Twilight sleep or Propofol, for Colonoscopy?

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ocstacy
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Twilight sleep or Propofol, for Colonoscopy?

Postby ocstacy » Sat Jul 15, 2017 12:31 am

Hi all!

I finally met my G.I. today and went over the Colonoscopy procedure. Keep in mind, that I really had to fight hard to get this GI referral as my general dr. didn't feel that it was necessary at my age. I went in for a 2nd opinion, and after talking to that dr, he finally approved it thank goodness! I will be getting my first Colonoscopy in the next couple of weeks. I'm a little nervous but I've had a C-Section, D&C,Propoful, Epidural, tongue pierced, tatoo, bee sting, root canal, painful hemmy's etc. I would say that the worst procedure I have experienced is the root canal at a whopping 2 1/2 hours with your mouth propped opened the whole entire time. Didn't hurt too much, just a time consuming procedure. I'm pretty sure the most painful thing I have ever encountered were infected hemmoroids! Felt like a never ending bee sting or knife pain in my ass!

have heard both pro's and con's about colonoscopies. GI was very kind and understanding and explained everything that I needed to know about the procedure.She mentioned with my medical background, that I should be fine with the "Conscious sedation" AKA (Twilight Sleep) which I have had before during oral surgery over ten years ago. I remember I felt little pain and TUGGING during the oral surgery :shock: I did find it a little creepy weird seeing the Dr, and glancing at the tools that were used. I had no idea what he was doing. I remember feeling pain on my upper roof of the mouth and feeling him tug on my tooth and putting stiches in :shock: That was scary weird :roll: So, if I had a choice back then when I was a kiddo, I would have asked to be put out.

So here are my questions:

1.) How was your experience with your first colonoscopy? Was it painful? Did you remember any of it?

2.) Did you choose Twilight Sedation (conscious sedation) or General Anesthesia (Propoful, the Michael Jackson drug) ? I am okay paying the extra cost so that isn't a problem.

Thank you in advanced!
Last edited by ocstacy on Tue Jul 18, 2017 12:25 am, edited 3 times in total.
Caregiver/daughter to dear mother age 77, diag.5/09/17
Rectal CA Stage 3A Low grade adenocarcinoma- 6 cm
Neoadjuv. Chemo/Rad. start 7/10/17 ended 08/16/17
Xeloda 2600 mg daily Rad.Onc Mon-Fri (28 days) -3 mth break now
Lap. surgery @ Keck USC, Dr Sang Lee-chief- Winter 2017 temp colostomy
Chemo Xeloda post surgery following reversal
Any Stage 3A survivors out there? Please share your journey
Praying 4 "Complete Response" or "NED"
Love my mom, BUTT she is a horrible patient! :roll:

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LeonW
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby LeonW » Sat Jul 15, 2017 4:48 am

ocstacy wrote:had to fight hard to get this . . . first Colonoscopy in the next couple of weeks

Well done. As said a zillion times here, if in doubt insist on a full scope.

1.) How was your experience with your first colonoscopy? Was it painful? Did you remember any of it?

I've had a scope twice. Didn't feel a thing either time. Have no memories whatsoever.
My DW was there during the first one (Dx) and told me afterwards that I was quite talkative during the procedure. Felt a bit dis-attached from reality the first half hour afterwards. That's all.

2.) Did you choose Twilight Sedation (conscious sedation) or General Anesthesia

Standard procedure over here is conscious sedation. Had no reason to question it and went along without hesitation both times without any regret.

It's only a very light and I woke up in the middle of the second one (April '15). Found it interesting to watch - doc adjusted the monitor so I could see better while he explained. Dozed off again during recovery. I'll certainly ask to stay awake again, next time (Q2 2018).

No reason for worry, best wishes
Leon
Dec 2012 - Dx CC; MM @ 65yrs, 2 unresect liver mets, CEA 41.8
Jan 2013 - colectomy @ spleen (IVa T3N1bM1a) 2/26 nodes, MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, mets shrink from #3
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Tdubz
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby Tdubz » Sat Jul 15, 2017 11:51 am

Really the worst part of a colonoscopy is the prep lol. I had propofol and it was great. Didn't feel a thing, woke up and felt great.

tarheelmom
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby tarheelmom » Sat Jul 15, 2017 12:27 pm

I've had both (2 of each). I seemed less groggy/tired and more alert after the propofol, but it was interesting to watch the monitor with conscious sedation. No pain with either. Quicker procedure now that my colon is so much shorter.
52 y at dx, mom to 4
DX: RC on 2/22/2016
Stage I, T2N0M0, 0/32 LN
23 mm x 7 mm moderately differentiated invasive adenocarcinoma
3 cm from anal verge
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby Aqx99 » Sat Jul 15, 2017 12:32 pm

I was fully out for mine. I prefer it that way, because I can only imagine having to hear the doctor talk about his findings as he works. I don't want to hear that. I woke up just as the scope left my buttcheeks, talk about a rude awakening. I also heard my doctor mention 2 polyps. I obsessed about those polyps as they rolled me to recovery and laid there waiting for the doctor to come in. Little did I know, he had worse news for me. I also know the rectal ultrasound hurt like the dickens, so I'm glad I didn't have to feel the scope bumping my tumor during the entire colonoscopy.
Anne, 39
Stage IIIB Rectal Cancer
T3N1bM0
Diagnosed at age 39
2/21/17 Diagnosis
2/21/17 CEA 0.9 ng/mL
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby bitchslapped » Sun Jul 16, 2017 2:32 pm

Found this from looking @ a couple of websites, did a cut & paste only because it basically coincides with what my gastroenterologist told me while I was under "Twilight" & wanted to make sure I was remembering correctly:

Robynne K Chutkan, MD, FASGE
Assistant Professor of Medicine
Division of Gastroenterology
Georgetown University Medical Center
Washington, DC
Medical Director
Digestive Center for Women, LLC
Chevy Chase, MD

Excerpt:
Then, there are the significant anatomical differences between the male and female colon. For example, it takes me three times longer to do a colonoscopy on a woman than a man. That’s because the female colon is 10 cm longer and much like a slinky- all tangled up with lots of redundancy. By contrast, a man’s colon is shaped like a gentle horse-shoe.

Also, the female pelvis is wider to accommodate a fetus, so the colon falls deeper down into the pelvis and must compete for space with other organs. Thus, the colon ends up wrapping around the uterus, ovaries, and Fallopian tubes and blockages, backups and bloating occur in all those twists and turns.

I have had a few colonoscopies, 2 w/ twilight sedation of which one of those where I felt a momentary sharp poke of which I expressed the discomfort, the last one w/Propofol. I didn't have a choice. First 2 were in clinic, propofol @ the hospital.

So basically you really can't compare males & female experiences + like everything else, everyone is slightly different.

I don't have a preference, really, the hospital a little more hassle maybe. Also agree a little more awake after Propofol.

Agree w/others, the prep is the worst part.

Best Wishes
BS
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
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LPL
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby LPL » Sun Jul 16, 2017 4:38 pm

BS,
Very Interesting this difference between Male & Female Colon ! Thank you for that info.
As I understand it the length of the colon can vary from person to person? There was a note in the surgery report from my husband's primary tumor resection + anastomoses that his colon was very short (what ever that means..) ?
Has anyone else had a comment like that?
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
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4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
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horizon
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby horizon » Mon Jul 17, 2017 12:06 pm

I was and am a "hell no" to being awake for any part of the procedure. They tell me I'm going to sleep and the next thing I know I'm waking up in the recovery room with the procedure over.
I'm just a dude who still can't believe he had a resection and went through chemo (currently 6 years NED). Is this real life?

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betsydoglover
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby betsydoglover » Mon Jul 17, 2017 2:09 pm

Propofol is great - you are out and then you come to and feel perfectly normal.

Colon lengths do vary. Based on scope my tumor was at junction of transverse and descending colon. Scan showed it in sigmoid colon - seems my colon was more "squiggly" than mosy.
Betsy
diag. Stage IV, 5/05, liver met
lap sigmoid colectomy, 6/05
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby DarknessEmbraced » Mon Jul 17, 2017 3:51 pm

I've always had conscious sedation with colonoscopies. I've never felt pain or remembered the colonoscopy. I hope your prep and colonoscopy go well!*hugs*
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
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ocstacy
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby ocstacy » Tue Jul 18, 2017 12:18 am

Excerpt:
Then, there are the significant anatomical differences between the male and female colon. For example, it takes me three times longer to do a colonoscopy on a woman than a man. That’s because the female colon is 10 cm longer and much like a slinky- all tangled up with lots of redundancy. By contrast, a man’s colon is shaped like a gentle horse-shoe.

Also, the female pelvis is wider to accommodate a fetus, so the colon falls deeper down into the pelvis and must compete for space with other organs. Thus, the colon ends up wrapping around the uterus, ovaries, and Fallopian tubes and blockages, backups and bloating occur in all those twists and turns.


Wow, thank you for that helpful insight. I have taken human anatomy and physiology and the prof. never mentioned this to us except that the small intestines are as long as a football field!! :shock: Well, based on the answers and being a witness of my mother's colonoscopy and seeing her after twilight, it took her awhile to wake up from the "Cocktail" drug that they gave her. She did remember what the GI dr. said to me (sort of) and she heard me crying in the background. But I told her she was dreaming.. I didn't want to tell her that she had cancer so fast. :( I wanted her GI Dr. let her know at the f/u which was 3 days ahead. I do remember her being groggy and very tired.. like so relaxed..
Found this interesting:

The Mayo Clinic performed a digestion study and found there is a marked difference in digestion time between men and women. The time it takes food to travel through the large intestine for women is 47 hours and 33 hours for men.
I found this info on this website: http://www.newsmax.com/FastFeatures/fem ... id/726146/

PS) I know I have polyps, I have felt one, feels like a pimple. :roll: :cry: :o :(
Caregiver/daughter to dear mother age 77, diag.5/09/17
Rectal CA Stage 3A Low grade adenocarcinoma- 6 cm
Neoadjuv. Chemo/Rad. start 7/10/17 ended 08/16/17
Xeloda 2600 mg daily Rad.Onc Mon-Fri (28 days) -3 mth break now
Lap. surgery @ Keck USC, Dr Sang Lee-chief- Winter 2017 temp colostomy
Chemo Xeloda post surgery following reversal
Any Stage 3A survivors out there? Please share your journey
Praying 4 "Complete Response" or "NED"
Love my mom, BUTT she is a horrible patient! :roll:

Jacques
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Colonoscopy prep

Postby Jacques » Thu Jul 20, 2017 12:54 pm

I have had both types, but I prefer Propofol.

Good luck on your colonoscopy. Here is my post from another thread:

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=58258#p459965

Here is a post on colonoscopy prep by Colondar Model Danielle Burgess:

https://fightcolorectalcancer.org/blog/colonoscopy-prep-tips/
Last edited by Jacques on Sat Jul 22, 2017 4:00 am, edited 3 times in total.
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby NHMike » Fri Jul 21, 2017 5:08 am

I had two done recently: one for the biopsy without a full prep and one to find any other polyps to remove them.

As many others will tell you, the full prep is the worst part of the procedure. You have dietary restrictions so you're very hungry and you spend a lot of time on the toilet the night before. I've seen some forum threads where they recommend bringing a blanket and pillow into the bathroom with you. I'd add a laptop with movies or lots of reading materials.

I had the Propofil. It started going into the IV and I was out in ten seconds and woke up in recovery both times. No memory of anything about the procedure. I've heard that it can sometimes be harder to get the insurance company to go for Propofil because they have to pay for an anesthesiologist but I'd go for the Propofil if I had the choice after having gone through it twice.

On dental work. I've had lots of fillings and crowns done and I don't get any painkillers for those procedures. On my first root canal, I asked the doctor if he could do it without the pain killers. He was incredibly nervous about it but we tried it out. It quickly became obvious to me that this wasn't a level of pain that I could handle without something so he gave me stuff for it though it delayed things. On my second root canal, we went with numbing stuff.
Rectal Bleeding biopsy June 23, 2017, Diagnosed Stage 3B rectal cancer late July 2017 via MRI.
T3, N1b, M0.
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ocstacy
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Re: Twilight sleep or Propoful for Colonoscopy?

Postby ocstacy » Fri Jul 21, 2017 1:02 pm

On the dental work, I've had lots of fillings and crowns done and I don't get any painkillers for those procedures. On my first root canal, I asked the doctor if he could do it without the pain killers. He was incredibly nervous about it but we tried it out. It quickly became obvious to me that this wasn't a level of pain that I could handle without something so he gave me stuff for it though it delayed things. On my second root canal, we went with numbing stuff.


Wow, I give you props for not getting a numbing shot before the root canal or during!! My tooth was sensitive to cold sensation I would cringe. How did you do that? :shock: That is so amazing!? I think I will def. do the Propofol since I do not want to remember anything during .. Thank you for sharing!
Caregiver/daughter to dear mother age 77, diag.5/09/17
Rectal CA Stage 3A Low grade adenocarcinoma- 6 cm
Neoadjuv. Chemo/Rad. start 7/10/17 ended 08/16/17
Xeloda 2600 mg daily Rad.Onc Mon-Fri (28 days) -3 mth break now
Lap. surgery @ Keck USC, Dr Sang Lee-chief- Winter 2017 temp colostomy
Chemo Xeloda post surgery following reversal
Any Stage 3A survivors out there? Please share your journey
Praying 4 "Complete Response" or "NED"
Love my mom, BUTT she is a horrible patient! :roll:

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

Colonoscopy prep solutions

Postby Jacques » Tue Jul 25, 2017 2:02 am

ocstacy wrote:... I am nervous, I have the prep just lagging on making the appt! :(

Did you say that you already have the prep? If so,which one is it? Is it one of the ones below?

When is your appointment, and when are you going to start on the prep? It's very important to have a good clean-out.

• PEG/Electrolyte colonoscopy prep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_PEG_EL_Prep.pdf
• 2-day colonoscopy prep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_PEG_EL_2_Day_Prep.pdf
• Miralax/Gatorade colonoscopy prep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_Miralax_Gatorade_Prep.pdf
• MoviPrep colonoscopy prep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_MoviPrep.pdf
• Prepopik colonoscopy prep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_Prepopik.pdf
• Suprep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_Suprep.pdf
• OsmoPrep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_OsmoPrep.pdf
• 8-liter colonoscopy prep
http://www.med.umich.edu/1libr/MPU/UMHS_Colonoscopy_8L_PEG_EL_Prep.pdf

Source: http://www.med.umich.edu/1libr/aha/umcolon.htm
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
----
Info links:
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