Today’s Burning Question deals with deep, dark secrets, and I’m afraid I can’t tell you exactly what those secrets are, because I don’t know either. Our question came in anonymously, and the letter writer asks:
I am in my mid-fifties, and I have yet to have my first colonoscopy. I know I should have had one by now, especially since there is some history of colon cancer in my extended family.
Here’s is why I haven’t: I have heard many stories of people saying things while under the anesthesia that they normally wouldn’t, and that they usually have no recollection later of saying these things. There are some secrets I have kept from my spouse that I am terrified about disclosing under the anesthesia. He would normally be the one to accompany me to a medical procedure. Am I being paranoid? Does the fact that I am fixated on this make it even more likely that I will talk about it?
That must be a pretty serious secret if you’re willing to risk cancer for fear of revealing it. But I have good news for you. I brought your question to an anesthesiologist and a gastroenterologist, and both agreed that you’re not likely to blab anything, fixation or no.
The anesthesia used in a colonoscopy is more properly referred to as sedation and typically involves midazolam (Versed) along with the opioid fentanyl. If you have your colonoscopy in the doctor’s office, that’s probably all you get. For deeper sedation, an anesthesiologist would be involved, and you’d get those medications plus propofol. It would be possible but unusual for other drugs to be involved, so if you’re curious, definitely ask your doctor. It’s always fine to ask questions about any medication, including anesthesia, so you know exactly what you’re getting and what its effects will be.
None of these medications acts like a truth serum or will lower your inhibitions to the point you decide to strike up a conversation about something shameful from your past. Yes, you may say some things you don’t remember, and you might possibly say something slightly inappropriate. But not that inappropriate.
The disinhibition from anesthesia “resembles a mild impairment while being under the influence of alcohol,” says Dr. Amnon Sonnenberg, a gastroenterologist and professor at Oregon Health and Science University and the author of a study about sedation during colonoscopy. That sounds worrying, but then he adds: “Such disinhibition is also rare, and disinhibited patients do not reveal any type of personal information that they absolutely hold secret and do not want to communicate in the first place.”
Anesthesiologist Dr. Wesley Clark agrees: the things people say in his care are minimal and boring. “They might say one or two things right when they’re waking up that they may not remember, but they are … exactly what you might think someone would say to a stranger in a situation like that. Like ‘Oh, is it already over?’ or ‘When’s it going to start?’ or ‘Whoa, I was sleeping.’ They may say little things like that when they’re waking up but it’s not like they suddenly either feel free to, or need to, bare their souls. I’ve never seen anyone do that.”
Even if you were to be the only person who starts blabbing secrets while under anesthesia, your spouse is very unlikely to hear them. The sedation begins right before the procedure, when you’re with the doctor and the person who accompanied you is out in the waiting room with nothing to do but read year-old magazines. The staff won’t call them back to the recovery room until you’re back to your senses.
By the way, the medical staff are bound by ethics (and human decency) to keep any weird things you say private. Maybe somebody who is less than totally upstanding would share a hilarious comment at the dinner table later without mentioning names, Dr. Clark conjectures, but that assumes that you say anything at all, that it’s somehow the exact thing you’re afraid of, and that the staff even cares. “There are just so many layers of improbability.”
So the bottom line is that you can get that colonoscopy with confidence! But Dr. Clark wonders if what you really need is to work on communication with your spouse. So I consulted a third expert, resident Tough Love columnist Patrick Allan, for advice on that front. He says that your worries about anesthesia, even though they turned out to be unfounded, “should be a reminder that these deep dark secrets are weighing heavily on your mind, and they will continue to do so until you find the courage to reveal them.”
If you, too, have questions about deep dark secrets (or anything about health, medicine, or the human body), email me at firstname.lastname@example.org or drop your question in the anonymous form at bethskw.sarahah.com.