Colonoscopy/Endoscopy double whammy!

Hi everyone. I just went to a new GI doc, really nice guy, to see why I'm having so much upper abdominal problems since my gallbladder surgery in 2007. Looks like he wants to do an "end-to-end-oscopy" as my boss calls it. Both ends at once.

I've had an endoscopy years ago, which wasn't so bad, except they didn't give me the xylocaine spray for my throat and I started heaving--not fun while under conscious sedation. Before that I had a sigmoidoscopy with NO sedation. That hurt!

Anyway, the doc knows I have severe sleep apnea and uses the Versed/Fentanyl cocktail. Guess I shouldn't be reading all the horror stories about Versed reactions and it causing panic attacks/anxiety, but... that's the way I am. Since I have panic disorder I'm a bit concerned. I also had a bad reaction coming out of general anesthesia from my GB surgery where I couldn't breathe and panicked. That was pre-apnea diagnosis though, so it was probably from lack of oxygen.

Doc doesn't think I would need my CPAP machine. I'm still nervous though. Any words of wisdom will be appreciated, and yes I've done a search already for this on our forum.

Jonah is doing really well! He will be 3 months on 10/9/2010. He just turned from tummy to back yesterday for the first time!

I did both ends in April. No worries. Better to only have to go under once. It was my third colonoscopy in 5 years. I mentioned to the anesthesiologist about the sleep apnea. "Not a problem" he said. They told me I did not have to bring in my CPAP, only if I was expecting a stay over in a hospital. I was more worried about the after effects of the endoscopy but I did not even get a scratchy throat. I was completely fine 30 minutes after waking. Good luck.

Jason S. wrote:I did both ends in April. No worries. Better to only have to go under once. It was my third colonoscopy in 5 years. I mentioned to the anesthesiologist about the sleep apnea. "Not a problem" he said. They told me I did not have to bring in my CPAP, only if I was expecting a stay over in a hospital. I was more worried about the after effects of the endoscopy but I did not even get a scratchy throat. I was completely fine 30 minutes after waking. Good luck.

Thanks, Bra--er, Jason! Really appreciate positive personal experiences.

I had both of these procedures done a few weeks before I was diagnosed with severe sleep apnea..

since I was on my side, it wasnt a problem, and nobody noticed anything unusual... however these were a couple weeks apart, and
my iv got plugged for the colonscopy, so I said, just do it without the drugs.. I would highly recommend the drugs, cuz it hurt like a bitch
on that first turn.. the fun part was watching it on tv

is your apnea positional?

Elena, my apnea is definitely positional. Still happens on my side but much worse on my back. I'll ask to be put on my side.

Thanks!

wow just make sure they do the top end first!!!! (or change scopes)
from what i've been told the "cleanout" is worse than the scope.

good luck

I've had about a dozen "upper" endoscopies but only one colonoscopy. But I have ha RF ablation of my esophagus in one of them so I was out for a fairly long time. I didn't notice any problem back them, other than the pain from the ablation when I woke up.

They usually give you lots of Versed and not that much opiate (demerol or fentanyl) - so you should be technically awake. I am somewhat tolerant to Benzodiazepines (of which Versed is one) and I tend to sometimes come out of it. It's not like waking up - I really think it's true amnesia. It was weird coming out of it in the middle of my colonoscopy watching what was going on over the TV screen. I was more high than out of it or it would have upset me - which it didn't. In fact I remember making jokes about what they were seeing, etc. I am a serious anxiety case and never have had a problem coming out of Versed. I don't think you are seriously sedated like in general anesthesia.
They do have an O2 saturation monitor on you, so they will know if you have any problems - and (at least for me) I was given O2 each time - and they were never told about apnea.

So I think your Dr. is right about not needing CPAP. Fentanyl is sedating to me and most people I talk to - my wife takes it for pain (long story) and it relaxes her too. We both have anxiety conditions. I really wouldn't worry about panic. The hardest part of a colonoscopy is "prepping" the day before, and you've done that. If you were truly given enough Versed you would not remember heaving in your prior endoscopy. You may be a bit tolerant. If you regularly take any Valium-type drugs (including Xanax, ativan, etc) they all cause some degree of tolerance. I would certainly make the Dr. be extra sure that it doesn't happen again. Just tell them what happened before and they know how to keep you in amnesia for the duration. Good luck - and you will do well.

aka fuzzy96 wrote:wow just make sure they do the top end first!!!! (or change scopes)
from what i've been told the "cleanout" is worse than the scope.

good luck

I'll be waking up saying, "What is this funny taste in my mouth?!" Yeah, I'm not looking forward to the prep at all, but I've gotten some tips, e.g., keeping it really cold, drinking through a straw, keeping a lemon drop candy in your mouth, etc., here and on the Interwebs. Better stock up on some soothing wipes!

jonquiljo wrote:I've had about a dozen "upper" endoscopies but only one colonoscopy. But I have ha RF ablation of my esophagus in one of them so I was out for a fairly long time. I didn't notice any problem back them, other than the pain from the ablation when I woke up.

They usually give you lots of Versed and not that much opiate (demerol or fentanyl) - so you should be technically awake. I am somewhat tolerant to Benzodiazepines (of which Versed is one) and I tend to sometimes come out of it. It's not like waking up - I really think it's true amnesia. It was weird coming out of it in the middle of my colonoscopy watching what was going on over the TV screen. I was more high than out of it or it would have upset me - which it didn't. In fact I remember making jokes about what they were seeing, etc. I am a serious anxiety case and never have had a problem coming out of Versed. I don't think you are seriously sedated like in general anesthesia.
They do have an O2 saturation monitor on you, so they will know if you have any problems - and (at least for me) I was given O2 each time - and they were never told about apnea.

So I think your Dr. is right about not needing CPAP. Fentanyl is sedating to me and most people I talk to - my wife takes it for pain (long story) and it relaxes her too. We both have anxiety conditions. I really wouldn't worry about panic. The hardest part of a colonoscopy is "prepping" the day before, and you've done that. If you were truly given enough Versed you would not remember heaving in your prior endoscopy. You may be a bit tolerant. If you regularly take any Valium-type drugs (including Xanax, ativan, etc) they all cause some degree of tolerance. I would certainly make the Dr. be extra sure that it doesn't happen again. Just tell them what happened before and they know how to keep you in amnesia for the duration. Good luck - and you will do well.

Good to know about your anxiety issues and not having problems with Versed. I take 0.125mg clonazepam (baby dose) but very, very seldom, so I don't think I have tolerance. Generally, I am quite sensitive to medications. My feeling is they started intubating before I was completely under. I haven't done the colon prep before. For my sigmoidoscopy it only required two fleet enemas.

tattooyu wrote:Elena, my apnea is definitely positional. Still happens on my side but much worse on my back. I'll ask to be put on my side.

Thanks!

With the colonoscopy, I'm afraid you don't have much choice!

Jonah is a real cutie. I see from your signature line he's already calling the shots.

Was privileged to have the double the fun on two different occasions. I was on CPAP by the time I had the last pair, but it wasn't used in the hospital for the procedure nor afterward. They said I had no trouble during the procedure, I'm guessing because I wasn't actually asleep. I made sure everyone knew to watch me afterward and bring family back as soon as they wheeled me into the recovery area. Also, the nurse said they always prop the head of the bed up after the procedure, and I was very nearly upright when I came around. That may have helped, but it went off without a hitch. I've not had a reaction to any of the meds, but can you ask if there's a med that could be on hand to counter anxiety should it occur? Maybe that would make you feel more comfortable with it all. Let us know how it goes - well, at least what you remember of it.

Jason S. wrote:

tattooyu wrote:Elena, my apnea is definitely positional. Still happens on my side but much worse on my back. I'll ask to be put on my side.

Thanks!

With the colonoscopy, I'm afraid you don't have much choice!

My mom just had hers done and was on her side the entire time (she thinks).

kteague wrote:Jonah is a real cutie. I see from your signature line he's already calling the shots.

Was privileged to have the double the fun on two different occasions. I was on CPAP by the time I had the last pair, but it wasn't used in the hospital for the procedure nor afterward. They said I had no trouble during the procedure, I'm guessing because I wasn't actually asleep. I made sure everyone knew to watch me afterward and bring family back as soon as they wheeled me into the recovery area. Also, the nurse said they always prop the head of the bed up after the procedure, and I was very nearly upright when I came around. That may have helped, but it went off without a hitch. I've not had a reaction to any of the meds, but can you ask if there's a med that could be on hand to counter anxiety should it occur? Maybe that would make you feel more comfortable with it all. Let us know how it goes - well, at least what you remember of it.

Oh yes, there's a new sheriff in town, and his name is JONAH!

I'm much less worried about it now. I'm more worried about the prep giving my palpitations and what-not, but at least the Trilyte has electrolytes in it to help replenish some that is lost. Still, I'll have some Pedialyte on hand.

If it sets your mind at ease...I've been in the GI field over 20 years, you will be fine. Generally a colonoscopy is done in a left side lying position. you'll be out for 15-20 (30-35 for a double endoscopy) and you'll never even know when it starts or is over. By all means, bring your cpap, and plan to nap on and off through the day when you return home. Trust me, the prep is the most uncomfortable part.

One thing you might want to do is make sure your wife knows how to pack up the CPAP and bring it to you if there are any complications and you have to be hospitalized.

I worry about this--not sure my husband would know not to put the humidifier in the case with water in it, and to make sure there's a nasal pillow attached to the headgear since I take the pillows off in the morning to wash them.

I have this grand plan to write out detailed instructions with photos in a sheet protector and put it on the top of my CPAP bag so if he ever has to pack it up for me he will know what to do. I'm thinking of putting a sign on the other side for air travel asking that TSA inspectors please change gloves and use a fresh swab (Not that I travel by air much these days ). Just the old girl scout in me--that's IF I ever get around to it.

Anyway, good luck with this procedure. YUCK--I'm supposed to do that this year (my dad died of colon cancer), but I can't quite talk myself into starting the process yet. My husband has been on the Kaiser waiting list for an appointment for his since June.

they do BOTH precedures while you are lying your side... you wont be on your back...


Now, I have a great preperation tip for you!

The gunk you have to drink for the colonoscopy.. ewwwwwwwww....

Now I asked for the MOST gentle concoction.. .. and I got the one you have a choice to do it all in one day, or break it in to two days..

I WOULD ADVISE DOING THE TWO DAY DEAL! I know, youll think, " I want to get this over with"but actually if you do it in the evening,
then finish in the morning... you get to sleep thru the night, and get a badly needed break! Then you are ready to go for your appt..

another word of warning.. make your appt for the morning! Mine was in the afternoon on new years eve.. like four pm, and since I
had nothing to eat or drink all day, my iv plugged up, and they couldnt start another line cuz I was completely dry.. so no drugs! ouch ouch!

also, stay away from spicey foods a few days before you have to prepare, for the sake of your poor tummy, throat, and colon..

Now for the big tip ....buy yourself two or three liters of gingerale.. you have to mix the stuff with water, but after you drink it, stand over the
sink and get your gingerale and put it in your mouth asap, swish around and spit it out, it will kill the taste of that gunk really quickly..
if you do this every single time you take a sip of that stuff, youll get thru it! YOu dont have to use gingerale, but it seemed to kill the after
taste of the gunk the best.. so good luck!!!! let us know how everything comes out!