Replies sorted oldest to newest
quote:The last doctor that gave me one always does them with medication so I didn't argue with him. It depends on how much experience the doctor has doing j-pouch scopes I think.
Mark N & PSJ....
Do what is right and comfortable for yourselves .... Some people bungee jump other won't.
I had a colonoscopy once without sedation over 20yrs ago, when first diagnosed with U C.
I didn't know what to expect and I was too ill to care but since, I always had sedation.
Same since colon removal, flexi Sig and sedation is always an option which I select.
On one occassion, on the day of the proceedure, the physician insisted I didn't need sedation, stating I will have to return in 3 months time for a sedated procedure, yet curiously when I agreed to that, the proceedure was performed with sedation there and then ?
I always request sedation due to my personal experiences and I still feel apprehensive just prior to the procedure.
Cocktail of fentanyl and versed is the new standard for conscious sedation. It used to be demerol and versed in the 1990s into the early 2000s, but demerol has fallen into disfavor and been replaced by fentanyl. However some hospitals like Yale still stock demerol if you absolutely insist on having it splashed into that hypo needle.
Most flex sig providers offer 3 choices (1) nothing, (2) conscious sedation, or (3) Propofol, which puts you out cold, although hopefully not forever like Michael Jackson was when he and his Doc overmedicated him. I choose (2). What others choose is what they choose. I recently spoke to a friend of mine who has an MBA from Columbia Business School but was completely ignorant on these matters and didn't even realize he has a choice and can tell his Doctor what can and can't be put into his body. Hello, it's your body, you should decide what is put into it and why. He ended up choosing Propofol for his very first colonoscopy at age 51 after I educated him on the subject.
I don't know. At my current hospital workplace, and the hospital where I receive my care, it's Propofol that's the drug of choice, and I totally prefer it. Rarely have I received the Fentanyl/Versed mix, though it's still used. But there's pushes to get away from benzodiazepines.
Propofol is is metabolized and out of your system in minutes after it's turned off. No hung-over feeling with it, too.
We also use a med called Precedex often, too, though less with conscious sedation and more for short term (24-48 hours) in the ICU.
I think we need to distinguish between scopes at hospitals and scopes at a GI's office. Propofol (a) has to be administered by an anesthesiologist, and (b) is 15 times more expensive than conscious sedation. The profitability of administering Propofol has led to scams and I have personal experience with one. The scam is perpetrated by the anestheologist who insinuates himself or herself into a business relationship with a GI who does scopes all day. They sell the GI on Propofol being better but the TRUTH is it's not better, it's more money for the anesthesiologist than if the Doc gives the conscious sedation to his own patients (yes, and you don't have the grogginess).
The problem is people soon realize that $1500 vs. $100 is a lot of money when the insurance carrier isn't covering it. They then squawk about the needlessness of this and the scam is shut down. I was part of seeing one get shut down. It was all sales pitch and at the end of the day people were needlessly getting Propofol, complaining about bills, when Doc has to choose between angry patients and firing the anesthesiologist guess who wins?
Hospitals are in business to make money and to pay you and the anethesiologists they need to keep them busy and Propofoling people is one way to do that, like I said, it is 15X as much which is huge. And I am not sure why insurance carriers don't squawk because at the end of day someone has to pay the bill for 15x more expensive.
I am pretty sure at Yale that conscious sedation is the standard based on what I witnessed being put in the recovery room there BEFORE the procedure due to my Doc being late. I had always assumed it was due to costs although the other side of it is that it is easier to communicate with a patient who is not groggy. In any event I am stuck on the cost and I think Propofol is a needless waste of money for a flex sig and the only reason it's being done is to keep anesthesiologists busy and paid.
If anyone is wondering why Healthcare is headed towards being 33% of the GNP of the USA, there you have it. It's the easiest business in which to sell people things they don't need. You are selling to sick people, and they want to believe that what you tell them they need IS what they need, even if it isn't.
I've had 2 different kinds of scopes. I didn't realize there was a "straight scope" one and a flex sig one. Jan enlightened me then explaining that my surgeon had done the straight scope as he probably doesn't have the training to do a flex sig. He had me come a year after take down and without any prep he had me literally pull down my pants, lean over an examination table and it was raised up so he could stand up, insert it, have a look around and was done. It left like a broomstick or baseball bat was shoved into me. I actually visualized a scene from "Deliverance" then. He did have some air of sorts to inflate it so he could examine me. I will NEVER have this type again. I had cuffitis then and found out when I went to my GI for a flex sig that I had c.diff as well. So IMO only do one without sedation if you aren't having problems or the doctor that is performing it does them without sedation. One of the without medication flex sigs was enough for me. I am becoming a weeny in my disabled days. Last year I had 18 little cavities as my gums receded, because of all of the medications I take. No longer a tough girl I requested and gladly paid for nitric gas, think that is what it's called, for the 3 times I had 6 cavities filled at once. I also took a xanex and some times a xanex during the marathon drilling events.
Last year I had 18 little cavities as my gums receded, because of all of the medications I take. No longer a tough girl I requested and gladly paid for nitric gas, think that is what it's called, for the 3 times I had 6 cavities filled at once. I also took a xanex and some times a xanex during the marathon drilling events.
I just had 2 "little" cavities at my gum-line filled yesterday, it's the first time I've had a cavity in probably 20 years. The dentist said it was from all of my medications. Stupid UC and Medications.
If a medical professional offers me pain-relief for a procedure I'm taking it.
@ks1905, my dentist has me on a prescribed toothpaste that is 7% fluoride vs the normal of 1.7%. I'm brushing twice a day along with flossing and using my Waterpik a few times a week. I also am getting my teeth cleaned more than 2 times a year. I hate UC, and everything else. Mine were mostly at my gum line too and didn't occur until several years after my take down.
I've have conscious medication, like CTBarrister, and never been offered Propofol for any of my colonoscopies or pouch scopes, at clinics or hospitals. I think that would be overkill and I'm a pain weenie.
