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Conscious sedation for LLETZ?

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Pineapple
Conscious sedation for LLETZ?

Hello! I had my second colposcopy recently and it went fairly smoothly. I was, however, under the influence of 8mg diazepam, and still not what you would call relaxed! I am a bit of a fainter at times and generally not good with medical tests etc. The colposcopist was absolutely lovely. She could obviously pick up on my nervousness and she suggested that if my biopsy results show CIN2, which they might, then she would recommend a LLETZ under GA, purely because of my nervousness rather than any 'awkward to reach' type complications. However, thinking about GA has got me in a tizz as well! It sounds like rather an ordeal and perhaps an unnecessary medical risk to take for a 15-minute minor procedure. I wish I could just be stoic and brave and have it done under diazepam but I think the colposcopist was absolutely right; I imagine it can make their job rather tricky as well if a patient is on-edge.

Anyway, to get to my actual question, I was wondering if anyone has experience of LLETZ or colposcopy under conscious sedation? This seems to involve far less prep and fewer risks. I wonder if hospitals offer it. I know it is offered to nervous dental patients at some dental surgeries and it just seems the ideal middle-ground to me. Perhaps it is more labour-intensive to administer and monitor than GA.

I'm also wondering whether to make a GP appointment to discuss it now, even though I won't have my results for a few weeks so I won't know if I need LLETZ at all. I am jjust worried that the results/referral may be very short-notice and I won't have time to sort it out, OR that I will drive myself mad with thinking in the meantime!

Any advice would be appreciated, and apologies for rambling on for paragraphs! I'm generally feeling okay; it just seems to be at night when I start to work myself up about things!!

I was also wondering if I'll find out if I still have an active HPV infection from the colposcopy as a cytology smear was taken as well. I know they don't look for it in the biopsies because it's not relevant for treatment decisions (if you have CIN2 they'll want to remove it whatever your HPV status), but I know they can see it in the smear tests.

 

Thank you xxx

 

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Abnormal smear July 2014 (borderline changes)

1st colposcopy August 2014: punch biopsies showed CIN1 and suspected small area of CIN2

2nd colposcopy March 2015: awaiting punch biopsy results

Tivoli
Tivoli's picture

Hiya Pineapple,

I remember donkey's years ago you used to be given a pre-med before a GA if you were going in for surgery. I used to really enjoy the pre-meds, they were a bit like being that little bit too squiffy to walk. Though I have no idea whatsoever if they are still used. But even with one of those, if you don't like to think about what's going on below your waist I think you'd be better off being knocked out completely. I mean not trying to be funny or anything here, but it might be rather offputting for the doctor if she could hear little wimpering noises coming from the other end of her patient.

Be lucky

Tivoli

Pineapple

Thanks :) I do see your point completely! I don't want to make the doctor's job harder, obviously. It's just that GA seems scary and risky. If I had IV sedation that sounds like the perfect middle ground to me: patients in that state are oblivious but not completely unconscious. Recovery time is quicker etc. and it's offered for highly anxious dental patients so I certainly think it would be enough to make everything go smoothly. I suppose I just need to find out if my NHS trust can offer it. Frustratingly I have no rational problem with the LLETZ as it's just a teeny piece of skin being removed. Plus I felt no pain from colposcopy/punch biopsy. It's just feelings of faintness/severe nausea due to squeamishness. Shame I can't be hypnotised. I reckon that would do the trick too!!

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Abnormal smear July 2014 (borderline changes)

1st colposcopy August 2014: punch biopsies showed CIN1 and suspected small area of CIN2

2nd colposcopy March 2015: awaiting punch biopsy results

kirsty66

Hi Pineapple,

My mother-in-law was sedated when she had a tube-down-the-oesophagus thing and didn't remember anything about it afterwards. It was great!

I  have to say I was a bit fainty when I had my LLETZ which I found very scary until the nurse held my hand and told me it happened sometimes. Once I heard it was very common it calmed me down. My legs went very shaky too. Again, once I heard that was normal I could cope with it better.

I've read lots of posts from people who've had LLETZ under GA but I don't remember anyone talking about sedation.  Maybe someone who had that will be along soon!

Good luck!

Kirsty xx

23/9/14 Routine smear, severe abnormalities found

8/10/14 Colposcopy and LLETZ

30/10/14 CC diagnosed

6/10/14 MRI confirms Stage 1b1

11/11/14 MDT meet and decide best treatment is radical hysterectomy

19/11/14 First meeting with gynae oncologist and pre-op. RH booked for 12/12/14

23/12/14 Phone call to say lymph nodes clear and no further treatment. :) Check up in 3 mnths 

April 2015 Post-operative nerve damage confirmed

April 2015   Check up - all clear!

September 2015  Oh no.....lymphoedema! :(

Pineapple

Thank you :) Yes, it really sounds ideal for LLETZ but I can't find any mention on the Internet of it being offered for it. There may well be a reason why it's not suitable, I suppose. I think I will call the colposcopy clinic or my GP to discuss things even though I haven't had my biopsy results yet so that I don't spend the next four to six weeks obsessing! I feel that it's fairly likely I may need LLETZ in the future at some point.

I am a very 'fainty' person and when I first got the leaflet for colposcopy just reading it made me feel sick and faint. I have had CBT to help me deal with squeamishness, and I'm continuing it myself my looking at gradually-increasing-goriness pictures/videos of things like blood tests, colposcopy close-ups etc. Well, we all have to have a hobby I suppose..! I'm a bit sad that I was still anxious at my colposcopy despite all this and having taken enough Valium to fell an ox! But never mind. It is actually purely the sick/faint feeling that I fear. I feel fairly that it's all safe and that it is a positive thing to do for my health. My silly subconscious, eh?!

Thank you so much for sharing your experience. From your signature I can tell that you have been incredibly brave yourself with all the treatments you've undergone. I am sure I can get through a little excision without too much fuss :) xxx

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Abnormal smear July 2014 (borderline changes)

1st colposcopy August 2014: punch biopsies showed CIN1 and suspected small area of CIN2

2nd colposcopy March 2015: awaiting punch biopsy results

Rockqueen

Hi, I am going for Lletz treatment tomorrow under conscious sedation. I asked for it because I don't like the idea of GA either. Just wondering did you need to get it done and if so how did it go? I am allergic to local anaesthetic so that's why I can't do that option

SS

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