DOES SHEN ALWAYS SEDATE FOR SCOPES??

My surgeon always scoped without meds. My GI always scopes with meds. May just be a physician's comfort level. I always prefer meds. Also, if biopsies are done they will sedate you.

What do you mean when you say "put out"? Versed & Fentanyl and/or Demerol & Versed does not put you out, it is conscious sedation. Propofol, which killed Michael Jackson, puts you out. You have to explain exactly what you are talking about.

As I am going into the endoscopy area, I tell Shen's nurses I do not want sedation. Unless some special procedure is scheduled that requires sedation, they have no problem with it. Apparently this is not a typical request from patients, but is absolutely accepted.

Shen takes biopsies without sedation, has searched for a fistula without it, and has injected doxy into the fistula without sedation.

As the patient, you can choose to not have sedation if that is what you want, even if it is the doctor's preference. People have all sorts of reasons from difficulty obtaining a ride to not wanting to feel "rummy" all day.

My GI always takes biopsies and I never have had sedation except for a full blown colonoscopy, and that was last done 20 years ago. Biopsies do not hurt, since there are no pain sensor nerves in the bowel wall. The discomfort you feel is from the distention from the air they pump you up with.

So, bottom line; if you do not want sedation, just say you don't want it. My GI says that many of the other doctors at Kaiser even prefer to have their routine screening colonoscopy without sedation, so they can return to work afterwards. Now, THAT'S a dedicated doctor!

Jan

Shen used Versed & Fentanyl on me. I was OUT

not sure what Shen uses but I always fall out of it and don't remember a thing after

Yes, that is what is used for conscious sedation. Just because you sleep through it and don't remember it, it is not the same as anesthesia. Doesn't matter though, because the result is the same and you cannot drive afterwards.

Jan

I have never had biopsies without sedation, although I do remember coming out of a scope once while my surgeon was still taking them and Jan is correct in that there is no pain... just some bleeding when they snip and you can see it on the screen if you are looking.

quote:

Shen used Versed & Fentanyl on me. I was OUT

You think you are out; but you really are not. That drug cocktail causes short term amnesia. The amensia causes you to think you are out, because that slice of your life simply is not remembered.

The cocktail of Demerol & Versed, on the other hand, does not have such potent amnesia effect.

Like Shen, who was his mentor, my GI uses Versed & Fentanyl. He makes me count backward from 100 after injecting it so he knows when my mind has been clobbered by the drugs.

I always had colonoscopies while under conscious sedation. Since having my colon removed and a J-pouch formed, I always have full on scopes without sedation because I want to drive myself and feel totally functional the rest of the day. Minimal discomfort and I really enjoy watching the procedure on the monitor. However, there was one time the biopsy site would not stop bleeding and my surgeon cauterized the bleeder. Watching my inwards smoke was a little unsettling until he explained what was happening! No pain whatsoever while biopsies were taken. After several years of normal scopes, my surgeon put me on an every three years schedule. I see him next Monday and wonder if he'll want to do another scope. I'm having absolutely no problems so we'll see!

Anytime I have been put under anesthesia for colonoscopies or just recently a stricture dilation as soon as I woke up from my sedation I was able to walk out of there and go about my day normally. Maybe its just me and my high tolerance for meds but it has never seemed to phase me in the least bit. I actually remember coming home one day on a snowy winter day after a colonoscopy and shoveling my whole driveway and sidewalk with no issues at all.

Yes, but you need to inconvenience another person to drive you there and back. I always awoke feeling perfectly alert, yet was not allowed to drive. If I did not have a driver, they would have cancelled the procedure.

For some, it is no big deal, but my husband would have to take an entire day off work. So, if I could avoid that, it was a better choice for me.

Jan

Yeah Jan I don't encourage driving or operating heavy machinery like they usually state which always made me laugh because it sounds like they are telling you to make sure you don't go operating a crane or bulldozer after your procedure. I was just saying if you have a ride where you need to go you might be fine but like I said its all based on your tolerance and experience with anesthesia.

I always take myself out to lunch, then go shopping after my scopes. I have never shoveled snow, except on vacation (perks of living in the SF Bay Area)!

Jan

shen is very generous with his versed/fentyl.

But if you don't want sedation.. just tell the nurses in the pre-procedure area.

Well I was out. It felt like going under with proforol or however you spell that awesome drug. They both are good but I prefer the prof since I wake up very easily from it and usually go to work right after. Versed/Fen combo I am out of it all day.

If you don't want sedation, just tell them. They can't make you...it's your body.

That's funny Ct. Out GI always uses propofol on me and has said even under that I woke up when dilating my stricture from the pain.

It may be that he is using propofol on you because he is doing painful dilations, but in my case I am just getting scoping and biopsies and the same recipe every year of Fentanyl and Versed, injected in an IV. I spoke to his assistant about this once because my old GI specialist preferred to use Demerol and Versed. She told me Dr. O likes Fentanyl and Versed and undoubtedly his love for this cocktail was passed down from his mentor Dr. Shen from the other posts in the thread. Dr. O seems to apply all of the Shen protocols to his J pouch patients, talks to Shen weekly, knows the results of the recent studies coming out of the Cleveland Clinic (like the recent one on rectal cuff cancers), and generally is on top of things.

I think with Demerol and Versed you remember a little bit of the procedure, but with Fentanyl and Versed you don't remember anything. Both cocktails result in post-procedure grogginess that lasts the rest of the day. I had propofol once about 6 years ago and I was fine with it but I was a little bit afraid of it after I read more about it, and then after what happened to Michael Jackson I said forget it, I don't need it.

There is nothing wrong with propofol, when used appropriately and with constant monitoring. The problem in Michael Jackson's case, it was used inappropriately and without proper monitoring. Night and Day difference. IV fentanyl without monitoring can kill you too.

Jan

My scope I was out but it was more of the twilight concoction of medication. Either way I was out!

I prefer propofol myself.

Blink you're out... Blink you're awake, procedure done, and you are ready to get dressed and leave with your driver.

I've had my share of office scopes and milder sedatives. The pain is too much. And the psychological trauma is over the top...for the doctor, not me.