Are retirees moving to the new DTV visa - anybody done it?

[david_je]

I'm considering having a colonoscopy without sedation, mainly to avoid possible risks of anaesthesia. But I'd like to find a doc who has has some experience doing it unsedated, skilled in the maneuvers that would cause least distress. So I'd appreciate hearing from anyone who has had an unsedated colonoscopy in Bkk. Seems uncommon here; three friends here all had it done sedated. Thanks.

[Sheryl]

Never heard of anyone having it done without sedation and I seriously don't think you'd want to. There is a limit to how much discomfort even the most skillful and careful endoscopist can avoid.

In addition, the need to try to minimize patient discomfort may work against the need to properly visualize, making the procedure less thorough/effective. And as for removing any polyps that may be found (something normally done at the same time as the colonoscopy and thus saving a lot of time and money) -- serious ouch.

If you have specific risk factors or prior history of adverse reaction to sedation, inform the doctor. it would also be quite reasonable to insist that an anesthetist be in attendance throughout (usually the case, but good to verify) and to inquire into the qualifications of the anesthetist and insist on meeting him/her before the procedure. I'd suggets that rather than trying to have this done unsedated.

[Robby nz]

I was asked by Dr Sahapon at Pramonkutklau Hospital if I wanted sedation or not, I chose light sedation and woke (sort of) part way through the procedure after the scope had been inserted.

I watched the screen and saw the inside of my colon as the scope was withdrawn, there was little or no discomfort other than a sensation of something going on down there.

As Sheryl says the worst part is the clean out, you don't want to be far from the correct hole in the ground during that.

There will also be a shave and if you get it done at a top end private hospital there could be quite a pain in the wallet.

There is another procedure they do, don't remember the name, where the insert a device in the rectum which allows a doctor to look at the rectum only, no anesthetic.

[depe]

I have had colonoscopy done multiple times at my home country without sedation. Few times they gave some mild sedative (or painkiller or whatever) during the operation because I was having a lot of discomfort and the doctor was not able to proceed.

I had a colonoscopy at BKK last year. This took place at Phyathai Nawamin (the hospital was called earlier Paolo Memorial, but the name was changed last year). They gave me two options - I don't remember how they called them, but the idea was basically 1) strong and 2) not so strong sedation. During that time I understood that the stronger (and recommended?) one was going to be a "full anesthesia" (I don't know the medical terms), and I did not want it because of the possible risks and because I've had the colonoscopy done many times even without any medication, so I knew I can manage it. Anyhow, even the second option was from my point of view actually quite strong. I have no memory of what happened during the operation - just the beginning and when the doctor said that he's done. Unfortunately I don't remember the name of the doctor. I think there were (and most probably still are) two doctors at the gastroenterology department. The other one's name was Sirivan and the one who did the operation is the one whose name I don't remember. Actually I have no idea if the doctor was skilled or not, but at least I am still alive and didn't have any complications.

[Thanyaburi Mac]

Depe

Sure it was a colonoscopy and not a Sigmoidoscopy?

http://www.nlm.nih.gov/medlineplus/ency/article/003885.htm

Sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest the rectum.

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The sigmoidoscopy is done under light anesthesia and when I had one, yes, I rolled over to watch the screen while the doc pulled the tube out.

For the colonoscopy, I was fully knocked out.

Mac

[Lefty]

Had a colonoscopy without sedation at Bangkok Hospital in Korat--not a big deal,no discomfort at all .

Lefty

[depe]

Depe

Sure it was a colonoscopy and not a Sigmoidoscopy?

http://www.nlm.nih.gov/medlineplus/ency/article/003885.htm

Sigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest the rectum.

xxxxxxxxxxxxxxxxxxxx

The sigmoidoscopy is done under light anesthesia and when I had one, yes, I rolled over to watch the screen while the doc pulled the tube out.

For the colonoscopy, I was fully knocked out.

Mac

Yes, I have always had a colonoscopy (entire colon). It was done for me so many times without sedation. As far as I understand the amount of pain and discomfort varies a lot between people - some people can do it with no problems and for some it is really painful.

To be honest the operation done at BKK was the best colonoscopy experience of my life due to the relatively strong sedation. Even the preparation part (emptying the colon previous day) was easy because they had somehow different meds for this than they do at my home country. If I can choose, I want my possible future colonoscopies done at Thailand.

[katana]

It can be done without sedation, although the painful bit is often where they come to the end of the descending colon and try to go around the 90 degree bend to the transverse colon. Without sedation you may not be able to go past that point.

[inbangkok]

It can be done, and I know people who have done it. It is quite uncomfortable though. However, I don't know anyone who has done it like this here in BKK.

I personally have never been brave enough to try it without sedation.

Edited January 3, 2015 by inbangkok

[prodriver]

I've had two colonoscopies done in Bangkok. First time was at Siriraj where I was "knocked out" completely. Second one was done at Thonburi Hospital (private hosp.) whilst fully awake.....most uncomfortable!!!!!!!

[TallGuyJohninBKK]

Anyone want to recommend a specific good doctor/hospital in BKK for having this procedure done???

That is, someone who not only did the procedure without complication, but also was effective in communicating what would be involved in advance, and then after, what was done and found???

[tutsiwarrior]

I had the procedure done in saudi with a muscle relaxant and was fully awake watching the monitor as the 'scope glided along and as the doc removed a polyp...with no discomfort at all, sudanese doctor...and I'm usually very sensitive to the slightest discomfort, unabashedly scream with pain at the slightest, etc...

[elektrified]

...although the painful bit is often where they come to the end of the descending colon and try to go around the 90 degree bend to the transverse colon. Without sedation you may not be able to go past that point.

I've had about 5 colonoscopies since one time many years ago I had colitis. Each time they administered IV Demerol, Versed, and Benedryl. I was not asleep, just well-sedated. I watched on the monitor the procedure each time. But even with the medicine I could always feel the scope/camera going around that bend as described above. It can be quite painful.

I can't believe anyone would want to go through a colonoscopy without the medicine! Sigmoidoscopy - no problem. I had 2 without any meds. Just uncomfortable.

[BangkokHank]

I had my first colonoscopy in Thailand under full sedation and didn't feel a thing. For my second colonoscopy I happened to be in India. I assumed that I would be sedated but somehow (miscommunication/misunderstanding?), I wasn't. The discomfort was such that I had to abandon the colonoscopy at about the halfway point. Never again would I consider having a colonoscopy without being fully sedated.

[Robby nz]

Anyone want to recommend a specific good doctor/hospital in BKK for having this procedure done???

That is, someone who not only did the procedure without complication, but also was effective in communicating what would be involved in advance, and then after, what was done and found???

See my post No 3

[david_je]

Thanks everyone, for all your replies on this.

A main reason I asked about doing it unsedated -- In 2008, at St Louis Hospital, I requested a colonoscopy and underwent the procedure without any sedation. The doc gave me a medical report that described it as "colonoscopy -- up to terminal ileum (as far as I can make out those two words)-- normal." He never asked if I wanted sedation or not; the possibility of sedation was never mentioned. Since then, people in this forum and friends all say that in Thailand, the doc either just performed it fully sedated as default, or at least asked the patient whether they preferred light sedation rather than full. It made me wonder if I indeed got a full colonoscopy and not a sigmoidoscopy, which usually is done unsedated. But if it includes the terminal ileum, it must have been colonoscopy, correct?

I recently tried to reach the doc without success, and the hospital has thrown out all records before 2010.

Appreciate any thoughts on this.

By the way, procedure was around half-hour, uncomfortable throughout and painful for short periods but tolerable if you have a moderate-high threshold.

[inbangkok]

Thanks everyone, for all your replies on this.

A main reason I asked about doing it unsedated -- In 2008, at St Louis Hospital, I requested a colonoscopy and underwent the procedure without any sedation. The doc gave me a medical report that described it as "colonoscopy -- up to terminal ileum (as far as I can make out those two words)-- normal." He never asked if I wanted sedation or not; the possibility of sedation was never mentioned. Since then, people in this forum and friends all say that in Thailand, the doc either just performed it fully sedated as default, or at least asked the patient whether they preferred light sedation rather than full. It made me wonder if I indeed got a full colonoscopy and not a sigmoidoscopy, which usually is done unsedated. But if it includes the terminal ileum, it must have been colonoscopy, correct?

I recently tried to reach the doc without success, and the hospital has thrown out all records before 2010.

Appreciate any thoughts on this.

By the way, procedure was around half-hour, uncomfortable throughout and painful for short periods but tolerable if you have a moderate-high threshold.

Sounds like a colonoscopy. A sigmoid can be as short as 5 min....thus the reason they don't sedate. I have had both.....but am not brave enough to so the colonoscopy un-sedated.

[Tolley]

I have had one done in Oz.

They used what they call twilight anaesthesia.

Knocked out for 40 mins and wake up with everything done.

Had three polyps removed as well.

Highly recommended and no after effects whatsoever.

[bkknow]

The gastroenterologist might want to take biopsies if anything remarkable is found in the colon or ileum, i guess that's not a very pleasant feeling when awake.

P.s. What is the reason for wanting to undergo a colonoscopy? If it's IBD or anything related then go to a specialized hospital in your home country. IBD is not very prevalent in Thailand and most gastroenterologists are not very literate on the subject. I've been misdiagnosed time after time for my type of IBD in Bangkok until i went to a specialized hospital in my homecountry.

Oh the money that i have wasted on so called "american board certified" gastroenterologists in private hospitals.

[joeyg]

Yes at the VA in San Diego because my ride flaked on me at the last minute. It can be done but not reccomended.

[TallGuyJohninBKK]

Oh the money that i have wasted on so called "american board certified" gastroenterologists in private hospitals.

Any gastro doctor here that you'd have a good opinion of???

[loppylugs1]

I had my first colonoscopy in Thailand under full sedation and didn't feel a thing. For my second colonoscopy I happened to be in India. I assumed that I would be sedated but somehow (miscommunication/misunderstanding?), I wasn't. The discomfort was such that I had to abandon the colonoscopy at about the halfway point. Never again would I consider having a colonoscopy without being fully sedated.

Same here India,first time with,second without. No pain as the doc said,no nerve endings where the camera goes,but felt is if I wanted to go as it got further inside,just wind being trapped I guess.Wanted the polyp screening down the throat too,that cert had to be with.

thing is "without" you can watch watch the camera as it wends its way inside. The removal of polyp is fascinating to watch ,no pain

Edited January 11, 2015 by loppylugs1