Concern Over Symptoms and Doctor's Dismissal: Am I Overthinking?
As a 29-year-old male, I recently consulted with my gastroenterologist regarding some unusual physical issues I've been experiencing. For the past six weeks, I’ve been contending with a burning sensation and discomfort in my stomach, coupled with intermittent bloating. My doctor recommended that I undergo an endoscopy, which I promptly scheduled. However, upon researching the procedure, I discovered that it often requires sedation, sometimes utilizing propofol, which can lead to respiratory depression. Here's where it gets complicated: seven years ago, I began experiencing peculiar symptoms that hinted at a possible neuromuscular condition. Admittedly, this might sound a bit eccentric, but it began with numbness in my right little finger, forearm, along with my leg and foot. I started noticing involuntary muscle spasms, primarily affecting my thumb, and my right leg appeared to shrink significantly. Additionally, I noticed a decline in strength in my right shoulder, especially when trying to hold something overhead, which caused a burning and shaking sensation. I even have atrophy in my tongue, making it increasingly difficult to maintain dental hygiene. A couple of years after my initial symptoms emerged, I experienced episodes of shortness of breath, particularly after light activities like moving furniture or running a brief distance. Sometimes, I find myself struggling to finish a sentence without gasping for air. Fortunately, I don't experience breathlessness at night or have trouble sleeping—although I do feel a heavier sensation when lying flat on my back, making deep breaths more challenging. For a long time, I hesitated to discuss these symptoms with a healthcare professional, out of fear and embarrassment. Truthfully, I’ve been attempting to ignore these feelings altogether. However, I manage to lead a fairly normal life despite these concerns; I do not face significant muscular limitations. I’m active, hitting the gym four times a week, growing stronger, and gaining muscle. Engaging in physical exercise has notably alleviated pain and the sensation of weakness in my neck, back, and shoulders. In fact, I believe my legs are feeling stronger too—I appear to be a healthy individual. With all these complications, I’m particularly apprehensive about being sedated, especially given my symptoms. My primary fear centers on the respiratory depression that propofol can induce. If there’s any underlying weakness in my lungs, could this pose a problem during sedation? In light of these concerns, I requested to discuss my situation with my gastroenterologist and finally revealed my symptoms. Regrettably, his response was somewhat dismissive. He seemed indifferent to my concerns, stating, "Pre-anesthesia assessments are typically for individuals aged 70 and older. Just go ahead and book the procedure; it’s quick and low-risk." The reality is I need to proceed with the endoscopy and will require sedation, but my anxiety persists, largely due to my symptoms. Unfortunately, my doctor did not address my fears or provide any reassurance. Am I overreacting in this situation? What steps should I take next?
Answers (1)
3/24/2025, 3:40:42 PM
OpenHealth AI
It's understandable to feel apprehensive about medical procedures, especially when you have underlying health concerns. Your symptoms and anxieties regarding sedation are valid, particularly given your history and the way your recent concerns have been brushed aside by your gastroenterologist. Here are the main points to consider and some actionable steps you can take.
Key Points:
- Sedation Concerns: Your worry about sedation and potential respiratory effects is valid, especially with your history of shortness of breath and neurological symptoms.
- Communication with Your Doctor: It’s essential to ensure your concerns are taken seriously, even if the initial response felt dismissive.
- Next Steps: Address your concerns clearly and consider getting a second opinion if necessary.
Explanation:
You mentioned experiencing a range of symptoms that impact both your gastrointestinal health and overall physical well-being. Your history of neuromuscular symptoms, breathing difficulties during exertion, and current observations regarding your strength can indeed complicate the sedation process. It’s essential for the medical team to be aware of these factors to manage your sedation risk appropriately.
Sedation with propofol, while generally safe for most people, can lead to respiratory depression, especially if there are underlying concerns about lung capacity or function. Anesthesia teams are trained to assess these risks before any procedure, and they can take extra precautions based on individual health profiles.
Actionable Next Steps:
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Document Your Symptoms: Keep a detailed journal of your symptoms, including when they occur, how intense they are, and any triggers you notice. This will help provide a clearer picture to healthcare professionals.
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Request a Pre-Anesthesia Consultation: It's reasonable to request a consultation with the anesthesiologist before your procedure. They’ll assess your respiratory health and can tailor the sedation plan to your needs, taking into account any neurologic conditions.
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Seek a Second Opinion: If possible, consider consulting another gastroenterologist or a neurologist who specializes in neuromuscular disorders. A fresh perspective might offer additional insight and help address your concerns more thoroughly.
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Communicate Your Anxiety: Use your upcoming appointment or the consultation with the anesthesiologist as an opportunity to express your fears about the sedation process. Ask specifically how your symptoms will be managed and what precautions will be taken.
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Prepare for the Procedure: Learn about what to expect during and after the endoscopy. Understanding the process can sometimes alleviate anxiety.
Feeling anxious about medical procedures, particularly those involving sedation and potential risks, is common. By proactively addressing your concerns with the healthcare team, you can take steps to ensure that your symptoms and fears are acknowledged and managed appropriately. Don't hesitate to advocate for your health—it's your right as a patient.
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