# EGD scheduled for next Friday, possibly with Propofol



## keebler

So, for the last month, I've been having a lot more problems with nausea, lack of appetite, fatigue/foggy head and generally feeling ill. I've had IBS since I was a kid and a lot of problems with nausea since then, too (probably anxiety related). My GP wanted to see what's up with my tummy before doing further testing so he sent me to my GI doc. I knew the GI was going to want to do a scope and I really, really didn't want to hear it. By the way, I noticed on my paperwork that it was listed as an EGD with possible savary dilation. What is savary dilation?Here's the thing - I'm a very severe emetophobe. I know there are some emets on these forums but for those of you who don't know, it means I'm terrified of vomiting. As in having a panic attack when I feel nauseated or gag, even if it doesn't lead to vomiting. The idea of having a tube shoved down my throat is scary enough that I started crying (and feeling like an idiot for it) as soon as my GI doc said he wanted me to have the test. He offered the barium swallow as an alternative but said he would prefer the scope because it's more accurate, can be done more quickly and you're drugged for it. He said he's had one and it was no big deal (but I don't trust doctors to understand the depth of my fear).I had a colonoscopy a few years ago for bleeding (which turned out to be coming from an internal hemmie) and that was rough. The prep was bad for me - I did the Phosphosoda and Dulcolax and the soda made me really nauseated for a while which made me freak out. For the test, I was given Versid and Demerol. I felt really panicky as they were kicking in (the dizziness and feeling like my throat was closing off even though it wasn't) but don't remember anything after that. I was worried about having it again for the EGD simply because I'm scared that it will be anxiety producing - even if I don't remember it, I still have to go through it so amnesia isn't a comfort for me. Plus, I really didn't like how I felt while it was taking effect. My pulse was so high from anxiety at that time that they were concerned.Anyway, I know this is long-winded but I'm getting to the point. lol I voiced my fears about the procedure and the doc (even though he looked like he was getting a bit exasperated with me) said they could use Propofol instead (or on top of the other stuff if I needed it? not sure if that's what he meant and I need to find out). I know that Propofol causes deeper sedation and therefore more risks (such as unintentional sedation to the point of being under GA) but is it better? Can it cause nausea after you wake up like other general anesthesia drugs?Even having my throat numbed makes me anxious simply because it's an odd sensation in the throat. I had some dental scaling done with only a topical rather than injections because the injections make my throat numb and cause anxiety. It all sounds so ridiculous, I know, but I know how I react to certain things and I know it will be hard for me to handle on top of worrying that they'll find something bad. Ugh.Any opinions on having the Versid/Demerol or the Propofol (do they always include Fentanyl with the Propofol and does it induce nausea?) would be really appreciated! Also, how common is it to have abdominal discomfort, nausea and/or vomiting after the procedure?Thanks for taking the time to read this.







- A very worried Keebler


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## BQ

As you said any anesthesia can give SOME people nausea. It is usually fleeting and passes quickly. If you ever get ANY nausea... doing this breathing exercise has helped me to combat & relieve nausea tremendously:Just breathe slowly & deeply... from your gut.. NOT your chest.INHALE - Through your NOSE, with mouth closed.EXHALE with lips pursed allowing ALL of your inhale to come out of your MOUTH... NOT your nose.This ZAPS nausea like nothing else I have tried. And it does it quickly. Give it a try or practice a bit now before your test. You have done all you can by speaking to your Doctor about your concerns. Now.. if you are not sure about which sedation to go for... why not ask your Doc for his opinion on what would be best considering your emetophobic. He may know best.And I imagine the savary dilation is just another way to say they will be dilating your espophagus which one would kinda expect with an EGD; Just opening things up there so they can see better if they hit a tight spot. I wouldn't worry about it as that is more for their own info as to what they want available to them to complete the test...than what a patient might need to know.Keep us posted.All the best and DO try to relax. Just communicate as clearly as possible with your Doc and the staff where you are having it done.Try to recall how you felt after the colonscopy.. the prep was way worse than the procedure you said and here... the anticipation will probably be way worse than the actual procedure! So keep your perspective and I bet you do fine.BQ


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## sucuq

I just had a colonoscopy----and it sounds like you would have -- conscious sedation-- just like most have for c. I asked not to have narcotics as I react badly to them (nausea/ill) and the anesthesiologist agreed to not put that in my iv. afterwards, the dr. said I had propofol. So I can tell you *I had no nausea upon waking or afterwards. * AS for your anxiety. Don't feel ridiculous or worry what others think about your fears----I go through the same thing. I let my dr. know (although I've been seeing him for many years)--I am a highly anxious person--so i will want to know everything you're doing. Believe me you are not the only one who has panic/fear/anxiety about procedures --and how they may affect you. Don't be afraid to ask exactly what they are putting in your iv. I was adamant about the narcotics. I want to know exactly what they are putting in my body and what procedures they are doing or did. Ask the anesthesiologist what he/she is putting in---discuss your problems with nausea--(usually the anth. does have a talk with you before the procedure--at least where I went he did) Don't hesitate to speak up---And call your dr's office and ask what savary dilation is--- set your mind at ease so you know what it is. hope this helped, Su


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## Kathleen M.

I have no fear of throwing up, but I get a lot of nausea from anesthetics. Fortunately most of the throwing up happens before I'm aware of what is going on, but I've had some rather weary sounding attendants in the recovery room as they ask if I think I'm going to throw up, again. Anyway, I always tell the doctors that I will most likely throw up when they start to bring me up so they always pump in a little anti-nausea drug before we get to the point of coming back up where that hits. If they don't know if it will happen or not they usually will want to wait to see if you are going to throw up before they give you that, but with me, since we know it is most likely going to happen, they just start the anti-nausea drug before they bring me back.They may be willing to give you whatever that is just in case if it really will make you less nervous about the procedure. I think it is one of those things they usually keep on hand in case they need it, so it isn't a big deal.


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## keebler

Thank you all for taking the time to respond to my post.







Good points made.I spoke with the surgery center today regarding what medications will be used and made them aware of my level of anxiety. There is now a note in my chart about using Propofol rather than conscious sedation (which is what was used for my colonoscopy, and I fought the meds terribly then) so I will be speaking with the anesthesiologist about it before my procedure. I also told the nurse with who I spoke about my worry regarding nausea (both from anxiety and from medication) and she said I could ask for something to combat that (which they also did for my colonoscopy). All in all, she seemed confident that I would be quite sedated after I made it very clear that I would likely be one of the people who try to pull the endoscope out of her mouth if I was at all aware of it being in there.







Hopefully, all will go smoothly.I decided last weekend that I wasn't going to worry too much about it until at least the night before the procedure. No point in being anxious that far ahead!The bottom line is that I really don't want to be aware of the procedure at all simply because I know intimately how my anxiety works and how likely I am to panic if given the slightest chance to do so.I'll check in with an update after it's done. Friday morning can't be over soon enough.


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## BQ

I'll be thinkng of you Keebler!May it all go smoothly for you.BQ


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## keebler

Thank you, BQ. I just got an email about lots of Propofol being recalled due to elevated levels of endotoxins in the vials. So, now I don't want it! It seemed like it would make the EGD easier for me to handle but it's not worth risking serious effects.I suppose I'll have to go with the Versed/Demerol cocktail (I'll be asking for Phenergan, too). My anxiety was already climbing this evening but now it's worse.







I'm so afraid of being aware of the procedure or waking up in the middle of it! And even if I do, I probably won't remember so I won't know that for future reference.This sucks.







I just want this procedure over with!


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## sucuq

maybe ask your dr's office if they know about the recall and if they have the specific lot numbers mentioned in the recall??


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## vickieibsd

I had an EGD in May and it was a piece of cake ! Much easier for me than the colonoscopy. I was nervous because they say you have to be able to swallow when the doctor tells you too....I don't remember a thing and had no nausea because of the "cocktail" Good Luck !!


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## IanRamsay

Hi KeeblerI am a 20 year emmet. dont be ashamed about it. tell teh doctor doing teh camera that you have emmet and the you WANT a anti sickness drug given BEFORE You wake up, reguardles of weather you will or wont vomit. they are usually very obliging, and most doctors are very understanding about emmet.Also, you wouldent believe how many people have teh same fear as us. it is one of the most common phobias on earth. its just most people wont admit it for fear of ridicule. i even have a friend who is a doctor, and she is as scared of it as me, a doctor!!!!DOnt worry, everything will torn out to be just fine. cheersIan


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## BQ

Keebler hope it is all over by now and that you are resting and enjoying the fact that it IS over!Have a decent weekend!BQ


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## keebler

Well, I survived the EGD.







Oh, and to *Ian* - I'm sorry you're emet as well. I've been emet for about 25 years and it's rough sometimes. I'm not shy about telling my doctors about it anymore because I know I won't get the type of treatment I need if I don't speak up about it. Usually doctors will work with me after I tell them about my fear and that turned out to be true this time, too. I ALWAYS ask for Phenergan for anything that may make me feel nauseated.







By the way, how on earth does a doctor deal with being around sick people if he or she is emet? What kind of doctor?As for yesterday, I did ask the nurse about the recalled Propofol and she told me she orders the meds herself, and does not order them from Teva because she doesn't care for them. So, I stopped worrying about bad drugs and instead worried about getting sick from the cocktail. The anesthesiologist was REALLY patient with me. I was asking him so many questions about what meds he was giving me and what I could expect from them, and telling him over and over again how worried I was about it all. He was probably ready to smack me by the time he put me out, but he was nice.







The nurses who were in the procedure room with me were also very kind. It was rather pathetic - they had barely wheeled me into the room before I started crying and telling them I didn't want to do it. LOL They just kept telling me that I was going to be fine and that I had a good team working with me. I was so panicked that I hyperventilated, probably for the first time in my life (which is saying something since I have had severe panic attacks for over 20 years), so they went ahead and started getting me ready for my drugs. They gave me Diprivan (Propofol), a narcotic (probably Fentanyl) and Phenergan.I had decided I would count in my head so I would have something to focus on, especially after they injected the Propofol cocktail. I was counting before the anesthesiologist even gave it to me (which made him laugh) and within a few seconds I started feeling the effects and tried to count out loud. Even after they put in the mouth piece.







It probably only took 15 seconds or so before I was out. The next thing I remember is someone asking me how I felt, to which I replied, "I feel sick." I knew it was over but I really did feel nauseated and started freaking out (as much as one can freak out while still well under the effects of anesthesia). They ended up giving me another dose of Phenergan and a dose of Zofran but I was still feeling pretty ill. Part of that may have been from having so much anxiety and not eating, and the air they put into my stomach, etc. I wonder, though, if the nausea may have come from the Propofol/narcotic combination. It seems like most people who have just Propofol don't have so much nausea... or maybe my system is just sensitive to those types of drugs. I didn't have any nausea, though, when I had the Versed/Demerol combo for my colonoscopy. I should ask the doc about that for future reference.At any rate, the GI doc said that my stomach and duodenum look healthy - no ulcers or gastritis or polyps or anything like that. He did tell my mom and boyfriend (who went with me) that he wants me to get an ultrasound of my gallbladder, which surprises me since I don't really have classic symptoms of gallbladder troubles. Hrm.All in all, I'm proud of myself for going through with the test because I really, really wanted to back out! I've been avoiding this test for 18 years or more, so it's a pretty big thing for me. -_-I know this was a long post but maybe someone who's looking up info about EGD's will stumble across it and it will help them feel better about it.Thanks for all the support you guys gave me. It really did help!







Hopefully I can help others who are afraid of this procedure - especially being an emet.


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## Kathleen M.

Good Job!It isn't easy stepping over the fear and I'm glad you made it through.


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## IanRamsay

Hi keebler, she is a GP, and lives on caffiene and nicotine to controll her nerves apparently! she wasnt always an emmet, it started after she had her daughter years ago. by that time she was a doctor.Im glad you didnt have a bad time with the Camera. i guess it is a strange world we all live in!CheersIan


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## sucuq

Keebler, Good for you, glad it's over---- Su


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## BQ

AWESOME JOB!Way to go Keebler! You should be very proud of yourself!And I'm very glad they found nothing!BQ


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