July 25, 2010
Major Tom @ 12:25 pm
Great article and I hope that everyone who reads it will consider getting a colonoscopy. There is a TON of misinformation about colonoscopy, especially with the sedation drugs. My job involves a lot of international travel (I fly for a commercial airline) and my healthcare always takes a back seat to the rest of the things that I have to do. My primary care doc is always admonishing me to get a colonoscopy (FAP runs in my family and I could not be in a higher risk catagory for colon cancer) BUT I don’t want to risk the long term memory-loss that sometimes occurs (rarely) with the sedation drugs such as midazolam (Versed). My neighbor is a nurse practitoner and she sustained some pretty serious and long-term memory loss after getting just 4mg of Versed for her colonoscopy and this is the most commonly used drug. I’m not a doctor (although I did get accepted into med school before starting my current career); when I google “versed problems” I get a slew of credible horror stories about Versed and memory loss/PTSD. Sure, some of these people are nuts, but most are certianly not. My primary care doc says that Versed is usually safe, but in a certian percentage of patients, it’s really, really bad and that you feel great immediately afterwards, but then you gradually notice memory loss (PIN numbers, birthdays etc). She said that Versed is commonly used because it’s cheap and that a lot of insurance companies won’t pay for diprivan (the MJ drug) which is much better. Now I’m having symptoms (bleeding) and have been trying to find a doc who will do the colonoscopy without drus (common everywhere but in the USA and with a decent doc, it’s painful without drugs). What really bothers me is that I scheduled an exam, was promised no drugs, did the prep and reported only to have the doc try to browbeat me into accepting an IV (just in case) and she insisted that I sign a sedation consent! Luckily a nurse told me that if I signed the consent that I would get sedation no matter what I was promised, so I politely proceeded to get my clothes and leave. I was bleeding slightly and the GI doc insisted that I not leave; she explained that they basically use subterfuge to get everyone to sign the sedation consent then give them the Versed and that most will have amnesia anyway, so what is the harm?? I have been told that I’m a really calm, nice guy (especially with female medical people) but I lost it after hearing that. The nurse verified what most people say about colonoscopy: immediately afterwards they feel fine (are we really done?) but after they get home, the creepy amnesia starts and they get hostile, call and get really agitated as they begin to remember what really happened to them. Cute. When did ethics get stricken from medical practice in the GI suite? This scared me badly (and I have been in real combat). To be honest, the GI doc freely admitted that they lie to patients about the sedation to get them to agree to the colonoscopy and you can’t dispute that this saves lives. She said that if they actually explained that Versed may cause a small number of people to have long-term memory loss, that few would agree to receive it. Especially when they find out that an alternative exists (diprivan/propofol) but that it’s expensive. Anyway, I didn’t sign the sedation consent, the doc started the exam without any drugs and it was pretty comfortable. She then ran into a bend that she couldn’t navigate and told me that the nurse anesthetist who was standing by would give me propofol; which I declined..the GI doc then told me that she was going to finish the exam and that I was getting sedation despite my protests. The nurse anesthetist said: “I’m not administering anything to this guy since he’s refusing to consent” and she verified that Versed had a lot of problems but that propofol did not..I still didn’t want to risk it. I asked to have the scope removed and the anesthetist suggested just painkiller (fentanyl)which I agreed to, she gave it and in went the scope without problems. The GI doc apologized about her deception; she explained that a previous patient who refused sedation (same reasons) had an incomplete exam (same problem) and that he ended up with undetected colon cancer that killed him within months. At this point I stopped seeing the GI doc as a liar and understood her posistion; reluctantly admitting that sedation with propfol was probably o.k. The anesthetist asked if I was consenting to propofol for the rest of the exam, I replied yes and the next thing I remember is waking up in recovery. Long story, but it’s sad that docs have to lie to patients about Versed just because insurance companies often refuse to pay for propofol. I now understand (sort of) why GI docs feel that they have to decieve colonoscopy patients; I don’t agree but I understand the logic. And I had a precancerous condition so I need yearly exams. When the doc called me to tell me that I needed a repeat exam in 12 months, I thought that she would be surprized that I readily agreed to do this. She laughed and told me that I was already on the schedule for next year, with the anesthetist…go figure.
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I can't be the only person who finds this alarming! First of all this drug Versed is harmful, extremely so, in many people including the arrogant medical providers... Why the NP that this person refers to would ever allow herself to be given this drug is beyond me! Secondly, look at what else the staff indulged in with this man. They promise NOT to give you Versed and then give it to you anyway. I thought that informed consent laws allowed the patient to decide how much risk to take? (at least he GOT an informed consent, unlike myself) Informed consent laws also state that the patient is to be informed of the "risks, benefits and alternatives prior to treatment." How does it happen that they use lies, tricks, omittions and deceit and GET AWAY WITH IT? But the most telling statement in this whole story is this one; "...the GI doc then told me that she was going to finish the exam and that I was getting sedation despite my protests." OH-----MY-----GOD! Who in the hell is this "doc" and who gave her the right to defy the patient, subject him to extreme risk he was unwilling to take, not to mention breaking every single law there is pertaining to "informed consent?!" Just so she could "finish the exam?" That is NOT her place to decide. Shocking, horrifying, geez there aren't words to describe this kind of criminal behavior! How and why is this abusive and lawless behavior happening?
I also want to add, that in this PARTICULAR case the CRNA did the right thing. All you CRNA's who come here and post stupid, hateful comments and act like lunatics need to make an example of this one and use this person as a role model.
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I can't be the only person who finds this alarming! First of all this drug Versed is harmful, extremely so, in many people including the arrogant medical providers... Why the NP that this person refers to would ever allow herself to be given this drug is beyond me! Secondly, look at what else the staff indulged in with this man. They promise NOT to give you Versed and then give it to you anyway. I thought that informed consent laws allowed the patient to decide how much risk to take? (at least he GOT an informed consent, unlike myself) Informed consent laws also state that the patient is to be informed of the "risks, benefits and alternatives prior to treatment." How does it happen that they use lies, tricks, omittions and deceit and GET AWAY WITH IT? But the most telling statement in this whole story is this one; "...the GI doc then told me that she was going to finish the exam and that I was getting sedation despite my protests." OH-----MY-----GOD! Who in the hell is this "doc" and who gave her the right to defy the patient, subject him to extreme risk he was unwilling to take, not to mention breaking every single law there is pertaining to "informed consent?!" Just so she could "finish the exam?" That is NOT her place to decide. Shocking, horrifying, geez there aren't words to describe this kind of criminal behavior! How and why is this abusive and lawless behavior happening?
I also want to add, that in this PARTICULAR case the CRNA did the right thing. All you CRNA's who come here and post stupid, hateful comments and act like lunatics need to make an example of this one and use this person as a role model.
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