Possible side effects of midazalam

The lethargy could be from a low blood pressure.  The brain needs oxygen from a good BP to function normally.  Low BP can lead to less oxygen getting to the brain, leading to lethargy, just as a low blood sugar can to lethargy, which you mentioned you already checked.

Hi joe10258

I have a question for you since you have experience as a nurse. It's been a long time that I have burning, pain and presure in the left side of my colon. I went to three different GI doctors I had CT scan from before and many blood works, calprotectin stool test and MRCP which all were normal. Then they asked me to do Colonoscopy as the last test but I am truly afraid to do it. It's been two years now that I keep postponing it. but my mind makes me crazy of what If I have this or that. The last doctor now wants me to do another stool test which I think is FIT.

Now I don't know if this test will show anything or it will show falls negative.

Have you ever herd about it? Is it accurate?

I don't know what to do

Hi cathy, i had my colonoscopy without any sedation or anesthesia. A colonoscopy is very quick and simple! Being wide awake and fully aware i could never describe what i felt as pain but more like pressure but it only happened around three times during the at best 10 to maybe 15 minute procedure. I did not have inquiry at those three times because it was not pain but rather a discomfort which all three episodes at different times occurred. Like something that was swelling for seconds inside your belly or gut. Other than that i really did not feel anything. I would rather have that sensation for a few seconds rather than to have a toothache or severe headache anytime. Keep in mind this procedure is normally 10 minutes no more than 15 if you dont over react. Looking at the screen the hole short time talking with the doctor and nurses engaging in laughter and so on i saw the washing away of debris and a healty colon as described during the procedure. The doctor is looking directly at your intestine or colon clear plain and simple there is noting there that cannot be seen with this procedure. They are looking for polyps or any other abnormality in that area what i saw was one of the clearest vibrant pictures but live one could hope to see and they give you pictures to take home. This was done 01/18/2016. Before i made my decision not to be unconscious or sedated in any way i went on line to see what others knew before me about no drugs and they all said exactly what i am telling you now.In any event i am not saying you should not be sedated if thats what you would like to do. Hope this helps

Hi Cathy,

I would suggest that you ask your doctor what it is that they are specificallty trying to rule out, and what they they would do with any results that they learn.

I worked in surgical ICUs before, but with little abdominal surgery since abdominal surgery usually does not require ICU care. 

I can see you had MRCP, and calprotectin tests, which are usually done for biliary tree/ gall bladder and just for detection of internal bleeding respectively.  The FIT is another test for bleeding.  I can only guess that your doctor may want a colonoscopy to see if there is a reason or a specific site of bleeding.

Colonoscopy is often for colon/rectal cancer screening (which would be a reason for bleeding), and investigation of inflammatory bowel disease issues, like Crohn's disease and diverticulitis, etc.

A far less invasive test for cancer of the colon/rectum is a cologuard test, which documentation by NIH reveals as highly accurate (over 90% sensitive) but if your doctor is trying to rule out other issues, then the cologuard would not be beneficial.  In the US, a cologuard test is about $700 from what I have seen  .... but it is a test that requires no prep whatsoever, as it is just requires a stool sample in the privacy of your home.

I hope that helps.  Best of everything.  It can be very upsetting to just not know what is causing your burning and pain, I'm sure.

Let me know if you have any other questions.

Hi joe

Thank you so much for the respond. I should tell you that i asked the doctor about any other possible test rather than the colonoscopy that I can do but he said no. I asked him if there is a special test that can show the polyps he said no. The only test that he gave me was that FIT test. He was only talking about colonoscopy and its accuracy but he also told me if he find blood in the stool then deffinetly he would do the colonoscopy. And all other GI doctors wanyed me to do colonoscopy as well. I aske all of them many times for other tests like virtual colonoscopy or non sedative one but all four of them said no. So I don't know if he will agree with this test beacuse when I asked him for more test he said this should give me a clue and its enough. I wonder why they do this to me. I have insurance and I pay for it but they just don't want me to use it.

And Joe all of them are using the drug propophol for sedation and they really like it. They told me that is fast acting and it wears off right away unlike other sedatives that stays in our system for hours.

So there is nothing I can do other than accepting thier suggestion. I really don't want to do it due to my fear but this presure, burning and pain in my left side scares me too. And all the what ifs are making me crazy. I don't know if herina, IBS, or inflammations can cause this or not.

Thank you again

Hi Cathy,

Yes, I did work as an RN in surgical ICUs, as well as research, and the like.

The test I mentioned before, the cologuard, which is a stool sample test, does detect colon/rectal cancer (sensitivity 92% -- meaning it detects it when it does exist so it means fewer false negatives, and specificity of some high 80%  -- meaning that cancer is present when the test says it does or fewer false positives), plus it has some degree of recognizing pre-cancerous polyps, but that ability is not as great as cancer detection.  Of course, the cologuard does nothing for recognition of IBS or hernia.  Cologuard works by detection of DNA, which is detects cancer DNA from regular cellular DNA.

As an RN I have given propofol for bedside procedures to avoid trips to the OR with patients not stable enough for a "road trip."  Of course, I gave propofol because all the patients receiving it were already intubated (have a breathing tube), and on ventilators for their management of whatever brought them to the ICU, so an anesthesiologist wasn't needed.  Sure, it's the "Michael Jackson" drug but propofol for sleep is outrageous, and, it naturally has a risk of breathing issues, but that is why an anesthesiologist or CRNA (nurse anesthetist) is present in case intubation is needed.  As long as there are not other health issues, like COPD (emphysema), then the risk of intubation is much lower.  Again, just the fact that somebody knowledgeable in anesthesia is present is reassuring.  Propofol works fast, and does wear off quickly, from my own experience giving it. 

I can empathize with your concern about the colonoscopy, and I also can see that it can rule out a number of issues that would be more difficult to determine with other tests.  I hope you the best with your moving ahead to learn the source of your pain and burning.

Take Care ....... Joe

Thank you Joe

Your informative message was very helpful thank you. As I said none of the doctors gave me the test that you mentioned but I will ask them again. And I don't understand why after all the explanation that I gave them and my fears instead of giving me the DNA test they gave me those other stool test. Now I'm worrying about this last test FIT that what if it shows false negative or false positive beacuse as you said it dose not have high acurecy like DNA test

One more question if I had s colon infection would it show up in my blood works?

And if I had other problems would it show in the DNA test?

Thank you again

Hi Cathy,

Wow ... I have to admit that your question about a colon infection is way out of my experience.  I just double checked the Mayo Clinic website, and it clearly says the FIT (fecal immunochemical test) only tests for the presence of blood in stool, and that could come from a polyp (cancerous or non-cancerous) that happens to be bleeding (but not all such polyps are necessarily bleeding), and such blood could also be from hemorrhoids.  The FIT does NOT check DNA, but merely for the presence of blood; also the  FIT is rather inexpensive at under $30/USD, compared to cologuard, which is advertised as $599/USD, which may make it less of an option in the health service in England.

A website that is maintained by Harvard University mentions the use of assays that can be performed by on stool sample which can be "quite expensive."  When I read that "quite expensive" part, I admit I felt too discouraged to see which infections are tested for.  As I said, infectious diseases are not really within my experience outside of commonly found nosocomial infections (that is, infections related to being in hospitals and oftentimes acquired because of antibiotics that wipe out "good bacteria" that aid digestion in the colon, as well as surgical infections that are yet again different).

Everything I've read on the cologuard test (and I've read a lot the last several months) indicates that it only tests for DNA of cancer (with 92% sensitivity), and for pre-cancerous lesions (at 42% sensitivity, meaning it misses 58% of the precancerous lesions).  Even colonoscopies miss some lesions (some of which are polyps, and some are flat lesions that are more often found in the ascending colon, and flat lesions are apparently harder to detect).  I don't want to scare anyone, but a colonoscopy is only as good as the doctor doing it. 

Life is full of risks, and sometimes we all take calculated risks, like in crossing the street.

For $599, I would hope that a cologuard would test for all kinds of scenarios, but that is not the case currently. 

I am not certain if any specific colon infections give any early  "hints" in any blood work.  I do know from my experience that blood tests called blood cultures DO test for infections; but the situation in which blood cultures are drawn is unfortunately in the ICU when the patient is in shock (with a plummeting blood pressure, and on a ventilator at that point), septic shock specifically, and the blood cultures are drawn to identify the infection so the right antibiotic is given, per IV always.

Trust me, when the infection goes from the colon and crosses that barrier and gets into one's blood, it is VERY SERIOUS.  I don't want to scare anyone, but septic shock is bad news, though medicine treats it everyday and often successfully.  Cathy, if you are reading this, you can't have positive blood cultures because you would be in septic shock.

Again, Cathy, I wish you the best, and you are in my thoughts.  In the US, if I knew I was going to have a colonoscopy, I would locate a hospital that does many colonoscopies, and hang out in the hospital cafeteria (hopefully the hospital RNs are in the same cafeteria), and strike up conversations with RNs to locate one that has assisted many times in colonoscopies.  An RN with a lot of experience knows which doctors are more skilled, and more in tune to patient comfort as well as having the expertise to do a thorough and competent exam.

I hope that helps.  Whatever choice you make, believing you made the best choice goes a long way to help your own anxiety level.