Locomotoring

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.

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 correct. The “day before” diet was my first experience with fasting. I am the kind that becomes hangry because hunger gives me abdominal cramps. But that didn’t happen. Coconut water and chicken broth 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, I counted them to ten per suprep, to the toilet following two doses 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. I recovered fully in a matter of minutes. I was expecting my body to retain the imprint of the procedure, but there was none. 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.

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 doctors 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). And apparently, it would be years before anesthesia procedure routinely monitors the brain as well.

The deep sedation I experienced or more correctly, I did not experience, was a gap in my personal timeline. That 20-30 minutes didn’t exist. I am told that is what amnesia is.