problems with sedation

Thank you for your helpful and kind reply.

Thank you for your reply. Can you remember how many minutes was the procedure?

I understand certain people are genetically predisposed to being adversely affected by psychotropic drugs like those used for sedation.

If you have had sedation in the past without adverse affects you may likely be okay using the drug again.  I don't like the idea of being immobilized and not in control of a procedure. I will continue to think this over and probably will not go for sedation unless other people's bad experiences indicate otherwise. However, presently I'm unceratin.

Best wishes that it works out for you. You can always ask for mild sedation if you like a compromise.

I've never had sedation before, so I am concerned about it and the after effects but I'm worried if I don't have it and things get a bit tense during the procedure and I want to stop it, they may carry on regardless.

Ask what type of drug and dosage is used for sedation and do a search on adverse effects from that drug. In toxicology the dose makes the poison.

In my opinion, if you can avoid psychotropic drugs it is better.

Nonetheless, find out what drug is used and check on its known adverse effects. Everybody is different and the effects of drugs can be different too. If the doctor doing the procedure knows you are not sedated, he or she may be more considerate and this can mitigate physical problems.   If you find out what drug is used, let me know.

Regards.

Hi John. We all have our own experiences, of course, but from my personal experience I'd say mild sedation is a really bad idea. If I ever had to have another gastroscopy - which I devoutly hope I don't! - I'd go for throat spray only.

I say this because people my age (over 65) don't have the option of full sedation. They only give us a half dose anyway, as there's a very small potential risk of cardiac or respiratory arrest in the elderly. (Like poor Joan Rivers.) My case was a bit complicated and has been described elsewhere on this site: large, spiky denture stuck in my throat for three weeks while I was thrown out of one hospital after another because no one would believe me that I'd swallowed it. By the time someone believed me (after threats of legal action from a friend) it was well and truly embedded and they had a bit of a tussle to get it out.

I had what is medically known as a "paradoxical reaction" to the half-dose of sedation. I was fully conscious throughout, knew where I was and what was going on, but was unable to control my actions. It felt like all my higher centres (which would have helped me cooperate) had been suppressed by the sedation, and the primitive limbic system was in the driving seat. It took six people to hold me down and I would have gouged the nurse's eyes out if she hadn't been kneeling on my arm.

I certainly didn't have any memory loss. When the nurse was wheeling me out of the endoscopy room in my bed afterwards, I remember kneeling up, clutching the head of the bed and yelling in her face. (I was still mad at everyone and out of control.) She laughed, said I'd crash out in about two minutes' time and would wake with no memory whatever of the procedure. In the event, I climbed over the cotsides so I could get a proper phone signal the minute I got back to the obs ward (where they at least had the decency to keep me for 24 hours for IV antibiotics) and didn't close my eyes for the next 30 hours. "Wired" wasn't in it! I only wish I did have memory loss.

Yana, if you're under 65 (or 60 in some areas) I'd say go for either. Younger people get a full dose of sedation and it's extremely rare for them to retain any memory of the event at all. However, if the sedation had a bad effect on you, maybe best to go for the throat spray alone. The vast majority of people on this site report good experiences (or at least not too terrible) from throat spray. For myself, phobic as I am about having tubes (or forceps in this case) poked down my throat, if I ever had to have it done again I'd opt for throat spray and staying in control. As John says, we all have different reactions to drugs.

In British Columbia where I live, hospitals do not do followup on patients who received sedation. In my opinion, hospitals should be required to do "risk management" or "quality control research" where they do followup on the status of patients.

I believe that generally, sedated patient don't suffer undue effects. However, there is a small proportion of the population (me included) that has a vulnerability to psychotropic drugs. It is our responsibility to make our concerns known to the medical people.

In every population there are outliers, and these people need to be addressed adequately, which I believe is not done in every case.

I will ring the hospital tomorrow to see if I can find out what drug they use, and then do some research as my appointment is Wednesday, I will let you know.

Hello Lily

Wow, I'm scared now, I'm pretty good with pain and I won't take any tablet unless I really have to, but as my partner had an endoscopy several years ago with throat spray and said it was horrific, I'd sort of made up my mind for sedation.

I suffer with anxiety and I do need medication for it, so my worry is, if I go for the throat spray and can't control my breathing then the whole situation will become out of control for me, but then as the medication slows my heart rate the sedation may affect this.

I will ask the hospital tomorrow as I'm going to try and find out what they use to sedate you, I will also mention what medication I'm on as on the forms it just says to bring a list with you.

I may find out that sedation isn't possible with my medication.

Forgot to say I'm 51.

Hi Yana, I don't think you'll have any problem at that age, as they'll give you a full dose of sedation and you won't know a thing about it. My problem was that they could only give me a half-dose because of my age, so I got the worst of both worlds - impulse control depressed while remaining fully conscious. Plus I remembered the whole thing afterwards!

The only possible problem could be with the medication you mention. If you're taking some kind of benzo they might only want to give you a half dose, or even none at all. Still, even then not everyone has a paradoxical reaction like mine. You say your mum has had it done and was out the whole time. If you're 51, she's presumably in the senior bracket like me, which means she won't have had a full dose of sedation either.

As a former NHS nurse (long time ago) I must say I'm not very sanguine about John's suggestion to get the hospital to tell you exactly what they plan to give you - if you're in the UK, that is. I suspect they may be a bit more open to dialogue with patients in Canada than they are on this side of the Pond! Still, it's worth a try. But don't forget - as John and I have both said - everyone is different. It's quite possible that even a half-dose might put you out. Also, paradoxical reactions to benzos are far more common among the elderly in any circumstances, not just procedural sedation.

Don't forget either that my procedure was far more traumatic (physically and mentally) than just having a tube slipped down, apart from which I was already dehydrated and malnourished, and had lost 15lbs in three weeks due to problems with swallowing. In fact, I suspect that if they'd believed my story about the swallowed denture they'd probably never have attempted to do it under simple sedation anyway, but would have put me under GA.

I'm sure you'll be OK.

Hi Lily

Yes she's my partners mum and quite poorly, she's 80 and only has mild sedation, she's had two this week.

I had thought that the hospital may not want to divulged that information, I'm expecting them to say the consultant will discuss things with me when I arrive, they did say when they rang me about the appointment that if I had any questions to give them a call, so I'll give it a go.

Things were extremely traumatic for you so I would like to take the least stressful option which I thought would be sedation but I hadn't considered a possible reaction so I really don't know.

Yes I'm in the uk.

Thank you. Remember to ask what the drug(s) is intended to do.

For example, reduce pain and/or make you forget the procedure.

 

Oh thanks, I hadn't thought of that.

Really all I want is for it to reduce the pain as I'm quite happy to be aware of what's happening.

Maybe you can arrange before the procedure to signal  if you want them to stop.

Well we actually met a couple a few weeks ago and he said they told him to raise his hand if he wanted them to stop but the nurses were holding his hands down.

I'm sure as I suffer with anxiety they wouldn't do that to me, but I do think they want people in and out so the throat spray is what they push for.

You need to have an understanding ahead of time as to how to stop the procedure. If they go against your wishes, it's called battery.

I will raise my concerns with the consultant but I do need this procedure to go ahead because I need to know the cause of my problems so I can move forward in trying to solve them rather than just masking them.

Not in Eruope/UK it's not!

Yana, one way or another, a normal endoscopy (i.e. not like mine) only takes a few minutes. Go for it, one way or another, find out what's wrong so you can get treatment.

Good luck - whatever happens, I'm sure it can't be as bad as your worst fears!

This web site lists some suggestions to reduce the gag reflex

http://www.wikihow.com/Suppress-the-Gag-Reflex.

 

Many thanks, I rang the hospital and they said I'm first seen by a nurse for a pre procedure assessment and to voice any concerns then.

The hospital have said to raise any concerns at my pre procedure assessment, so that's what I'll do, I'm so unsure of what to do re sedation.

Tell them about all your concerns and be forthright about anything you fear and use their advice to make a decision.  

Try and get them to tell you whether they're planning to give you a full dose of sedation as opposed to a half-dose. If you're getting the full dose, you have absolutely nothing to worry about - you won't remember a thing about the procedure and it's unlikely to have any long-term effects on your memory. This can occasionally happen, as it did in John's case, but it's a very rare complication.

I'm sure you'll be fine.

Hey, that's a useful site John! If I ever have to have another gastroscopy I'll probably try and train myself not to gag so I can skip the sedation.

I understand that a proportion of the population doesn't have a significant gag reflex. However, those who do have such a reflexc can train to reduce the sensation or use desensitizing methods.

Thanks very much John, it's sounds good and although I only have three days to go I'll start practicing now, and will continue after the endoscopy just in case I ever have to have another.

I am so undecided at the moment, so I do think that is the best thing to do, using their advice to make my decision and I will voice any concerns that I have. I think for me it's purely the gagging thats worring me as I'm not worried about any discomfort while the procedure is taking place.

If you are not a senior, I believe you can probably tolerate sedation better than older people. Maybe there is an antidote for post procedure sedation effects?  From comments of others who have experienced  this procedure, it appears the duration is short - perhaps a few minutes?

I'm 51, so it will be a question I ask if I decide on sedation. My partner was in and out when he had it done, although he does say he would never have just the throat spray again.

I had no post-procedure sedation effects whatever - though of course, I only had a half-dose. All the bad effects I experienced were during the sedation. Once it was over I became my normal self again, albeit a bit hyperactive. I texted a friend while waiting for the porter to arrive to take me back to the obs ward just minutes after the procedure. I subsequentIy checked my outbox and found that the text was perfectly lucid. Once back in the basement obs ward, where there was no phone signal, I climbed over my cotsides and walked into outpatients in my gown - IV drip held aloft - to get a better signal to call another friend. I could easily have got myself home on public transport if necessary, but was kept in because of the damage the swallowed denture had caused. (And also, I suspect, because the hospital was concerned about legal action, having thrown me out three weeks earlier and tried to do the same thing on the day!) I suffered absolutely no long-lasting effects from the sedation and I think that's true for 99.9% of people.

Yana - I really don't think you have anything to worry about on this account.

Wow Lily, I can't believe what you were doing while you were sedated, it could have been so much worse had you gone out of the hospital.

I really think what with having anxiety that sedation is the way for me, I've been trying my gagging reflexes today after going on the site John mentioned, given enough time I could see how this may work but I've got two days so I have to go for sedation.

Many thanks for your help.

I think it was only the direct effect of the inadequate sedation, combined with what they were doing to me (which was much more traumatic and painful than a normal endoscopy). Within about five minutes of the procedure I was completely normal again, albeit wakeful and a bit hyperactive. Climbing over the cotsides was just an expedient. The friend who'd accompanied me that day had already had to cancel a couple of meetings with clients, and had been told to come back and collect me around 4pm. I knew the hospital had refused to take his phone number as next of kin as they'd said there was nothing wrong with me. It was already 3pm by this time, I hadn't been given a call button, couldn't find the release for the cotsides, and I was in a hurry to let him know he didn't have to come as they were keeping me in. So it's actually an indication that I was 100% all there. The overnight stay wasn't because of my reaction to the drug, but because they were scared of repercussions. They'd sent me away three times in three weeks, saying there was nothing wrong, only to find my throat was ulcerated and infected because of the damage done by the denture.

That being said, I have read accounts of people jumping up and running out of the hospital while under sedation, but this is very rare. I would also stress that I had no after-effects whatever from the sedation (though the scarring in my throat was another matter) and still retain a clear memory of the whole event.

Once again, I'm sure you'll be fine with sedation. You won't remember the procedure and you won't have any after-effects. And just think how relieved you'll feel once it's all over! Don't forget to come back and let us know how you got on.

Extremely traumatic! How awful for you that this was the case, whereas people go in and out with no problems. I do hope that I'm one of them!

I will definitely let you and John know how I get on, it's at 9.30am Wednesday. My fingers will be tightly crossed.

Hello Lily

I thought I'd let you and John know how it went today.

Well I chose to go for sedation, there was no pressure to just go for the throat spray, the nurses were very nice, I got called in and I had the throat spray and a canular put in my arm, one of the other nurses was getting a tube ready for my nose and that's it!! That's as much as I can remember, I woke up in a different room, had a cup of water by the bed, don't know if I'd been asked or they just gave it to me, so I drank it, a nurse put the sides of the bed down I got up, sat for a minute then went in a room with my partner and the nurse for him to tell me what happens next.

I felt fine afterwards and even did a bit of shopping, the only thing I have is, its a bit painful when I eat at the moment, feels like there's something stuck in my chest every time I swallow, I'm sure that's down to having something pushed down my oesophagus and hopefully it won't last long.

Hi Yana, delighted to hear it went well. I thought it would, as you're young enough to have had full sedation. That feeling in your chest will just be due to very minor damage as the tube went down and will soon clear up. I hope you soon get the results so they can treat the problem.

Ah thanks Lily, I thought it must be something like that.

Well they told me they didn't find anything so it's a short wait for the biopsies to get to the doctors.

I'm pleased it went well for you. It sounds like they accessed your throat through your nose?

Hopefully everything will be okay and you can carry on without any anxiety.

 

Hello John

Well I thought they'd gone in through my throat, they did give me the throat spray, which albeit not very nice, it was the most taste I've had in months! The tube was a clear tube with the little things that go in your nose.

Although I don't want anything serious to be found, I do want something to be causing all my problems as food is my enemy at the moment and if nothing is found then I'm back to square one.

Oh, that was the oxygen tube! They don't normally give oxygen as a routine, but they do always put the clip on your finger that measures oxygen saturation levels in your blood. Maybe they felt your oxygen levels were a bit low, or it could just be that they'd had a bad experience in the past in this particular hospital, and they always give oxygen - or at least have everything set up ready for it - as a precaution. A lot of medical practice in individual hospitals is determined on the basis of past accidents.

At least you will have eliminated one possible area.

I heard of a person who moved to a different city and was found to be allergic to the municipal water so it can be a difficlut process isolating what causes problems with food.

They never mentioned giving oxygen in my pre assessment with the nurse, but yes that was the tube I saw just before the sedation took hold.

Yes, and it's good to know there are no visible signs of damage to the oesophagus.

If nothing is found in the biopsies then I can only imagine that this will be a long process in finding what is causing my reactions to food.

Actually, nothing abnormal is found in the majority of endoscopies. Most of them are done in the interests of the doctor rather than the patient! This is called "defensive medicine".

Hello Yana

It's been a few months since this post, how are you doing now.

I am so confused with all the posts on GET SEDATION OR DONT GET IT. Enough to make your head spin .

I was suffering from chronic nausea for over a year all my tests point to nothing.

I am a little nervous of getting sedation from what people point out here yet also nervous if no sedation I might freak and the dr won't be able to continue.

My GI is ok either way he does say if no sedation it's harder to get biopsies on the patient . I want to see what is causing all my problems so so so confused which way to go. My scope is scheduled on Mar 1st .... I am pretty healthy a little overweight and 59 yrs old.i actually had to stop looking on this forum and others got too anxious with all being said

Robin

I understand people who are relatively young don't have the risks from sedation that older people have, especially those with vertain allergies.

It's welcome that your experience went fine and the process is over.

When you can, advise on the results.

Good luck and keep shopping!