Endoscopy and sedation?

Hi

I have an endoscopy coming up in a few days. He is going to look at my ulcer and do a biospy too. I'm not so afraid of the endoscopy although I do hate things in my throat. I'm really really afraid of sedation though. REALLY. He insisted it's best to do it with that though. I have really bad reactions to it. I hate the feeling anyway. I'm so afraid that I started to cry in his office at the mention of it. I can't reember everything he said, but the basics were that he usually combines Versed with an opiate ( I think ) but instead he would just give me 2.5x the versed dose and I would be conscious but sedated. Which scares me. Everything I read about all the sedation options isn't very comforting. Can anyone make a suggestion? What should I ask him for that has the LEAST amount of side effects/complications. I really don't want it at al but he's insistent. HELP!

[ggreg]

Many people have problems with twilight sedation, and the drug Versed has come up a lot as being the culprit.  Therefore, you should ask the doctor to skip the Versed and instead use extra of the opiate type drug.  You can find stuff online about Versed and print it out, in case you have to convince the doc of this.  You should not have any problem whatsoever with opiates, they will make you feel wonderful, and there are no scary side effects.  I hope this helps you out, and I'd be interested in hearing if the doc responds properly, and also how the opiate sedation does go when you have it.

[ggreg]

I need to clarify myself a little bit.  All drugs have side effects; it's the scary ones we want to avoid, as well as individual negative reactions to certain ones.  Also, often a cocktail of several drugs are used, so while you heard the word opiate from him perhaps, he may have even said barbituates, and who knows what all is put in there.  With that said, I stated you should not have any problem whatsoever with opiates, but the fact of the matter is, they do indeed have side effects.  

But I have not personally heard any mention of opiates, rather it's the Versed that people suspect is the problem, which was why I posted to you in the first place.  So, be careful with ALL drugs used to sedate you, since you had a problem with it before, and disregard what I said about how opiates should not cause a problem.  I should have just stuck with advising you to watch out for the Versed.    

[kitkat57]

Thank you. I know for a fact that the one that caused me the most trouble in the past was a combination of Valium and Nubain....I literally had holes in my memory for 2-3 days afterwards, and spent much of that time throwing up. It was highly unpleasant. I also woke up during the surgery and THAT was an experience all itself. The whole thing terrified me. I don't like the feeling of going under, waking up, or the aftermath.

Does that change anything at all?

[ggreg]

Well, that adds two more drugs you should not be given when you have the endoscopic procedure.  Could be since the doc will know what categories of medication those two fall in, as well as the Versed, he will avoid all three types and give you something else.  You could do a search online of local anesthetic or twilight sedation, see can you find the list of drugs they put in those I.V.s.  Also, wikipedia has some info on that.  I wish I knew what my docs used when I had twilight, I had no problems at all, but each person is diff.  Just below my post is a list of posts that relate to anesthesia and people's comments on the situation, too.  I'm sorry you had a bad experience before, some people do.  As long as the doc avoids at least the two categories that gave you problems before, and probably the Versed just to be safe, you should be okay.  Wish I knew more.

[kitkat57]

Hi...

Just to update. He *did* give me Versed. He usually does a combination of Versed & demmerol but avoided a cocktail & just did a light dose of versed. It was fine. Actually, I felt great. I was a little woozy afterwards but now I am completely fine. MUCH different experience than before. I am a little sleepy but other than that, nothing different. I'm very thankful!

I wonder if you (or anyone) has any input on what this means though...he didn't find an ulcer as suspected. Instead, he found LA Grade A reflux esophagitis (which I already knew I had), gastric mcosa abnormalty characterized by erythema (I can't find any info on this!) & the gastric antrum & gastric body are both erythemaous (hyperemetic). The only info I can find on that is confusing. I guess it means there's too much blood in my stomach? He also said a sphincter (esophagus maybe?) doesn't close properly causing the sever reflux. He took a biopsy from the stuff in my stomach.

Anyone know what that all means? He also gave me something called Kapidex to take daily. I had looked that up previously & I'm a little uncomfortable with all the side effects, but he said I need to take it anyway.

[kitkat57]

oh, I don't see a way to edit but I wanted to add that I was quite awake for the whole thing, he gave me *just* enough to relax me slightly. :)

[ggreg]

Glad and amazed it went well for you, KitKat.  I'm glad you could work with the doc on the right solution for you!  I'm afraid I wasn't much help.  Thanks for updating us on that whole thing.  As for your other questions on the endoscope findings, you might try doing a new post with a new title about it, I don't know too much about that part.  

[michell221]

The spincter thing is maybe a Schatzkis Ring or hiatal hernia.  You can ask to clarify.  I would ask specifically about all those findings.  Glad that you did not have much trouble with the sedation.  I have had demerol before which caused a horrible reaction with me.  I was so sick and had hallucinations.  The next time I asked for no sedation since I was overseas and they only had demerol.  They agreed.    It was very uncomfortable but I managed.  The next endoscopy they gave me versed and something else and the versed was fine.  I slept a lot that day and felt a little weird the next day.  The doc I use now used propofol for my colonoscopy and I was completely knocked out and woke up immediately after they procedure..  I had no side effects at all.  This was the best sedation I have had.  He uses it for all his procedures.