Colonoscopy without sedation, should I?

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LeonW
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Colonoscopy without sedation, should I?

Postby LeonW » Mon Mar 05, 2018 7:49 am

I need you advice . . .
Hospital called to set a date for a next scopy in May.

  • Had my first one fully sedated @ Dx in 2012 - my dear wife witnessed the ordeal a-z :(
  • Went for another one in 2015 when nervous about a hardened lump around the place where colon was shortened. Woke up in the midst of the proceedings and had all explained when Docs turned the screens. Dozed off again a bit later and woke up in the recovery room. Appreciated the experience.
Because of what happened in 2015 I opted to have it without sedation, this time.
That was a couple of days ago but can't stop thinking about it. Am starting to feel less certain.

Anyone here who ever had a colonoscopy without any sedation?
How bad was it - should I change my mind?
Can they still put me out during the session when I decide I had enough??

Thanks, L
Dec 2012 - Colon Cancer MM @65yrs, 2 unresect liver mets, CEA 41.8
Jan 2013 - colectomy @ spleen 2/26 nodes (IVa T3N1bM1a) MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, shrinkage from #3
Sept - 2x failed Portal Vein embolization
Oct 2013 - R liver resect 28 hosp days (liver failure, delirium, emboli, encephalopathy) pCR - cancer gone
2014/15 - recovery/benign polyp
Apr 2016 - new town, new life
clean CTs and (1.3-1.4) CEAs: 4x2014, 6x2015-17, 1x2018
June 2018 - 2 polyps, 5yr survivor

Utwo
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Re: Colonoscopy without sedation, should I?

Postby Utwo » Mon Mar 05, 2018 9:40 am

I was told that extra pain (without sedation) leads to higher intensity peristaltic, that can complicate insertion of a scope and can increase a risk of perforation. This is a main reason why American doctors dislike no-sedation option.
I do not believe that this risk is high, because in many countries doctors prefer colonoscopy without sedation.
I have no independent confirmation of this point of view.

If you want to see what's happening in real time, you may ask for milder sedation.
58 yo male at diagnosis - T1bN0, 0/15 lymph nodes, low grade/moderately differentiated adenocarcinoma
03/2016 colonoscopy #1: 2 small polyps removed in left colon; CEA = 1.3
04/2016 colonoscopy #2: caecum sessile 3.5 cm polyp piecemeal removed with kind of clear margins
05/2016 CT scan, blood test ...
05/2016 "prophylactic" laparoscopic right hemicolectomy with a few complications (bleeding, leak, infection)
06/2017 CT scan (lower body), colonoscopy OK; CEA = 1.6

Eleda
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Re: Colonoscopy without sedation, should I?

Postby Eleda » Mon Mar 05, 2018 10:32 am

I had sedation ,
but didn't work, because I was so anxious, so saw and felt ,everything as ot was happening including biopsy
( not sure,its a good or bad thing)

( not really painfull, only on turning the corner of the sigmoid)I could see the tumor for myself and became slightly hysterical,( confirmed my worst fear )
Suprised they didn't sedate me there and then tbh lol

Next one due soon and will definitely skip sedation
I did hear a nurse trying to talk another girl into getting a cannula, just incase she changed her mind mid way on sedation

Tbh its not that bad,,,,,

Good luck hope all goes well
Adele
SWF, 47
Mom to 3 sons 6/8/12
Dec4th colo for intermittent rectal bleeding over the Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV
JAN 3RD started 1650mg Zelda 2xday, concurrent with 28 radiation

zx10guy
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Re: Colonoscopy without sedation, should I?

Postby zx10guy » Mon Mar 05, 2018 11:21 am

I have had it done twice.

What started me doing this has been issues in my personal life with my wife. That is another story.

I won't lie to you. It is uncomfortable especially when you're pumped full of air and they have to press on your abdomen some times to help the scope snake around some bends with your colon.

With that said, I'm due for another one in April. Will I do this one without sedation? Most probably. Issues with the wife are still there. And I don't want to bother anyone to drive me to the facility and back. Another reason for me to want to do this awake is as you've indicated. I was able to watch the entire procedure on the monitor. My doc moved the monitor so he and I can see the same thing. The first time I did it without sedation I saw at the same time what he saw which was a polyp in my appendix opening. This was taken out via a right hemicolectomy and turned out to be Stage 0 Appendicial Cancer.

The colonoscopy after the above was done a year ago and we didn't find anything. There was a black spot on the colon wall which he took a sample of just to make sure. Came back as nothing. But my doc thinks it may have been a suture.

Also without sedation, the whole prep is less involved. No need for the anesthesiologist to do his/her thing. Minimal waiting period in recovery to get out of there. Only thing I had to wait on was another baseline set of vitals to be done. I also requested a copy of the reports from that day's procedure which held me up.

Pemba
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Re: Colonoscopy without sedation, should I?

Postby Pemba » Mon Mar 05, 2018 12:25 pm

I had mine without sedation, but they gave me a colon relaxer drug ?? have no idea what it was or if it helped me in any way. I came with some outbursts along the way, but it was nothing i could not handle, my grandpa who semi often have colonoscopies NEVER get drugs and claims it dose not hurt him at all!! my gastro dr mentioned that women have more organs that gets pressed on along the way and that it can hurt more, when i first had my small sigmodioscopi it was the day before my period and it felt like my uterus was about to burst the whole time.
Age: 26
2017: 15mm Tubulovillous adenoma- Low grade dysplasi.
Next scopy: original 2020 probably 2018-19

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bitchslapped
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Re: Colonoscopy without sedation, should I?

Postby bitchslapped » Mon Mar 05, 2018 3:17 pm

I'm happy to get the rundown on replay from the doc's version over the phone vs real time! In my experience w/3 or so colonoscopies you usually have some basic idea of results before you leave, but doc does followup call w/more thorough info. They can also send reports & pics of problem areas. I've felt the jab under twilight, nothing under Propofol, however women's intestinal configuration different than men's:

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.


Re: your last qx, I'm going to guess the doc will not be too happy to interrupt the middle of the colonoscopy to administer sedation. If you have any reservations Leon, maybe twilight sedation is the way to go for you.

BS
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
FOLFOX+Avstn 4 Rnds d/c 10/'14
Stent 9/'14
FOLFIRI+Avstn 10/'14
Gone From My Sight 2/20/15
Me:garden variety polyps + precancerous polyp
Carergver x2 DH,DM dbl occupancy,'03-'10
DH dx 47YO mCRC,'04-'07 fried x HAI
DM dx CC 85YO,CC,CHF,stroke,dementia,aphasia

Leeloo
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Re: Colonoscopy without sedation, should I?

Postby Leeloo » Mon Mar 05, 2018 7:21 pm

Hi Leon,
I’ve had a colonoscopy 4 times now. Three times with sedation and once without.

I chose not to have sedation as I wanted to be able to drive and work the next day. My surgeon was not happy, the nurses had to state very firmly that I did not want sedation.

The nurses in pre-op said this doc was the best, they would not advise going without sedation if I was having the scope done by some of the others! However the doc really was not keen, although they agreed to go ahead. In reality, yes it was very uncomfortable, but not painful. I have felt worse post op or giving birth.

The last time I had it done I had sedation but a smaller dose. It is more comfortable, definitely much better IMO. If I had to have a polyp removed, I would not want that done without sedation. If I was in the same situation and needed to drive home, I’d do it again without.

However the surgeon was more comfortable with me having some sedation, and I think happier to have a good look, instead of being distracted by my discomfort. Since the whole point is to let the doc get a good look, this compromise seemed sensible.

Hope all goes well during your next one.
(R) hemicolectomy 13/08/13
Stage IIB T4N0(0/6)M0
Xelox x 4 (Scot trial)
NED

jaybel
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Re: Colonoscopy without sedation, should I?

Postby jaybel » Tue Mar 06, 2018 2:16 am

I had one 9 years ago without sedation and it was painful but the doctor was not very nice. For my one year colonoscopy after my resection for Stage 1 colon cancer in the Sigmoid I decided to go without but my doctor told me if it gets bad to let him know and they will give me a shot of fentanyl and versed. They gave me just enough to kill the pain and I still remember the entire colonoscopy.

NHMike
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Joined: Fri Jul 21, 2017 3:43 am

Re: Colonoscopy without sedation, should I?

Postby NHMike » Tue Mar 06, 2018 6:48 am

I had two last summer and was completely out both times. It worked out great.

I lost my GI doctor - he's taking a job as the CMO of a regional hospital. I have to send him a letter of congratulations. I consider him the best GI doctor in the state and maybe the best doctor overall. He was voted as such by his peers a few years ago. I will miss his services and his GI capabilities.
6/17: ER rectal bleeding; Colonoscopy
7/17: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda +radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8
MSS, KRAS G12D
10/17: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx 8 cycles 12/17-6/18

justin case
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Re: Colonoscopy without sedation, should I?

Postby justin case » Tue Mar 06, 2018 6:36 pm

Eleda wrote:I had sedation ,
but didn't work, because I was so anxious, so saw and felt ,everything as ot was happening including biopsy
( not sure,its a good or bad thing)

( not really painfull, only on turning the corner of the sigmoid)I could see the tumor for myself and became slightly hysterical,( confirmed my worst fear )
Suprised they didn't sedate me there and then tbh lol

Next one due soon and will definitely skip sedation
I did hear a nurse trying to talk another girl into getting a cannula, just incase she changed her mind mid way on sedation

Tbh its not that bad,,,,,

Good luck hope all goes well
Adele

I've had several sigmoidscopy's with out sedation, no problem, I would refrain from the entire colonoscopy without it !
Michael
7/11 diagnosed Stage 2 colon and rectal cancer
chemo/rad
lar/temp ilio
Reversal & port removal
21 round of chemo Folfox 9tx, 5fu 12 tx
Last treatment July 2012

Swirdfish
Posts: 284
Joined: Sun Jun 19, 2016 3:57 am

Re: Colonoscopy without sedation, should I?

Postby Swirdfish » Wed Mar 07, 2018 4:22 am

Get sedated and go to sleep. Nothing beats a good sleep. :lol:
06/2016 Went in for colonoscopy came out with a tumor. Age 35
12cm from verge at junction. Rectal cancer.
Clinical stage T3 NO MO
Temp illestomy
Completed 5FU and Radiation
LAR surgery planned 13 Oct 2016
Completed ULAR surgery 11-10-2016.
0/22 nodes
pT3 N0 M0 R1
Stage 2A

Pathology reviewed and changed
ypT3 N0 M0 R0

Started folfox 21-11-2016
5-4-17 NED
Reversal 12-4-17

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LeonW
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Location: Amsterdam, Netherlands

Re: Colonoscopy without sedation, should I?

Postby LeonW » Thu May 03, 2018 7:13 pm

Hi Everyone

Thanks for your comments.

I had the scopy yesterday without sedation. Am glad that I made the decision - it was all very easy. No problems, no pain or even the slightest discomfort. Docs (over)rated my (dis)comfort level at 1 (Gloucester score 0-5; "one or two episodes of mild discomfort, without distress"), but I can't remember when/where that could have happened. The only thing noticeable was when the probe passed the place where colon was re-attached. It just felt different and the sight of the area there looked more messy than elsewhere.

I hesitated until the very last, weighing your opinions. Ultimately decided to gamble and to have it sober. I'll certainly will go without sedation next time. Also being able to see the full journey on the monitors was interesting. And listening in into the chat between the docs (there were two) explained a lot.

They found two small polyps (5 mm sessile and a 7 mm one on a smallish stalk). Both showed prominently on the displays / were taken out on the spot, neatly documented with pics before and after removal. Docs thought they were adenomatous. I'll see if Anatomy comes up with anything else. I'll get the official results (telephone) May 23, but the path report should be be on-line earlier.

I again/still feel very lucky. Wanted to share this with you all.

One final question:

This was my third scopy (the second after the very first one back in 2012 that lead to my membership here). The previous one (asked for it when I felt a small lump developing where the colon was resected - still there / can sometimes feel it) found a tiny flat polyp (removed / benign). This time, two new ones (the ones above) showed up.

Is it normal that new polyps develop so soon?

Thanks again for your comments,
With greetings to you all from a sunny Amsterdam
L
Dec 2012 - Colon Cancer MM @65yrs, 2 unresect liver mets, CEA 41.8
Jan 2013 - colectomy @ spleen 2/26 nodes (IVa T3N1bM1a) MSI-low
Feb-Aug - 1x Xelox-7x Xelox/Avastin, shrinkage from #3
Sept - 2x failed Portal Vein embolization
Oct 2013 - R liver resect 28 hosp days (liver failure, delirium, emboli, encephalopathy) pCR - cancer gone
2014/15 - recovery/benign polyp
Apr 2016 - new town, new life
clean CTs and (1.3-1.4) CEAs: 4x2014, 6x2015-17, 1x2018
June 2018 - 2 polyps, 5yr survivor

DarknessEmbraced
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Re: Colonoscopy without sedation, should I?

Postby DarknessEmbraced » Sun May 06, 2018 2:48 pm

I'm glad having the colonoscopy without sedation went well and hope your polyps are benign!*hugs*
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

L.andr
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Re: Colonoscopy without sedation, should I?

Postby L.andr » Sun May 06, 2018 3:45 pm

Hello - Glad your no-sedation scope went well. I was going to tell you my experience on April 18, 2018, I was looking forward to being totally relaxed and "out". Well, in my "sleep" I felt very painful tugging inside and yelled, twice. They added to the meds to relieve my pain, thankfully.
I woke up feeling great. THEN, got the news, the tugging was a 3 cm tumor in the way, 22 cm up, in the sigmoid colon.
I was scheduled for surgery rapidly, had it removed on April 26th. Stage 2, was in the wall but lymph nodes negative thankfully.
I will be speaking with the oncologist about whether chemo is recommended.
If anyone has suggestions, would be glad to hear. I hear that the jury is out with stage 2 colon CA, once the tumor and lymph nodes are out.
Thanks.
Lynn RN BSN
Age 65 female
Dx 4/18/18 at colonoscopy
Sigmoid colon tumor 2.8cm.
Lap colectomy 4/26/18.
Stage 2a adenocarcinoma.
CEA 3.3


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