Endoscopy NO Sedation

Tests and investigations
1

Hello, Had my first endoscopy a few days ago (I suffer from panic disorder) and was scared stiff of having it done the night before i was due to have it done i was thinking of not going.

As was going to have it with sedation but have read alot of horror stories on the internet about people gagging, being sick, pulling the endospope out, having to be pinned down So you can see way i was scared stiff.

But i found the courage to go to the hospital to have it done the nurse asked me if i wanted sedation i said no way so she said OK the dr will have a word with you.

The dr came in and asked me again about sedation and i said no so he said ok we will do it TRANSNASAL so no need to go through the mouth no need for sedation and I have to say it was a alright procedure a slight bit of dicomfit in the nasal passage (brought a tear to my eye) but i was able to breath properly and also talk no gagging and best of all NO sedation.

It took intotal 5 mins to have the endoscope done and a further 5-10mins in recovery and then home.

If you have one coming up phone and ask about having it done TRANSNASAL as it is a pleasent way of doing it.

2

I'll always avoid anaesthetics if at all possible. When I went for my endoscopy some years ago now I was given an illustrated leaflet explaining the procedure. I opted for staying fully awake and the procedure was again explained. The throat was sprayed with something that tasted vaguely of advocaat. Doctor said that was the worst bit but it didn't make me gag. Gum shield put in place and tube was fed in a little way and I was asked to swallow. It felt exactly like swallopwing a piece of dry bread and that was it I was able to turn over and have a guided tour of my stomach. Would definitely recommend this method though I must admit I'm not a gagger and can swallow quite large pills ok.

Everone else had to stay and recover but after a quick once over I was allowed to drive myself 20 miles home. ( I had arranged alternative just in case.)

Hope this is encouraging.

3

Well I have had 3 endoscopies performed, the first two were done without sedation and it was horrible to say the least, so for the third occasion I opted for sedation being that I was having a colonoscopy done too, and I can honestly say I didn't feel a thing, and the sedation takes all your fear away.

I know it will be different for everyone but this is what happened to me for sure.

4

Hello All,

I have have had 6 endoscopies, 4 with local anesthetic throat spray and the last two without as the anaesthetic made my throat feel like I could not swallow which was very scary.. I watched every one of them on the monitor..

I have also had 1 Gastroscopy (Camera down to stomach) with anaesthetic into my vein and have to go for another one on Monday 6th where as yet I am undecided whether to be knocked out or to watch the screen and stay awake if thats possible as last time I had to lay on my side with a mouth guard in so watching the monitor would have been a bit difficult..

An alternative if you are scared would be to ask your doctor for something fast acting to relax you 4 hours before the proceedure like Diazepam which has a half life of 200 hours once in the system .. Which means that 8 1/2 days after taking it it is still 1/2 the strength that you originally took in your system..

P.S. Its also not a good idea if you drive as it can make you drowsy..

5

Everybody says "You shouldnt look on the internet" about symptons you have or procedures you are going to have.

The reason they say this is because most people are stupid , cant put things into perspective and have the tendancy to exaggerate.

So you need an endoscopy? You must be in extreme pain then? I was telling my stupid doctor for 4 years that I either had an ulcer or stomach cancer and that I wanted an endoscopy or barium meal, she just laughed. Oh well she knew best, until I was hospitalised.

So make sure you need an endoscopy, dont just seek it unless like me youve spent 4 years rolling on the floor for an hour 5 times a day in intense agony that the GP doesnt give you pain relief for.

Ok, you are definitely having an endoscopy now. Thats it, you are in. You are having it done , you will survive and this will help.

Dont bother asking them any questions. The questions you want to ask, they will avoid and distract you. Everything happens very quickly.

Throat spray or sedation?

I had throat spray.

Survival guidline.

Consent form. You might as well tick "take all my dna and body tissue" -I ticked the box which stated "I do not want my samples to stored" - thought that was pretty clear yet she questioned me on it and in short of getting into a political argument about my property I just asked her "why bother with the consent form if youre just going to get pateints to change their tick boxes? I read and understood everything, which part are you having a problem with?"

Tell the nurses you want to make their job as easy as possible for them and if there is anything you can do to help. Its nice, it will put them at ease and they might give you a few extra pumps of Lidocaine like they did me. Tastes like banana. Nice.

All of a sudden your throat feels like its constricted, exactly like you have a golf ball stuck in your throat. DONT PANIC. You can breath. Your throat is numb and your brain has stopped receiving signals tricking your body into thinking you cant breathe. Breathe. Its normal.

On a bed, lying down on your side. Forefinger in a pulse reader.

Little green mouth piece with air hole - bite down ( youll notice in endoscopy pamphlets there is a warning about maybe losing crowns and fillings but it doesnt tell you how this might happen- given that I was biting down on this thing for my life I would say that whatever is about to happen to you for the next 10 minutes and you find yourself biting down just REMEMBER your teeth- your mouth is numb you could smash your teeth out with a hammer and you wouldnt feel it!

Ok , here we go . Its just a little wire with a tiny camera on the end. Going to have a good look. No. Its not a tiny wire with a camera on the end. It should be a tiny wire with a camera on the end. Its 2013, we're into nano technology and space exploration. Its a pipe. So stop thinking kettle flex and start thinking hose pipe.

I goes in, you do not feel a thing. No pain. But this is not a painful procedure anyway.

They fill your stomach with air - didnt even feel it. No pain or unusal feeling.

This lasts for 10 minutes while they look around and take photos.

How you deal with these 10 minutes is up to you. I was convulsing and choking for most of the time but kept brave. The nurse kept telling me to breath but since I had a pipe down my thoat I found it a little difficult. I was calm and constantly giving them the thumbs up as I they seemed to freak out as I was choking and fighting for breath while at the same time trying to lie as still as possible. (stomach tearing is a rare complication , and this is probably when it happens so I was aware of this incase I survived) You do feel like you are dying and you could believe that the nurses are not aware that you are dying but you have to trust that they know what they are doing. But you do really feel like you are going to die from lack of oxygen. Its like drowning. Thats not an exaggeration, it is like drowning and knowing you are going to die.

Now it turned out I had an ulcer and a hiatus hernia and the reason I was gagging and choking all the way through the latter part of the procedure was because of the hernia so it may not be as bad for you. However, I look at it like this. Youve got a hose pipe all the way down your throat.

I'd have sedation next time. The reason being is that that is the option that the nurses try to steer you away from. Knowing what I know about doctors and nurses is that they want to make it easier for themselves during procedure. If you have sedation , they have to do a little bit more work, they have to monitor this and that and it takes longer and you're more of a dead weight to them. Im assuming sedation means you are completely out of it.I had loads of marijuana in the morning which took the edge off the horror. Also reading people experiences on other website leaves me feeling a little cheated. " Oh its nothing, you lie down, they put you under and you wake up ands its all done"....excuse me? As far as Im concerned, if youve been asleep the whole time at some magical surgery then your opinion is somewhat limited.

Im pretty tough. I know pain. This is something else. Probably on a par with being waterboarded with no secrets left to tell. For those ten minutes just think of yourself as an empty vessell that needs examining and it will be over. The worse outcome is going through all this only to find nothing there. So make sure you definitly need an endoscopy, i.e. you have constant agonising pain.

Remember, its a hosepipe. Not a wire.

6

Hi All,

I would just like to add my 2 penneth. I had a Gastroscopy today and although it is not the most comfortable procedure I've had, it isn't as scary as most people think. To the previous post, I think your post is very descriptive but I will say this. If you have sedation you are not knocked out. It is not a General Aneasthetic.

As I had mine without sedation. I was in and out of the hospital within 45 mins. And was able to eat about an hour afterwards. Although you must be careful and read the leaflet they give you. The reason you can't eat or drink straight away is that you could ingest food or drink into your lungs after the throat spray.

Remember it is numb and you can't control the little flap at the back of your throat that blocks your wind pipe when you swallow until the spray has warn off. Yeah I gagged a couple of times but as long as you focus on your breathing nothing much else happens. The throat spray is similar to going to the dentist it wares off after a short time. A little advice though take plenty of tissues to wipe your mouth as you will be dreweling afterwards.

I must admit I'm of the ilk that I won't have sedation unless it is absolutely necessary. I was in the waiting room watching people on their come down. Being Sick etc. My actual procedure lasted 6 minutes then I sat in the waiting area for 15 minutes, had a chat with a nurse and drove myself home.

If you go for the sedation you are concious the whole time with added bonus that you will feel awful afterwards and have to have the next day off work etc as you are not allowed to drive for 24 hours. The choice is yours, however I do understand if you did go for it as I nearly decided to as I was as nervous as the people reading this forum.

Good luck to anyone who is having one. And remember the staff at the hospital know what their doing and have done it thousands of times before. Have confidence in them.

7

I would like to add a slightly different approach to how I felt with my endoscopy with sedation as I had 2 endoscopies without sedation and the experience was not that good with gagging etc, so on my third visit I had sedation, and I can tell you that I didn't feel sick or anything afterwards.

So sedation for endoscopy was good for me, ok I had to stay a little longer in the hospital till the drug wore off, but that wasn't too long and it was worth it for the easier experience.

8

I had a Gastroscopy today and have to agree with extreme it was horrendous!!!!!!!iwas gently persuaded to have just the spray,has that's what most people have, I can see now that has the waiting room filled up, being very busy for a Saturday, that it was quicker for people just to have the spray, especially has my appointment was for 8.55and I was not called in till 10.40. And there was only two people in front of me when I arrived and one was In a different clinic for colonoscopy.

They also told me the camera was no thicker than a pen, A pen my a** it was just like a hosepipe as described earlier! I gagged and choked that much! my eyes were crying!I was belching like nobodies business!it really was horrible! I have had a colonoscopy last year and I would have these any day over what I had today.

On top of it all I have dukedom it's, two small erosions (ulcers) some biopsies taken,and yet my Gastro enterologist a told me straight after my bowel surgery 3.5 months ago I had wind in my stomach !!!!I have really lost faith in hospitals especially as my first husband was told he had an ulcer at 41 years of age and was dead six months after with cancer of the pancreas, how's that for a good diIagnosis with an endoscope.

Know what if I ever agree to have another it will defintley be sedation all the way, I will not go through

That barbaric procedure again.Nurse told me after she was still nursing a very bad shoulder where a gentlemhad gagged that much, he pulled out the endoscope and jumped off the table and knocked the nurse over.

Just shows how people re act to this procedure.. make sure you get sedation.

9

Hello,

I am a doctor interested to know what the average person understands by the term 'sedation'. I would be very grateful to hear your views on this: What do you think it means? What do you want from 'sedation'? What do you want to be told about it? What should 'we' do if you appear to be unhappy during a procedure; stop, or give more sedation even if the latter might be risky?

Thank you for your views.

JP

10

Sedation for me, and I speak with experience, is the removal of fear and anxiety prior and during whatever procedure is being performed, which helps both the patient and also the surgeon and his staff to get the job done.

11

im do for mine next week, not very encouraged by what being said here about it. i want to be put out thats for sure but im having two procedures done in the same morning so i hope they will agree to do this. ill just freak out on them so they wont have a choice haha.

12

Thank you Fay and Fred. When you say 'put out' Fay, do you mean that you don't want to remember anything at all about the procedure, or that you you just want to be less anxious (in the way Fred describes)? Fred, when you say 'removal of fear and anxiety' do you expect to be fully aware of what is going on at the time and have a full memory of the event, or do you have another expectation?

13

Hi James,

Maybe I'm saying this because i've already had and endoscopy twice without sedation just had the throat spray, and had sedation for a double procedure endoscopy/colonoscopy and I personally found that with sedation although I was fully aware of what was going on the sedation made me feel like I had no worries in the world. One really good note I will say is that sedation normally helps and stops any gagging during endoscopy.

14

I know not everyone experiences the same, but I have to say for me personally that I would have no hesitation whatsoever if I had to have the exploration of the oesophagus and colon again that I would certainly be asking for sedation.

My last experience with sedation was good, like I say no gagging and all fear gone, it's the fear that I think causes the issues, and with sedation there is no fear at all, you just feel relaxed and you let the surgeon get on with his job, the sedation leaves your system quickly, the only thing I forgot to mention is that if you do go with sedation then you will need someone to take you back home as you are not allowed to drive or be on your own for 24 hours, but I can guarantee it is well worth it.

The sedation involves a needle into one of your veins, but this isn't a problem, well not for me anyway.

I really hope that this helps all people that are unsure whether to have sedation or not.

15

Thank you for these helpful comments. Does anyone else have a view on what they feel sedation should provide? Do you feel that allaying fear is just a part of it? Do you expect complete amnesia? Do you recognise that you may be aware of waht is happening? Please let me know.

16

This morning I had a gastroscopy at Brighton RSUH. I had read some of the terrifying and almost blood curdling accounts above and was naturally somewhat aprehensive, to say the least. My appointment was for 09.30 so taking advice from above subscribers I had nothing to eat after 6.00 pm last night. I arrived a little early and was seen almost immediately. My blood pressure, reflecting my anxiety, was above the 199 limit on the machine. However it didn't appear to be of concern so I was shown to a cubicle where I waited for about ten mninutes before I was called in to the "operating" room. There I had my throat sprayed twice with the banana flavour which quickly deadened it. I was asked to lay on my side, had the mouth shield inserted and before I knew it the camera tube was in my stomach. There was little sensation and certainly no pain. The investigation lasted four or five minutes which included two "procedural" biopsies. The tube was withdrawn without me being aware that it was happening. Certainly no gagging and no pain. Breathing through the mouth is normal and unrestricted.

Am I just lucky or do people who write on such forums only tell the bad stuff? No kidding, I would be happy to do the same thing again tomorrow. It is one of the most straightforward and painless procedures I have experienced in my 76 years. A younger lady who had the same procedure just before me agreed totally with my findings and experience. It is nothing to worry about at all.

Thanks to the excellent NHS staff involved.

17

This was my experience, too. I have been very surprised to read some of the traumas and feel I was very fortunate. Another would hold no fears for me.

18

I believe its all to do with the person who is performing the procedure.

If they are experienced then gagging etc will be void or limited.

19

To James Palmer. What did I expect from procedural sedation? Well, I would normally understand that to mean I'd be conscious but feeling pretty laid-back or, better still, I wouldn't remember a thing even if the procedure turned out to be a nightmare. (Though there's an interesting philosophical point in there somewhere.) In my own case, I expected the worst. I'm a former nurse and I'm over 65 so knew I'd only get a half dose. However, as it was an emergency - a large, spiky denture stuck in my throat for three weeks after a series of hospitals turned me away refusing to believe me as it wasn't radio-opaque - I knew I couldn't argue.

I can only describe the experience as feeling as if the sedation had switched off my higher centres, which might have induced cooperation, leaving the limbic system (kill, kill, kill!) in the driving seat. I felt like a terrified animal. It took six people to hold me down and I'd have cheerfully gouged out the nurse's eyes if she hadn't been kneeling on one of my arms. I remained not only wide awake but completely "wired" for the next 20 hours. I'm still having flashbacks now, two months later.

The young doctor who did my discharge check the following day told me I'd have to be followed up as they might have damaged my throat as I'd struggled so much. He seemed to think it was my fault. My throat feels far from right, probably due to scarring, but I'll live with it. I'll have another gastroscopy when hell freezes over!

To the under-60s out there, I'd say don't worry about this. Most younger people don't remember a thing after procedural sedation. If you're a senior, it might be better to skip sedation.

20

I totally agree with the two people who said that they had it done without sedation and it wasn't as bad as they had read. I am a particularly nervous person and I was absolutely dreading the procedure. I practiced sticking my fingers down my throat to try and avoid the gagging sensation but don't know whether this helped or not. When I had it done I was surprisingly calm, I only gagged once and that was at the taste of the spray in my throat as I didn't want sedation. I tried to keep my breathing calm and regular which I think was a big help. The camera went down without any trouble, took a couple of minutes and was taken out without any problems. The doctor who did it was very impressed with how I handled it and said that he could do with me to be in a training video for staff and patients!

I had read several messages about how bad it was, in fact, a woman said that it was so bad she felt "violated" which had really raised my anxiety levels. I'm sure that some people do have a bad time but everyone is different and it's no good just going by the bad reports as there are probably just as many good experiences or perhaps even more good ones than bad. If I had to have another one done I wouldn't feel half as nervous as I did the first time.