I have severe medical anxiety and panic

You're not doing this alone on Tuesday, and the panic you already know comes is the thing to plan around today — not on the day. Since the test is a week out, tonight's job is small: make one phone call and put one person on the calendar.

1. What you tried vs what actually moves the needle

Skipping the test — understandable, and worth one phone call rather than a silent no. Ask the team what the test is looking for and what happens if it's postponed. Some people get a different route to the same answer. That call is free and it converts a dread into a decision.

Not telling the team about the panic attacks — this one works against you. The endoscopy team sedate people every day and would rather know. Hiding it means the plan is built without the one fact that matters. Telling them changes what they offer; not telling them guarantees you get the default.

What to ask for on the pre-procedure call (these are all requests, not demands — they can say yes or no, and either way you learn something):

• "I have severe anxiety and panic attacks about sedation. Can we talk about my options?"
• Topical anaesthetic spray only, no sedation — real for some people, and it's a genuine choice you can ask about.
• "What sedative do you use, and can you tell me in advance?" Knowing the name in advance takes away the biggest unknown: not knowing what they'll give you.
• Can someone stay with me in the room? Endoscopy units vary; asking is the only way to know.
• Can I be shown the recovery area, or told exactly what the first hour feels like? Uncertainty about *after* often drives more fear than the tube itself.
• Is there a consent/nerve-control option — for example a signal to pause, or asking them to pause if you raise your left hand?
• Ask about a pre-procedure anxiolytic. This is a prescription question for the team, not something to get or dose yourself. If they're willing, they'll tell you exactly what and when; if not, that's their call and not a failure.
• Ask for the anaesthetic spray to throat and the sedation decision to be discussed with me while I'm calm, the week before — not in a corridor on Tuesday.

2. What actually happens, so you can stop imagining the worst

From the NHS gastroscopy page (checked 20 Oct 2026):

• A nurse talks it through with you first, then you get a local anaesthetic spray to numb the back of your mouth and throat, and sedation through a small tube in your arm to help you relax.
• The tube goes in, air is pumped into your stomach so you feel bloated and burp, and you may feel like you want to be sick until it reaches your stomach — sedation helps with that. Biopsy samples don't hurt.
• The test itself should not be painful, and you can ask for it to be stopped at any time. That sentence is the one to reread tonight.
• The test takes 15–45 minutes. Plan for around 4 hours in the hospital in total.
• Afterwards you go to a recovery room and go home once you feel well enough — usually within a few hours. If you have sedation, someone must take you home and stay with you for 24 hours. That is your support person's job.
• 24 hours after sedation: no alcohol, no driving, no machinery, no signing important documents.
• Throat and stomach soreness for a few hours afterwards is normal.

3. Tonight / today — under 25 minutes

• [ ] One call or portal message to the pre-procedure team, using the script above. Best time: morning, when they're staffed and you're not doing it at midnight.
• [ ] Name the support person on the calendar now. Tuesday morning through Tuesday night. Write down: who drives, who stays, whose school run or elder-care it covers.
• [ ] One cover line for the rest: "I'm having a routine test Tuesday. I'm fine, I'll be back by ___." One sentence. People ask because they care, not because they've noticed something wrong.
• [ ] Put the paperwork where you'll see it Tuesday — ID, medicine list, fasting instructions, the phone number of the unit, the escort's number.
• [ ] Tonight itself: eat normally, don't go researching worst cases, do one ordinary thing that isn't about the test (a bath, a short walk, an episode of something you like). Panic about a procedure is fed by rehearsing it.

4. Avoid list

• Don't buy or take anything for the anxiety on your own — no online "calm" supplements, no powders, no someone else's tablets, no alcohol as a night-before helper. Alcohol before sedation is a real interaction problem and it's also a common reason people panic harder.
• Don't change any medicine on your own because of the test — including the day-before question. The team tells you what to take or skip; that instruction goes in writing.
• Don't fast beyond what your own letter says.
• Don't let the school week or the elder-care become the reason to postpone silently. If Tuesday genuinely can't work, say so on the call and ask for a date — don't cancel by not turning up.
• Don't rehearse the procedure in your head at 2am. If the thought starts looping, write the question down for the call and switch tasks.

5. Decision tree

Is the panic about the test, or is it happening right now with physical symptoms?
→ Physical red flags below = the emergency branch, not the test.

Can you make one call to the team this week?
→ Yes: make it, ask the list above, write the answer down.
→ No, and the dread is escalating: still call — you can say "I need to reschedule and talk about my anxiety first." That's a legitimate call.

Tuesday arrives. Panic spikes in the waiting room.
→ Say it out loud to the nurse: "I'm having a panic attack." Staff see this often; naming it usually gets you help in the moment.
→ Ask them to pause, to slow down, to tell you what they're doing next. Every one of those is legitimate.
→ Slow exhale — in through the nose, out longer than the in — with the person beside you, feet on the floor. Four or five of them.

Do you want to go through with it, or stop?
→ Both are allowed. The page says you can ask for the procedure to be stopped at any time. Deciding mid-procedure is not failure.

After the procedure
→ Someone stays with you 24 hours. Sooner: a different decision — see red flags.

6. Red flags — stop the DIY and get help

Before the test, now: any new chest pain, breathlessness, fainting, black or tarry stools, vomiting blood, or a fever with feeling very unwell — don't frame these as anxiety. Same-day clinician or your local emergency number.

Thinking about not being here / harming yourself — this changes everything. Contact your local emergency number now, or go to the nearest emergency department now, and stay with someone. Don't manage it alone at home.

After Tuesday, go now: you keep being sick, you vomit blood, you are short of breath, or you have severe stomach or chest pain or pain that gets worse. Persistent panic in the days after, or panic that stops you eating or sleeping, also deserves a clinician this week rather than another month.

Call the unit the same day: a high temperature, feeling hot/cold/shivery, or poo that is dark or black like tar.

What success looks like in 24 hours

Not "not anxious." A realistic Tuesday-eve scorecard:

• The call is made, and the answer is written down somewhere you can find it.
• The support person's name is on the calendar for Tuesday, with the school run or elder-care covered.
• You know the name of the sedative, whether spray-only is an option, and whether someone can be in the room.
• You've told two people in your household the one-sentence version, so nobody has to ask you on the morning.

If you get the call made and the person booked, tonight was a win — whatever the anxiety does in between. Panic that peaks the week before a procedure and eases once the plan is concrete is the normal pattern, not a sign you're doing it badly.

None of this is a diagnosis, and none of it replaces the team who do the procedure — what it does is make sure they hear the part about your panic before Tuesday, not in a corridor on the day.

Say the word and I'll turn the pre-procedure call script and the Tuesday-morning timeline into a one-page sheet you can print.