Sedation-Free Colonoscopy in NJ
Posted , 4 users are following.
Does anyone know of doctors in Northern NJ who do sedation-free colonscopies?
0 likes, 9 replies
Posted , 4 users are following.
Does anyone know of doctors in Northern NJ who do sedation-free colonscopies?
0 likes, 9 replies
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cjb106 steve69615
Posted
I live in the UK so cannot help you with specifics but would have thought all endoscopy departments should offer the option to do without sedation.
I have to have regular colonoscopies and opt to have them without sedation as I like to be alert so that I can ask questions about what I can see on the big screen.
Also, I don't want the hassle of having to have someone accompany me and stay with me overnight as hospitals here insist on because of the amnesiac effects of the drugs used in sedation.
You don't say why you are reluctant to have sedation and that may be something you prefer to keep private. All I would say is that most of the colonoscopies I have had have been painless - only a little uncomfortable when the scope is negotiated around the bends of the colon. One was quite painful because I was in a severe ulcerative colitis flare and the inflammation impeded the scope. Some big gulps of Entonox (nitrous oxide and oxygen - gas and air) saw me through. though.
steve69615 cjb106
Posted
You would think. It is an American thing. The cynic in me says that it is because it drives up the cost. Most gastrointerologist web sites say "You vill be sedated and you vill like it!" My primary care doctors will not even answer this question, saying its not up to them to comment on how other doctors do their procedures.
cjb106 steve69615
Posted
I guess it could be. It might arguably speed up the in-theatre procedure time although lengthen the time spent in recovery. If it's anything like here the endoscopy department is a bit of a conveyer belt.
Sedation may mean the endoscopist doesn't have to make the effort to be particularly gentle with the patient or lose time to those who change their mind part way through and insist on sedation after all. I once went through the prelims with a nurse who was adamant that I should have a canula just in case but I was equally adamant in my refusal.
First time around, my primary care doctor (GP) advised me to have sedation simply because she said some people do find the procedure unpleasant but it really should be up to the patient to decide whether they want amnesia- inducing drugs or not. I certainly don't want to be losing a whole day having to be watched afterwards including not being able to drive all for the sake of a sixty minute procedure (far less for a flexi-sigmoidoscopy).
steve69615 cjb106
Posted
Keep in mind I'm not a doctor—but I play one on TV: from what I have found in the studies it is actually faster for the doctor without sedation. However, as you say, the doctor has to be more careful without sedation. Which leads to another thing I find in the studies is that there are fewer complications which I why I am going on this hunt.
cjb106 steve69615
Posted
I wish you luck with your search. Important to get the test done if you are experiencing symptoms which might indicate a GI disorder.
I read that the drugs commonly used in the sedation process include opiates, such as meperidine or fentanyl, benzodiazepines, such as midazolam or diazepam, and/or a hypnotic, such as propofol. Medical facilities must surely have to take account of the fact that some people may have very good reasons why they should or would not put these substances into their bodies unless absolutely necessary. What, for example, do people who have a history of substance addiction or allergies do?
For anyone who has not has this procedure before it's worth looking out for the YT videos by UK TV presenter Lynn Faulds Woods. There are long and short versions of the film. She does have sedation but is conscious throughout. I won't put a link as it will throw this post into moderation. It shows what a straightforward procedure it is from the patients point of view and what a simply procedure it is to remove a polyp which could turn into bowel cancer.
Note that they want to keep her in recovery for 45 minutes afterwards (and will have needed someone to take her home and watch over her for at least twelve hours afterwards. I come out of theatre, have a quick cup of tea and biscuit (very welcome after the fast and bowel cleansing the day before) then drive myself home with no ill effects.
The longest the actual theatre procedure has ever taken was 35 minutes. An earlier flexi-sig had shown ulcerative colitis so the endoscopist was now scoping the whole large bowel to look very carefully to see where the disease extended to (and take several (painless) tissue samples for biopsy) and I wanted to see too. I believe that even if you stay awake but sedated through the procedure you may struggle to recall what you saw but that would depend on the drug used. The nurse's preliminary health checks, form filling, consents etc, getting undressed takes another 15 minutes. Getting dressed and a drink 10 minutes so an hour in total.
howard88963 steve69615
Posted
I am actually looking for the same thing in the Central Florida (Orlando) area as well.
raffie steve69615
Posted
Problem here in the states is plain & simple GREED and compliance.
Many places here in the states won't do the test without the drugs because they want that extra cash & the drugs make you more compliant so they can go faster & make more MONEY! Colonoscopy testing is an assembly line type of test. Get them in and out asap & keep the cash flowing.
I refuse to do the test simply because of the amnesiac effects of the drugs used. I don't want my memory touched as studies have shown the older the individual the longer the effects of the drugs stay with you.
steve69615
Posted
It's a long drive but I finally found a doctor who specialized in sedation-free colonoscopy. He expressed to me that he was surprised this is not the norm because the sedation DOUBLES the cost. He'll do it with sedation if you want. Scheduled in 2 weeks.
I got a call today about billing and learned that, if nothing is found, insurance pays for it all. If something is found (e.g., polyp), I pay for the whole thing and the amount goes to my surgical deductible.
Had I note shopped around, I could be facing an added out-of-pocket cost of about $2,000.
If patients were told up front that they might have to pay $2,000 for sedation, do you think 99% of colonoscopies in the U.S. would be done with it?
If the choice is $2,000 for sedation or 20-30 minutes of pain, I'll take a stick to bite on if I need it.
steve69615
Posted
Update: I had it done with no sedation. Basically it's uncomfortable having tube running through your body and a few times (around corners) there were some moderate pain spikes. Considering the entire experience, the actual procedure seemed anti-climatic.
When it was over, I was wheeled into the recovery room where I immediately put on my pants and left. I heard other patients ask the nurses how come I was leaving at soon as I got there. There was shock in the room: "He did it without anesthesia?"
I imagine that some people cannot tolerate that level of discomfort. It does take a level of self control. However, if you can, the advantages of no sedation are overwhelming: cost, safety, quality of life. I didn't need to have anyone drive me to and from. Given those advantages I am shocked that so few doctors give the option and so few people take it.
I'll put on my cynic hat and say that the doctor has to use greater care with the patient awake. With anesthesia doctors can bang around inside as much as they want.