Sedation or Gas and Air? My Colonoscopy Experience

Part 2: Having Sedation - The Alternative View

And that was it. I was taken into the endoscopy room and gotten ready. At this point, I'll mention I was wearing my fitbit the whole time. When the nurse who fitted the cannula checked my pulse I compared her equipment to the fitbit. Their readings weren't identical, but I suspect the hospital equipment is more sophisticated and accurate. Later I'd be able look at my heart rate over the course of the day and try to examine the effects of pre-procedure anxiety and being sedated.

In the treatment room, the endoscopist asked me a few more questions about lifestyle, stress and other factors, then it was time to lie down and let him crack on. Now at the point where I'm lying on my side and the nurse is putting these little oxygen tube things in my nostrils, I'll be honest - I was completely bricking it. I was so terrified, I was shaking and almost in tears. I think it was partly anxiety over how the sedation would affect me, partly anxiety about the procedure itself and partly a general anxiety of what was effectively feeling like a much more 'medical' experience. The presence of a cannula being a big factor, as well as the blood pressure, blood oxygen monitor and the oxygen tubes in my nostrils. It all makes the procedure seem more serious. All this stuff is essentially there to check that your body is still working. Ie: Check that you're not dying. The presence of it suggests there is a small risk that you could start dying. Silly, I know - but this is how my mind works. I'm analytical person and I'm an anxious person when it comes to receiving medical treatment. 

Now the endoscopist plugged a syringe into the cannula and said, in that monotone, 'explaining what I'm doing' way, which medical staff often adopt. 'Giving sedation.' or something to that affect. 

I'll be honest I don't know what I expected. I used to smoke a bit of pot, maybe something like that? I had a general anaesthetic years ago, something like a watered down version of that? Would I suddenly feel really tired and nod off on the table?

The fact is, the results were rather unremarkable. I didn't immediately feel different,  as if I'd taken a mighty hit on a Skunkweed-filled bong. I didn't actually feel anything. Not at first anyway. Slowly though, I began to feel a little bit more relaxed, more apathetic? Psychologically I don't think I was affected strongly, but I could feel my body reacting. My heart rate slowed, my muscles relaxed. I can only describe the feeling as the effects of psychological anxiety and fear, being blocked so as to not produce the physical symptoms of anxiety. This relaxing of your body, and slowing of your heart then seems to have an affect on your psychological anxiety. 

I'll be honest. The experience was significantly better. It was far less traumatic with sedation and I think the reduction in squirming and groaning made the endoscopist's job easier. I had to move around far less on this occasion, only having to make one or two changes in position. This could have been down to the skill of the endoscopist. Last time he basically did a visual inspection of the large bowel while subjecting me to a certain amount of medical torture - largely down to my unusually tricky to navigate bowel. This time he removed a polyp, took samples of the epithelium from eight points along the bowel and even explored the lowest section of the small intestine, beyond the cecum.  Though he did comment on a particular turn being 'very tight' so yet again, confirming the trickier than average to navigate bowel.

Watching this little crocodile clip on the screen biting and effectively ripping away little bits of you was surreal. I'm glad I was sedated. Not for the pain, but because I imagine without sedation, watching the little steel tool ripping bits of me away would have raised my anxiety levels.

After he'd removed all he wanted to remove and withdrawn the scope, I was wheeled into the ward and left to recover - oxygen still attached. I felt a bit roughed up, but relaxed. I nodded off I think - my memory is quite a bit hazier because of the sedation. Recovery time was much longer. A male nurse asked how I was feeling and offered me a glass of water. A little later a young, female nurse with tattoos on her forearms and dark hair came to take the oxygen off and later still to remove the cannula. She was nice, again I didn't watch the removal procedure, I prefer to turn away and allow them to work unobserved. The painful part was removing the big sticky patch and we joked about having to wax my other arm so they match. Eventually the next colonoscopy patient turned up and was placed opposite and talked briefly, before he nodded off. By the time I was out of bed and dressed, he'd come around and we chatted for a second before I went for my cup of tea and round of toast.

I'd driven again, but my wife got a lift over so she could drive me and my car back. (The Jaguar has gone sadly. This time it's a Ford Focus ST3 256 bhp). She hates driving it almost as much as the Jaguar but hey! For the rest of the day and part of the next day I felt a little slower mentally, a tiny bit spaced out? It was actually a pleasant feeling unless someone needed me to do something. My wife actually said I'm easier to live with sedated, I'm quite wired most of the time and not an easy person to spend time with. I didn't eat a great deal that night, partly because of feeling woozy, but mainly because I couldn't eat or drink after a certain time as I was having an abdominal ultrasound the next day.

The ultrasound was a doddle compared to the colonoscopy. The only real discomfort being covered in cold gel and some getting on my clothes. 

To summarize, I would say, if you are having a colonoscopy, consider sedation. It doesn't knock you out, it makes the whole experience far easier to bear. I think the previous time, they were running behind schedule and keen on NOT sedating me. They never said as much, but looking back and reading between the lines, I think not sedating suited them. The recovery was shorter, and by the time I was going the ward was already pretty much shutting down. They were more or less putting the chairs on the tables when I left Macclesfield. I wonder if time was why they didn't take samples or remove a polyp either? Macclesfield, were in all honesty fine. It wasn't a bad experience at all. I'd say it was good on balance, but Leighton Hospital was excellent. It had the edge. In future I'll probably choose Leighton for anything and everything. Partly because of the experience while having a Colonoscopy and partly because it's so much easier to get to than Macclesfield or the North Staffs.

I haven't heard anything back from the samples or the polyp. Maybe when I see the doctor again in a few weeks time she'll have some news for me. I'm expectant and hopeful that nothing sinister was found. (The samples and polyp would have gone to the lab)

I hope you've found this account interesting and useful. It's not as funny as the first one, I appreciate, but this time I wanted to focus on giving you a useful account of the experience, so if you're offered sedation for this procedure you can make an informed choice.

For the scientists among you or those interested in all things medical; when I checked my heart rate over the day on my fitbit, I could see a steady, then sharper rise leading up to the procedure, then a sudden drop at approximately the time the sedation was administered. It's interesting to see the effects of drugs on your heart rate in such a clear way. If you ever have a procedure, wear your fitbit and take note of the times when your procedure starts and your drugs are administered. It's not the most accurate piece of kit, but I'm confident you'll see a a correlation of changes in heart rate, with your anxiety levels and the times you were given drugs, on your graph at the end of the day.

Martyn Stanley