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

[ggreg]

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.

[n85082]

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.....

[rem223]

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.

[n85082]

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.

[n85082]

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!

[ggreg]

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!