Colonoscopy without sedation

[nursepract]

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

[sherryrc]

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!

[n85082]

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.

[nick469]

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.

[nonono3]

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.

[biopharm]

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)...

[michell221]

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.