I am thinking about doing that soon, did it hurt???
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I have had it done with and without sedation. I normally tell my GI doc in advance I want conscious sedation (fentanyl and versed is what they use). I reject propofol because it's 15 times the cost and I don't like being put out, plus it's dangerous as Michael Jackson found out. Propofol MUST be given by an anesthesiologist whereas a trained monkey could give you a shot with the right dosage of fentanyl and versed. Hence the HUGE cost difference. I have very strong opinions about GI offices that push propofol and it's usually because they have an anesthesiologist on staff who needs something to do to justify his or her existence.
On the occasion when I tried it without sedation, because I did not have a ride, it was tolerable, but unpleasant. I don't do needlessly unpleasant procedures. Speaking of which, if you want to get scoped you will need to have the Covid test.
Keep in mind that when the pouchoscopy is done they use an air pump on the pouch and lower ileum so as to inflate your pouch and ileum like a balloon. This enables better visualization of the bowel walls on the camera and eliminates the folds, nooks and crannies. The inflation process is uncomfortable if you do not have sedation. I am usually farting out the gas for an hour or more after the procedure.
It’s the only way I’ve had them done for the past 30 yrs. no requirement to bring someone with you. The only thing that hurt a little was the air which makes ya a little gassy.
I definitely prefer without sedation. It just isn’t a big deal to me, and I can drive myself to and from the procedure.
I've only had it done under sedation. I'm kind of afraid to have one without. I'm with CT in that I do not do unpleasant if I can help it. My GI and Surgeon have both said it could just be done in their office, and so far I always declined everytime.
I wish my doc would still do it in the office, it was so quick, in & out in 30 mins, no anesthesia.
@CTBarrister posted:I have had it done with and without sedation. I normally tell my GI doc in advance I want conscious sedation (fentanyl and versed is what they use). I reject propofol because it's 15 times the cost and I don't like being put out, plus it's dangerous as Michael Jackson found out. Propofol MUST be given by an anesthesiologist whereas a trained monkey could give you a shot with the right dosage of fentanyl and versed. Hence the HUGE cost difference. I have very strong opinions about GI offices that push propofol and it's usually because they have an anesthesiologist on staff who needs something to do to justify his or her existence.
On the occasion when I tried it without sedation, because I did not have a ride, it was tolerable, but unpleasant. I don't do needlessly unpleasant procedures. Speaking of which, if you want to get scoped you will need to have the Covid test.
Keep in mind that when the pouchoscopy is done they use an air pump on the pouch and lower ileum so as to inflate your pouch and ileum like a balloon. This enables better visualization of the bowel walls on the camera and eliminates the folds, nooks and crannies. The inflation process is uncomfortable if you do not have sedation. I am usually farting out the gas for an hour or more after the procedure.
Did it hurt without sedation???
@ytcrockpot posted:It’s the only way I’ve had them done for the past 30 yrs. no requirement to bring someone with you. The only thing that hurt a little was the air which makes ya a little gassy.
That gives me a lot of hope now! You have done that for over 30 years! I do not have ride so I am going to start doing it the way you do 
. Have you ever had a gastro that rejected you doing it awake without sedation?
@Scott F posted:I definitely prefer without sedation. It just isn’t a big deal to me, and I can drive myself to and from the procedure.
Does it hurt?
@Former Member posted:Does it hurt?
Any gastro ever reject you doing it awake?
There’s some pressure when the air is pumped in. It’s not something I’d do for fun, but it’s just not significant for me. I did once feel a nasty electric shock from the cautery after a biopsy. I think the system must not have been grounded properly, but that was a freak occurrence.
@Former Member posted:Did it hurt without sedation???
As I mentioned above- uncomfortable but tolerable. I didn't have a ride that year. I prefer to get a ride and get conscious sedation.
There will be no sedation option for the Covid Test you will be asked to do before the scope so that will prep you for it. Swab jammed up your nose in prep for flexible sigmoidoscope jammed up your ass and then attached to air pump.
@CTBarrister posted:As I mentioned above- uncomfortable but tolerable. I didn't have a ride that year. I prefer to get a ride and get conscious sedation.
There will be no sedation option for the Covid Test you will be asked to do before the scope so that will prep you for it. Swan jammed up your nose in prep for flexible sigmoidoscopy jammed up your ass and then attached to air pump.
Okay, perfect! 
@Scott F posted:There’s some pressure when the air is pumped in. It’s not something I’d do for fun, but it’s just not significant for me. I did once feel a nasty electric shock from the cautery after a biopsy. I think the system must not have been grounded properly, but that was a freak occurrence.
That sounds weird but I would definitely do that since I do not have a ride, that is totally worth putting up with! And you did it for over 30 years and did not have ride as well, so it must be worth it!
@Former Member posted:Okay, perfect!
You know a lot of stuff! You should be a doctor!
I've always done it awake. It's very quick. Uncomfortable, but not super painful. I have a super low pain tolerance and would not feel the need for sedation. I didn't even know it was an option.
Usually without unless I am having issues and I know it will hurt. To me, it is not worth ruining a whole day to get put out.
Always did it with sedation for 20+ years. Switched docs and she gave me a choice. Tried it without sedation and never looked back. Easy peasy, for all of the reasons others have mentioned. Done at the hospital.
@Mary O posted:Always did it with sedation for 20+ years. Switched docs and she gave me a choice. Tried it without sedation and never looked back. Easy peasy, for all of the reasons others have mentioned. Done at the hospital.
Do you know your exact days of your surgeries?
@CTBarrister posted:I have had it done with and without sedation. I normally tell my GI doc in advance I want conscious sedation (fentanyl and versed is what they use). I reject propofol because it's 15 times the cost and I don't like being put out, plus it's dangerous as Michael Jackson found out. Propofol MUST be given by an anesthesiologist whereas a trained monkey could give you a shot with the right dosage of fentanyl and versed. Hence the HUGE cost difference. I have very strong opinions about GI offices that push propofol and it's usually because they have an anesthesiologist on staff who needs something to do to justify his or her existence.
On the occasion when I tried it without sedation, because I did not have a ride, it was tolerable, but unpleasant. I don't do needlessly unpleasant procedures. Speaking of which, if you want to get scoped you will need to have the Covid test.
Keep in mind that when the pouchoscopy is done they use an air pump on the pouch and lower ileum so as to inflate your pouch and ileum like a balloon. This enables better visualization of the bowel walls on the camera and eliminates the folds, nooks and crannies. The inflation process is uncomfortable if you do not have sedation. I am usually farting out the gas for an hour or more after the procedure.
yeah but doesn't having an anesthesiologist there offset the cost due to they are like the highest paid medical professional?
@Pouchomarx posted:yeah but doesn't having an anesthesiologist there offset the cost due to they are like the highest paid medical professional?
I don't follow what you are saying. Let me use real numbers. Back in around 2007 when I actually had this choice the cost of injecting me with fentanyl and versed was $150 whereas the cost of propofol was $2000. Even if insurance pays for the procedure they calculate your total cost to them which is reflected in next year's premium. How is there any offset to me by choosing propofol? It's very simple - I cost my insurance company $2000 on my choice as opposed to $150 meaning they spent $1850 more on me than they had to and this will be reflected in my next year's health insurance premium payment. How and where is there any offset to me?
By the way- I made that choice not knowing what the insurance cost was. I later found out. It's hideously a waste of the patient's money and the only facilities that push propofol over conscious sedation do so so that THEY can get paid and reimbursed for the exorbitant costs of the staff anesthesiologist. That was the whole point of my post. When you give in to a "recommendation" to use propofol, that is what you are giving in to: helping THEM pay the cost of their anesthesiologist, while your health insurance premium goes up, up and away like the beautiful balloon.
I get sedation.
I've elected to go without sedation in the past, I found it empowering to be able to discuss what the doctor was viewing in real time. Like others have described, it's uncomfortable but definitely bearable. Unfortunately, I also have some narrowing above my j-pouch from a subsequent small bowel resection and that is difficult for the doctor to check if I'm not sedated--so those days without sedation may be over for me!
Muggsy,
Your post reminded me that I should clarify a little better why I get sedation. Typically in scoping they "take a peek" at the lower ileum to see what is going on up there above the Pouch. After 15 years they started to see scattered ulcerations in my neoterminal ileum, possibly related to backsplash stool, and possibly not (the latter is the theory they were most embracing due to the pattern of inflammation). Therefore I am getting more than a "peek" into the ileum above the pouch. Also, I have a large polyp near the J pouch inlet which last year my GI said he elected not to remove because "that one could be a bleeder." He said if it got bigger he would remove it. I don't think that polyp excision hurts, but I don't need to see it, and if bad things happen I would rather be sedated while they happen. He gives me pics afterwards and we intelligently discuss the pics 2 weeks after. So the notion that I need to be awake and seeing it all in real-time is a non starter because I can see it all 2 weeks later at the post scope appointment. There is no urgency to know it all while the procedure is happening.
@CTBarrister posted:I don't follow what you are saying. Let me use real numbers. Back in around 2007 when I actually had this choice the cost of injecting me with fentanyl and versed was $150 whereas the cost of propofol was $2000. Even if insurance pays for the procedure they calculate your total cost to them which is reflected in next year's premium. How is there any offset to me by choosing propofol? It's very simple - I cost my insurance company $2000 on my choice as opposed to $150 meaning they spent $1850 more on me than they had to and this will be reflected in my next year's health insurance premium payment. How and where is there any offset to me?
By the way- I made that choice not knowing what the insurance cost was. I later found out. It's hideously a waste of the patient's money and the only facilities that push propofol over conscious sedation do so so that THEY can get paid and reimbursed for the exorbitant costs of the staff anesthesiologist. That was the whole point of my post. When you give in to a "recommendation" to use propofol, that is what you are giving in to: helping THEM pay the cost of their anesthesiologist, while your health insurance premium goes up, up and away like the beautiful balloon.
not sure, I was told my surgeon could do the scope in the ER with an anethesiologist but it would be a lot more expensive than doing it in the regular procedure room with light sedation,
@Pouchomarx posted:not sure, I was told my surgeon could do the scope in the ER with an anethesiologist but it would be a lot more expensive than doing it in the regular procedure room with light sedation,
That was kind of the point of my post. When scopes are done at hospitals, the GI will press patient to use propofol for 2 reasons, neither of which have anything to do with your personal or financial well being: (1) a patient receiving propofol recovers more quickly and can be discharged more quickly so that the hospital can book more procedures; (2) it gives the staff anesthesiologist something to do so he or she can charge fees that will pay his or her salary. The pressure is even greater when it's a staff anesthesiologist at a private GI office, which you may see at larger GI medical groups. You as a patient need to resist the pressure because it's not in your financial or personal best interests in my opinion. It is literally 15 to 20 times more expensive than conscious sedation and that expense goes down on the payout on your behalf by the insurer which you may not keep track of - but they sure do. And it will impact your premium. Plus it can be dangerous when not administered by an experienced anesthesiologist. Ask Michael Jackson's personal physician about this.
my dh has it done without sedation.
I ask for sedation. A few times I woke up in the middle of the procedure, felt no sensation because of the sedation, and watched the camera scoping my insides, but that is rare (that I wake up in the middle).
I ask for sedation because (a) I'm chicken, and (b) I want my surgeon to get a good, thorough look inside, take a biopsy sample if necessary, and he does not have to deal with me clenching my muscles or gritting my teeth because I know I will. It's more important to me that he conducts a careful inspection: I have a j pouch because I had cancer that was almost undetectable. I always book the first appointment of the day, and arrange a ride and have a slow, easy morning and nice lunch afterward. I've never had an anesthesiologist administer the sedation; it was always done by my gastroenterologist before my surgery, and now by my surgeon who does all my checkups. Maybe it is different in the U.S. to have an anesthesiologist present?
@Winterberry posted:I ask for sedation. A few times I woke up in the middle of the procedure, felt no sensation because of the sedation, and watched the camera scoping my insides, but that is rare (that I wake up in the middle).
I ask for sedation because (a) I'm chicken, and (b) I want my surgeon to get a good, thorough look inside, take a biopsy sample if necessary, and he does not have to deal with me clenching my muscles or gritting my teeth because I know I will. It's more important to me that he conducts a careful inspection: I have a j pouch because I had cancer that was almost undetectable. I always book the first appointment of the day, and arrange a ride and have a slow, easy morning and nice lunch afterward. I've never had an anesthesiologist administer the sedation; it was always done by my gastroenterologist before my surgery, and now by my surgeon who does all my checkups. Maybe it is different in the U.S. to have an anesthesiologist present?
Wow you are lucky! My surgeon did not do maintenance check-ups
I have had years of pouchoscopys done without sedation in the doctor office. That was back when my pouch was in excellent shape! So I think it depends on whether or not you are having issues. I had many pouchoscopys done as a routine yearly checkup. No pain. Just some pressure from the gas they pump in there but definitely tolerable. I am a total wuss! It is all over in a matter of minutes. After my diagnosis was changed from UC->Crohn’s, that was a different story. I had to change doctors b/c insurance reasons and the doctors did the pouchoscopy under sedation b/c issues with fistulas and strictures. Hope that helps!
I guess I should add that the doctor also took biopsies during these “awake” pouchoscopys. Don’t feel a thing!
@LORI726 posted:I guess I should add that the doctor also took biopsies during these “awake” pouchoscopys. Don’t feel a thing!
Oh great! Thanks!
@Winterberry posted:Maybe it is different in the U.S. to have an anesthesiologist present?
It's only necessary to have an anesthesiologist present for propofol because it puts you out completely- you are unconscious. Probably the same in UK. Conscious sedation can be administered by anyone, possibly including a trained monkey so long as the correct dosage of fentanyl/versed is put into the IV line.
My GI offers me a choice of level of conscious sedation: light, medium, and heavy, although he has names for them like "twilight" for light and "hammered" for heavy. I usually choose something in the medium range.