When my doctor noted it was time for me to have a routine colonoscopy, I asked my physician if I could go through the exam without any anesthetic or sedation. Although he looked at me as if I had lost my mind, I had strong reasons for wanting a sedative-free colonoscopy.
Ranked at the top of my list of concerns? Every anesthetic strong enough to make me lose consciousness, no matter how temporary, made me violently ill for hours, confined to bed and feeling miserable. I’d done that and didn’t want a repeat performance. Seadation free colonoscopy would solve that problem.
Also, I’d read some information indicating that insurance companies were periodically examining the use of sedation and anesthethia during colonoscopies. If medical costs needed to be cut even more, I felt is was quite possible that insurers might refuse to pay for sedatives in the future. So I figured that I might as well give it a try now and see how it went before the choice was forced upon me.
My Experience – Colonoscopy without Anesthesia
So what was it like to get a colonoscopy without anesthesia or sedative of any kind? At most, it was mildly uncomfortable. I have to confess that I almost changed my mind at the last minute, especially after the gastroenterologist said that women tended to find the procedure very unpleasant. But a compassionate nurse stood by my side and (when the doctor was out of hearing range) said that I could do this and she’d be right there, encouraging me every step of the way. She held my hand and that kind gesture helped me relax.
Preparation for the colonoscopy was the most unpleasant part of the whole experience. The day before the exam, I had to take laxatives and drink plenty of water and other liquids to clean out my system. I spent all day at home becoming very familiar with my bathroom and going through some unpleasant moments as my body purged itself of every speck of food and solid matter in my intestinal system. After that, I was left feeling very hungry and almost eager to get the colonoscopy completed, anesthetic or not.
I Watched My Sedation-Free Colonoscopy on Screen, Seeing Every Move the Doctor Made
A major advantage of being awake during the probing and examination of my intestinal system? I could watch everything unfold on screen and knew exactly what the gastroenterologist was doing. While rare, perforations of the bowel have happened during colonoscopies.
I felt more in control because I could tell that the doctor was moving slowly and completing a thorough examination of my colon and lower intestinal system. One small polyp was found and removed for a biopsy. I had no discomfort as it was snipped off (it turned out to be cancer-free). There was no perforation of my colon and lower bowel.
There was never a moment when I felt that I was in extreme discomfort. There was one very short period of time – perhaps 30 seconds – when I felt a sharp cramp but it passed quickly. Before I knew it, the colonoscopy was over and the doctor was shaking my hand and congratulating me on my bravery. I didn’t feel brave, especially with the minimum amount of discomfort experienced, but I did feel very relieved. My husband didn’t even have to drive me home and I could go about my usual daily routine, even stopping at the grocery store.
Colonoscopy Without Sedation – the Wave of the Future?
If the thought of a colonoscopy without anesthesia makes you wince and my experience hasn’t convinced you to try a colonoscopy without sedation, consider the fact that some insurers have already balked at the use of anesthetics for patients undergoing colonoscopies.
They’ve made the case that sedation or medically supervised anesthesia, is not necessary, potentially risky and adds to medical costs, according to information from Physician Case Studies, found here . Even so, the majority of insurance companies seem to covering anesthesia costs during the procedure but this is not the case in many countries – and the United States could be next.
Of course, all anesthetics have potential risks and side effects (something I knew all too well). Cost is also a factor because anesthetics and sedatives cost money and extra time has to be spent monitoring patients as they awaken and shake off the effects of the medications. Extra staff, often trained nurses, have to be hired to keep track of patients’ vital signs. Although rare, when a serious reaction to sedation occurs, patients may even have to spend time in the hospital.
Does Colonoscopy Without Anesthesia Cut Medical Costs?
I definitely saved money by opting for a colonoscopy without anesthesia and I was able to leave the examination room at least an hour earlier than other patients who chose sedation. I saw nurses and doctors taking their patients’ blood pressure and monitoring their vital signs as I walked blithely out the door of the medical center. Of course, the total costs saved will vary by insurer and the agreement made with the doctor or medical center.
I also thought back to the days when I’d spent a good day in bed after a colonoscopy, feeling quite sick from the anesthetic, losing hours of work time. Not only was I saving money on an examination designed to detect colon cancer and other problems, but I was making money by being able to go right back to work (after stopping for food at the grocery store first).
Without Anesthetics or Sedation, Will Patients Avoid a Colonoscopies?
Although insurers have stressed the risks of side effects from anesthesia being used on healthy people, many gastroenterologists feel that the discomfort associated with colonoscopies could discourage patients from getting them at all, raising the chances of colon cancers going undetected. However, in a different study, at least 30% of patients opted for no sedation when given the choice of having it at their preferred medical facility or traveling at least 15 miles further to get a colonoscopy with anesthetic. That still leaves a good 70% who were willing to go out of their way to get sedation or anesthesia.
Anesthetics are not routinely used in many other countries and it is still possible that they may not be covered by insurance companies in the United States in the future. Doctors are experimenting with ways to lessen discomfort during the colonoscopy procedure, reducing the need for extra nurses and costly sedatives.
Sources:
Personal experience
Physician Case Studies, Would You Get a Colonoscopy Without Anesthesia? November 11, 2006 here
AMedNews.com, Study Supports Use of No-Sedation Colonoscopy, Jan 12, 2009, here
