Would you undergo a colonoscopy without Anesthesia?

[southern_belle]

Poll question: Would you undergo a colonoscopy without Anesthesia?

Aetna postpones sedation policy change

Aetna has decided to postpone the new policy that was to take effect April 1st, to stop covering the cost of using anesthesiologists "during routine upper and lower endoscopic procedures, such as colonoscopies".

The policy had been opposed by a group of New Jersey doctors who said denying coverage of anesthesiologists to anxious patients would lead to fewer cancer screenings...

The change was opposed by the Medical Society of New Jersey, which said patients should be assured that their insurance coverage includes the cost of anesthesiologists who administer propofol, an anesthesia the doctors say is effective and comfortable.

According to Aetna, the use of anesthesiology increases the cost of the procedure anywhere from $200 and $1,000, and would still cover anesthesiologists for high-risk patients.

Colorectal cancer is the second leading cause of cancer death in the United States and regular screening could eliminate as many as 60 percent of deaths each year, according to the U.S. Centers for Disease Control and Prevention.

http://news.yahoo.com/s/ap/20080227/ap_on_he_me/aetna_colonoscopy_sedation_4

Edited to add Aetna contact number: 1-860-273-0123 via their website http://www.aetna.com/info/letstalk/letstalk.html

[ProdigalJunkMail]

1. God...I LOVE hearing that my insurance carrier

makes decisions like this...what a pantload!

sP

[mikehiggins]

2. screw the health insurance swindlers

nobody is going to get these kinds of procedures done without some sort of anesthesia. Most doctors won't perform them without the patient being sedated, if only to prevent movements that can cause injury (and subsequent malpractice suits). All this is is another move to push the costs of medical care back onto the patient.

My insurer started out by stopping coverage for Viagra, of all things. Then they cut all coverage for most anti-allergy medications. More to come, you can be sure. Does this mean Aetna is going to lower their rates? Can anyone be that stupid or naive as to beleive that for a second?

Single payer is becoming inevitable.

[alarimer]

26. Even with sedation they stil injure people

My boss's wife had here colon perforated during this "routine" procedure. She's okay now, but fuck if I am going to do it at all.

[truedelphi]

75. I had Kaiser and they never once told me that I could have

Anaesthesia.

Went through that whole horrible thing and only found out a week later while visiting a friend who is a doctor that anaethesia is supposed to be part of the treatment.

Otherwise, he commented, who would have this done to themselves?

[LiberalAndProud]

3. insurance at its best

I would sure like to get rid of the middleman.

Me <> insurance provider (profit maximizer) <> My Doctor

That's one firewall I could do without.

[Coyote_Bandit]

18. Actually it's

you <> probably your employer <> insurance agent <> insurance company <> reinsurers <> hospital or clinic that employs your doctor <> your doctor <> whoever financed your doctor's student loans

Your employer is going to offer options to you that are most cost effective to them - not what is the best option for you.

The insurance agent is not an employee of the insurance company. He earns his own commission, his own profits and pays his own expenses.

The insurance company obviously earns its own profits and bears its own expenses. Because it is reinsured it is able to write more insurance coverage than it would otherwise be authorized to issue by state regulators.

Reinsurers typically share in the profits and losses of a book of insurance coverage on a pro rata basis. They bear their own expense and earn their own profits.

The hospital or clinic that employs your doctor is managed as a business with a profit motive. Even the non profits.

Your doctor didn't mind accumulating huge debts and putting in lots of hours to be authorized to practice. He expects to pay those debts off AND maintain a very good lifestyle.

Whoever financed your doctor's student loans did it to earn some money. They could care less whether he even practices.

Lots of players in this health care fiasco. None of them have any motive to protect the interests of patients/insureds. And you can add a whole other round of players when you actually start that about providing care because that brings in drug and medical equipment manufacturers, suppliers and distributors. Now consider that you, the end consumer are underwriting the livelihood and profits of every employee and institution involved in providing insurance, care, and medical supplies and treatments. As there are fewer end consumers participating in the game the relative costs of providing those profits go up.

There are lots of fingers to be pointed when discussing why our health care system is so fucked up.

Just sayin'.



Edit to run spell check......

[LiberalAndProud]

20. I am more likely to view it from the employers' perspective

because I am a partner in my own business, and I make the insurance decisions for my company. Do you know what decision I made this year? One co-owner is insured under his spouse's insurance (state employee.) We chose to drop group coverage two months ago. The insurance company lost the value vs. cost argument. The partners aren't getting younger, we are a micro, micro company and our premiums are skyrocketing. It is simply not an option for us any longer.

p.s. My insurance agent doesn't offer group health insurance to his employees either.

Edit to add:

http://online.wsj.com/article/PR-CO-20080221-902023.html?mod=wsjcrmain

[Coyote_Bandit]

34. The participants are all the same

You made a business decision that was in the best interests of the business. It was not necessarily in the best interests of the individuals who serve that business. And you are not obligated to consider their interests. I personally think that health care should be divorced from the workplace and that coverages and premiums should be standardized. Assuming some form of single payer health care is not instituted.

I am some combination of self-employed/unemployed/acquiring new job skills. Single. 40 something. Personally, I haven't had routine/preventative health care in about 15 years. Haven't seen a doctor for any reason in over 10 years. I am partially sighted in one eye and do get eye exams and new lenses about once every 5 or 6 years. Ponied up about $1200 for that in December. I also try to make it to the dentist every few years. I have high deductible ($5,000 with a co-pay up to $10,000) catastrophic health insurance coverage - coverage which does not include doctor visits. All my documented medical history shows me to be in good health with no pre-existing conditions. The monthly premium runs between $275 and $300. Realistically I can't find anything cheaper and know the cost of coverage will continue to skyrocket. And I know if I seek medical care and have even some minor precursor to a more serious medical condition noted that I am subject to either cancellation or more extreme rate increases. I also know that I have no expectation of doctor patient privilege with respect to my medical records. For all practical terms with respect to health care I am shit out of luck in this country. And I am not alone.

If I were a member of certain groups (e.g., native American) there would be a safety net of some sort to provide health care to me. It might be flawed but it would provide some care. In that sense I am less than equal to other citizens. I truly believe that access to minimum standards of health care should be litigated as an Equal Protection issue. Why are some citizens provided this benefit while others are denied and die because they do not have meaningful access to health care?

I am 40 something and do not forsee the health care crisis in this country being resolved before I enter my senior years. Eventually I hope to buy my way out of this country and relocate to a country where access to health care is not an issue. I will take all my assets and resources with me and start a new life and a new business endeavor there. Long term that is in my best interest. There simply is no reason for me to remain in a country where my physical welfare is at risk because I do not have meaningful access to health care. I cannot make my government respect me or my needs. But I damn sure have choices.

[LiberalAndProud]

40. Please let me help you understand.

Every employee in my business is an owner. Every single one of us. The COMPANY is US. So how does your long-winded argument above apply? Employee pocket = Company pocket. Company health = Employee Health. There is no distinction here.

[Coyote_Bandit]

47. You comments confirm

my original point. Part of it anyway. That being that business decisions are all about the bottom line and as such they do not consider the welfare of the individuals who serve the business. By definition they serve the interest of adding value to the business. Those who serve the business - including principals and employees - often have interests which are contrary to those of the business itself. Quite often they are separate legal persons with competing and conflicting interests. Flesh and blood employees and principals require access to health care. Businesses require a healthy bottom line. With respect to health insurance you personally wear two hats. The flesh and blood you has very real needs that conflict with the business manager you that must address bottom line concerns. The flesh and blood you is no better served by the health care decisions of the company you own than all the other flesh and blood people who obtain health insurance through their place of employment.

Employee pocket = Company pocket and Company health = Employee Health only in a sole proprietorship. A corporation or an LLC is a separate legal person with separate obligations. In a partnership the company pocket = partner 1 pocket + partner 2 pocket subject to contractual agreement regarding contributions and compensation. Company health = partner 1 health + partner 2 health. Company pocket and company health is diluted by any sickness or disability of either partner. And death dissolves the partnership.

As for the personal commentary, well, you can take it or leave it. You can be interested or not. You simply do not have to care. Noted. And ignored.

[LiberalAndProud]

52. Commentary retracted, rejected and denounced.

Sorry.

[Coyote_Bandit]

53. Ummmm

Sorry to be short. It's been a rough day around here. Need to get some work done. However, I have spent a good part of the day with the dog that has beat most of the odds - including a recommendation several years ago that he be euthanized. Looks like another trip to the vet may be in order. That'll be the second trip in five days.

I'm sure you made the best business decision you could. Tying health insurance to employment puts business owners, managers and their employees all in an unfortunate situtaion for various reasons. Business decisions don't always serve personal needs. On the other hand there probably shouldn't be expectations that they do.

[southern_belle]

4. I've added the Aetna contact number

for clients to contact them to voice their complaints. BE HEARD!!!

[TahitiNut]

5. I may have no choice.

I can't afford the colonoscopy, let alone the anesthesia. :shrug:

At my age, it's been a long time since I've had my head up my ass. :dunce:

[CTyankee]

43. What sold me was when I learned that this simple procedure could prevent nearly ALL cases of

colon cancer! That is astonishing. Those odds are good odds, if you want it put that way. Why die of something you could prevent? But I am speaking as someone with excellent health coverage.

I realize this is not the case with your situation and that is not good. But my guess is that you would not (or would think twice about) having it done if the procedure was paid for but not the anesthesia.

The only anesthesia I have to pay for is nitrous oxide (laughing gas) when I have my gums scraped...

[B Calm]

6. I had one done two years ago. There's no way in hell I would have

a colonoscopy without anesthesia! With all the Nurses and a doctor in the room while they are performing this emarrassment procedure, that alone, I just as soon be knocked out.

[riverwalker]

7. a piece of cake after this primary! n/t

[NC_Nurse]

8. No. Some people, usually men because their colons are larger, can do it. Most

cannot without a good bit of pain. Many people have torturous colons (lots of twists and turns) that make a colonoscopy very difficult.
Some people have strictures or narrowed areas in parts of their colon. It's not a pleasant procedure. This is a stupid idea.

[CTyankee]

44. They had to use a pediatric scope on me because of narrowness

and it hurt. I am getting more anesthesia with my next one...

[Hekate]

54. "Tortuous with redundant looping" was how my report put it. My doc said general anesthesia next time

... for HIS benefit. He's a very good gastroenterologist, and he said my gut was hard going. Damn, even with being pretty well doped up I groaned every time he turned a corner.

I had to have an endoscopy and colonoscopy at the same time to see if there was any occult bleeding that was causing my anemia (I'm grateful there wasn't). I was the one who asked for extra sedation because I was afraid that I would gag on the endoscope -- as it was, I could feel it but was too doped to reflexively fight it.

I have routine sigmoidoscopies in my internist's office without any problem whatsoever, but those procedures only go in so far. They are nowhere near as invasive as the others.

Aetna once again demonstrates that the United States has a Third World health care delivery system thanks to the insurance corporations -- if you can pay for it, you can have it, and otherwise you can hold a bake sale for your chemo while your friends shave their heads in solidarity. It's disgusting and immoral.

Hekate

[Locrian]

59. I HAD ONE WITHOUT and Wooooooo

exactly right. I HAD one w/o anesthesia - hurt like holey fuck. I have a sharp turn around the sigmund (?) bend and it was hell. Plus the doctor pumped me full of "air" like a balloon. Awful experience.

Had one with versid - the stuff where you are "awake" but cant remember. That was no problemo.

[Bonhomme Richard]

9. It couldn't be any worse than a Lower GI.

It was while undergoing that procedure that I discovered that I am capable of murder.

[CTyankee]

56. Is that the same as a barium enema study? If so, I am in complete agreement.

I was told it wouldn't hurt, but it was the most awful thing I have had to endure medically in my life. I even asked them to stop, it was so uncomfortable. And of course I had no sedation whatsoever. I would have a colonoscopy any day over that...

[Bonhomme Richard]

58. Yeah, same thing. If I could have gotten my hands on the Doctor

this would be written from prison.

[CTyankee]

60. Mine was done in advance of surgery to reverse a temporary colostomy.

That means I had the colostomy bag in place, which was difficult to manage, as you can imagine. I realized it was being done to see if my colon had healed so that the reversal could be done, so I was eager to get rid of the damn thing. (I had had complications from abdominal surgery which required the temporary colostomy.)

My surgeon's staff had said "We've never heard any complaints" when I asked if the test was at all uncomfortable. They could have told me the truth and then given me a mild sedative. I realize you have to be awake during the procedure but I could have at least had a xanax or some kind of relaxant. Were you told to expect what you experienced, or did they lie to you too?

[Bonhomme Richard]

69. Straight out lied.

A number of years ago they were trying to figure out what was wrong with me and did all kind of test. They never did find out and the problem went away.
I am not the complaining type, as a matter of fact, when they did a sigmoidoscopy on me I asked the Doctor if it was supposed to be tickling the back of my throat like it was....they cracked up.
I guess the warning I should have heeded during the beginning of the Barium Enema was everyone staying out of arms reach.

[CTyankee]

72. I thought my problem was caused by a newbie radiologist. I'm sorry to hear

that you had a bad time, too, but at least I feel vindicated. I had pain after the procedure until the substance they used (it wasn't barium so I thought it would be even better for me) went through my system. My surgeon's office didn't quite believe me! I did follow up with them later and told them that now they HAD a complaint!

This procedure, by the way, was done at Yale, where they have this "fabulous" medical school!

[dogman]

10. What! And miss my vacation.

It's one of the few breaks from work I've had over the last 20 years. A big plus was getting the pictures from my vacation, since my recollection was limited. I did awaken in the middle of one and definitely would never go back if I had to endure what I felt in that brief moment.

[panader0]

11. I thought this post was going to be something about how we have

been getting screwed for eight years.

[KansDem]

62. I thought the same thing. After this Bush malAminstration...

...maybe they think we're so used to getting reamed in the ass that sedation is unnecessary.

[bronxiteforever]

12. Everyday I am shocked anew at the walking disaster that is my country

k & R

[Bonhomme Richard]

13. They know that it will cut down on the number pf people that..

have colonoscopys.
It's always about money.
Sad ...Really.

[Sarah Ibarruri]

14. Whoever answered yes needs to own up to the fact by posting in here and explaining nt

[suston96]

15. I have had a few...and requested little or no anesthetic - I like to watch the screen.....nt

[madokie]

16. Been there and done that

no pain at all but a there was a little discomfort though and I'm not sure if it didn't have something to do with the embarrassment;-)

[Xithras]

77. Same here. The pain thing must vary between people.

It certainly wasn't comfortable, but I had a colonoscopy so that my doctor could confirm a diverticulitis diagnosis several years ago. I had no anethesia, and felt no pain...just this overwhelming urge to go to the bathroom.

The trick is simply to relax.

[Uben]

17. I had mine last year

My second. I had a colooscopy and an upper scope done last August. Had two pollups removed and found a bit of diverticulitis, nothing serious. No way I would do it without being put out. And, no way would I ever have Aetna as my insurance company!

The damned thing cost over $5000 and took about 45 minutes! I have $5000 deductible. Go figure.

[Kermitt Gribble]

19. This is horrible news!

I had one performed almost a year ago and whatever they used to knock me out was wonderful. I felt great as they were injecting the anesthesia, and felt even better when I came to! I'd love to have some that I could use at home!

Seriously, though, I hope whoever our nominee is, they can get elected and right the wrong path the insurance industry is leading us down.

[Kermitt Gribble]

22. I should have added..

that the hospital sent me a bill for $700 because my insurance didn't cover all of the cost. So, effectively, they weren't paying for the anesthesia.

[Ilsa]

21. I think the proctologists' medical association should make a special trip

the Aetna HQ with their equipment and off to do some free screenings for the boneheads who agreed to this.

[RC]

23. You need another category

NO FREKIN WAY!!!

[LeftishBrit]

24. Do you mean general anaesthesia or sedation?

I've had two colonoscopies. I didn't need or consider general anaesthesia, but I wouldn't have one without sedation. (I don't usually have high blood pressure; but it went through the roof before my colonoscopies!)

[alarimer]

25. Hell no!

I can't imagine how uncomfortable that would be. Hell, I want anesthesia for a mammogram (or at least a good stiff drink). I would be one of those people who would forgo the procedure.

[alarimer]

27. Actually it's called the Bush Administration

Giving us a colonoscopy without anesthesia for the last seven years!

[BlueIris]

41. Get this man a DUzy NOW please!

[Rosemary2205]

28. Written by someone who does NOT UNDERSTAND this procedure.

99.9% of people who have any of these types of procedures done need SEDATION. This is done by a trained technician not an anethesiologist. Sedation involves giving you a drug to make you unaware but still awake. You continue to breathe on your own normally, and it only affects your heart rate and blood pressure to a minimal degree. You can even follow some commands from the medical team. You simply have no memory of what took place. Within 30 second to 1 minute of the drug being stopped your body systems return to normal, and within about 7-10 minutes you are fully awake.

Anesthesia involves shutting down the body systems and requires a team of medical professionals. There are very few patients who need anesthesia during one of these procedures.

The author of the article need to educate themselves.

[Lex]

29. Exactly. I didn't think people underwent anethesia during the procedure anyway.

Sedation, yes.

Anesthesia, nope.

There's a difference.

[uppityperson]

32. Lower, sure. Upper, depends. What gets me is limiting doctors CHOICE, again.

Seems they are practicing medicine without a license. Used to be I helped do these on people with sedation. Then it became routine, here, to do it under a general using a CRNA. I think it depends on the person and the situation. Any time insurance companies or gvt tries to limit the choices a doctor has available, this is wrong. Will they be responsible for aftermath if they limit the choice and something goes wrong (as if)?

I know people who have had theirs under a general and they were very happy. I know people who have had theirs under sedation, some happy, some not so happy. There are short term anesthesias available that do not require intubation for the respiration problems. I had a general several yrs back when had a procedure done, was out 15 minutes under a CRNA and was fine afterwards.

The issue is should an insurance co be able to limit choice or available procedures/treatments, or should it be left up to doctor/patient?

[JerseygirlCT]

48. Agree with you on that. I want my dr. (in concert with me) to make that call

But given the choice, I'd always avoid the general. They always leave me sick for days, while the sedation just left me relaxed and tired.

[knitter4democracy]

35. I had anesthesia for mine.

Anesthesiologist and everything.

[JerseygirlCT]

38. Yes, definitely my experience - although I was more aware than

that the first time, I was not in the least uncomfortable. I know they used valium that time, and I remember joking with the nurse afterwards about taking some to go. I was that comfortable! It was downright pleasant, really.

[Dogmudgeon]

30. Takin' it up the ass for the Insurance Companies

Get out your violins, boys and girls. I'm going to whine about my big fat ass. Again.

:nopity:

I had my first C-scope in 2001.

I have pre-existing colitis. Not terrible, but not a pleasant part of life, either.

Even with a combination of diazepam and morphine, it hurt like hell. The physician who did the test was an asshole, so I guess what they say about what kinds of doctors choose which specialties is correct.

Several polyps were removed. I did get to watch the process on a monitor, which was cool, and took my mind off of feeling like a Toyota and a Peterbuilt had crawled up my ass to have sex in my large intestine.

I had several weeks of bleeding.

The doc also did hemorrhoidal band ligation that he botched, causing not just pain, but actual rectal damage. You don't want to hear the details.

Then came the bill. In spite of being given pre-approval, I was charged $8000. They said the pre-approval had been rescinded a week after the procedure. After two months of "negotiating", the company went bankrupt (not related to my $8k) and folded. So I put my name on an assets-recovery class action list and kissed yet another year of my savings good-bye.

Incidentally, I spoke to a few lawyers about my assologist's unpleasant and non-therapeutic performance, and none of them would take the case. So much for the complaint that the big bad trial lawyers are oppressing the poor little physicians.

My health has also gone to hell since about that time (from unrelated matters), and I finally got on medical assistance about a year ago. The only problem I am facing now is that nobody in a specialty wants an MA patient. I've been seeking a neurologist for nearly 8 months. And my long-suffering hiney has yet to even be referred for treatment.

I'd had about 5 years of medical coverage altogether between 1984 and 2006 (I'm not certain, my current lawyer figured it out under different combinations of circumstances and it ranges from about eight years down to bupkes). Since I had a low-grade but invasive cancer at 18, I was high-risk from day one -- and would have to pay heavily for individual insurance -- $2300 per month in 1994.

But if I had been able to pursue appropriate treatment over the years, my health would probably be fine and I wouldn't be disabled. The good news is that most of the stuff can be fixed, but it will take perhaps two or three years. So in order for two decades of employers to save a couple hundred dollars a year, they required me to self-insure at unaffordable rates, eventually rendering me unable to work for perhaps as long as a decade. Crazy, ¿no?

Crazier still is why I did not move to Canada in 1985 or so. Patriotism does have its downsides.

Now you know why I'm rather fond of Hillary Clinton. I haven't met a physician yet who doesn't fear and loathe her to a degree that makes some of our Hillary-haters seem dainty. Obama may bring us Hope, but Hillary will provide a different kind of pony under my Christams tree -- Revenge. But that's all GD-P stuff; still, it might be amusing to anyone in either camp.

But as I said in the computer rip-off thread, at least with a supportive family, I still have a tolerably bourgeois life; people in places like Darfur have real troubles.

--p!
My rump will go on ...
(Celine Dion, who was tragically born without an ass -- White's Apygia.)

[shanti]

65. yikes!

i have been putting off my first colonoscopy because of hemorrhoids. does having them make the procedure more painful?

[Dogmudgeon]

71. Hemorroids don't interfere at all.

You'd have to have extremely severe hemorrhoids for them to make it more painful -- so bad you would have to have surgery on the hemorroids first.

In general, a colonoscopy should not hurt. As some other people posted, you are sedated and usually fall asleep. I was insufficiently sedated, and I have a severe pain syndrome that is treated with some pretty powerful drugs, and THAT interferes with sedation. My physician didn't seem to care.

Having a knucklehead for a gastro-enterologist, though, is definitely a problem.

--p!

[ldf]

31. and the very first patients this practice should start with

would be ALL congresspersons.

i say we put it on the ballot in a referendum in all 50 states.

[IggleDoer]

33. Been there - done that!

I have to get Colonoscopies every 2-3 years. I got terribly depressed for a few days after the sedation. I didn't like how I felt so I psyche myself out and go without anything. I have even went back to work the same day!

[CTyankee]

45. I have a dear friend who went back to work the same day.

Me, I was so groggy I couldn't walk and had to have a wheelchair to take me to my car. It didn't prevent me from feeling the procedure though!

[knitter4democracy]

36. From what I've seen, all of the doctor groups are fighting it.

They're mad as hell, too. In this case, as in so many insurance cases, it's about taking away the doctor's right to treat the patient as needed. If a patient needs a general, then that's the right decision. No stupid insurance company should be second-guessing that just so their investors get another penny and their CEO gets another bonus.

[JerseygirlCT]

37. Every time I've had one done, it's been under sedation only

which has been fine. Once I fell completely asleep, once I talked with the dr. and watched throughout the procedure. I felt no pain, only very relaxed.

In fact, the prep is far, far worse than the procedure.

There may be instances when anesthesia is the proper thing to do, but I don't think it's wise to use it unless absolutely necessary.

[shanti]

66. the dreaded prep!

i've heard that too from a couple of people...like drinking snot. yech!

[JerseygirlCT]

79. And spending a good part of the day in the bathroom...

Not fun, that part.

[REP]

39. I have

Didn't really mean to the first time, but it turns out I have the paradoxic reaction to Versed - it wakes me up and keeps me up. The next couple I just refused he Versed, since i makes me feel worse and I can't sleep the rest of the day, so that means I've had a couple of 'scopies and a kidney biopsy with no anesthesia.

[CTyankee]

42. I FELT and REMEMBERED everything during my procedure!

I had it as a diagnostic and it turns out I had SEVERE diverticulitis at the time of the colonoscopy. Right then, the dr. should have known that scope was going to scrape past tissue inflamed by a big infection.

I had been told "You won't feel it or remember it." Bullsh*t. I remember asking the nurse for more anesthesia and she said "You've had all we can give you."

Thanks a lot. I have a new gastroenterologist and I made SURE he knew I needed more anesthesia. He is doing so when my next one comes up in June. Damn right I'm getting anesthesia!

[JerseygirlCT]

I remembered everything during my first, but didn't feel much

Could feel the scope, but it didn't bother me - that would be more accurate.

But I've got an excellent GI dr. I love the guy, just love him.

The second time, I just flat out fell asleep and woke afterwards. It was actually more fun getting the guided tour the first time!

[Homer Wells]

46. Having been there three times in six months

I say not just "NO", but HELL NO!!!!!!!!!

[uppityperson]

49. Insurance company limits doctor's CHOICE. bah

[Canuckistanian]

50. Where are the doctors on this?

Seems to me that a quiet, comfortable patient would make it easier on the doctor.

Do doctors have no say in this whatsoever?

[Lance_Boyle]

64. this doesn't imply no sedation - OP article is flagrantly misleading

The insurer refuses to cover the cost of having an anesthesiologist present to administer conscious sedation, which can be administered by a nurse (not a nurse practitioner, or any other special thing). The insurer is correct, and the flamingly misleading OP article is a major disservice to people trying to make sense of this.

[Phoebe Loosinhouse]

51. The clinic in Las Vegas that exposed a zillion people to Hep C and Aids

apparently did it while administering anesthesia for colonoscopies. What if Aetna has just determined that this practice of using multiple dose vials for this procedure is widespread and is just trying to cut off future claims at the source?

Maybe the Las Vegas clinic is just the tip of an iceberg?

[6th Borough]

55. Will the doctor call me in the morning?

;-)

[SidDithers]

57. Only if I got dinner and a movie first...nt

Sid

[w8liftinglady]

61. Maybe they just don't want to pay an anesthesiologist?

I'm a nurse who used to assist in a lot of procedures like colonoscopies,radiological procedures,etc-where a nurse would administer a gentle anesthetic,like versed,and monitor the patient.Now,there is a patient population that has to have an anestesiologist-people with severe lung or cardiac problems.If I were a doc-no way would I do one of these without something on board-I can just imagine trying to see something while someone squirms on the table..let alone biopsy polyps.(and for the record,I would insist on something before mine,too)

[slackmaster]

74. I've had Versed and fentanyl with no anesthesiologist present

Both times worked out fine. (I'm generally in good health.)

[Lance_Boyle]

63. yes, absolutely. Conscious sedation, not anesthesia, is the standard

Conscious sedation (usually a combination of demerol and versed) does not require an anesthesiologist to administer, and has been the standard of care for upper and lower endoscopy for years and years. Requiring an anesthesiologist for routine endoscopies is overkill, beyond accepted standard of care, and just not right.

Of course, both upper and lower endoscopies can be done without conscious sedation, too. Many patients opt for this, so they can drive home after the procedure.

[stubtoe]

67. The conscious sedation drugs are the best part!

Makes it all bearable.

[GoneOffShore]

68. I had a sigmoidiscopic exam without anesthesia

and although it was NOT comfortable, it was bearable.

I certainly wouldn't be happy meeting Colin the Colonoscope without being under, but I think I could deal with it. The discomfort couldn't be any worse than the gout flares.

[leftofthedial]

70. no, I'd just go to GD-P instead

[slackmaster]

73. "without anesthesia" and "without an Anesthesiologist" are two very different things

I've had two, and the Gastroenterologist controlled the anesthesia (by directing an RN).

[Jack Rabbit]

76. I had such an opportunity recently

I rescheduled my appointment to a time more convenient for someone to drive me to the VA hospital.

[hyphenate]

78. I didn't have regular anesthesia

when mine was done. A shot of Versed was what I received, which is a sedative and also an amnesiac. When I woke up, I didn't remember any of it, which was just fine to me.