy.  If you are not very, very anxious, I would encourage everyone to try and start the procedure without sedation. You can always ask for some if it feels too uncomfortable or it is painful.
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Hi my name is manny and I'm planning on getting a colonoscopy with out anesthesia or sedation but no one wants to do it with out it I'm from Texas.What doctor did you go to?
Avatar universal
So glad to hear your experience was positive. And am especially happy to hear you had a clean bill of health. I am about to have a colonoscopy in two days. Have requested NO sedation. I know I will feel some pressure as this has been done before with little sedation, but now there will be none. So I am a bit apprehensive, but am getting afraid of sedation as I am getting older and closer to death than to life...don't want to rush the end.
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Avatar universal
Thank you for sharing your information and experience on sedation for colono scope and EGD. I had gas and gas pain for many years and had bad experience using sedation. But I have seen several doctor in ut, all they only choosed sedation for my colonoscope and EGD.  How do you find these Gastroenterologists that support sedation free?  Thanks
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Avatar universal
It's easy to get an unsedated colonoscopy, just schedule one and when the nurse calls you the night before tell her: "I don't think that I want sedation" and just listen to her rant about the glory of sedation and amnesia.  On the day of your test: do not sign a sedaton consent and ignore the BS from the nurses!  They WILL do your exam unsedated and it will be fine.  The sedation is not required.  The lie about sedation "being required" so that the exams can be rushed (more money) and the so-called anesthesiologist is often an office nurse or an "anesthetist" (also a nurse with some additional training) certianly not qualified to administer any sedation or anesthesia without physician supervision is most states.
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Avatar universal
Hi just had my sedation free colonoscopy today and for me the worst part was all the worrying about the procedure. Informed my Doctor the only was I would consent to it was with no meds. He agreed saying that he'd rather see me attempt to get one then forgo one. Let me tell you don't give up except for some pressure at the two main bends for me the procedure was a breeze. When finished I was given glass of OJ and a couple cookies, the nurse finished discharge papers, I got dressed and left. Start to finish about 1.5 hours, that includes check-in, procedure, and check out. Good luck on quest hope you can find doctor willing to do, and I had clean bill of health.
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Avatar universal
How do you find these Gastroenterologists that support sedation free?  Every office in my area, when called, state they only do with sedation.  My initial was done sedation free up until 3/4 way through--I was given 5 mg Valium IV at that time.  That was 20 years ago.  Since then anesthesia is present all the time but I've been able to refuse propofol but rcv versed and fentanyl.  Awake but dizzy--of course remember at the time but then it goes.  I like to look at the screen.  Many patients are given pictures with a report--not with my group.  As a nurse practitioner you would think they would be a little more agreeable.  I'm 1 year overdue w a fam hx of colon ca.  Need to get this done and immediately.
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Avatar universal
I had my 3rd colonoscopy today. Was the first one I had without sedation. It was a breeze. I had an IV in and was given a tiny bit of demerol for pain. I watched the procedure on the monitor. I do remember one time where I felt some pain..when she was turning a corner i guess, and i flinched a bit and she asked if ide like a bit more pain medication and i said just a little and after that i didn't have anymore pain. I was able to talk with the nurses and dr throughout the procedure and left the facility feeling fantastic! i went out for breakfast and cleaned my house when i got home. All the other times I had the procedure  I was groggy and nauseous all day after the "twilight sedation" It took me 6 different dr's before finding my current gastroenterologist...all the other gastros refused to do the procedure without the twilight sedation. Glad i took the extra time to find this Dr. There is some pain , dont get me wrong, but its nothing i couldnt handle, just felt like gas pains and the demerol took the edge off of that pain. If you really want a colonoscopy without being sedated, there are docs who will do it and at least in my experience is wasnt awful at all.. I plan to have all future colonoscopies with this same gastro, the same way...no more twilight sedation for me!
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Avatar universal
Actually I didn't get any drugs at all for the first exam (no IV so it was impossible) and I fell asleep afterwards because the exam took forever (records show 60 min from insertion to withdrawl)..Lots of docs lie and just sneak sedation in so they can do the exam more quickly; my GI doc hates this because she sees the fallout of these "quickie" colonoscopies where they oversedate the patient, rush the exam and get them out the door (with cancer that was missed).  Many docs lie about Versed and many patients would not consent to it if they knew the truth.  After I learned the truth about the creepy Versed amnesia and PTSD, I decided to refuse sedation for ANYTHING (and I put this on the consent and the doc signs it). My GI doc said that she totally understands my concern and that she would refuse Versed herself.  She did tell me that my colonoscopy is a difficult exam (colon is all twisty and it took her 60 min to complete unsedated); for my second exam last year she asked me to consider something new: her anesthesiologist promised me a pain free colonoscopy, wide awake as I want to be, no hangover, no amnesia, no drug effects at all 10 min after the exam and I could drive home.  She did it with a remifentanyl infusion (ultrashort painkiller only), cranked up the rate when the doc was turning corners..felt absolutely no pain, no drowsiness and was totally alert during the exam and during the drive home. The anesthesia doc said remifentanyl isn't used much since it's expensive, but since I was considered an insider they did it free as a professional courtesy.  I feel sorry for the patients getting Versed.
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Avatar universal
You make some valid points but we are all unique with different likes and dislikes. There are always options available for those of us that have a disliking for sedation. You are within your right to choose to have no sedation and if a particular medical group won't perform it that way, you always have the option to choose another facility. I had mine done without sedation and watched the whole thing on the monitor and remember it. I have a friend that has his colonoscopy done every three years under local and watches the monitor while it's being performed and also retains memory of the whole procedure at its conclusion. Colonoscopies are routinely done in Europe without sedation; in fact more invasive procedures are performed under local. The medical business is just like any other business; we can take our business somewhere else if we're not happy with the options given.
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Avatar universal
Agree with your no-sedation stance, and thanks for sharing your search and story.

However, I don't believe your lying doctor at all. Why would you "fall asleep" in a procedure that takes 20min to half an hour? With something moving in painful ways inside you and air blown into you? She DID give you anesthesia, and you forgot it. Short term memory loss from whatever she drugged you with.

The fact that she lied to you is the saddest, most hideous thing of all.
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Avatar universal
I agree with your comments about demerol and especially with versed (that's a drug that I list as an allergy).  No doc that I know would consent to midazolam (versed)...
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611999 tn?1298758291
I have had all kinds of exams done.  In Italy I did the colonoscopy and the endoscopy without any sedation.  The colonoscopy they could not finish because the prep they give you over there is different and I was not cleaned out completely.  It did not feel good.  It hurt a lot when they had to maneuver through bends.  They also cut off a few polyps.   The endoscopy was tolerable and it was great to not have any meds in my system.  

I had the versed in the states for endoscopy and did not like it I tried to remove the tube and remember it hurting at one point and was out of it for days.  I also had endoscopy with demerol and the walls started melting I was so high from it.  I also tried to pull out the scope .  I then had to drive home and got sick many times and felt bad for a while.

Then I had the colonoscopy and endoscopy with propofol last year.  I was out in a few seconds and woke up as soon as they wheeled me out.  I was a little sleepy for a few hours but felt wonderful and had no after effects.  I now will get the propofol for any more procedures.  
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Avatar universal
I had some precancerous polyps removed otherwise o.k. and will get yearly exams....thanks for asking
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1208572 tn?1276142543
So howd the colonoscopy results turn out for ya?
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Avatar universal
I scheduled and rescheduled my colonoscopy a bunch of times, then the nurse who runs the GI clinic called me to come in for a checkuo.  As luck would have it, I had occult (hidden) bleeding, anemia and my usual extremely bad family history of colon cancer.  I promised to return as soon as possible fo rthe colonoscopy; these folks listened to my desire for an unsedated exam, they are the best.  I was about to leave when the GI doc came in and handed me a gown; I asked why and she told me that I was going to be admitted for the colonoscopy becauseof my labs and symptoms.  Initially I resisted, but felt pretty crummy so I agreed.  It was early in the morning and the nurse had me drink the golightly, which I chugged and it worked quickly. Luckily I hadn't eaten much for the past few days.  After I got out of the bathroom, a nurse form anesthesia came in to see me; I asked her why (I specified no sedation) and she reassured me that I could do the exam unsedated if I wanted to do it that way.  This CRNA could not have been nicer; she got me to admit that I wasnt't really allergic to versed or propofol; I just didn't want them (I'm a pilot and can't afford memory loss).  She smiled and told mr that she wouldn't want versed either, but that propofol was the drug to use. I politely declined the propofol and she reluctantly left; the nurse who was taking care of me told me to get into bed and I fell asleep.  Early the next morning, the nurse woke me and I could see that she had an enema bag on an IV stand.  The CRNA who I saw the day before came in and told me that she was going to convince me that I should get propofol...I admitted thta I didn't like having my life in the hands of a CRNA just for a colonoscopy; she looked a little hurt and asked if anyone flying on my airline felt the same way (their lives are in my hands..big deal)..She mada lot of sense and told me that a sedated exam was better and that I wouldn't have a problem with propofol.  So I agreed to the propofol.  She hooked up a line to my IV and told me that I may as well sleep thru the enemas that they were going to give..I didn't understand how they could do that on a sleeping patient, but agreed.  So I had the CRNA slowly giving me propofol and the other nurse started the enema.  I watched the bag empty and the CRNA asked me: "wouldn't you rather sleep thru this"?  I said yes but didn't want to "leak",the nurses both laughed and that's all I remember.  Next stop was the endo lab; my GI doc reviewed the colonoscopy procedure and the CRNA asked me if I was ready for another nap, I said yes and was out like a light. I woke up in recovery and it was all over.
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Avatar universal
I read this thread with interest.  I'm years overdue for a colonoscopy and recently started having symptoms...but I really don't want conscious sedation (can't afford the memory loss and I'm a pilot and it's just too much trouble to explain the use of narcotic drugs, no matter what the medical reason).....It made me angry that patients are not given the choice of an unsedated exam.  Today, I went to a local Veterans Administration hospital for a physical (I have changed jobs so many times that my health insurance hasn't caught up with me and free medical care is great).  I wasn't expecting mych, but was I ever wrong.  A great nurse practitioner did my phycical (better than the FAA exam); she asked me if I wanted a rectal exam, and I jokingly asked her if anyone ever said yes to that question, and she did it and of course I was hemoccult positive.  She was shocked when I told her my  family history of colon cancer and scheduled me for a GI consult the next day. I figured that requesting an unsedated colonoscopy would derail the process, but the GI doc told me that she would do the exam unsedated.  I almost fainted!  No argument at all. She did tell me that it's probably going to be uncomfortable, but totally tolerable.  And a CRNA popped in and offered to stand by with whatever drugs might be needed in case I changed my mind.  They both said that unsedated colonoscopy isn't offered because some patients have a painful exam and tell others and many people don't get screened.  But if you are motivated (or if you don't have a ride home), unsedated exams are quite possible.  So don't give up if you want an unsedated exam.  Yesterday, I thought it was impossible. Today, I'm scheduled for it in 2 weeks, have my golightly right here and have a heck of a team ready to do the exam:  a great doctor, a CRNA who insists on standing by if I change my mind about drugs, a  GI nurse who assists with the procedure and who promises to talk me thru the procedure. And it was all free.   If a government hospital is this good, you can get an unsedated exam at a regular hospital.  Either way, get it done.
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Avatar universal
You got the wonderful partial amnesia drug versed; lot's of people have terrible PTSD reactions from this stuff; worst of all you were screaming in pain (the demerol doesn't cut it) and now the versed amnesia is wearing off.   Versed does nothing for pain, it's given for amnesia and it allows many docs to be quick and rough.   Some people get propofol, it's real sedation and has to be administered by anesthesia and you will probably have to pay extra for it.  I have heard too many versed horror stories; it wasn;t a dream it was a nightmare.  check out askapatient.com
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Avatar universal
I had my first colonoscopy today.  The prep was annoying, of course, but not intolerable.  Having recently had an upper endoscopy exam done with Versed, I felt very confident that this also would go just as well.  
I was given versed and demerol for the colonoscopy, and woke up in recovery to nurses and my husband asking me questions and I was unable to form words.  Once i could, i told my husband i was glad it was over becuz i had just had a terrifying dream that i was in there screaming in pain and that i remembered and felt everything.  I thought it was a dream until the doctor came in and told us the procedure was incomplete because I was in so much pain and screaming, and then my blood pressure started dropping too low and she stopped.
It was still low in recovery, probably why i was unable to speak.

I want to have this screening done.  I followed all the directions, and went in with a positive attitude about it.  Not sure what to do now.
I have IBS and fibromyalgia, but had told the doctor that as well as that i've had two incompleted sigmoids done (no sedation) that were stopped due to intense spasms.

I'm feeling depressed and kind of frightened still, but it's only been a few hours.  
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Avatar universal
Glad you finally got that colonoscopy, n85, and I'd like to again point out to others that if you don't want Versed, and you don't want Propofol, then they can give you anything from an ordinary mild tranquilizer, all the up to the strong pain killer Demerol, really any number of medications can help relax a person or make them feel good, and yet are not "twilight sedation."  And n85 has proved that there are indeed sympathetic gastros who will do a colonoscopy without any drugs at all.  For others who are not worried about it, I am one of the nine in ten who did not have a problem, and in fact I gotta say it was the best day I had that particular year, as I had a terrible problem with my guts for months, so it was a relief to feel good that one time.  It won't be long before nobody uses Versed anymore, so from everyone's testimony here, do not be afraid to ask for some alternative solution.
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Avatar universal
Even though this thread is old, you comments about the severe problems that a LOT of patients are having with Versed sedation are becomming quite well-documented.  The doc who did my unsedated colonoscopy verified that about 10% of her colonoscopy patients complain about Versed; everything from PTSD-type reactions to long-term amnesia.  Read Allexperts under anesthesia, the anesthesia doc Starkman recently commented about many problems with Versed for endoscopy like long-term amnesia etc.  My doc said that she would not use Versed if insurance companies would cover propofol...neither she nor any of the nurses at the endo center(they do thousands of colonoscopies) said that they would consent to Versed.   They use the drug only because it's all that most insurance companies will cover and many patients are too spooked to try the exam unsedated....I though that unsedated colonoscopy was a breeze; I felt bad while I was dressing post-procedure to see Versed sedated patients babbling, some crying and worse.   Now if I can do an EGD unsedated.....
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Avatar universal
Great-another unsedated colonoscopy success story!!  There ARE a few good doctors out there who actually care enough aout their patients to take a few extra minutes and so a slow and careful and basically painless exam rather than "insist" on sedation.  Not everyone wants the dubious benefits of sedation with Versed (as well as the well-documented problems that some face), nor can everyone afford anesthesia services with propofol (no Michael Jackson comparisons please).  Patients shouls have the option as to how they want to have the test performed.
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Avatar universal
I got the unsedated colonoscopy and EGD done on friday.  No problems at all!  What a difference a good doctor makes; I'm sure that a lot of marginal gastros who do these exams rely on sedation because they are in a hurry to do them quickly, I don't know.  The gastro doc who did mine was a real angel; she was honest with me about the unsedated exam (evidently they get quite a fwe requests for them), she said that there is usually some cramping with the colonoscopy but if she went slowly it would not be bad.  The colonoscopy was a piece of cake and I learned a lot being able to watch the screen and remember it since I didn't have the amnesia drugs.  The EGD was a little harder for me since I have a strong gag reflex but we got it done.  One thing that made it easy was the fact that I trust this doc 100%.  The results from the EGD were fine, the colonoscopy indicates the need for frequent exams.  At the end, I guess that I was tired (up a lot the night before) because I fell asleep even without drugs and they didn't wake me up...She was standing by the bed when I woke up and asked me, now that you have had an unsedated colonoscopy, how do you feel about having another one?  I said no problem.  She smiled and said that was wat most unsedated patients say and that patients who have had sedated and unsedated exams prefer no sedation. So maybe I'm not so weird after all. Thanks to all for the help.
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Avatar universal
The comments here and yours in particular prompted me to continue my search for sedationless colonoscopy.  My insurance pays for anything, even the Michel Jackson drug propofol, but Iwould prefer nothing.  I met with a gastro today who knocked my socks off.  I went in planning to argue with her, but she read over my file, especially my terrible Versed experience and said "holy s**t, no wonder you don't want sedation.  She said that she could do me without it and that she had done colonoscopy on several of the nurses in the office without sedation; it's no big deal and not too bad, she promised to talk me thru it.  She also wants to try an EGD at the same time, "if I will let her"...this might be difficult, but heck, why not.  After arguing with gastros who "insist that colonoscopy requires sedation", it was great to meet one that has done many without it.  I didn't have to argue at all.  It was gratifying when I checked out to see that the nurse had crossed out the :"driver required" part on the instructions since I won't be getting sedation.  So it's scheduled for the 17th; this doc was great, easy to talk to and no BS.  She did tell me not to worry, but she said that my symproms were potentially problematic, so let's do the test and you are NOT crazy for requesting an unsedated exam.  Thanks for the encouragement and I might just bring the whiskey flask to the test, but them I WILL need a driver.....Thanks again!
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Avatar universal
Why don't you call your insurance company and ask if they cover colonoscopy sedation with propofol.  Then ask them to give you a list of sedation that they do cover.  Then ask the place where you're supposed to get the colonoscopy if they would use whatever accepted anesthesia the insurance accepts.  Also tell those people you are freaked out about it, and you will need to be tranquilized on top of everything else just to get you in the exam room.  (They gave me that in the outside office, and then injected me in the procedure office with whatever else they gave, but it was not Versed...that stuff is dated.)  Hope this helps.  Bring you a flask of whiskey so when the whole thing is over, you can gulp that down and forget about the whole thing a lot quicker!
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