Scared To Death Of My Biopsy

[GFinBC]

After thinking that I would have to wait over a year for my biopsy (I'm in Canada and that's what my GP estimated) I received a call yesterday from the GI office scheduling me for the beginning of February, only 5 weeks after I received my blood test results. I have been gluten free for 2 weeks now and feeling great. Although the GI's office recommending going back onto gluten 1 week prior to the biopsy I am opting to make this coming Saturday my first gluten eating day.

My initial joy, at having an appointment for my biopsy, has been replaced by dread. For some reason I assumed that the anesthetic used would be local. The office told me it was some crazy non-sleep inducing general anesthetic. Is this what you have all experienced?

Why am I so afraid?

a ) As a rule I'm scared of general anesthetics.

b ) The only experience that I've ever had with local anesthetic has been at the dentist and my body seems to not go completely numb.

I'm scared that I'm going to be awake and feeling pain but not able to communicate it to the Dr.

Also, what is the recovery like from the biopsy? Do you have really sore throat afterward?

Is there anything else I should be aware of?

Thank you,

Marianne

[*lee-lee*]

i was freaked out too before my biopsy, but it was a piece of cake. here in the states, they use an IV sedative. i don't remember anything after they put the bite plate in my mouth until i woke up in recovery about 40 minutes after the procedure was over. aside from being a bit groggy for the rest of the day, i was totally fine. i went home and took a nap and then went to bed at my regular time. my throat was just a little scratchy for a few hours the next morning but that was it. it really is a simple procedure.

as soon as you stop eating gluten your body will start to heal. i think you're wise to start a gluten-filled diet ASAP and continue until the biopsy to ensure the most accurate result.

[sazzie]

I was exactly the same

Even more so when i was waiting at the hospital and after waiting for 3 hours i told them i was going home, as i didnt want to wait anymore. (me bawling my eyes out too)

Well it turns out because i was the youngest (i am 23) i was the last person on the list!

So the lovely nurse pulled a few strings and 10 minutes later i was on my way up there.

They put in the I.V and 20 seconds later i started laughing and told them all that he had given me somthing but it was okay because i liked it.

I do remember being asked to roll on my side, other than that the next thing i was being wheeled out of recovery. Apparently the doc had tried to talk to me afterwards in recovery but i was out of it.

I was surprised as i never had a sore throat or a sore rear end, it did make me wonder if anything had actually been done as i never actually saw the doctor myself and i was not sore at all.

In actual fact the prepping for the colonoscopy was alot worse than the procedure

Also i agree with the going back on gluten now as well. Good luck!

[ravenwoodglass]

Don't be too scared of the biopsy. What they normal give is a sedative that will give you amnesia so you wouldn't remember if it was uncomfortable anyway. The most common one is Versed. If you are extremely anxious about the procedure mention to the doctor and see if they can give you a tranquilizer, usually they would use valium in either the form of a pill that you would take before going or in an IV after you get there. Some folks will have a bit of a sore throat afterwards but not all folks do. The biopsy itself will not cause any discomfot normally after it is done. There are some folks who have done the procedure with no meds at all and although I would never do it that way and it wasn't a pleasent thing most don't report any pain.

You are wise to start back on a full gluten diet ASAP. There is a possibility of a false negative even with a full gluten diet and a week is not long enough. Hopefully with only 2 weeks gluten free the 3 or so weeks back on will be enough.

What you are doing when you add gluten back in is a gluten challenge. Do be sure to let the doctor know if you experience an extreme reaction from it. For some the body's reaction to adding the toxin back in can be very obvious.

After the biopsy is done you would be wise to immediately go back on the diet. You may already know from the reaction from the challenge that it is needed but if you have been feeling better on it that is what counts the most.

[GFinBC]

Thanks for your responses. I think that asking for a tranquillizer would probably be a good idea. Although I'm 31 I feel like a scared 5 year old when I think about this procedure. I'm off to look Versed up. I always feel way more relaxed about things when I am well educated about them.

Do you know of anyone on this board who has done it drug free? I'd really like to hear from them if they're out there.

[GFinBC]

One more thing.....

When you come to do you know where you are and why your there or is your memory a bit hazy?

[psawyer]

I have undergone the procedure twice, both times with the sedation. From my perspective as a patient, I cannot tell you what the difference is between the sedation for this procedure and general anesthesia, and I have experienced both as an adult. You lose your awareness completely, and later slowly resume awareness in the recovery room. I remember nothing of either examination, and had no pain or discomfort after the procedure. I knew where I was and why I was there, but was a bit woozy.

[kbtoyssni]

I seem to remember someone on here posting that they'd done it without anesthesia. They said it was uncomfortable and they wouldn't recommend it, but it didn't seem to be too awful. I remember them saying if you gag easily it would be hard to do it without anesthesia.

[curlyfries]

I knew where I was and why I was there. And evidently, when I first woke up, could tell my hubby about the procedure. But even that disappeared from my memory. I kept dozing off and when I would wake up, forgot anything from the last time I was awake!

Funny story.....

When my DD had it done, after she woke up the nurse told her that when she was awake enough, she could get changed. She said "OK", and proceeded to take off her gown in front of everyone! Of course, she doesn't remember it, though!

[heatherjane]

I had my EGD biopsy done yesterday, along with a colonoscopy. It was like taking a very deep nap. I woke up briefly during the procedure and could hear my Dr talking to somebody about some bar he went to (nice ), but then i was out again. Nothing traumatic about it at all. I had a scratchy throat w/ a cough yesterday afternoon, but I'm much better today.

[tom]

I had mine 2 days ago. Piece of cake. I'd expected something negative but only felt a slightly scratchy throat for 1/2 a day.

And I agree w/ the above, DEFINITELY mention any negative impact, if any, of going back on the evil gluten!!!!

[curiousgeorge]

I had mine done in Toronto at Mt Siani and it was fine. No sore throat, no memory other than them putting something in my mouth. I woke up as soon as they were done and was still in the procedure room. I was kinda stoned for the rest of the day but fine other than that. They put an iv thing in my arm but just the clippy part, no fluid bag. They inject the meds that way. The throat spray was the worst part. It was a horrid banana flavour but its starts to kick in and you don't taste it. The nurse gave me the best advice before hand and said to just remember to breathe through your nose. I remember them sticking somehting in my mouth and thinking ok breathe through nose and then I was gone.

I also had a really quick time getting the endoscopy too. Doc sent referal end of june and I had them call me two weeks later with an appt for mid july. Enjoy the gluten fest!

[sbj]

For some reason I assumed that the anesthetic used would be local. The office told me it was some crazy non-sleep inducing general anesthetic.... I'm scared that I'm going to be awake and feeling pain but not able to communicate it to the Dr. Also, what is the recovery like from the biopsy? Do you have really sore throat afterward?

Hi Marianne. Try not to be scared - your doctor will make sure you are perfectly comfortable throughout the whole ordeal. Something to be sware of: you have a say in the type of sedation used!

"Deep sedation or general anesthesia should be considered for patients who have been difficult to manage with moderate sedation and are anticipated to be poorly responsive to sedatives. ... The choice of sedative is largely operator dependent and is based on maximizing patient comfort while minimizing risks."

So don't let them tell you how you are going to be sedated. You tell them what your fears are and that you think you want deep sedation. I'm sure the doctor will be able to assuage your fears and you will both agree on a plan of action before the endoscopy. Also, if you are awake and feeling pain then don't worry about not being able to tell the doctor. You can simply wave your arms around! I had no sore throat at all and I was eating lunch within about one hour of the procedure. You should be fine but they'll tell you what to do if you experience any issues.

In truth it is not much of an ordeal. I was sedated but conscious for both the endoscopy and colonoscopy. I did not fall asleep and actually conversed with my doctor during portions of the colonoscopy. I was carted to recovery but did not wake up there as I was already awake. I remembered virtually the entire thing with pretty good clarity. I had an IV in my hand (top) and was sitting upright. They sprayed my throat/mouth with something and then snaked the tube down right away. They took a look around (I could watch in a monitor), snipped a quick biopsy (just one for me - make sure they do more!), and the whole thing was done in less than 5 minutes.

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"The level of sedation required to perform a successful procedure may range from minimal sedation to general anesthesia. Patient age, health status, concurrent medications,

preprocedural anxiety, and pain tolerance influence the level of sedation required to achieve the desired result

. The procedural variables include the degree of invasiveness, the level of procedure-related discomfort, the need for the patient to lie relatively motionless (eg, EUS-FNA) and the duration of examination. Typically, diagnostic and uncomplicated therapeutic upper endoscopy and colonoscopy are successfully performed with moderate sedation."

[spinsterwitch]

It's just like having an induced nap. I don't remember anything from the endoscopy I had done...I do remember a bit from the colonoscopy, but I really didn't care at the time and just went back to sleep.

When I woke up in recovery, I was a bit groggy but aware of where I was.

[Mtndog]

I have undergone the procedure twice, both times with the sedation. From my perspective as a patient, I cannot tell you what the difference is between the sedation for this procedure and general anesthesia, and I have experienced both as an adult. You lose your awareness completely, and later slowly resume awareness in the recovery room. I remember nothing of either examination, and had no pain or discomfort after the procedure. I knew where I was and why I was there, but was a bit woozy.

My experience was the same. Hang in there- you'll be OK.

[MELINE]

I slept, I woke up, I went home. So simple......

[Fiddle-Faddle]

I seem to remember someone on here posting that they'd done it without anesthesia. They said it was uncomfortable and they wouldn't recommend it, but it didn't seem to be too awful. I remember them saying if you gag easily it would be hard to do it without anesthesia.

That was me--and I have a TERRIBLE gag reflex, but I did not want to be sedated. They sprayed my throat really well, and I pretty much warned them that I would probably gag a bit anyway (and I did). The whole thing took only 5 minutes or less.

HOWEVER--I am of the opinion that, if you already have positive bloodwork for celiac, then you don't NEED a biopsy to confirm. There are many doctors who agree with this--and just as many who don't! However, it is YOUR call--NOT your doctor's. Unless there is a good reason to need to see the inside of your intestines (or esophagus--for example, if you have years of reflux and they need to rule out a pre-cancerous condition called "Barrett's Esophagus"), then YOU DON'T NEED AN ENDOSCOPY.

The biopsy has been considered the "gopld standard" of diagnosis since the 1950's--because in the 1950's, the serology/technology was NOWHERE near as advanced as it is today (no surprise). Today, those bloodtests are practically no-brainers--YOU DON'T MAKE ANTIBODIES TO GLUTEN AND GLUTEN-INDUCED ANTIBODIES TO YOUR OWN BODY UNLESS YOU HAVE A PROBLEM WITH GLUTEN. This means that the biopsy is no longer the "gold standard," even though many doctors still believe that it is. But think about it--they make a lot of money on that procedure, insurance companies pay for it with a murmur--and it IS invasive, and DOES carry risks. No, not as many risks as, say, open-heart surgery--but real risks, nonetheless.

When you sign in for surgery, the day of surgery, that's when they will ask you to sign a form saying that you are aware of all the risks. They may or may not actually TELL you what these risks really are: puncture ANYWHERE the scope goes, torn or scarred vocal chords (happened to me, not a big deal unless you like to sing), allergic reaction to sedation drug, unexplained reaction to sedation drug, and infection, especially a hopsital-acquired infection (these days, MRSA is a real risk). Oh--and death. Death is a risk. They don't always tell you that. (They didn't even MENTION it when my 2-year-old had open-heart-surgery. When I ASKED them about it, the surgeon brushed it off with a laugh and said, "Oh, but that's always a risk!" Ha Ha.) But any medical malpractice attorney will tell you that it is an assumed risk and that you knew about it going in.

If your bloodwork is positive for celiac, then it's actually a better confirmation to go on a truly gluten-free diet, and see if your symptoms resolve. If they do, no further testing is needed. If they DON'T, then you can still have a biopsy/endoscopy, with the idea that something other than gluten is causing your symptoms.

Sorry for the long post. In short--if your gut says, "don't have this done," then--don't.

[sbj]

puncture ANYWHERE the scope goes, torn or scarred vocal chords . . . Oh--and death. Death is a risk.

Well! That should certainly 'reassure' the poster!

[ravenwoodglass]

That was me--and I have a TERRIBLE gag reflex, but I did not want to be sedated. They sprayed my throat really well, and I pretty much warned them that I would probably gag a bit anyway (and I did). The whole thing took only 5 minutes or less.

HOWEVER--I am of the opinion that, if you already have positive bloodwork for celiac, then you don't NEED a biopsy to confirm. There are many doctors who agree with this--and just as many who don't! However, it is YOUR call--NOT your doctor's. Unless there is a good reason to need to see the inside of your intestines (or esophagus--for example, if you have years of reflux and they need to rule out a pre-cancerous condition called "Barrett's Esophagus"), then YOU DON'T NEED AN ENDOSCOPY.

The biopsy has been considered the "gopld standard" of diagnosis since the 1950's--because in the 1950's, the serology/technology was NOWHERE near as advanced as it is today (no surprise). Today, those bloodtests are practically no-brainers--YOU DON'T MAKE ANTIBODIES TO GLUTEN AND GLUTEN-INDUCED ANTIBODIES TO YOUR OWN BODY UNLESS YOU HAVE A PROBLEM WITH GLUTEN. This means that the biopsy is no longer the "gold standard," even though many doctors still believe that it is. But think about it--they make a lot of money on that procedure, insurance companies pay for it with a murmur--and it IS invasive, and DOES carry risks. No, not as many risks as, say, open-heart surgery--but real risks, nonetheless.

When you sign in for surgery, the day of surgery, that's when they will ask you to sign a form saying that you are aware of all the risks. They may or may not actually TELL you what these risks really are: puncture ANYWHERE the scope goes, torn or scarred vocal chords (happened to me, not a big deal unless you like to sing), allergic reaction to sedation drug, unexplained reaction to sedation drug, and infection, especially a hopsital-acquired infection (these days, MRSA is a real risk). Oh--and death. Death is a risk. They don't always tell you that. (They didn't even MENTION it when my 2-year-old had open-heart-surgery. When I ASKED them about it, the surgeon brushed it off with a laugh and said, "Oh, but that's always a risk!" Ha Ha.) But any medical malpractice attorney will tell you that it is an assumed risk and that you knew about it going in.

If your bloodwork is positive for celiac, then it's actually a better confirmation to go on a truly gluten-free diet, and see if your symptoms resolve. If they do, no further testing is needed. If they DON'T, then you can still have a biopsy/endoscopy, with the idea that something other than gluten is causing your symptoms.

Sorry for the long post. In short--if your gut says, "don't have this done," then--don't.

You bring up some very valid points. It is important that people become knowledgeable about all the benefits and all the risks of any procedure.

[GFinBC]

Thank you to everyone who responded!!!

I've been reading along but haven't had time to respond as I have a 5 and 2 year old running around here. Now that I understand the purpose of the medication (I have confirmed with my GI's office that they are using Versed) and that it isn't actually an analgesic I feel a bit more comfortable with the whole situation.

Fiddle-Faddle: Thank you for pointing out the possible risks in having this procedure done. I too feel that we should listen to our intuition about things. I n this case my intuition says "go ahead". I just needed some clarification about the action of the anesthesia.

Thanks again,

Marianne

[Tallforagirl]

One more thing.....

When you come to do you know where you are and why your there or is your memory a bit hazy?

I remembered where I was and why I was there, but didn't remember being driven home (that's why they ask that you have someone take you home, and won't let you ride home alone in a taxi).

I don't remember anything about it now, except the throat spray, injection of sedative and the mouth guard going in.

[GFinBC]

I don't remember anything about it now, except the throat spray, injection of sedative and the mouth guard going in.

What's the purpose of the mouth guard? I assume it keeps you from biting down on the instrument.

Do any of you remember the mouth guard? Was it comfortable? I'm just having flash backs to my last dentists visit

[Fiddle-Faddle]

The mouthguard is similar to the mouthpiece of a snorkel, but it's a little bit bigger, so you have to open your mouth a bit wider.

I understand about your gut saying to go ahead--best of luck for a smooth procedure, and I hope you get all the answers you are looking for!

[Tallforagirl]

YOU DON'T MAKE ANTIBODIES TO GLUTEN AND GLUTEN-INDUCED ANTIBODIES TO YOUR OWN BODY UNLESS YOU HAVE A PROBLEM WITH GLUTEN.

Just like to point out that this is incorrect. Any of these antibodies can appear in conditions other than celiac disease. In particular the antibodies to gluten are a particularly unreliable indicator of celiac disease.

[Fiddle-Faddle]

Tallforagirl, I never said that making antibodies to gluten means that you have celiac disease. Please read what you yourself quoted me as saying! I said that it means that you have a problem with gluten.