BRONCHOSCOPY WITH EBUS AND SEDATION DIDNT WORK

Chest and lungs
1

Hi , this am i went in for a Bronchoscopy with EBUS under sedation. On arrval, the admitting nurse asked how i was feeling, I said a little nervous. 'You must relax ' she then went on to tell me how under a recent surgical procedure, how she panicked, had to be resucitated for 90 mins, during which time , she had out of body experiences..... Heart rate is rising. I asked how unpleasant the procedure was, 'not very pleasant' ...HEART rate goes up again.

Im taken through to the ward, given a robe , had a cannula inserted and told I just had to wait for the doctor. I enquired whether it would be the surgeon I know and trust as had been agreed. The nurse checked, and said no, a junior doctor would be carrying the procedure out....Heart rate pounding now.

The said doctor turned up, very pleasant, " is there anything you want to ask"...i asked why my own surgeon wasnt doing it, to be told he was away all week. I explained i was agitated and had specifically asked for him to do it, which he agreed via emails, which were in my files there.

I was asked if i wished to postpone it, I said no, Im here, cannula in, lets just do it.

I was taking into the theatre, put on the bed, given a rather spiteful injection in my trachea, which was not pleasant at all, followed by throat spray.

I was then given my 1st 'coctail ' ....felt nothing. A 2nd was then given, my eyes covered and then was aware of being made to bite on a mouth guard.

i started coughing the fluid from the injection up and was told to swallow it, 'Are you sleepy' i was asked....no was the response. 

More was given and then I felt the tube in my throat and just started heaving BIG time....just take a deep breath i was told, I did , nothing happened. 

By this time my heart rate was off the scale and they aborted the process, as legally they could give no more sedation and my heart rate was causing them concern i think.

i was wheeled back to the ward, and bizarly slept lightly for an hour.

The procedure was being done as I had pneumonia 18 months ago, and the CT scan showed an enlarged lymph node. A further CT scan in August, showed this to still be raised

The whole episode was horrific, has anyone else experienced sedation not working, and if so , what did you do ?

thanks

Bricklayer

2

I have never experenced sedation not working,

I have had numerous bronchoscopies and have Never experenced what you went thru.

First, the nurse should never have related her story to you. What was she thinking! Very unprofessional.

Second, why wheren't you put under general anesthesia. I always have been.  They have me use a nebulizer with a med that numbs my throat, then wheels me into the or room, then they put me completely under, the next thing I know, I'm waking up in recovery with just a slightly sore throat.

I live in the states, so they must do things differently else where.

So sorry to hear of your bad experence, Beth

3

Wow, Bricklayer, this is right down my alley.  My story is similar and it's probably not good to talk about it but I wanted you to feel better --  I too was scheduled for a bronchoscopy, my first, and also nervous like you.  they were wanting to get a biopsy of lung tissue I think because I had mycobacteria.  Anyway I go to the hospital into a treatment room at 8am and my Pulmonologist was to do the procedure.  The girls were very nice and there was a nurse on hand sitting at the back of the room in case she was needed (THAT is really comforting) and the other two girls put spray up my nose which is pretty ghastly.  This does not sound like the same thing you got at least not the way they did it.  You had yours in your throat and mine was nasal.  Also I did not have injections at all (and the trachea???OMG, I can't imagine).

So, now we wait and we wait and we wait -the doctor doesn't show and we are all ready and I'm now getting quite nervous.  When he does finally show up about 8:30 he's all rushed and not smiling as if he's just had to drop his kids off at school and then go by the office first and heard bad news.  That's what he looked like. So now the girls have to prep me again so more squirts up the nose and they do have an IV in to give me something to calm me but I never felt anything from that.  I might have been a touch drowsy but from what I've heard we are supposed to be asleep like when you have a colonoscopy.

The doctor starts the procedure and all went well for probably a few seconds while he put the scope up my nose but when I felt it go down my throat  I started to cough and my BP went way up, they said, and I mumbled that I couldn't breathe so he had to end the procedure without going down far enough to get the biopsy.

My husband was in the waiting room and the dr. showed him a picture of my airway and of course he wouldn't understand that and when I asked for a picture later like at my next appt. he couldn't find it. I'd think it should be in the file but it wasn't. So I really have no idea how far down he did get.  But he did tell me that he saw Pseudomonas and he mentioned something else I can't recall now but I wasn't clear on whether he had a chance to try for a biopsy and it was just a failure as far as he was concerrned.  

I am now terrified of having this procedure again and I've managed to avoid it so far.  If we were asleep for this perhaps we wouldn't feel anything and therefore BP and coughing might not be an issue?  I don't know. IF ANYBODY ELSE READING THIS can add to this I think you'd make two of us very happy.  We need to know how it's supposed to be done successfully.

Mine was done in the USA - was yours, Bricklayer?  I think the way mine was supposed to work had the dr. shown up on time, meaning less nervousness, probably would be a lot better than the way you describe yours.   However,  maybe the injections you were given in the trachea were to paralyze the throat or something so that you wouldn't feel the scope going down and then there would be no coughing.

You were asked to bite on something - could that be to distract you from the thing going down your nose and into the throat? Oh, by the way, I think when you are especially nervous the sedation to make you drowsy perhaps doesn't work and you need it either earlier on or more of it earlier (because u did finally sleep).

It'll be interesting to see what others have to say about this procedure.  

Tabatha

4

Hey Beth !

thanks for your reassuring words . I'm in the UK , I have private health insurance but this was done under our public health scheme .

it was a fiasco from start to finish . I shall email the consultant tomorrow to let him know how I feel .

Really appreciate your reply ... Watch this space ...

5

hi Tabatha !

thank you for your reply ! At least I know I'm not the only one ! I am in the UK , I have private health care but this was done under the public health system & the whole episode was traumatic .

my initial thoughts are I will not go thru this again , however a nurse friend of mine things I need the lymph node investigating .

i will email the consultant tomorrow expressing my views and see what happens next !

Stay well !

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Yes, you should let them know what a bad, bad experence you had.

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"Supposed to be asleep like when you have a colonoscopy ....". I don't think that is standard in the UK Tabatha.

Maybe different for blokes but I have had 2 at different private hospital colonoscopy units and neither was more than a drowsiness shot - still fully awake. In fact I did the second with no shot initially as I only had a taxi to take me home which was against hospital policy (had been ok with the first). The first was no more than slightly uncomfortable and the second became a bit "oof" so he agreed to give me a bit.

I think it's ok to assume that like a colonoscopy a bronchoscopy is uncomfortable but not painful if you have the relevant shots but lets hear from others.

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But did you cough or not be able to breathe or a BP elevation?

It didn't hurt me at all but rather scared the heck out of me because I was aware of those horrible discomforts.  The feeling of being clogged up and sort of like suffocating was terrifying and that would drive up the BP which of course I wouldn't feel but the urge to cough was very strong and the cannula was down my throat (I think that's what they call it).  I am in Florida and I've talked with others here who say they are 'out'.and Elizabeth (above) says she had general anes.  Wow, that's more than what I'd expect.  I think a twilight sleep would be adequate and I think that's what we get in colonoscopy.  Not sure.  Yes I hope we hear from more people on this who have had successful scopes and with exact details.

Tabs.

9

Hi there. This just happened to me yesterday. Pneumonitis so needed bronch. On nice amount of O2 currently. Little nervous going down. Had albuterol treatment just prior. Taken down on reg O2, not vapor O2. All okay. I was Told I would respond to commands but just wouldn't remember procedure. Sounds fine. I got lidocaine breathing treatment for numbing....no shot. They did good with O2 but because of sat levels did another albuterol. Sedation...first vial a no go. Second a no go...1/2 of third and I'm not the slightest bit tired. I tell them to go for it. Spray vocal cords with nasty tasting stuff...no pain. Yes some coughing occurred and you can't easily get rid of what you cough up but yes I could still breath. Heard them talking about the washings they were doing and how much they were getting and next it's over and I'm done. I HAD to do this test. Option 1 was the above..option 2 was intubation! To me option 1 was the only choice. It never hurt but was just unpleasant. Given the same choices, I'd did it this way again without hesitation. I'm sorry it was so traumatic for you. Perhaps all that anxiety was the undoing of it all. Why I didn't respond to sedation is a mystery to me.