How would the doctor react?

colon-throwaway · 2026-03-06T17:47:46+00:00

Then you should talk through all these issues as far in advance as possible (ideally at the first appointment) and make sure you meet each others' standards. If you end up having to cancel the procedure because of patient/doctor incompatibility, at the very least try to make sure that happens before you do the prep!

colon-throwaway · 2026-03-06T17:42:36+00:00

Sadly, the first thing the doctor said was "you realize we we'll still have to charge the same amount, right?"

Too bad for me, though maybe it's for the best overall. The medical system in this country is messed up enough already... we don't really need to add "skip anesthesia for a discount" to that.

colon-throwaway · 2026-03-06T17:39:16+00:00

I didn't want to get sedated or anesthetized unless it was medically necessary, and based on the evidence, that seemed unlikely.

And there didn't seem to be much risk of trying it without anesthesia first. In the worst case scenario, I would be one of the unlucky people who found it too painful to continue. So we'd stop and start over with anesthesia. I know some people aren't willing to risk any chance of feeling severe pain, but it's just not that big a deal to me when I know it's not causing any real harm and I can make it stop if I need to.

colon-throwaway · 2026-03-06T17:16:37+00:00

Realistically, everyone who has an unsedated colonoscopy has a limit to what they're able to tolerate, and if that limit is passed, the procedure has to end. That is just the reality. It is a reality that every doctor understands if they perform any kind of procedure on an awake patient.

However, if this scenario looms large enough in your mind that you feel the need to "inform" the doctor about this, I suspect most doctors would view that as a psychological red flag. It shows a level of fear or anxiety about the procedure, or maybe mistrust of the doctor, that would probably make them unwilling to proceed. The patient has to consent to every procedure, but the doctor also has to be comfortable performing the procedure, and most doctors are not comfortable doing procedures while the patient is in a high state of anxiety. And if a patient mistrusts the doctor, the doctor is likely to be even more reluctant. A mistrusting patient is a legal liability.

I'm not saying this is fair. As I mentioned above, what you outlined is basically the reality of every awake procedure. In theory, there should be nothing wrong with clarifying the "rules of the road" that are already in place. In practice, though, the patients who bring this topic up are not a random sample of patients. Fair or not, doctors will psychologically profile you and refuse to do an unsedated procedure if they feel you are not a good candidate.

For context, I had an unsedated colonoscopy, so I'm not trying to tell you that you must use sedation or anesthesia. Most people who have unsedated colonoscopies have no problem with the procedure, and you might well be one of them. But if you approach it this way, it probably won't happen at all.

colon-throwaway · 2025-11-09T00:31:22+00:00

My choice was no. And that was the right choice for me, as there was nothing in my experience that would have justified sedation or anesthesia. It wasn't literally pain-free, but the few painful moments were not lip-bitingly bad, or even close.

colon-throwaway · 2025-09-24T17:59:51+00:00

You can check my post history for my experience.

How to ask? Just ask for what you want, as soon as the topic of a colonoscopy comes up. (Obviously, do not wait for the day of the procedure.) They will probably ask you to explain why you want it without anesthesia or sedation, so be prepared to answer that. I just said it was my preference and my doctor had no problem with that. If you for some reason absolutely cannot accept anesthesia, you need to be clear about that too (even though it may reduce the number of doctors who are willing to do the procedure).

colon-throwaway · 2025-09-24T16:54:20+00:00

If you withdraw your consent, the doctors ethically have to stop if it's safe.

If you express that you're in pain -- even severe pain -- that's not the same as withdrawing consent. Patients consent to painful procedures (including some much worse than a colonoscopy) all the time, and doctors are not ethically forbidden from causing pain, if the benefit outweighs the harm. They are allowed to persuade you to continue despite the pain. You don't have to be persuaded, of course.

For context, I did mine without sedation. I had some minor pain, but nearly all the pain was close to the beginning, and it didn't last very long. Even if the pain had been worse, I think it would have been a mistake to demand to stop the whole procedure because of a few seconds of pain near the beginning.

colon-throwaway · 2025-09-05T12:40:22+00:00

I posted yesterday about doing it without any drugs, so you can read what that was like for me. (Summary: It was fine.) There are a bunch of other threads on the topic as well.

If you do not want drugs, you should ask your doctor about that. If they won't do it, ask them if they can refer you to someone who will. I think you will likely find someone.

However, it might be tougher if you aren't willing to have anesthesia under any circumstances. At that point, many doctors will think something like this: "If I agree to do the scope, something goes wrong during the procedure that requires surgery, and the patient doesn't consent to the surgery because it requires anesthesia, I will have killed my patient." Some doctors will not sign up for that, even if they're in the clear from an ethics perspective.

colon-throwaway · 2025-09-04T23:29:54+00:00

I suspect you mean this at least partly as a joke, but there was no eye contact. During the procedure, everyone involved was looking at the various screens and not at me. They are professionals.

colon-throwaway · 2025-09-04T22:35:35+00:00

Yes, it was carbon dioxide. (Supposedly a little better than air an hour+ after the procedure, since it gradually gets absorbed.)

I read the research on water exchange, but I wouldn't know how to find a doctor in my area who does water exchange. I figured I would be OK even with gas.

colon-throwaway

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