colonoscopy and sedation

[zulushooter]

I'm 53 and have a bad family history of colon cancer (sister died from it and father had it)....I was told  some time ago that I needed to get a colonoscopy, and that isn't a problem for me.   My problem is that don't want "conscious sedation"; I had a previously horrible experience with it and will never do it again. I understand that most people want this (I think that it's dangerous and unecesary; common in the USA but certianly not worldwide).........I finally met with a gastro who reluctantly agreed to do the test without sedation (I know that I will be painful).......So I do the prep and report to the endo clinic where a CRNA promptly told me that "everyone gets something" and had a hissy-fit when I declined to sign a sedation consent.  The doctor who agreed to do the procedure without sedation sat there like a potted plant and would only say "it's an uncomfortable procedure and better with sedation"-pretty much ignoring our  previous agreement and now advising me to change my mind...........I'm normally a calm person, but a very unpleasant arguement ensued.....I reminded the doctor that it was her decision as to how to do the procedure (not a nurse working for anesthesia).........I got dressed, removed the IV and as I was leaving, the doctor says: that I should let them do the test so "they don't lose the time slot in the endoscopy suite"..........obviously, the colonoscopy was not done..........what do I have to do to get a doctor to honor my wishes?  I could understand this if I had never discussed this ith the doctor, but we had discussed this........................If I wasn't having symptoms, I would forget this.....any advice will be appreciated........

[April2]

Did you have a bad side effect from the medication of something? I'm trying to figure out why in the world you wouldn't want sedation. I'd just as soon they knock me out and get it over with.

I've had one colonoscopy so far and I asked if they could only lightly sedate me so that I could watch the moniter. I was interested in watching. The doctor told me that they could do that and that if at any time they could give me more medication if it started getting uncomfortable. I agreed. I did ok for about half of it and then when he came to a part where my colon turned or something, I guess, I started feeling a lot of pressure and pain. I told him to stop! He immediately stopped and asked me if I needed more pain medication. I said yes and the nurse put some more in my IV. They waited a few seconds and then I don't remember the rest. Next thing I knew they were moving me and saying they were done. I was a litte dissappointed. I had wanted to watch the whole thing, but I wasn't about to let myself be in pain for it.

Keep looking. There are doctors who will do it without sedation. My mom has a bad reaction to anesthesia so they can't sedate her. So she has to have a colonoscopy done without medication. I told her I don't know how she does it. She says she concentrates on her breathing (deep breathing) and she prays.

You said it's dangerous and unnecesary. It's a very safe procedure and has little side effects. I know things can happen, but they're rare. You might want to consider at least being lightly sedated where you are still awake and can talk to the doctor but you're very, very relaxed. Like I said, that's what I did.
Good luck. I hope you can find a more understanding Gastroenterologist. Best wishes.

[zulushooter]

sedation for colonoscopy is dangerous and done for the ease of the doctor; not for the poor patient.........

[zoomistic]

can pylori also effect the bowel movment and cause little to no bowel movements?

[CalGal]

You're going to have to hunt around for a doc who will do it without sedation. And it will mean relating your current story to try to make a point. Most docs are going to think that you'll 'cave' once you get into the center, and a lot of people do, so it's going to be difficult but not impossible. Most docs want you out cold, because it's much safer for the patient. There are no unwarranted movements that could result in a perforated colon, which I hope you understand can happen even in the best of circumstances. You're also going to have to be willing to move and help them to turn you when they need to get the scope past 'sticking' points and you'll have persons doing some fairly heavy pushing on you at points in the procedure.

You may find that most facilities don't have the paperwork that will allow them to do the procedure without sedation, so ask around. Good luck.

[Ruza500]

First, your original post was a little over 6 months ago I'm wondering if there is any update on your search.  Second, you have every right to have the procedure done your way, if it is possible, and unsedated colonoscopy is possible.  I had one done just last month and I was offered the option of no sedation and it was clearly indicated on the intake form.  If fact, if you couldn't arrange for someone to drive you home they recommended it. I'm located in the Chicago area and maybe it's regional thing but it didn't seem like a big deal to them, that's not to say that they didn't care, I received great treatment from them.  The patient who walked into the GI lab after me clearly stated to the technician that he did not want to be sedated and introduced himself as Dr. so-and-so.

In short, stick to your guns and actively search out of your area if you have to but PLEASE have it done.  With your family history it would be a shame to become seriously ill because you couldn't find a doctor who would abide by your wishes.  They are out there.

Good luck and keep up posted.

[Ruza500]

I forgot to mention that I did opt for the sedation; I can be a real coward about pain but I believe that everyone should be in control over my medical options and choices, much to my PCP's dismay :)

[zulushooter]

I'm still searcing for a place that will do the exam without drugs; it's not a matter of paperwork (just dont sign a sedation consent or cross out the part on the procedure consent that concerns sedation).........colonoscopy is done without sedation all of the time...you just aren't offered that option very often.  I did meet with the doctor who had agreed to do the original procedure w/o sedation, then caved in to the idiot nurse.   I was surprized at how honest she was, especially after I called her a liar after the first debacle.  She was apologetic and said that they do deceive patients into believing that the procedure requires sedation "for your own good", not because it's medically necessary, but because they want a compliant patient who has amnesia of the event.  That way you tell everyone how "great" it was; even if it was horrible........problem is, not everyone thinks that having severe pain and then having little memory of it (they hope) is a good idea.  Then the doc apologized again and said that she would schedule the test for next week and assure me, no sedation, no IV nothing.   And she told me that she had hers done without sedation and had no problems (and said it's harder in women)...as ar as perforation, being sedated carries a higher risk of perforation, if you are wide awake, you will scream and let the doc know that they are doing something wrong.....you have to accept that the procedure will probably be somewhat painful; but I asked why not just get painkiller on demand (fentanyl)? and I got the company line that they like patients to be cooperative and have amnesia of the procedure.....nice touch....anyway, at least she finally told the truth, I thanked her for caving in the first time, having me miss a day's work and doing the prep for nothing....she was somewhat miffed that I declined to reschedule the exam; especially after talking to me in the office for nearly 30 minutes on her own time....at this point, my wife (who accompanied me) asked the GI doc a question:  "you understood that my husband can't do conscious sedation and agreed to do the exam w/o it, he does the prep and then is told that he has to have sedation?"  no answer..........so I'm not sure what to do............if this is what medical practice has deteriorated into in the USA, I'm getting the test done in Thialand........

[ggreg]

Zulu,
Wait a minute, wait a minute.  You can have FULL anesthesia if you want.  I have a relative who dislikes "twilight" sedation, and they put her all the way under for the exam.  She lives in a good-sized city and is elderly, good hospitals and lots of docs.  PLENTY of people don't like that twilight deal.  Sure, there's more risks with knocking someone out, they have to be ready to breathe for you and all that expensive turmoil, but they CAN do it that way.  I mean, why suffer?  You don't have to do it straight if you don't want to.  There is that third option.

I'm sure if you're willing to pay for it, or your insurance is willing, and you look around, you can most definitely be put under.  The reason it might cost more is because the quickest way to get folks in and out is the other way, and these days, with insurance companies in charge over us AND the docs, anybody who throws a wrench in the works is going to have to be tough.  A few phone calls, and you should be able to locate some people who will do it that way, for any future exams.

But NO WAY would I ever do that exam without sedation of some kind.  Years ago, that's how they did it, and I know people who are still in emotional turmoil over the discomfort.  Oh, there's folks that I guess they get drunk before they go in and will say it was no big deal.  But I just think you ought to consider a different sedation, is all.