Post-op summary

Well, it’s over. I never got the opportunity to post more updates during the prep itself, but that’s largely because there wasn’t a lot to report. Here’s the quick rundown:

The first round of prep went rather easily. As my earlier post shows, I thought it was going almost too easily, actually: no cramps, nausea, or butt soreness. It was suggested to me that the prep might have been relatively easy-going for me because in general I eat a pretty good diet, low in processed foods and pretty high in fiber. So it wasn’t like I had to clean out months of colonic accretion from McDonald’s, etc. I took the dose of stuff at 4pm, action began at 5pm, the first major round of purging was done by 6:30 or so, and I had a few more (much briefer) trips to the loo between 6:30 and 8:00 or 8:15. By 9:00 I was ready for bed, and slept without incident until 4am.

At 4am I got up and took the second dose of purgative. I had been told by my doc’s office manager and someone at the GI lab at the hospital that I could wait until 5am and get a little more sleep, but I thought it would be wise to err on the side of extra time. I’m glad I did. After heading back to bed and enjoying some nice stomach-gurgling, I woke up around 6:30am for the second round of purging.

That second round was a lot less intense than the first round (no doubt because there was a lot less to purge in the ol’ GI tract, and also because the second dose of purgative in the EZ-Prep kit is only 1 oz. rather than 1.5 oz.). But I was heading back to the john until about 9:30 or so. Since I had to be at the hospital at 10:15, I was a bit concerned that I’d need to make an emergency stop somewhere along the way to use the bathroom, but that didn’t prove to be the case. (But that’s why I’m glad I got up at 4am to take the second dose; I suspect that if I’d waited until 5:00, things might have been dodgy on the way to the hospital.)

Once at the hospital, everything went smoothly. They hooked me up to my IV, which took a few tries because the dehydration makes it harder to land a vein. After trying unsuccessfully to get one going on top of my hand, the nurse had to settled for the inside of the elbow. (That was fine with me, actually; it’s a lot less painful there than on top of the hand.) I lay in my bed, feeling sleepy and hungry and trying to read a book (it was difficult to focus). The doc was running about half an hour behind schedule because earlier procedures had gone longer than expected), but it wasn’t too bad. I did get to enjoy the sounds of the previous patient farting like crazy after his return to the room. I can only hope that I was able to serenade the person after me as tunefully and majestically as he did me.

Then they wheeled me into the room where they do the procedure. The nurses were really pleasant, and made some nice chit-chat while I lay there. They explained the procedure to me (which I already knew about, of course, from reading all about it on the internet), then put the oxygen thingie into my nostrils. The doc came in and explained the potential complications (“perforated colon” is a bit of a troubling thing to hear in that situation, but what can you do?). Then the nurse said she was going to start the drugs.

I was remarkably unstressed about the whole thing, perhaps because I’d had the upper endoscopy a few months back and knew that the drugs were the same. Sure enough, I floated into dreamland pretty quickly. I actually have a vague recollection of the procedure. There was no discomfort at all, just a weird sensation of something wet-feeling going in and out of my butt. (It was really similar to the wet feeling that accompanies the prep process.) As I say, not at all uncomfortable, just curious. I definitely had no sense of time, though, and I have no idea how long he rooted around.

Before I knew it, I was back in the waiting/recovery room. I came to much quicker than I thought I would, sooner, it seemed, than I did after the upper endoscopy. The nurse came in and said that they’d found nothing other than a couple of small internal hemorrhoids: no polyps, no signs of cancer, nothing. Great news! She gave me some apple juice and a package of graham crackers, and I sat there contentedly munching on them and enjoying the post-procedure drug-induced grooviness.

Then the nurse came back and took out my IV and said I could get dressed. I did so (though in that state it took me three tries to get my t-shirt on correctly), then went out in the hall and drowsily listened to the post-procedure instructions, which are pretty simple:

• don’t go back to work or try to do anything of consequence for the rest of the day
• go easy on your stomach: light, soft foods for the first few meals
• no popcorn or nuts for two days (how bizarre is that?)
• call the doctor if you’re in pain, have a fever, or are pooping bright red blood. (You’d think that one would be a no-brainer even without the instructions.)

Then my lovely wife drove me home and made me a sandwich, which I ate along with some soup and a glass of ginger ale. I felt a wee bit queasy after eating, but only barely. Then, man oh man, did I crash hard! I couldn’t keep my eyes open, and ended up sleeping from 2 to 5pm. Deep, deep sleep, too. Then I got up and ate a yogurt and drank some Gatorade. We took the dog to the park, which was nice because I finally got some fresh air. I had a few slices of Greek pizza for dinner, along with more ginger ale, and was in bed by 10pm.

This morning I woke up starving. Some oatmeal and an English muffin later, and I feel fine, though the caffeine in the coffee is hitting me much harder than it usually does, presumably because I’ve got much less in my stomach than normal.

All in all, I’m feeling great!

So, in sum, if you’ve got a colonoscopy coming up, here is my take-home message:

• Don’t believe the horror stories. Surely those who have had them are serious, and they happen, but my sense is that you hear about the terrible situations much more frequently than you hear about the mundane, uneventful ones.
• Eat well (high-fiber, low-processed foods) for the week or ten days leading up to the purge; it’ll make things a whole lot easier coming out.
• Baby wipes are, in fact, the key to comfort during the prep—everyone was right.
• Because most of the things you’re allowed to drink during the prep are sweet (Jello, soda, Popsicles, Gatorade, etc.), make sure to buy a box or can of low-fat, low-sodium chicken or beef broth to intersperse with the other clear fluids. It’s almost like having food, and the saltiness and warmth are a really welcome change from the sweet and cold of the other things you can consume.
• While it’s true that the prep is the worst part of the whole experience, it’s actually not that bad. I recommend the Fleet EZ-Prep method: it’s easy to get (and keep) down, and didn’t cause me any trauma.
• Don’t think for a second that you’ll do anything productive the afternoon after the procedure. Count on napping, or at the very least lying on the couch and watching TV.

Thus concludes my colonoscopy and, barring any new insights or reports, my colonoscopy blog. To those of you who will be undergoing to procedure for the first time, take heart! The dread is ten times worse than the prep or the procedure will be. I’m not looking forward eagerly to my next one (in luck, till I’m 50, eighteen years from now), but I know that when the time comes I won’t worry about it at all.

Bon courage!

Is that it?

Maybe I’m totally crazy, but it’s now just over an hour since the purging began, and it seems to be almost completely at an end. It was an exciting first 30-45 minutes, to be sure, but now there seems to me almost nothing happening; I’ve head back to the john twice since the initial burst, but I’ve done a lot more reading than purging. It’s fine with me, of course; I just wonder if I’m doing something wrong! No cramping, no incredibly sore butt, nothing like that.

Maybe there will be a second round (and third, and fourth…) soon, but for right now I’m feeling fine. Amazing!

Now we’re rolling

Almost one hour to the minute after drinking my first dose o’ the prep, we’ve got some action. It’s a very strange sensation, I must report. (Perhaps this will be too graphic for some readers, but you are, after all, reading a colonoscopy blog.)

It doesn’t really feel like the diarrhea you get when you have the flu. For one thing, I haven’t had any cramps or desperate feelings of urgency. It’s been very… relaxed, I guess. (How unexpected is that?) And there’s really rather little in the way of sensation, overall, apart from lots of water leaving your butt. It doesn’t burn or anything, and right now I’m not experiencing any of the rawness (ick) that other folks have reported online. Of course, to paraphrase Karen Carpenter, I’ve only just begun.

More as it occurs, though something tells me that the operative phrase for the next few hours is going to be “more of the same.”

Dose #1

About half an hour ago I mixed together one (1) lemonade flavor packet; twelve (12) ounces of water; and one (1) bottle of “phospho-soda.” (Note: phospho-soda not recommended for ice cream floats.) It wasn’t exactly tasty, but it wasn’t too horrific either. That 12-ounce concoction along with the 12 ounces of water they tell you to drink right afterwards, though, is a lot of fluid. And there’s a bit of an aftertaste. But all in all, it’s not too bad.

So now I’m just kind of waiting around for things to happen. I feel some gurgling in the gut, and I feel a little gassy, but nothing too unpleasant. Thus far no nausea, no cramping, etc. Let’s hope that keeps up.

If I’m brave, I’ll bring the laptop into the bathroom with me for exclusive (!) real-time reportage on the colon-evacuating experience. Exciting stuff, y’all.

Prep day begins, and I’m already hungry

So here we are, finally at the prep day. How exciting. It’s just after 9am, and I’m already hungry. One bowl of Jello just doesn’t do the trick; I suspect that ten bowls of Jello really wouldn’t do the trick either, though I’m willing to give it a shot. This may be a long day. All evidence points to that being the case.

Provisions acquired

Tomorrow is the prep day. Yikes. Until about noon today, I was kind of looking forward to taking a “day off” from work. (Unfortunately I’ll actually have to do some serious work from home, but without the benefit of food, so I’ll be cranky and irritable and probably pretty spacey. Oh, and I get to close out the day by intentionally inducing several hours of diarrhea.) Now I’m really dreading it.

But my lovely wife was kind of enough to procure:

1. Several bottles of lemon-lime Gatorade.
2. Four boxes of Jello brand gelatin des[s]ert (see below re: the [s]).
3. Four liters of ginger ale
4. Four liters of 7-Up
5. A box of popsicles.

This, combined with our stores of coffee, tea, and chicken bouillon cubes, should mean that I’m in pretty good shape in terms of variety of fluids. I guess I’m more worried about lethargy and headaches. But what can you do? I’m ready as I’ll be.

Could it have been worse?

Here’s something I forgot to mention earlier. When I was meeting with my GI doc about my, errr, bleeding problem, he asked me “Is there any history of colon cancer in your family?” I said “no.” And he said, “Okay, we should do a colonoscopy.”

So wait a second—if there’s no history of colon cancer, he’ll schedule a colonoscopy. What in God’s name would he have wanted to do if there were a history of colon cancer? (Note the Lovecraftian sense of horror connoted by the italics.) I tremble to contemplate it. Perhaps a complete bowel transplant?

Doctor, heal myself

I have alluded in previous posts to my gastroenterologist’s somewhat lackadaisical attitude to my impending colonoscopy. This is welcome in some respect, since it highlights that this is a common test… but it’s common for him, not me. So I would appreciate a bit more guidance, or at least recognition that this is rarely a pleasant experience for those involved.

When he scheduled me for the procedure, he handed me a sheet with the following instructions:

• Do not eat food or drink milk on the day before your procedure (DRINK CLEAR LIQUIDS ONLY). Clear liquids include [a list follows, concluding with "non-red gelatin desert [sic]“).
• Purchase a Fleets [sic] EZ Prep Kit and take as directed.
• Nothing to eat or drink after midnight.
• NO ASPIRIN, MOTRIN, ADVIL, ALEVE, IBUPROFEN AND IRON FOR 5 DAYS PRIOR TO PROCEDURE.
• A friend or relative to drive and/or assist you home MUST accompany you.

I get most of these, but largely because I’ve read up on this stuff online. But a few comments on these.

1. “Non-red gelatin desert [sic]“? Are GI docs really not in the market to endorse Jello-brand products? It really did take me a second to figure out what a “gelatin des[s]ert” would be. It’s like Band-Aid or Xerox or Kleenex, doc—you can go ahead and say it. Sure, the legal wonks at the Jello company might come running (after ASCAP threatened to litigate the Girl Scouts, anything’s possible…), but I think clarity of expression probably wins the day when we’re talking about things as sexy as bowel cleansing.
   Also, as a snarky aside, I love the idea of a gelatin desert. I imagine that the Sahara would be lemon Jello, and the Mojave would be lime.
2. I did get the Fleet[s] EZ-Prep kit, and boy does it look ez! Actually, from what I’ve read, this is actually one of the better preparations, relatively speaking. Better than drinking a gallon of disgusting gloop, for example. (I think that’s the Golytely prep, which wins the award for tackiest name. Not that “EZ” is much less disingenuous.) The EZ-Prep involves mixing two smallish bottles with some “flavor packets” (ugh) in about 12 oz. of water. That I can handle.However, my doc’s instructions to “take as directed” fall short a bit, since the instructions in the EZ-Prep kit say “take dose #1 at the time instructed by your doctor, and take dose #2 at the time instructed by your doctor.” Of course I called my doctor today to say, in essence, “instruct me, vis-à-vis the times,” and spoke with, not him, but his receptionist/office manager. She too was pretty nonchalant about the whole thing, almost disconcertingly so, and made me feel like I was an idiot for not understanding the EZ-Prep’s instructions. For the record: the EZ-Prep kit says to take the second dose no less than three hours before the exam, and to wait 10-12 hours between the first and second doses. My doc’s receptionist’s advice was to take the second dose “plenty early” in order to allow for, ahem, complete evacuation, even if that means “getting up earlier than [I'm] used to.” That’s fine with me, don’t me wrong; I just don’t think that I’m out of line expecting a bit more guidance on the issue.
3. “Nothing to eat or drink after midnight.” Okay, but how do I reconcile that bit of wisdom with the fact that I have to drink, oh I don’t know, the second dose of the EZ-Prep kit? How do I reconcile that with the EZ-Prep kit’s instructions—which, remember, I’m supposed to follow, according to my doc’s instructions—to drink plenty of fluids up till three hours before the exam? Too many internal contradictions! Too much confusion!

Actually, there really isn’t that much confusion. Obviously I have to take the second dose, which involves 12 oz. of fluid, after midnight. I just think that maybe my doc could be a bit more explicit and clear about the whole thing. I know he probably goes up a dozen bums a week, but this is a first for me. Help me out here, doc. Hold my hand a bit.

Initial measures

Okay, so my colonoscopy is scheduled for next Friday morning. Since hearing that I’m going…wait, actually, that brings up another issue. I can’t say I’m going “under the knife,” since I’m not having surgery. But let me tell you, the prospect of a colonoscopy sounds a hell of a lot more invasive to me than most surgery. And “going under the knife” sounds like such an active thing, like I’m actually doing something. With a colonoscopy, though, it’s bascially the most passive thing in the world: I will doze quietly while someone crams a rubber tube through my bowels and takes a gander at what’s going on. Even better, he might even snip some things out of there! Hooray!

Right, anyway. So once I heard that I’d have to submit to this, I started looking around the internet (like one does) to find out as much as I could about it. It turns out that there are a good number of gastroenterology docs and centers out there with some pretty good info on what to expect, how best to prepare for it, and so on. This British doc, for example, gives a pretty good hour-by-hour guide as to what to do. It’s not applicable for me, but still, if I were his patient I’d be pleased with this level of detail. Harvard Health Publications has this little online tract, though frankly it doesn’t tell you all that much that you wouldn’t know from your own doc’s instructions. (“Arrange a ride home”? No kidding, Harvard Health Publications. That’s not really ‘advice’ as much as it is ‘required’.) On the other hand, this doctor’s tale of getting a colonoscopy is a bit reassuring for us layfolk.

Then there are the bits of casual advice (like the very thing you’re reading), such as this. And of course there are ample message boards with readers offering their advice (like here and here), and the occasional blog entry (like this one). From reading numerous such message boards, I think I can distill their collected wisdom thus:

1. Baby wipes are key.
2. Stock up on reading for the bathroom.
3. Everyone has a different idea about which laxative prep kit is (a) best or (b) worst, and what the best mixer/chaser combination is for the various preps.
4. Did I mention baby wipes? They seem to be the one great piece of advice that circulates only by word of mouth, and not through doctors’ “official” advice. What’s the deal with that, I wonder. If you can warn patients about constant explosive diarrhea during the prep, surely you can add a little heads-up about baby wipes?

And so it begins

A few months back I began having some weird stomach ailments: a little bit of nausea every once in a while, but mostly a general feeling of, well, grossness. These kinds of symptoms, as my doctor told me, could signify any of a thousand different conditions, from heartburn to stomach cancer. I thought: great!

I had a blood test, a urine test, and, ultimately, an ultrasound (in the wee hours of Easter morning, oddly enough, as there weren’t a lot of people scrambling for that appointment time). All the results: nuthin’.

Finally I took this crazy breath test. You breathe into a bag, blowing it up like a balloon. Then you mix this little packet of powder with water and drink it (it taste like really crappy Country Time instant lemonade), then wait fifteen minutes and breathe into another bag. This simple test revealed that what seemed to be plaguing me was a visit from my friend Helicobacter (“H.”) pylori, the funny little bug that causes many stomach ulcers. (The breath test works because the H. pylori turns acid into carbon dioxide. The lemon-flavored powder creates a bunch of uric acid in your gut, so if the second bag you breathe into has an elevated level of carbon dioxide, it’s because H. pylori created it. Elegantly simple, and brilliant!) After 14 days of antibiotics, the bug was dead.

But the gross feeling kept on happening. That necessitated a trip to the gastroenterologist, who did an upper endoscopy. That procedure was a little bit freaky to contemplate, but it turned out to be a walk in the park. All I had to do was fast after midnight the night before, then head to the hospital and wait around a while. They put an IV in my arm while I read a book. Then they wheeled me into a room, gave me some oxygen through one of those thingies in the nose, and the next thing I remember I was waking up in the recovery room, feeling relaxed and groovy. I spent the rest of the day lying on the couch, feeling equally groovy—awake and alert but very relaxed—, and was pretty much back to normal by dinnertime. The only funny side effect is that evidently I made the same comments to my wife several times, not remembering that I had said them to her already at least once or twice before earlier in the day. The amnesia drug they give you so that you don’t remember the procedure, you see, lingers a bit. Weird.

So I have GERD, it turns out. No biggie—I’ve been on an acid-blocking drug for a while now, which seems to be doing the trick. I feel a whole ton better than I did.

But then, about two weeks ago, I noticed a little blood on the TP in the morning. That’s happened a few times before—doesn’t it happen to everyone occasionally?—but it seemed to happen a few days in a row. That kind of freaked me out, especially after an ill-advised trip to WebMD, where I immediately realized that I have colon cancer, Crohn’s disease, diverticulitis, and quite possibly leprosy as well.

So, in short: I have to have a colonoscopy, next Friday. I’m dreading it, of course, as everyone seems to. From cruising the web I’ve learned a lot about other people’s experiences, but only in minor, fragmentary detail. This wholly solipsistic blog is all about my experience, which I will describe in far too much detail. From what I hear, the prep is far, far worse than the procedure itself (and given my excellent experience with the upper endoscopy, I have to assume that the downstairs version of that procedure will be about the same). Maybe someone out there, Googling “colonoscopy experience” or something similar, will come across this blog and find it useful, or mildly amusing, or inflammatory, or something else entirely. In which case, success!

As you might guess, the name comes from one of the greatest commerical spoofs on Saturday Night Live: Phil Hartmann hawking Colon Blow, the breakfast cereal with the largest amount of fiber possible…except for Super Colon Blow, of course. (“It would take 2.5 million bowls of your cereal…”) You can watch this masterful bit of television here (Flash) and here (Windows Media). Warning: may cause abdominal distention.