Locomotoring

Spending our time untethering the mind, getting the fidgets out, exploring the in-between ideas, and learning kintsugi.

Posts Tagged ‘colonoscopy’

An experience that is defined by lack of experience

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I recently underwent a drug induced deep sedation. This is the story surrounding that.

My gut has been rather delicate the last two decades. So much so that it has made me gut obsessed (link). After a decade of annual physicals where I went through the question of “to do or not to do” colonoscopy, I finally decided it was time to do. I come from a family that can digest a stone if they have to. So it isn’t my genetics. I cook three meals a day, I eat a ton of plants and ferments, so my gut bacteria isn’t wanting either. The procedure is over and there are no findings. In medical explorations, lack of findings, often although not always, means good news. In my case, it is good news. My conclusion, my gut is idiopathically sensitive to fermentable carbohydrates.

I also learned that I don’t mind fasting.

I have embraced the concept of well running chemical factory in the gut. More recently, studies in intermittent fasting have shown the value of reducing the eating window to give the gut microbes a rest. Apparently, they too get stressed if they don’t rest. But I have not really tried intermittent fasting before. This medical procedure needed me to do a near 48 hr gap in eating window. And I not only managed it, I didn’t mind fasting at all. So, now that I am on the other side, I starting my intermittent fasting journey, starting with non-boxing and non-weekend days.

The thought of getting a colonoscopy was clearly causing apprehension for a decade. In fact one of my mental prep steps included listening into Alie Ward’s Ologie podcast on the topic (link). In the end, I decided I needn’t have been apprehensive. Communal wisdom says that the prep is harder than the procedure and that wisdom is right. The “day before” diet going into the procedure was my first experience with fasting. I am the kind that becomes hangry and hunger gives me cramps. But that didn’t happen. Coconut water and chicken broth had kept me well hydrated. The suprep solution, a bitter cough syrupy tasting fluid composed of sulfate salts, was awful for the taste buds but I followed Gemini’s suggestion of chilling the liquid and sipping some salty broth in between. Both helped cut down the nauseating impact of the fluid. The numerous trips to the toilet following two doses of suprep wasn’t a surprise, my gut does that to me sometimes if I accidentally ingest sufficient galacto-oligosaccharides (gos, one of the fodmap carbohydrates). Besides, a state-of-the-art Toto bidet has made the toilet a comfortable seat in the house.

However, the deep sedation during the procedure, my first, is where I was truly left surprised.

The procedure documentation say they put you to deep sleep. We go through different stages during sleep – REM, Light, Deep – and I would have a hard time explaining what deep sleep really is. My anesthesia doc told me it would be quick and I won’t feel a thing. When they pumped propofol through the IV line, I was staring at a large wall clock. I was expecting to count down for 30 seconds. That countdown lasted less than 5. The next thing I remember is waking up in the post-op room feeling as if I woke up from an afternoon nap, somewhat groggy and slightly disoriented. If it weren’t for the pathology reports that followed, I would have had a hard time convincing myself that I went through a complex procedure that would have been highly uncomfortable if I were conscious.

The deep sedation was a gap in timeline. That time didn’t exist. I am told that what amnesia is.

Much like the body is a chemical factory, the brain is an electrical circuitry. The neurons are buzzing about at all frequencies, chaotically. These neuronal buzzing is what makes up our conscious self. But in deep sedation, the neurons are essentially being made to shut up. Propofol, the sedation drug, sticks to proteins called GABA receptors, making it harder for the cells to fire electrical impulses. The deep sedation state that comes in matter of seconds, like a sledgehammer, is a state of non-chaotic low frequency background firings.

Anesthesia has been around for over 150 years and is a continuum. Deep sedation is somewhere between being given enough drugs so you aren’t anxious and being given a lot where your airways stop working on their own. The docs monitor your breathing and heart rate during deep sedation and are on a standby to intubate. But they are not monitoring your brain activities. In a fascinating research where the researchers monitored the brain, they found that deep sedation is neither sleep nor coma (link).

Written by locomotoring

September 25, 2026 at 8:58 pm

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