Gastroscopy

I had a gastroscopy a few weeks ago (technically an EGD - esophagogastroduodenoscopy), but I sure as heck knew why I was having it. Unless you have upper GI symptoms suggestive of something that needs further investigation the procedure may be questionable. Can you call and ask why it’s been ordered? I wouldn’t get confrontational, but I also wouldn’t have the procedure without knowing why I was having it, even if I lived next door to the endoscopy suite. The sedation is necessary but not a particularly big deal. I hope you get this worked out.

I agree with Scott- you need to talk to your former GI about the reasoning for the procedure since it’s going to be a major pain for you logistically.  Perhaps he could refer you more locally, or do an alternate investigation.  There are pill cameras you can swallow now that don’t require any procedure beyond an office visit.  Or a CT or MRI.

If the sedation is the same as what’s used for pouch scopes, then it’s not a big deal.  It’s just sleepy time for an hour and then you’ll be awake and capable.  I find that my memory is a little hazy for an hour or so following the procedure.  But you won’t want to drive - hence the adult requirement.

Just a legal note here.  You are legally impaired for 24 hours after sedation or anaesthesia.  Please do not drive unless you are 24 hour post sedation cocktail.

@capper posted:

As far as the procedure, I am quite apprehensive.  (A) being put under, and (B) just the thought of what they are going to do.  

You need to distinguish between conscious sedation, in which you are NOT "put under", and anesthesia (usually propofol) in which you are. I believe, although I am not certain, that both are options for this procedure - as they are for a pouchoscopy. I uniformly refuse propofol, which will be pushed on you, because it's retail cost is prohibitively expensive, and for other reasons. You have a say in what is put in your body and it is up to you to voice that say. Many patients meekly accept, like sheep, what they are told they should be doing. I am here to tell you that you don't need to do a sheep imitation. If you are in Canada, the cost objection to having propofol isn't really an issue since the government is footing the bill for your treatment. In the USA, in case anyone is interested, propofol is roughly 10 times more expensive than conscious sedation. If you are paying coinsurance on outpatient procedures, you are going to be raked big time. You have the power to control whether that happens.

On another related note, my coinsurance on my last endoscopic balloon dilation at Yale was just over $1000. A component of that bill was anesthesia. Somehow they are charging now in outpatient procedures at Yale the "drip time" that they sedate or administer anesthesia. That component of my overall bill came to $1200 for 61 minutes of conscious sedation (fentanyl and versed); it would have been much more if I had allowed propofol to be administered.

If in fact you are in Canada and can subtract the cost issue, one benefit of propofol is you will recover quickly and will not be drowsy all day. This is not to say you should be driving but you can probably go back to work if needed. Conscious sedation usually requires taking off the day of the procedure. Anyway, you have a choice and good luck with it.

Thanks for the all the feedback to my post.

LovelyCarrot made a great point about logistics and maybe I should question my GI about this procedure.  I thought about that for sure.  However, considering I am on my 4th biologic in the past 5-6 years (Humira, Remicade, Entyvio, & now Simponi), and since I am still having my share of issues, I should probably keep my mouth shut and do what they say!  I suppose it's a small price to pay considering what I have had to live with over the past 22 years post surgery and for another 8 years prior.  I assume that they want to see if there are issues with my upper intestinal tract that could be adding to the difficulties in living with a pouch.  I have never seemed to have been able to get to a point of a consistent lifestyle of 3-6 bowel movements a day. Some days yes, and then some nights I'll be up 4-5 times for toilet runs before breakfast time!  It goes from one extreme to the other.  That being said, without the 360mg of Codeine I take daily, there's no telling where I'd be right now...  Life would likely be a lot worse...

And I am pretty sure that if there were alternate more less invasive and simpler ways to do the test, that it would be an option.  At least I would think so, but I suppose I could always ask.  Being in Canada, the biggest expense for this procedure will be my transportation, accommodations, and meals while on the road.  The procedure in Canada will be covered by my provincial healthcare. 

I am sure glad that I am covered for my Simponi medication by 'compassionate care' as each monthly injection costs CAD$1,584.29 before shipping!