colonoscopy and day surgery

[allend]

Hi Everyone,

I am about to schedule a colonoscopy and I was wondering what you all have experienced with your Drs. surgery and your xPAP machines. The last time I had one, I wasn't put out, as there was no anesthesiologist. It was just the gastro Dr. I felt nothing but in the event something gets found, its removal could be painful. In otherwords, I'd rather be "under" than awake.

I've read what is on here but not a lot is current except for that May 2006 Alert. I have a few questions regarding yout experiences:

1. Were you put "under" with anesthesia?

2. To what extent were you "under"..i.e. twilight, heavier narcotics?

3. Did the Dr. use your xPAP machine and mask when you were "under"?

4. If your normal settings are 11/9, should they be the same under anesthesia or should the be higher?

5. Operating tables are very narrow, where did they put your xpap and do they generally have a place for it and a place to plug it in?

6. Was it too clumsy to hook up, as well as the tube getting in the way (well not for a colonoscopy) and for that reason they just didn't use it?

7. I had surgery 2 years ago and didn't bring my mask or machine. Once the anesthesiologist heard I had OSA they gave me a spinal, which I really didn't want. I insisted that I not be up for this so they gave me twilight too. I wonder if that was dangerous. The surgery wasn't serious but it was in a special male area and I was sitting up but in a reclining position.

8. So, what are we supposed to do? Are we fine with the xPap at our normal settings? Do we force the Dr. to pay attention to this problem before we walk into surgery or a procedure?

Allen

[Slinky]

Oh, aren't you lucky, Allend. Enjoy the prep!!!

You should notify your gastro ahead of time that you have apnea and are on CPAP and also ask what sedation or anesthesia he/she will be using. You really ought to try to contact your sleep doctor and ask him what he suggests as far as taking your CPAP w/you and also know for sure what sedation or anesthesia you might be having to tell him.

Having Crohn's disease I've had many a colonoscopy. The interior of the colon has no nerves to signal pain. If they find a polyp or polyps and remove them you won't feel it. Any discomfort or pain you encounter is from either the flexible scope shaft looping back on itself or over insuflation w/air, either of which stretches the colon wider and THAT the colon does feel, but its the outer layers that have the nerves to do the feeling.

I also have my scopes w/o sedation or anesthesia, just some demerol for discomfort and once in a while a little phenergan if the vagus nerve gets ticked off and I get nauseous. I have had a polyp removed during colonoscopy.

Good luck. And again, enjoy the prep!

[Mile High Sleeper]

I was scheduled for a colonoscopy and upper GI endoscopy at the same time. As soon as my GI doctor heard that I have sleep apnea, she said that they would use an anesthesiologist. I faxed day surgery/anesthesiology about 12 questions, similar to yours, in advance. Since day surgery doesn't know in advance who the anesthesiologist will be, the head doctor phoned me to answer my questions. Some of the answers in my case:

- no CPAP needed during the procedure, since the anesthesiologist is responsible for your breathing

- I could bring my own CPAP and mask and hose for recovery. It did not need to be approved in advance. They believed my pressure settings. Day surgery did not have any CPAP machines.

When I got there, the nurse said I didn't need the CPAP for recovery, but I was glad it was on the premises just in case.

They used a mild intravenous anesthetic called propofol. It worked great with no after-effects. I did ask that I be placed in a reclining position (not flat) on my side after the procedure but before awakening, since I thought that might help reduce apneas.

There are 3 articles on CPAP and surgery in the light bulb/our collective wisdom, under CPAP safety.

Good luck! The prep is the worst part.

[mindy]

Hi,

I just want to second what slinky noted: polyp removal is not at all painful! I have to have colonoscopies every 2 years and this last time I had a polyp removed. They give me fentanyl and versed - the fentanyl is for pain and the versed is so wipe a slice out of my memroy (it's an amnesiac drug). So I was technically awake and was watching the doc remove the polyp via the TV screen. After the procedure, they only kept me there for about 1 hour so I never did sleep.

An yes, Mile High Sleeper is also right ... the prep is definitely the worst part. Hold your nose when drinking that stuff and it goes down easier.

Good luck!
Mindy

[roster]

I have had two colonoscopies. The anesthesiologist kept me breathing during the procedure with a tube. I had the cpap machine for recovery but the nurse kept me sitting up and gave me a little jostle every time I stopped breathing. At least that is what he said. I believe him because I felt fine after the anesthesia wore off.

They used a light sedative in an IV. The second one I slept all the way through. I woke up during the first one, watched the monitor, mumbled some nonsense about not getting all of the green peas cleaned out and fell back to sleep. They clipped out a couple of polyps but I did not know until they told me.

On the other hand, if your name is descriptive of your anatomy, a colonoscopy might be one heck of an experience. . Sorry, too tempting.

[ozij]

I knew I would be given Versed (iv), (5 mg. and it knocked me out entirely...). The OR where I had the procedure is used more or less only for those procedures, and had no ansetheasilogist or intubation options.

I enquired what the procedures would be, talked to a the head nurse on the phone, came to the clinic the day before asked to meet the nurse who would be there during the procedure, discussed the need for electric outlets, how I could use the cpap etc. and made sure to come early the next day. I told the nurse I would bring a friend along for the recovery, and would want her to put the mask on me and run the cpap.

It's the nurses understanding and cooperation that you need - they'll be fine especially if they know you're not adding too much to their (usually) heavy load.

I explained the need for cpap by saying: " I don't breathe well when I'm not thoroughly concious. I have breathing interruptions. so I would like to use my cpap. " (Didn't even use the word sleep). When you put it like that they cooperate, because of course they want you to breathe well through the procedure. And I doubt they can say it isn't necessary, because they know how sedated you may be, but they have no idea how badly you breathe when sedated.

Had a friend along for the recovery, and she took care of what was necessary in the recovery room.

Since by now my cpap and mask are the equivalent of security blanket - I was very glad I could use them.

Versed is a benzodiazepine (called midazolam) and anyone who takes benzodiazepines on a regular basis will probably need more of it than those who don't. It's a very efficient memory wiper...

O.

[tuna]

Almost got one at one time! But got very lucky being able to get out of it!

[ozij]

Almost got one at one time! But got very lucky being able to get out of it!

NOT.

[lvwildcat]

I'm having gastric bypass on Dec. 6. The machine is definitely coming with me. I know in recovery I'll still be very groggy/stoned from anesthesia so I figure I won't be awake enough to put on my Oracle and put in the nose plugs and tape them (my nightly routine). So I'm going to bring my backup Flexifit 431 just for immediately post op and then switch to the Oracle as soon as I get my "bearings" back.

[msheda]

Sorry, but this whole subject sounds like a giant pain in the A_ _


<<<ducking now....

(come on, if I hadn't said it someone else would have... and all of you raise your hand's that were thinking it.... )

[goose]

My hand is up.....

I've had two colonoscopys and a sigmoid colectomy (for acute diverticulitis) all with anesthesia -- however it was prior to my being diagnosed.
The surgeon that did the colectomy also does the scopes, but I gotta tell ya, ain't nobody gonna put a hose up my -- well you know -- while I'm still awake !!!!!!! If I'm still awake, I can walk (run )!!!!!
I also had the endoscope the last time to look at my GERD situation. Just had mild irritation, nothing remarkable.....which was good to hear.
Interestingly he didn't say anything about any breathing issues while I was out and neither did the anesthesiologist....
It will be interesting to see how he handles the next scope (soon) now that I have both diabetes and apnea.....I'll let ya'll know......

cheers
goose

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CPAPopedia Keywords Contained In This Post (Click For Definition): hose

[Guest]

I had a colonoscopy in Jan of this year. The surgery center told me to bring my CPAP. I called the anesthesiologist office and spoke with one of the doctors and he said essentially what MHS stated, he is responsible for my breathing, so I did not need to bring it. Encountered no problems. Worst part was the prep, only way I got it all down was to drink each glass of it as quickly as possible (definitely not a sipping type of drink).

TM

[JZ]

I had a colonoscopy in June of 2006 at age 54. The procedure is recommended once you hit 50, but I put it off. Now that I have been through it, I am a big promoter of colonoscopies and other available diagnostic procedures. Sure, these procedures can be very unpleasant, but they are a cakewalk compared to having cancer. And yes, the prep for a colonoscopy is yucky, but for the procedure itself, I was totally under and did not know or care what was happening.

I'm glad I had a colonoscopy for a couple of reasons. It gave me peace of mind (I don't need to have another one until 2016), and it led me to CPAP. The gastroenterologist who performed my colonoscopy came into the recovery room and told me she believed I had sleep apnea because I had apnea events when I was anesthetized. Not too long after that I had a sleep study and the rest is history.

Janna

[Slinky]

Congratulations, Janna. By the way, you had one h*ll of a good Endo nurse that she brought the apnea events to your attention!

[ozij]

[quote="JZ"] ... The gastroenterologist who performed my colonoscopy came into the recovery room and told me she believed I had sleep apnea because I had apnea events when I was anesthetized. Not too long after that I had a sleep study and the rest is history.

Janna