Colonoscopy drug-free, avoiding being lied to

[scopescared]

I had a virtual colonoscopy which showed some polyps and some weird-looking stuff and my GI doc tells me that she wants me to get a regular colonoscopy ASAP.  My family history of colon cancer is bad and I'm having symproms.  I have reasd a lot about colonoscopy and want to get one without drugs; I had conscious sedation for dental work (versed) and really freaked out and it still scares me when it when I think about it.  Googling "versed problems" brings up hundreds of people who have had the same, so I'm not alone.  And only in the USA do they "insist" on sedation for colonoscopy.  I was promised no sedation and showed up for the exam and a CRNA (anesthesia nurse) who told me that she was giving me propofol; I declined and joked about that being the drug that killed Michael Jackson".   I knew that my insurance would not cover it, the CRNA told me it was probably not too much, but the GI nurse called and as we were about to start the procedure she told me it would be $700-$1,000., Which is unreasonable, and I didn't want any sedation anyway.  The CRNA and the doc said that I was causing them to get behind in their schedule; I got mad because I was promised no sedation.  I basically got lied to and they tried to make it seem like my fault.  The kicker came when one of the nurses whispered to me "they do these colonoscopies unsedated, it's unusual, but they do occur, usually the patients are medical people who don't want to miss work for the rest of the day".  As I got up off the table, the CRNA said "lets just do this and I'll work something out with billng later".   She then asked me to sign the anesthesia consent, which I refused.  I kept hearing that "sedation is required for colonoscopy, you really don't have a choice"...I asked the doc outright: "have you ever done an unsedated colonoscopy?"   She  tried to evade the question, then the CRNA  offered to just do the propofol for free and wrote that on the consent.  Wow, I thought that was nice.  But I still wanted an answer from the doc who told me that unsedated colonoscopy was "impossible", I asked again if she had ever done one (a non-emergency exam) unsedated and she blurted out "well, o.k. yes, but fewer than 5% of the total; now that you are getting propofol for free, lets just get the exam done".  I politely said no thanks and she asked me why; I told her that I didn't appreciate  being lied to. The CRNA flipped out since she had all of her stuff set up for the propofol and had some choice words about medical ethics and honesty.  My question:  when I specify no sedation and the doc agrees; what do I have to do to insure this?    The doc actually said that I was "being infantile" and the CRNA said "that's because he was lied to"........o.k. I quit. does this happen often?   I'm not afraid of medical procedures (until  now)..any suggestions?  thanks

[ryanmh0927]

I am having my 1st colonscopy april 26 and am freaken out. does it hurt I don't know if I'm supposed to be sedated. I think so. so if I am sedated does it hurt?

[colonoscopeace]

I needed to have a colonoscopy done but refused if sedation was insisted upon..........I had serious bleeding but was turned off by non-anesthesiologists (maninly CRNA) insisting that "sedation" by non anesthesiologists (nurses) was safe.  It's not.  I was told that my exam sedation would be done by an anesthesiologist, nope, they lied: I was supposed to accept a nurse (CRNA) who didn't know crap about advanced life support (I do).....sorry, CRNA are nurses, not physicians and if I'm promised a physician, then I won't consent to a nurse.  Interestingly enough, the CRNA (once she knew who I was) offered to get an anesthesiologist to do my case....."insiders" get anesthesiologists not nurses"...I was so tired of the BS (and the prep) that I decided to do the colonoscopy with nothing....the CRNA offered to attend my procedure as a professional courtesy, but I asked her why, since I wouldn't consent to a nurse providing any sedation unsupervised.............

[swingerofbirches]

I've been lied to before too. I have a bad reaction to certain anesthetics because of the medications I take and I went to an oral surgeon who I was very clear with about not wanting certain anesthetics used. He used them anyway and I had a huge reaction where my blood pressure skyrocketed and the oral surgeon freaked out so much that he ran out of the room and called for my dad to come in! Some of these doctors are so uncaring and so terrified by real medical situations.

Sedation is absolutely not necessary for colonoscopies. They are commonly done without sedation in Scandinavia. I would imagine they do sedation because many of these doctors just want to walk into a room with a sedated body to work on and get in and out. They run these places like factories. And then they also get to bill for sedation. I think the sedation is what makes people feel so bad--it makes people feel sicker afterward. I had all of my wisdom teeth removed with only local anesthetic (and I have very, very severe anxiety disorder) and I felt fine afterward, but these people who get anesthesia seem to get sick for like a week afterward in pain. I took 2 ibuprofen and that was it.

I may need to get a colonoscopy, and in spite of having panic attacks and extremely bad anxiety, I *know* I will be calmer without twilight sedation. I had a dentist try it on me three times and the oral surgeon that one time, and each time it made my anxiety so much worse.

[scopescared]

After my initial attempt at getting a colonoscopy without sedation (and almost getting the sedation anyway because they lied about it), I finally got the exam done today unsedated and it didn't hurt much at all.   Interestingly enough, it was the CRNA who was there for my first "exam" who called me at home with the name of a doc who would do the exam unsedated.  She said that it just takes a good doc who taked his/her time doing the exam rather than sedate and just "ram and rush" through the exam.  The CRNA said that Versed is a less than ideal drug for colonoscopy and is often given incorectly by GI docs; too much, too fast, too bad.  They rush the patient out the door to deal with the mental anguish that 10% experience; depression, anger and long-term memory loss.  Propofol is a better option, if your insurance will pay the additional $1,000 or so. My second GI doc was puzzled by the first doc "insisting" on sedation; she says that a recent Wall Street Journal article pretty much says it all: sedation isn't necessary for colonoscopy and has many downsides.  She told me that we would do the exam unsedated, but that the nurse would have fentanyl (painkiller) on standby of things go bad and I changed my mind about how uncomfortable it was.  She did say to bring a driver if there was any chance that you might request drugs.

[geminigirl1963]

I agree there probably are many GI docs that are more worried about their schedules and making $$ than the welfare/comfort of their patients.  The same is true in all medical specialties I think.  I remember the good old days when you called the doctor's office and the first question they asked you was either "How are you feeling?" or "What can we do for you?" - nowadays it always seems to be "What is your insurance" instead.  Pitiful!

Is there another GI group in your area that you could go to?  If there is, I would not hesitate in contacting them - and be outright with them about why you are seeking a new doctor - the fact that your current doc lied to you about being able to have the colonoscopy done without sedation and also that you don't feel they have your best interest at heart.  If you're having trouble finding a GI group, try calling your local hospital and ask them if they have a physician's referral service - many of them do and most of them are free of charge for that service.

I'm lucky enough to have a great GI doc who is more than willing to listen to me about any fears or concerns that I have.  Even though I've had several colonoscopies (family history of polyps and personal history of multiple GI problems) and endoscopies, I still get VERY nervous before each procedure.  Like I said, I've never had a colonoscopy done without sedation, but I still am leery of being sedated.  i've never had a problem with it, it's just a scary ordeal.  My GI doc is very good about making sure that the anesthesiologist gives me "a little something" to take the ede off my nerves even before wheeling me into the procedure room.  This may actually even reduce the amount of conscious sedation they need to give me, I'm not sure.

I wish you the best of luck.  In my experience, the worst part of the colonoscopy is the prep the day before - YUCK!!!

[scopescared]

Patient915: you are correct about GA being occasionally used, especially with kids. I didn't know that; my neighbor (an anesthesiologist) says that she sometimes does GA for MRI's also.  Gemini-you jit the nail on the head; the group that I went to cared more about getting behind in their schedule (and possibly losing money) rather than patient care. Unfortunately,  a lot of GI docs do colonoscopies this way, quick and sloppy and they don't dive a damn about the patient.

[patient915]

At the hospital where I got my colonoscopy done, I had general anesthesia, intubation, and all because I was under 16 and kids under 16 are hard to sedate so they don't try.  They also do general anesthesia when someone doesn't respond well to sedation.  You should find a different place to go, I wouldn't trust these people to do anything.

[geminigirl1963]

It is YOUR body and should always be YOUR choice whether to accept sedation or not.  For your doctor and nurse to "insist" upon you being sedated, I feel, was "infantile" on their part.  I, personally, would not have a colonoscopy done without sedation (have had several with it and have made out fine), but I have heard of many people who have had it done without the sedation.  Yes, it may take a bit longer because the docs need to go a bit slower to ensure their patient is as comfortable as possible and yes it may be a bit more difficult simply because when you're sedated, you're very relaxed, so it makes EVERYTHING relax.  But yes, it can and has been done.  It sounds like your doctor was more worried about "getting behind schedule" than the safety and comfort of their patient, which is ludicrous!!!

I would not go back to that same doctor - if you need to have the procedure done, and it definitely sounds like you do, find another doctor IMMEDIATELY!!!  If you have trouble finding a doctor who will agree to do the procedure without sedation (if they say yes they will, I would insist on getting that in writing before the procedure date), then maybe ask about them prescribing you something like valium or something along those lines - it will relax you some, but will not "put you out" like conscious sedation will.

Best of luck!

[scopescared]

thanks, that's good advice.  Insurance isn't a problem since the anesthesia nurse offered her services (propofol normally about $700+) for free.  propofol sedation is abour the most that they do; general anesthesia is almost never done.  I'll have to go with nothing since I no longer trust these people..I just didn't understand the dishonesty. thanks

[patient915]

I personally would be freaked out to have a colonoscopy without sedation.  Have you considered seeing if the doctors can do a colonoscopy with general anesthesia?  But if you wanted to do it without anything then I would find a place to get it done so you don't have to deal with the issues of this place.  Sorry, I don't know anything about insurance stuff so I can't answer those questions.  Good luck.