Having an endoscopy under general anaesthetic

[Petal02]

I’ve been having indigestion symptoms on and off for a while, and I’ve been terrified that my GP will send me for an endoscopy. I’m a huge wuss when it comes to anything medical, and even though the doctor hasn’t recommended this procedure yet, just the ‘worst case scenario’ thoughts have been keeping me awake at night. I’d manage OK if they knocked me out completely, but I gather than most hospitals offer sedation, which might not be enough for a highly-strung coward like me …….

However I’ve just phoned our local BMI Hospital, I spoke to the secretary of one of the gastro specialists, who confirmed that endoscopy with a general anaesthetic is available for nervous patients, and that it costs £1396. The specialist in question also practices at two local NHS hospitals, so hopefully that’s good. But this information has really calmed me down – obviously I really hope I don’t need an endoscopy, but if I can have this was a general anaesthetic for £1396, then that’s such good news!!!

Am I being ridiculous? I can’t help being such a coward, but if I’m properly knocked out then surely it won’t be such an ordeal? And DH will drive me to/from hospital, and keep an eye on me for as long as is required, so I won't be trying to drive or use power tools!!!

Anyone??

Having slept on this, I'm thinking that £1396 is a lot of money to spend, to save me from 20 mins of horror, but on the other hand, I can't event contemplate going through an endoscopy unless I'm properly knocked out, so it's probably the only way it's ever going to happen.

Hi - I've had several endoscopy's and I do sympathise with your fears .It's a horrid thought .But ..the thought is worse than the procedure .

The drugs you're given will knock you out .You have a cannula in the back of your hand and when you're lying down they'll add a drug which will knock you out and you won't know anything until it's all over .Before they add the drug they get you to bite on a mouth guard - no worse than having those little x ray things in your mouth at the dentist . But I'll be honest ,I didn't like that bit ,it's a little intimidating ,but then you're out !

Just because it's not a general anesthetic ( it's not it's something else ) doesn't mean that you're half awake and know what's going on .You won't experience the tube going down at all . One of the one's I had they couldn't get the tube down ( I had a tumour ) but I knew NOTHING about it ,they told me afterwards when I came round .

Having said all that ,do tell them that you're very nervous and ask them to ensure you're well sedated .As I understand it they give you a bit of the wonder drug and then top it up as needs be .

I hope this helps .I do sympathise and if you want to ask anything else at all ,just ask .

Where are you having it done ? If it's in London maybe I could come with you if it would help ?

I have had gastroscopy without any sedation, I just had the throat spray, and whilst it was not very pleasant, it literally lasted about 2 minutes from when they started to put the tube down. It really was not that bad at all, the anxiety beforehand was a lot worse.

I really would not contemplate a GA for this, it is a lot of money and the risks of a GA, etc.

Ginger, thank you so much for your kind offer, but I'm in the Midlands!

I've read quite a few endoscopy threads on MN, and whilst the majority of sedated patients had similar trauma-free experiences to you, I've read enough accounts of insufficient sedation to unsettle me. So I suspect there's a 95% chance I'd be fine with sedation, but the tiny element of doubt would make me ill with worry in the run-up to the appointment, and probably result in me cancelling. But if I know from the start that I'll be properly knocked out, then this takes the fear out of the situation.

Although £1396 is a lot of money!

I may not even need this procedure, so I'm getting ahead of myself here, but if I know there's an acceptable way forward available, then it stops me worrying so much.

I've also read about 'deep sedation' (using propofol) rather than the 'moderate sedation' that's usually offered - and some NHS hospitals clearly use this, although an anaesthetist has to be present, which obviously increases costs, and I can see why this isn't the standard option. I read an interesting thread about a lady who'd aborted two endoscopy attempts (she didn't feel sufficiently 'out of it' to let them start the procedure) and rather than risk a third failure, the hospital let her go on the 'propofol waiting list'. And if our local NHS hospital also has a 'propofol waiting list' then I think this would work for me, but I don't know if you'd need to have a few failed attempts first, or whether you could plead your case right from the start?

And then I come back to the point where I could simply book myself in privately, and not have any fuss or uncertainty. DH has just bought himself a ride-on lawn mower (which cost a small fortune!) so I wouldn't feel too guilty about spending £1396 on medical care!

Hyacinth I totally agree it's a lot of money, and you're right that a GA always carries a risk. Just to give some context - it took me 10 years to pluck up the courage to have my tonsils out (then realised afterwards that once you're unconscious you don't know what's going on ...... ), I've never dared have a baby, and any blood tests/injections etc have to take place while I'm lying down, otherwise I become very faint. I wish I wasn't like this. its irrational.

I've had issues with indigestion symptoms, stomach pain etc. I'm also half asleep so apologies in advance for typos etc. I didn't get sent for an endoscopy until my symptoms landed me in hospital with suspected gallbladder issues AFTER they had ruled out other things and done several ultrasounds. I was incredibly nervous and panicky about the whole thing (and I'm due for another endoscopy in two weeks, so am very anxious again), but can confirm that the sedation does indeed knock you out completely. Like gingeroots said you have to bite on a mouth guard and then you're gone.

My local hospital don't like sedating you if they have to keep you in over night (I have no one to look after me for the 24 hours post-sedation that they require) but there isn't a chance in hell I'd be having it without, because I'm way too anxious to cope with anything like that, so I do empathise.

Lostplatypus hope you don't mind me asking - but as you've already had one endoscopy where you were clearly properly sedated, what's making you so nervous about the a second procedure?

Petal I was unbelievably anxious about having a gastroscopy, I managed to get it put off for 6 months. I was a complete wreck when i finally went, kept bursting into tears etc. Everyone was very kind about me being like that (very out of character). I'm 52 and a bit of a tough as old boots type normally. The person doing the procedure went and got me extra sedation as I was freaking out so much about opening wide for the throat spray. I don't remember anything about that tube going down my throat and I came to just as they removed it. I wouldn't be queuing up to have another one by any means, but honestly I don't think you need to have it done privately under GA and part with that much £££. I take my hat off to those who can do it without sedation.

If you are sedated you are asleep. You won't be aware of anything until they call your name to wake you up when its over.
Really, don't waste your money. You will be out of it, completely. You are 'knocked out' for it. There'd be no point in them doing it that way otherwise.
Please, do not spend money on getting it done some other way.
The people who have had one and were asleep and knocked out don't post on forums talking about it.
I'll try not to get all Monty Python Parrot Sketch but.....
University College Hosp in London does 10,000 endos per year just as an example. So how many is that when all the hospitals in the NHS and privates are added up? All those people are ASLEEP! They are NOT AWAKE.
That's what Sedation means it means you are asleep.

There are degrees of sedation. I have it regularly for procedures and always ask for as little as possible and put up the discomfort because I want to get out and back to work! You can ask for enough to to properly knock you out. I've only had one endoscopy but do remember I was properly knocked out for it.

I agree with Sadie. The sedation will knock you out and you won't remember a thing plus you have a shorter recovery time afterwards. GA's are harder on your body. Save your money.

Sorry to ask so many questions: so if were to go to an NHS hospital, I assume I'm within my rights to say STOP if they try to start any sort of procedure that I feel too awake to tolerate?

Obviously if I'm out for the count then I wouldn't be arguing/objecting, we'd go ahead and it's Job Done.

But if I didn't feel able to go ahead, I could abandon the appointment and then go down the private/GA route?

Sorry Petal, I have only just seen your questions. Re my anxiety, you make a very good point. It's not the procedure itself that worries me, it's the hospital stay afterwards and generally being out of my comfort zone. I have major anxiety issues so anything that isn't in my control or involves me being away from home is a huge source of anxiety for me. Does that make sense?

As for having the right to say stop at any point, you absolutely have that right at any time. I would say, most importantly, if you explain your concerns to them and how anxious you are, then they'll be better placed to deal with it. My local endoscopy department have been fantastic with me, and answered as many of my questions as they could. One lady even put a note on the letter to call and ask if I had any questions or concerns. I really hope you have a similarly positive experience if it comes to it.

I had one with sedation snd I didn't feel out of it as other people have experienced however it was still fine and I was obviously sedated enough to be able to go through with it. After it was done I was up and dressed and ready to go home! It was no where near as bad as I thought. I have terrible anxiety and can't believe I managed it.

Was it a case of being sedated enough not to care what was going on? Which I could probably cope with.

Do you recall gagging or being sick? Or any pain?

I haven't had an endoscopy but I have had a procedures under sedation, including probes down the throat. Even if you are awake, you don't care. It's like drinking 5 G&T's straight down but without the hangover. You will love everyone. And absolutely they will stop if you don't want to proceed.

There's a weird tasting banana flavoured spray that numbs the throat to help them insert the probe. You will have to fast before it so you won't be sick.

Afraid I don't agree with a lot of you. I had sedation and I think they didn't give me enough as I was fully awake throughout and only fell asleep afterwards in the delivery room. If I had to have one again I would gladly pay £1400 to avoid going through that again as I really came out of it thinking it was the worst thing I had ever endured.

A friend had had one before and I asked her why she didn't tell me how bad it was and she said it was because she didn't want to scare me!

I know people who have had it done since and have been knocked out with the sedative so I was maybe just unlucky but ...

I had two of these procedures with sedation and I was fully awake and in a lot of pain.
Admittedly other patients were either knocked out or almost asleep but the sedation had very little effect on me. It was torture.
I did ask why I was the only patient to remain fully alert throughout and I was told that different people had different reactions to the sedative. That actually the sedative was not meant to send you to sleep as they needed you to be aware enough to follow instructions.

I had another two later on and thankfully had general anaesthetic for both.
On the ward, another patient played merry hell with the medical staff as she had gone through the same experience - she maintained that they had deliberately cut back the dosage to save costs!

If I ever had to have another one I would opt for GA no question, even if I had to pay.

Thank you everyone for the replies - it does sound as though it's possible to get a GA with the NHS, I wonder what the criteria is? I still think that £1400 is worth paying to avoid a potentially traumatic experience, plus the pre-appointment apprehension.

It amazes me that given we're now in the 21st century, such an invasive procedure doesn't automatically come with a GA.

I gagged once and it was strange swallowing the camera but it was manageable-a wee bit sore . I felt awake and aware of what was going on and remember everything. The staff were unbelievable and held my hand and stroked my hair explaining everything throughout which really helped.

OP - bear in mind that people who have had bad experiences will always post on threads like these .

More so than people who have had good experiences .

If you are referred for an endoscopy, check how the hospital will do it before making a decision.

I had one about 18 months ago and the camera went up my nose and down the back that way rather than through my mouth. So no gagging etc. I had a numbing spray up my nose before hand and it was a bit weird having to swallow so the camera could go down but it was a quick 5 min procedure and I def wouldn't think it worth paying that much money or the risk of a GA to avoid, if they use the method I had. The staff were also amazing and there was a nurse who was there to keep me calm - she stroked my hair and talked to me and told me everything that was going on.

I am going to be honest, I had it with no sedation (sedation does not work on me at all) I just had the throat spray.

Yes, I did gag, it was not a pleasant experience, I felt like my stomach was trying to vomit the tube out but the nurse was really good, helping me with my breathing and trying to relax me and once the tube was down, it was fine, no pain at any time. It did not last long, about 2 minutes in total.

I would have it again with no sedation if needed no problem so it cant have been that bad.

I had similar experiences (no sedation, unpleasant but over soon)l