Colonoscopy + being awake = ?

October 4, 2022 12:21 PM

You had a colonoscope with twilight sedation, not full anesthesia. What was that like?

My stupid insurance company isn't covering full sedation for colonoscopy anymore, which annoys me because I'd rather be unconscious during the procedure (which I've done in the past). My choices are to pay cash for the full anesthesia or do the covered twilight sedation. So what's that like?

posted by BlahLaLa to Health & Fitness (45 answers total)

Best answer: You don’t remember it.
posted by Melismata at 12:28 PM on October 4, 2022 [14 favorites]

I fell asleep like I was taking a nap and don't remember anything until it was over, where I asked a nurse if I had snored. The falling asleep was different than full sedation where you're just out suddenly and completely, but it was like going under a dose of nyquil when you're tired. My dad said when he had it he remembers at one point coming to a bit and asking them what was on tv, it looked weird, and then he fell back into a nap like state. No pain felt or anxiety in either case.
posted by lizard music at 12:29 PM on October 4, 2022 [2 favorites]

I've only had the twilight sedation for the colonoscopy (i've had actual anaesthesia for other stuff) and here's what I remember.
1. go into the OR as usual
2. get some sort of injection, "count backwards from ten..."
3. wake up and don't remember anything.

of course your experience may vary! but the only diff for me vs full anaesthesia is that twilight sedation didn't make me feel as horribly nauseated after.
posted by capnsue at 12:29 PM on October 4, 2022 [2 favorites]

I got scoped under twilight sleep. I’ve had other procedures done under it. I was 100% out in each case.
posted by adamrice at 12:29 PM on October 4, 2022

Best answer: I wasn't completely out for the whole thing. I have memories of a few moments of being awake and feeling mild discomfort. I am a baby about any remotely painful medical procedures, but I found it very manageable.
posted by FencingGal at 12:36 PM on October 4, 2022 [1 favorite]

I had twilight sedation for a colonoscopy. I don't remember anything from the procedure; I might as well have been unconscious.

There is a period of time as you are coming out of sedation after the procedure where you may or may not fully remember conversations you have. You will seem coherent but may not be able to remember things yet. It's important that you not be asked to sign anything or make any decisions until you are fully aware and able to remember things. If you can, bring a trusted person with you and have them sit with you as soon as they are allowed.
posted by expialidocious at 12:38 PM on October 4, 2022 [1 favorite]

I haven't had a colonoscopy, but I had an endoscopy under twilight sedation and the experience for me was literally "Ok, we're starting the sedation," and then the next thing I was aware of was waking up at some point after it was done in an entirely different room. In theory I may have been conscious for the procedure, but I don't have any memory of it.
posted by Aleyn at 12:40 PM on October 4, 2022 [8 favorites]

I had a colonoscopy done under light anesthesia. I watched it on a screen. Afterwards, I was chatting with the doctor, and I said I didn't think that the anesthesia had much of an effect. She smiled and asked me if I remembered a conversation we had during the procedure. I didn't remember. Then she mentioned another topic of conversation. I didn't remember that one, either. Overall, from what I do remember, the procedure was mildly uncomfortable, except for one brief period where it was borderline painful (it only lasted a few seconds).
posted by JD Sockinger at 12:41 PM on October 4, 2022

I’ve had a colonoscopy under twilight sedation and I’ve had a different procedure under full anaesthesia; I remember neither, but the sedation was much easier to recover from.
posted by third word on a random page at 12:46 PM on October 4, 2022 [6 favorites]

I sort of hazily remember things mostly from the start and end, and then essence of memory here and there throughout, but what I remember isn't pain or discomfort. I don't in any way regret it or wish I had been fully under.
posted by cmm at 12:46 PM on October 4, 2022

I know this doesn't answer your question, but for others who might be interested: I recently had a great experience with a completely unsedated colonoscopy. A few 10-15 second periods with mild to moderate pain (which apparently is more pain than average), but totally worth it to me to be able to just walk out without any restrictions and no worry about side effects (though I know they are extremely rare). It's rare here in the U.S., but in many countries it's the norm.
posted by Mr.Know-it-some at 12:48 PM on October 4, 2022 [4 favorites]

I was shepherding a relative after endoscopy with twilight sedation and she plain didn't remember the next hour after leaving the doctor's office (which included being very gregarious at random service people). Get someone to sit on you and stop you telling private things to random people.
posted by I claim sanctuary at 12:56 PM on October 4, 2022 [4 favorites]

They wheeled me into the room on the gurney, then a moment later I realized they were wheeling me back out of the room because they had somehow finished putting all the things up my butt while I was distracted by a thing.

Seriously don't worry about it, it's fine
posted by ook at 12:56 PM on October 4, 2022 [8 favorites]

I just had one done in August. They told me it would be twilight this time. Honestly, my experience was the same as if it had been full anesthesia. You go lights-out, then lights-on, and you’ve lost a half-hour of your life somewhere in between.

I did have a bad headache the rest of the day and into the next, which I have never had with full anesthesia.
posted by Thorzdad at 1:00 PM on October 4, 2022 [1 favorite]

Response by poster: Okay, phew. This is all very reassuring!
posted by BlahLaLa at 1:12 PM on October 4, 2022 [4 favorites]

I had an endoscopy under twilight, I remember waking up and panicking a little bit at the tube in my mouth, and then I heard "she's awake, more.." and that was it, until the recovery room.

I also had a combo endoscopy and colonoscopy. I don't remember a thing about that one at all.
posted by Ftsqg at 1:15 PM on October 4, 2022 [1 favorite]

Best answer: I've had a colonoscopy with no sedation.
I'm also a GI who does colonoscopies.
Unsedated colonoscopies are the norm in our healthcare system and are usually quite well tolerated.
I usually recommend a sedated procedure for people with past lower abdominal surgeries / C sections, people with diverticulosis, people who lost a lot of weight or have very weak abdominal muscles (think elderly ladies), or people who are very anxious about the procedure.
The reason colonoscopy is sometimes painful is basically the scope looping inside which is most likely if there's no padding a.k.a. abdominal fat (the easiest procedures are those in middle aged men with a slight belly) or if the bowel has adhesions.
A person with no past surgeries or history of diverticulitis and not small-frame-thin will often tell me the procedure was much more pleasant than the prep. On the other hand, adhesions from past surgeries can make the procedure painful.
Not medical advice just general musings. Best of luck.
posted by M. at 1:15 PM on October 4, 2022 [13 favorites]

The above comments are the same as my experience with propofol.
Once I had the procedure with a valium-type sedative and I was more aware. I didn't feel a thing and kind of enjoyed watching the procedure along with the doctor on his video screen.
posted by JimN2TAW at 1:17 PM on October 4, 2022

I had my first colonoscopy this summer, with the twilight stuff.

They counted me backwards, then a (subjectively) very short time later I was awake and could see a monitor so I said something about them already working and they replied in a casual way and my lights went right out and then I awoke in the recovery room.

I am a pain-tolerant redhead who's pretty resistant to anesthesia, and it was fiiiiiiine.
posted by wenestvedt at 1:25 PM on October 4, 2022 [1 favorite]

I've had other procedures done under twilight and don't remember anything from them.

My husband's recovery from colonoscopy with twilight was MUCH better and faster than his recoery from colonoscopy with anesthesia. Like, remarkably better and faster.
posted by cooker girl at 1:47 PM on October 4, 2022

I had a completely wide awake colonoscopy and it was a little weird feeling but totally fine!
posted by yes I said yes I will Yes at 1:47 PM on October 4, 2022 [1 favorite]

Best answer: I'm going to take a different approach and say that mine sucked; even though I went to a specialist place and warned them I was painkiller-resistant they didn't provide anywhere near enough meds and refused to revisit the dosing so I spent the entire time suffering some fairly weird-feeling discomfort. I'm still a bit angry about it, tbh.
posted by aramaic at 1:58 PM on October 4, 2022 [1 favorite]

I was out like a light for my twilight sedated procedure. definitely didn't experience or remember anything.
posted by supermedusa at 2:15 PM on October 4, 2022

Another zero-sedation-at-all-not-even-the twilight-sort colonoscopy haver here, it was fine. Most of it was either super-interesting (watching my insides on the screen, the nurse pointing out my appendix and various other sights en route) or just hilarious (nurses who were happy to joke with me, plus a lot of gas & air). There were a couple of very painful bits, which I'm guessing were maybe turning the corners, but they gave me fentanyl to get me through those and it was all good.

I went home with a clear head and a clean bill of health and a whole new respect for my insides.
posted by penguin pie at 2:15 PM on October 4, 2022 [2 favorites]

I had an endoscopy and FNA biopsy of an abdominal organ (so, potentially extra painful) under twilight sedation and I remember nothing until I woke up, demanding, "Am I supposed to be awake?" The nurse laughed and said they'd already been done for a few minutes.
posted by praemunire at 2:16 PM on October 4, 2022 [1 favorite]

I had a colonoscopy under twilight sedation 5 years ago. I am generally more sensitive to pain than other people and I have had 2 prior abdominal surgeries so there's definitely scar tissue gumming up the works. I remember almost nothing about the procedure, except at the beginning, being asked to lie on my side. They had to remove a polyp but I have no memory of that or even the drive home. As others have said, the recovery from the twilight sedation was much easier than when I've been completely knocked out for other surgeries.
posted by tuesdayschild at 2:23 PM on October 4, 2022

It was like the reality of the examination room pulled away and shrank to a small, almost irrelevant view in my perception; and compared to the fast-induced hunger and head-achy feeling of just beforehand, afterwards I was flying high, feeling great!
posted by Rash at 2:30 PM on October 4, 2022

I kind of woke up during twilight sedation, saw the monitor with my colon in front of me, thought "oh interesting, I wonder what the rest looks like," and then started trying to "scroll" to another picture. I was scrolling and scrolling on my pillow and getting really frustrated that it wasn't doing anything. I didn't feel any pain or distress about the actual procedure, just pissed my imaginary touchpad wasn't working. I was very high.
posted by Mavri at 2:52 PM on October 4, 2022 [5 favorites]

I just did this yesterday and it was so easy. Completely conked out, I remember nothing from the procedure, but woke up totally clear headed and was fine for the rest of the day (though I did take it easy). Big plus for me was that I didn’t have to have someone with me afterwards to leave the clinic - was able to ask take a taxi home.
posted by tinymojo at 3:06 PM on October 4, 2022

For some reason the sedation didn't work for me and I experienced a fair amount of pain. But the doctor said that was highly unusual and there is a note in my file for next time. And while it hurt it was not traumatic and again, I think pretty darn unusual.
posted by jeszac at 4:04 PM on October 4, 2022 [1 favorite]

Colonoscopy with no sedation whatsoever. Had them with twilight in the past. I personally would never ask for any sedation again. It was no problem at all with no sedation. Like penguin pie I was fascinated by the video of the whole thing. Little bit of pressure when they made a turn.

In my opinion, it would be a waste of money to pay for the full sedation.
posted by JohnnyGunn at 4:24 PM on October 4, 2022

I've never heard of anyone I know getting full anesthesia for colonoscopy. Full anesthesia relies on sophisticated monitoring of your basic functions and is not typical for an ENT 1 hour outpatient procedure like a colonoscopy. That said, I have done it with twilight sedation and it was absolutely fine, no memory whatsoever. Once I tried to do it with no sedation. It was way more painful than I could have anticipated, horrible really, which is (as referenced above) not true for everyone but you can't know until the experience -- it depends on your particular colon.
posted by ojocaliente at 4:35 PM on October 4, 2022 [1 favorite]

Same as others. Told to count down from 10. Got to about seven. Then woke up.
posted by NotMyselfRightNow at 4:59 PM on October 4, 2022 [1 favorite]

No sedation, somewhat awkward. On my list of painful medical procedures it doesn't even rate.
posted by ovvl at 5:56 PM on October 4, 2022

I was punchy from little sleep and no food, and all I wanted to do was take a nap, so I was glad to be able to get knocked out for a bit. They hooked me up to oxygen, then said I might get a metallic taste in my mouth when the sedative started going in. I remember saying, "Ah, there's the metallic taste," and then I woke up in recovery. It was twilight sedation, but felt like nothing more than a good nap.
posted by emelenjr at 6:07 PM on October 4, 2022 [1 favorite]

I had an unusually bad experience of a colonoscopy under twilight sedation. My experience is rare but has a non-zero chance of happening.

I was conscious, verbal, and in agony.

I kept begging them for more pain meds and more lubricant, and they ignored me.

They kept trying to forcibly ram the scope in, which caused intestinal spasms, and they tried to forcibly ram the scope in against the intestinal spasms.

The whole experience was deeply distressing, and honestly left me feeling as though I had been sexually assaulted.
posted by chariot pulled by cassowaries at 7:39 PM on October 4, 2022 [1 favorite]

I skipped twilight sedation and it was... good? I was super squeamish / anxious about being unconscious while Things were done to me. It felt very violation-y. I'd rather be awake and a little uncomfortable but remember everything and feel I have some agency.

I told them that and they obliged by giving me enough meds to make me happy as heck and remove most discomfort. I know it was propofol and then either midazolam or fentanyl, added in tiny bits based on my discomfort. The charge nurse was awesome - we discussed what his kid planned to wear to prom.

I didn't think I was really high but afterwards I crashed hard, an afternoon of low-grade blues with grumpies and crying. Still totally worth it.
posted by Ink-stained wretch at 7:55 PM on October 4, 2022

I have had about 15 colonoscopies so far (Crohn's/colitis) and I've not used any medications for the last dozen. As mentioned by Mr.Know-it-some, the main benefit is immediately being able to leave on my own after the procedure. I also watch the procedure and kibbitz with the doc during. There is some discomfort, and a few instances of pain (at the corners) but it is more tolerable than an endoscopy without sedation (just some local anaesthetic in the throat to allow the scope down). I still think the prep is worse than the procedure, but it is so much better with a Washlet.
It will likely be fine, whatever you choose.
posted by birdsquared at 8:12 PM on October 4, 2022

It's HILARIOUS because drugs. I can feel myself getting high and becoming aware I'm babbling and then there's pink insides on the screen, then seemingly straight away it's over and you're back down to earth and you eat a little sandwich. Zero stress and pain. It's a shame you need to have a colonoscopy for the drugs, really.
posted by i_am_joe's_spleen at 2:42 AM on October 5, 2022

I have malignant hyperthermia so I can’t have general anesthesia. I have had 3 colonoscopies and don’t recall a thing. Out like a light and then awake and groggy.
posted by terrapin at 5:38 AM on October 5, 2022

Another note: I use a CPAP machine at night, and let them know. It wasn't necessary during the procedure, which I thought was interesting.

A final note: the doctor read me the results as I sat in recovery, which I figured was optimistic about my condition...but I was already quite clear-headed, and very lucid when my wife drove up to bring me home.
posted by wenestvedt at 8:03 AM on October 5, 2022

I have observed somebody after twilight sleep for a colonoscopy and will never ever ever get it, his experience freaked me out so hard. True, he was an enthusiastic Xyrtec-taker, and Xyrtec is apparently one of the medications that can cause problems, so that may have contributed, but he lost the entire day of the colonoscopy and for days afterward kept having memory lapses, and he complained and complained and bitterly complained. It was terrible. Also. It's only terrible after the propofol wears off and you return to planet Earth. During your propofol trip around the world, you will be having A Time. Higher than ever before. Living a fully consequence-free life for many delightful hours. As a result, you will happily and eagerly tell all your secrets to anyone in earshot. Ask if it's okay to have your jaw wired shut before the procedure. Srsly. The things I heard!

There are simple tests they give seniors who may be at risk for cognitive fallout from anesthesia. My dude was 50-ish, thus did not get screened. Ask if you can get screened. Tell the doctors way way in advance about any medication you're taking that might complicate things. Or just skip anesthesia.

Of course your mileage is likely to vary; anybody else I've ever interviewed on the subj. has been fine with/delighted with the experience. But no way will I ever do it. Yeeesh, not worth it. Bleeee!
posted by Don Pepino at 8:58 AM on October 5, 2022 [2 favorites]

Twice with Propofol. No memory of the procedures and no side effects. I think I could have driven home both times, but they wouldn't let me.
posted by jindc at 10:44 AM on October 5, 2022

Response by poster: I appreciate the responses. My colonoscopy is in 4 weeks, and I'll update afterward.
posted by BlahLaLa at 12:52 PM on October 5, 2022 [2 favorites]

Response by poster: Okay well my procedure got changed to colonoscopy + upper endoscopy, so for that they'll do full sedation. But I'm glad these answers are here for future reference.
posted by BlahLaLa at 8:39 PM on October 5, 2022 [1 favorite]