Long story just because I am in a foul mood all of a sudden.
I have a "thing" about sedation, anesthesia. I don't like not knowing/remembering what is going on, not having any say in what is being done, what decisions are being made, etc. I have nightmares afterwards the few times I've had either.
It didn't help that my gastro and I spent a couple of years arguing about my agreeing to a colonoscopy and her agreeing to do them w/o sedation. FINALLY she agreed to do a scope w/o sedation. EXCEPT when I arrived, was gowned up and in the procedure room and the nurse wanted to set the IV and I asked why and she said for the sedation and I told her I wasn't having any sedation, she said I had to and I said cancel the procedure and climbed off the table. She went running for my gastro who came in and tried to make me change my mind and when I insisted on cancelling she agree to doing the scope w/o sedation. EXCEPT all during the procedure both nurse and gastro kept encouraging me to accept sedation. That was interfering w/my concentration and I finally said "Okay, BUT, JUST a little, I want to watch the monitor". I felt a sting and was out of it. The d*mn nurse hit me w/a full bolus immediately instead of a slow "titration" and I got agitated and then hostile. So much so my husband could hear me way down in the family waiting room threatening to kill them all. Needless to say my gastro removed the scope and it was an incomplete colonoscopy!
Altho she insisted I should have a colonoscopy every year due to having had Crohn's for 20 years I kept refusing unless she would do it w/o sedation. I finally let her convince me to agree to a scope w/diprivan (Propofol) but I was an absolute basket case before and actually was waiting for the elevator leaving even my husband sitting unaware in the waiting room when the nurse caught me and convinced me to return to the endoscopy suite. I was in tears by that time. The scope went well and I LOVED that I woke up and was alert so quickly. BUT between the panic beforehand from the time I agreed to the scope w/Propofol and the scope itself and then the nightmares afterwards for almost a week I made it quite clear we would do my scopes w/no sedation or we didn't do any scopes. Pure and simple.
I provided her w/the full articles from the following abstracts:
Endoscopy 2002 Jun;34(6):435-40
Patient pain during colonoscopy: an analysis using real-time magnetic endoscope imaging.
Shah SG, Brooker JC, Thapar C, Williams CB, Saunders BP.
Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow, London, United Kingdom.
PMID: 12048623 [PubMed - indexed for MEDLINE]
Gastrointest Endosc 1996 Feb;43(2 Pt 1):124-6
Why is colonoscopy more difficult in women?
Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, Williams CB.
Department of Endoscopy, St. Mark's Hospital, London, England.
PMID: 8635705 [PubMed - indexed for MEDLINE]
To her credit she actually underwent both an upper endoscopy and a colonoscopy w/o sedation before she finally agreed to do my scopes w/o sedation. And she even admitted that she agreed w/me, the upper endoscopy was worse w/o sedation than the colonoscopy due to the gagging.
So we've been doing my scopes w/o sedation every two years *wicked grin*. We've also had our disagreements on what prep to use. Until they took PhosphoSoda off the market that was my preference and I just filed the script for the NuLytely and later the HalfLytely and continued to use PS. I just can NOT do the volume of liquid in such a short time needed for the Lytely products and I am always careful to drink LOTS of fluids over the entire prep day and have always been squeaky clean. Even when I've used Magnesium Citrate instead of the PS. Again, always drinking plenty of liquids the ENTIRE day of the prep. And up until 2 hours prior to the procedure once I read the current literature saying 6 hours prior is not needed and even provides a worse outcome due to dehydration, etc.
Anyway, the head nurse of our usual endoscopy department transferred out to radiology and the new head nurse said we could no longer video the monitor during the scopes. So I insisted we switch facilities. We have a brand new facility in town that I really, really like. The staff are all marvelous! Radiology on two floors and endoscopy on one floor. But they don't have an anesthesiologist so can't do Propofol. And we continue to video the monitor.
My gastro's office wasn't always the most organized and efficient. But she's remodeled, added on another gastro and more staff and they've seemed to have it all together now. I like my gastro, we've managed to come to a meeting of the minds about scopes, and she is slicker than snot on a doorknob w/those scopes!!!
To shorten the story a bit I've developed the confidence in her that I think I can do a colonoscopy w/Propofol IF we can still video the monitor. No video, no Propofol. That means we have to switch facilities again. To the other local hospital I've not had much experience with. I said I would agree IF this hospital would allow us to video the monitor. She said she would check and then she got back to me and said they were agreeable. So the scope is scheduled for today.
I even let her convince me to do the HalfLytely bit but to change the times so that I had more time to get that volume of bilge water down. I did the Dulcolax even (which always cramps me up) and then the 4 glasses of 8 ozs of the HalfLytely w/Lemon/Lime flavoring. It wasn't too bad. I didn't get particularly sick or bloated. And I was running clear by the 3rd glass. But dutifully finished the 4th glass at 7:30 PM last night.
I'm scheduled for a 4 PM scope, be there at 3 PM. The instructions say to start the last of the HalfLytely at 7 AM. I figured I'd start at 5 AM to give me the needed extra time to get it down. Except I was still running clear at 5 AM so ..... I figured the instructions are for scopes scheduled from 1 to 4 PM - and that is a 3 hour spread. 7 AM to 1 PM is 6 hours. So 10 AM to 4 PM is also 6 hours. So I WAS gonna start the last of the HalfLytely at 10 AM.
BUT I had forgotten to call and get pre-registred so I called the endoscopy unit to get pre-registered. And .... to shorten the story a bit more I asked a few questions (trusting soul that I am) and it turns out they have me down for Versed and Demerol and NOT Propofol AND I figured I'd better ask about the video of the monitor .... and was told NO WAY! So I told them to cancel the procedure. Well, lets not cancel just yet, the nurse is going to check into our making a video of the monitor. Scheduling the Propofol instead of the Versed/Demerol shouldn't be a problem. I told them I was willing to do the scope w/o sedation as we have many times before BUT UNLESS they allow us to video the monitor the scope is CANCELLED!
So here I sit, burning up w/anger, MORE than anger, I'm absolutely furious and fit to be tied!!! I've done my part and my gastro or her office has screwed up yet again!!! IF I have gone thru this prep for nothing ..... I won't be quiet about my feelings on the matter. NOT AT ALL! I WILL make one big ole billy heck of a stink about it!
I'm so sorry I EVER agreed to the Propofol. We would have just routinely done my scope at the new facility where we've been doing them w/all the great staff, we'd video the monitor and I'd have been completely satisfied.
Instead, now I am in one FURIOUS twit!!! And still have no idea whether we will be doing the d*mn scope today or not.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.