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Reply to "Pouchoscopy While Awake Review!!! FAQ (Frequently Asked Questions!!!!"

Winterberry,

Insurance covers sedation in the USA as well. However patients are often asked to choose between Propofol (the retail cost of which is 20 times more expensive than conscious sedation) and no sedation and they believe they have no other choice. It's completely false to believe this. Conscious sedation is both cheap and covered. However hospitals and busy medical offices push the more expensive propofol for a reason: they can do and bill for more procedures because Propofol reduces recovery times and enables them to push patients out the door. I once confronted a doctor I know who owns a facility that performs numerous endoscopies every day and he laughed and admitted it was true. That's exactly why it's policy. I get conscious sedation and have someone drive, it's cheap and more effective for the patient unless they need to go back to work or drive themselves from the facility.

I don't know what is used in Canada but the standard conscious sedation cocktail used in the USA is fentanyl and versed.  They have and will vary dosages on request. My GI uses a comical scale, "twilight", "medium", and "smoked", or something like that. I go medium rare, or medium twilight. I also one year had 50 mg fentanyl and no versed (versed causes short term amnesia) so that I could recall the procedure. Can you tell me what is the standard cocktail in Canada?

There have been a zillion other threads on this topic and in reading them and in also speaking to patients in real life I find that most people are remarkably uninformed on what their options are, what the insurance coverage and cost issues are, the propofol vs. conscious sedation cost analysis, and how it benefits the provider far more than the patient (especially when they don't tell you the impact of the payouts on your next year's insurance premium, which they don't). The result is that many patients make uninformed choices that are of more benefit to the doctor than it is to them.

I have also had the procedure done with no sedation. I can tolerate it, but don't prefer it. I find that J Pouch and Ileum being pumped full of air is uncomfortable both physically and mentally. I just don't see any need to deal with it when I don't need to. There is no need to have a hero complex on medical procedures.

Last edited by CTBarrister
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