Saturday, July 11, 2020

The facts please, Dr.

   Joan Rivers died at age 81 during an endoscopy, attributed, rumor goes, to being over-sedated.
   I have an appointment scheduled this Monday with Dr. G. As I understand it, a "consult" to discuss the events of June 30.
  During this type of procedure, I have typically been mostly aware of what's going on. Last time I viewed the entire procedure on the screen, totally aware, with some positioning being implemented during the process.
    This time, I have concerns because I was not awake for any part of it at all, not even the presence of the doctor in the room, or any screen either.
   The nurse called M. after the procedure, saying it would take an extra 15 minutes before I was discharged. I think she said the doctor told her I was not clear on the questions I was asking.
   I would not agree with that. He told me 2 polyps were "big." And he said he was not able to perform the scheduled endoscopy because I was over-sedated.I would have asked why but it is the custom of that doctor to scoot out of the room in short order to perform another procedure. And maybe he was now 15 minutes late.
   I have a patient portal at St. Peter's Health Care System. All labs are promptly posted, as well as reports of procedures and pathology reports. Except for this particular doctor, who does not enter any notes or reports under the documented procedures. He does not believe patients can understand the patient portal entries, so he told me one time. Plus doing so would take his time, and leave a record of what happened, so I surmise.
I need to know what happened. My patient  portal list only the names of the procedures, with no explanation, as customary with Dr. G. But the medications administered are complete;
   fentaNYL  100 MCG / 2 ML        (Analgesic, for pain
   Midazolam HCL   2MG / 2ML     ( Short-acting Hypnotic-Sedative, Amnesic
   EPINE  1MG/ 10 ML                    (Adrenaline
Since I am like Karen, I access my prior reports of the same procedure. The dosages of the first 2 meds are the same. BUT EPINE is a new addition, not administered before.
     So I google its use during this procedure. It seems it could be useful if there is bleeding, but I detected not a single drop of blood at any point. The main use I gather  is when  the patient suffers a drop in blood pressure, which can impact the heart and breathing. (Think the late Joan Rivers.)
   His mention of my being over-sedated worries me, since dosages were the same as before, several times in fact. So why the adrenaline, I'll ask at  Monday's consult.I do not expect to receive a complete  answer. Even though it was 15 minutes out of his life.
    I hope there was a certified anesthesiologist administering the sedation,*but maybe that is not now necessary in the age of COVID. If the sedation was administered by either of the 2 nurse-persons responsible for the IV insertion, I would have no difficulty believing they may not distinguish between a dosage of MCG and MG, resulting in an overdosage and the resultant over-sedation.
      Unless there is a clear explanation, I think I'll be doctor-shopping next time.
 * Sedation for this procedure does not involve an anesthesiologist. The nurse present does the sedation. EGAD!

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