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Thursday, July 24, 2014
Is colonoscopy possible without an IV?
I`m scheduled for a colonoscopy (no problems, just a routine screening) and I don`t want to be sedated as I have never been sedated for anything including two chilbirths (for which I also did not receive pain medication) and I don`t want an IV. My Mother and both sisters had a lot of bruising and pain at their injection sites that lasted for weeks and I refuse to go through that. I want to be aware of what is happening to my body through the entire procedure and be able to convey to the doctor if I want to stop the procedure. I can`t do that if I`m sedated. I also want to be able to leave the hospital afterwards without any residual medication affecting me. In other words I don`t want to leave in a drugged stupor as my husband did after his procedure. If I go through the procedure the way the doctors have outlined it to me then they will be taking all of the decisions about what happens to me out of my hands. I am trying to retain as much of my dignity as I can in this wholley undignified experience. So the question is, is it possible to have a colonoscopy done with no IV or sedation?
During the Civil War, men had their limbs amputated without anesthesia. As you've mentioned, women may endure childbirth without medication. I am sure it is possible to have a colonoscopy without sedation. I guess it is your right as an autonomous patient to request this.
Before you make your request, you should consider these questions:
- Why are you having the colonoscopy? - What are the rights of the physician?
These are my suggested answers:
You are having a colonoscopy to screen for asymptomatic abnormalities. Such abnormalities can be polyps or even cancer. You want the physician to have the best possible chance of detecting these because their detection could save your life. You give the physician the best chance at detecting abnormalities by lying absolutely still so she can concentrate on finding abnormalities. If you are not sedated you are likely to have significant discomfort, with which the physician will be concerned, and find difficulty being immobile. Your physician may be distracted by your discomfort and be pushed into completing the procedure as quickly as possible. As a result the abnormality may be missed. This would be a very unfortunate outcome for both you and the physician. I imagine that in the US it might even be grounds for a lawsuit against the physician!
Your dignity is important. How important is your life? Your dignity may be best safeguarded by not having to endure a procedure that is difficult for both you and the physician to complete.
An IV doesn't have to result in prolonged bruising and discomfort. Ask for someone who has had lots of experience putting them in.
I suggest you discuss this issue with your physician, and the sedation with the anesthesia provider, who may or may not be an anesthesiologist. I suspect that both will be willing to give it a try without sedation provided you agree they can step in and provide this if necessary to ensure a good outcome.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University