Upper Gastroscopy/Endoscopy Without Sedation
Posted , 48 users are following.
Browsing this site because I can see a Colonoscopy coming my way. Got side tracked and ended up in this section.
Just wanted to say about 4 years ago I had to have an upper tract endoscopy (tube down throat) and was beside myself over it. I'm the biggest wimp going and very frightened of invasive procedures.
Anyway, circumstance on the day were that if I had sedation I'd have no one to drive me home afterwards but I wanted to get it over and one with.
So believe it or not I asked for it without sedation. The nurse tried to dissuade me but I stuck to my guns. I did accept the throat spray though. I calmed myself as much as I could and walked into the procedure room.
I'm please to say I managed it without sedation and it wasn't as bad as I thought it would be. No pain and only minimal discomfort. I did mumble about getting the endoscope out quick just before the end but by then it was nigh on all over. The examining doctor said I'd done so well to tolerate it. That made me doubly proud of myself because at the time I suffered from severe panic attacks (now thankfully gone).
Back in recovery all my fellow endocopees who'd had their procedure before me were snoring their heads off. I waited there a while because I wanted the numbness the spray had caused to my throat to wear off. During this wait I heard other patients who had been sedated fighting, groaning, moaning and shouting during their investigation. I'm sure that would have been me if I'd been left with no control.
Now possibly got to face a colonoscopy and heading to that section to see what the score is on that front.
2 likes, 132 replies
PanPilot Guest
Posted
woodbon Guest
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ntpk77 Guest
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The doctor told the nurse to spray a few extra pumps all over my throat. One of the spray got to deep that made me choke severely and tear for longer than a minute. However, I didn't feel numb at all, but I didn't realize I should have told them that. Then they put the mouthguard in my mouth. I saw my teeth, tongue and all of the sudden the nightmare began.
As soon as the tube touched the opening of of my esophagus I started gaging violently. I couldn't stop gaging and couldn't breath at all. I felt like the bronchi and the esophagus had their own mind, since I couldn't control either of them. I gagged every time she moved the tube. I kept on gaging till I felt like suffocated. At that time my breath was coming in gasps. I realized that gagging reflex and breathing couldn't happen at the same time. The problem was my esophagus fought so hard that I couldn't take a breath.
Despite my doctor tried so hard rushing the procedure, it took longer than she expected. I had so many ulcers all over my esophagus, stomach and deodenum. She had to take more than biopsies. She had to stop for a few seconds for the nurse to get more tissue jars. When she stopped, I was able to breath again and suppress the gagging reflex. So the biggest tip I learned is to tell my doctor to take many breaks instead of rushing through.
Talking about the pain, I was in great pain during the procedure unlike most people only experienced some pressure to the stomach wall. It could be because my stomach and intestine was severely inflammed. I also felt the spasms from the overly contracted esophagus. The whole thing took about 8 minutes, but I felt like centuries.
The nurse asked me if I could walk. I said yes, and she gave me my clothes and let me go to the dressing room myself. I was so weak, and blacked out in the dressing room.They should have been more careful.
After waking up, I was starving, so I asked the nurse some juice. I choked badly on the first sip due to the throat spray still afftected. I had mild bronchitis for 2 days from that juice.
My experience was unpleasant, but I wanted to share with you, who don't want or can't have sedation. A simple thing, but very helpful is to tell your doctor to give as many breaks as they can rather than rushing it. When they stop, try to breath right away. I know that I should focus on breathing, but it is impossible to do so when I gag. Also tell the nurse that they have to make sure you're fully recovered from the procedure.
PS: Please forgive my broken English, which is not my first language.
PanPilot ntpk77
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lily65668 PanPilot
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ntpk77, I think you were incredibly brave to suffer all that without fighting back. I had inadequate sedation that left me wide awake but badly confused, and it took six people to hold me down!
Still, at least the examination served its purpose if they found the cause of all your symptoms (as it did in my case as well). It sounds as if you're suffering a lot of stress if you have so many ulcers. I hope you'll get the treatment you need now, and perhaps some help in caring for your son - though I know from experience that help for carers is in short supply on both sides of the Atlantic.
Best wishes,
Lily
ntpk77 lily65668
Posted
Breathing is the key to help reducing gagging. When you were partially sedated, you could neither control your breaths nor follow instructions. Many people feel fine as soon as the scope pass their throat. That wasn't my case. Every time the doctor moved the tube up and down, I gagged badly as my esophagus fought to reject the foreign object. After gagging a few times, it was terrifying me anymore. Feeling like being suffocated the the worst experience of all. Physiologically breathing and gagging can not happen at the same time.That's why doctors should stop sometimes so patients can take a breath. However when you feel like you almost die from suffocation, you will gasp, controlled by the involuntary nervous system.
Thank Lily for wishing me well with treatments and helps. I have support here in the US for the care of my son, but I couldn't find any one available with such a short notice. Even though stomachache was the original reason I saw my doctor, but it wasn't the reason that my GI specialist ordered an urgent EGD. I waited for over 2 months for the appointment with the GI specialist. She reviewd my case and tests prior to the meeting. The minute she entered the room, she asked if I was aware that I have lost 15 lbs in the past 2 months. She wanted me to have the endoscope as soon as possible. Yet we found the reason for my stomachache, we don't know what make me losing weight and anemic. I wasn't brave Lily, but I have greater concern to worry about.
For those who hesitate to undergo this procedure, I encourage you to get it done. The benefits of the procedure out weight 5-10 minutes of your discomfort. Without sedation, it's managable and endurable. Keep breathing, people keep breathing.
Kupotee Guest
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as a result off being misled my trust of scope procedures is su h I won't have another ever I don't honestly care if it's life or death I couldn't walk through endoscopy unit doors let alone have one .
when I explained to doctor who wanted to do endoscopy he almost laughed and said yes but ypud have sedation this time lime it wasn't my choice I was being told to have it ,
I explained I found the idea of sedation even more scary and wasn't nervous he again tried convincing me with patronising stories about
discomfort and if I couldn't cope I'd get pain killer aswell ,
I ended by saying it's not happening it's just not going to be done I won't do it .
ok another appointment in 2mts time to monitor me ,
so much for being an important can't do without this procedure .
I am 100% serious I will never put myself through sedation or a scope procedure again in my life .
Lexbiles Guest
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The one that I had today was under sedation. The nurses and doctor could tell that I was very very tensed and jittery. My BP went up rather high and the doctor decided to give me a slightly higher dose of sedation. Funny thing is, the view of the equipment in front of me went fuzzy and they seemed to move like it has a life of its own! Strangely, I don't even remember the tube going in but I do remember when I was pushed out of the room. I knew I was awake but not entirely clear-headed. That is the power of sedation. I suggest telling the doctor that you are indeed very nervous and request for a safe yet higher dose of sedation to help you.
I had done one with and without sedation, I would definitely prefer the one with sedation. That's what it's for. Besides, I was well awake after the procedure. i only rested for about 1 hour, in which I was awake nearly the whole time and eating the sandwiches given. It was great!
katy86034 Guest
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Anyway I wanted to encourage people not to worry - I think the worrying makes it worse. Sure it isn't very pleasant and there are so many things I'd raher do, but if you get yourself worked up and anxious rather than being calm this will make it worse.
For me the only gagging I had was when it went over the back of my throat - it felt hard and uncomfortable. Once passed this bit I really concentrated on my breathing rather than thinking about it - I sort of zoned out and closed my eyes.
I elt the air go into my tummy, this was a little odd and felt like ressure. The worst thing then was the gas coming back up the side of the tubes giving me the most embarrassing burps!
I think I was better off without the spray as I know th sensation of numbess at the back of the troat can make some people panic.
So in summary, it's not great but it's not as bad as I thought so try not to worry too much. If I can do it without anything by keeping calm and breathing as well as I can then it is possible for most.
Jannena Guest
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Far more pain than the previous two. Only throat spray each time. Feel very unwell today not able to fuction at all and in pain. On the previous occasions I was fine within a couple of hours. I hope one day someone will invent something to replace this barbaric procedure. Very envious of those who seemed to cope so well.
lily65668 Jannena
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Sorry to hear you had such a bad time, and I hope you'll soon be feeling better. I didn't cope well either, so I know how you're feeling.
A lot of conditions that are normally diagnosed with gastroscopy are already diagnosable by other means. There's been a breath test for helicobacter pylori - the organism responsible for causing most gastric and duodenal ulcers - for at least 20 years now. And an MRI will spot most things. However, cost is the issue - especially in the UK, where patients aren't allowed to just pay the difference if they opt for a more expensive procedure, but are forced into paying through the nose for private treatment for the whole thing.
I'm sure you'll soon improve. I was left with scarring in my throat after a particularly barbaric procedure, but soon recovered.
veronica46807 Guest
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Sedative did not work, the guy doing it was so rough and it felt as if my throat was being torn apart.
One doctor kept telling the other one to turn this way then , no, turn it as you are bringing it up so you will be able to see downwards as well.
I cannot believe that in this day and age they can calmly do this to a human being. SURELY there has to be a far more easier way of doing this? I thought I had Jack the Ripper visiting - and I KID YOU NOT!. From the throat experience I was in so much shock and was so relieved once he had the pipe out that I cared not one iota when they went into the back passage. That was painful but bearable. I just feel like I~ have been invaded by some perverse sick person who cared not one iota of what I was feeling at the time.
Let me rather die from cancer or whatever, but nothing would make me take that test again. And I may tell you that I am never so melodramatic, but I am still in shock and horrified that I had to be put through that. Every single move was felt. Horrendous. Was it just a bad doctor doing it?
The only way I got through that was to keep telling myself to breathe and try to relax and it would soon be finished. Gagged at least 5 times, mucus and eyes streaming but most of all the feel of that contraption in back of my throat being wrenched about and then the pipe being inserted then taken out then re inserted a number of times - Still cannot get over it and nightmare day and night on this one.
Just cannot believe that they can do this and in such a way. Will it be open heart surgery next without aneasthetic. Hmmmmmmmmmm NOT impressed and strongly suspect had I gone with this privately and not with NHS it would probably not have been as bad experience as this was.
lily65668 veronica46807
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I'm so sorry to hear you had such a bad time with your gastroscopy. I did too - and if it's any consolation I don't live in the UK, so it wasn't done under the NHS.
I fully understand how angry and violated you feel. I felt the same way. I'm not in any way dismissing your outrage - or my own - but perhaps it would help if I explained how so-called conscious sedation works (and very occasionally doesn't). I'm a former nurse, btw.
There's an inherent potential flaw in the process of conscious sedation, which only affects a tiny minority of people who undergo it. The clue is in the word "conscious". Although most people who undergo endoscopy or any other procedure under sedation come out of it with no memory whatever, they remain fully conscious throughout the procedure. The medication takes just takes away the memory. If you don't remember something, it's as if you didn't experience it.
Others do retain hazy memories of the procedure when the sedation wears off, but were sufficiently calmed by the drugs administered that they were able to accept the procedure.
However, a lot of us struggle during gastroscopy, especially under sedation. I did too. It took six people to hold me down. (Though I have to say mine wasn't a straightforward gastroscopy.) And some of us have a paradoxical reaction to the sedation. It damps down our higher intellectual centres, leaving the more primitive "fight or flight" impulses in the driving seat. That's certainly what happened to me.
In these cases the staff continue with the procedure, restraining the patient if necessary, not because they're being deliberately cruel but because they "know" the patient will recall none of this afterwards so will not be traumatised by it. Quite understandably, their aim is to complete the procedure, so they can find out what's wrong with the patient, in order to be able to help.
Unfortunately, in an insignificant minority of us, the cocktail of drugs we're given completely fails to remove our memories of the event. The medical and nursing staff have no way of knowing this will happen at the time they're forcibly completing the procedure. This, combined with a violent struggle on the part of the patient, results in the emotional trauma you experienced.
I'd like to stress to anyone else reading this post that the combination of a paradoxical reaction and full retention of memory of the event is very rare indeed, particularly in the under-65s, who are always given a full dose of sedation. It's slightly more common in over-65s (my case) who are only ever given a half-dose.
If you ever have to have a gastroscopy again, I'd urge you to opt just for the throat spray, without sedation. If you can't tolerate it and start struggling then, the medical staff will know you mean it and will not continue, as this would constitute an assault. Either that, or insist on a GA. I think I'd go the latter route, as I live in a country where I can easily do this (although I'd have to pay the cost of the anaesthetic myself). I used to believe this wasn't available under the NHS, but I've seen a couple of posts on these boards where British patients have been able to insist on a GA.
Once again, you have all my sympathy and understanding for the way you're feeling right now. But the medical staff weren't being cruel and arrogant, they genuinely believed at the time that you would remember nothing of these events and would just come out of it with a sore throat. And the sense of violation does wear off. My experience happened three years ago and I've long since stopped having nightmares about it.
And again, to any others contemplating gastroscopy under sedation: don't worry about this. Only a tiny handful of patients have an unpleasant experience.
Cathuk veronica46807
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I would never have it again unless in hospital, yes you wait longer but it's not tramatic xx
Cathuk lily65668
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Much better experience
lily65668 Cathuk
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I actually had mine done in the endoscopy suite of a reputable university hospital. However, the circumstances were unusual. I'd swallowed my spiky one-tooth denture, it was stuck in my throat for three weeks while one hospital after another turned me away, saying I'd imagined the whole thing!
Finally, when I'd lost 7kg/15lb, was badly dehydrated, running a fever and coughing up blood, a friend took me back to one of the hospitals that had thrown me out and insisted something be done. While I retched uncontrollably and spat up blood and mucus (completely unable to swallow or talk by this time) a woman doctor screamed at me that the denture was in my head, not my throat, and to get out of the hospital. Fortunately, my friend stood his ground, with threats of legal action, and I was added to that afternoon's gastroscopy list "to prove once and for all that you didn't swallow your denture". Everyone was quite unpleasant too, implying I was a neurotic nuisance, taking up resources unnecessarily.
In the event, they found the denture as soon as they started on the way down, of course, but it had become embedded and there was a tussle to get it out, with a fair amount of bleeding into my throat to complicate things. In fairness, I think they would have given me a GA without question if they'd actually believed me in the first place and had known what they were going to find.
They were fine after that, kept me in for 24hrs with IV antibiotics. But I never got an apology, even after I sent in a written complaint by recorded delivery.
As I know only too well from my nursing experience, most of these events arise from medical staff "knowing" they're right, even when they're wrong. They "knew" I'd only imagined I'd swallowed the denture and they also "knew" that all three of us wouldn't remember our experiences. I often think a little humility wouldn't go amiss...
Cathuk lily65668
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lily65668 Cathuk
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Seniors are automatically given a half dose because of a theoretical risk of respiratory and cardiac depression so we're more likely to have a rough ride. It's possible I got even less than a half-dose, as they were convinced it was going to be a straight-up-and-down affair.