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Tuesday, July 15, 2008

WARNING!

I'm going to tell about my colonoscopy. You might want to skip this.




As a rule, I don't like surprises. My parents threw me a little surprise party for my 16th, and I didn't even like that. I mean, I enjoy the anticipation of events, so I felt like I missed out on part of the fun. Don't get me wrong. I am thrilled by the unexpected bouquet of flowers or the unexpected gift. But for most of life's events, I prefer to have some idea of what to expect and I DEFINITELY want to be appropriately prepared.

So, I'm going to go ahead and share about this experience on the off chance that someone else out there is anticipating having to have a colonoscopy and would like some input.

First, I'm quite late at having my first procedure. You're supposed to have your first at age 50, earlier if you have a family history of colon cancer (I don't). I won't repeat my story of suicidal neglect of my health except to say that this is one of the health hurdles that I need to check off. After this a tetanus shot and other than the follow-ups, I'm done for a while (until the cycle of yearlies kicks in again sometime after the first of the year.)

Anyway, the process started with a referral by my internist. Having only met GI Guy once I can't claim absolute confidence but was suitably impressed. He was able to figure out that the little pain in my side was a muscle pain related to a floating rib, and was heads up enough to assume that I had sleep apnea (never been tested but I do snore like a freight train so it's a good bet), which affects the kind of anesthesia used for the procedure.

I usually take a baby aspirin every day, but had to stop that for a week.

Today is prep day and is a most inconvenient day. The dread of the process this morning was significant but unnecessary (although there's no way not to dread the thought of hours of diarrhea, is there?) The instruction is to do a liquid diet thing, but I just chose not to eat at all. Given my druthers, I would never eat until after ten in the morning anyway. I just drank water all day and other than the HABIT of eating have not been uncomfortable.

At 1:00 I started the (dum dum dum) cleaning out process. There are lots of different ways to prepare for a colonscopy. GI Guy had me take four Dulcolax (they were kind of cute) at 1:00. At 3:00 I mixed up 255 mg (looks like a pint or bigger bottle) of Miralax powder into 64 oz. of Gatorade. I'm not allowed any RED dye, so that eliminated the only flavor of Gatorade I can tolerate easily. I chose the lemonade flavor instead. I had three hours to finish all this stuff and I gotta tell you, after the first 32 oz. it was making me sick to my stomach.

I drink very few beverages. Water, milk, water and - in restaurants - the occasional iced tea (no fruit, just straight brewed, don't even wave the lemon over it.) Sometimes green tea, sometimes hot chocolate and, in Utah, Cream O'Weber chocolate milk. Never have had nor plan to have alcohol and never developed a tolerance for anything with bubbles. Gagging this stuff down was a real challenge.

And then the fun began. It's 10:23 pm and I'm still hitting the toilet, although I think we're about at the end of the process and I may get to go to bed soon. The goal is to flush everything out of the colon. I won't go into the details except to say that the goal is clear fluid and that's been achieved. I wish someone at the doctor's office had noted somewhere on the written directions to pick up some moisturized wipes for this day.

The last six hours have been an adventure. I'm grateful for the internet and my spiffy computer which is just across the hall from the bathroom.

Second Installment - July 16, 4:00 PM

And everything's fine. Clean as a whistle.

I checked in at the hospital at 6:00 am (anesthesiologist had to do the deed at 6:30 so that he could be someplace else). I was there at 5:59 am having been told to tell Priscilla and she would send me directly into the room and they would check me in there. Nobody told Priscilla the process, I guess. There was another woman there before me who Priscilla had to check in (and who had the wrong records so we had to wait for those.) I reminded Priscilla that I was on fastpass, but there was no way she was letting me past her desk without making her appropriate keystrokes. As she was flipping through papers I noticed that someone else's drivers' license was attached to my cover sheet. Priscilla had to enter all my data anew. It actually went pretty quickly, all things considered, but the paperwork snafus ensured The Team would only have fifteen minutes to do their routine before the 6:30 start time. The procedure room had a bit of a Keystone Cops feel to it as everyone scrambled to finish all the hook-ups. One nurse inserted the IV while the other took my BP. The BP nurse said, as soon as the cuff deflates, roll onto your left side." Well, it deflated and I started to shift, then the cuff started to inflate again. I paused, she smiled and said, "Go ahead," I rolled up and that's the last I remember.

I woke up in recovery, still on my left side and looking at a monitor that said my BP was 110/62 which I thought was really good.

Then the doctor came in. He explained that my colon was clear, no polyps or anything. I don't have to go back for ten years.

Then he spent quite a bit of time explaining that I'd had some kind of vasovagal reaction to him pressing on my abdomen and my heartrate had dropped into the 20s (hence the low blood pressure). His simplified explanation was that as he had done the procedure, blood had rushed to my abdomen, essentially abandoning the rest of my body. The anesthesiologist fixed me and all is well.

As he told the story I was reminded of a time nearly 30 years ago when I had suddenly been struck with violent diarrhea and vomitting and had passed out. (The last thing I did on the way out was grab my one-year-old's ankle; my last thought was that maybe I could at least keep him in the hallway with me until I came to.) Anyway, DH called an ambulance and my BP was REALLY low. I saw a doctor later who had no explanation for anything, but hearing GI Guy explain all this to me I concluded it sounded like the same thing. I told him the story and he agreed. He said this is something I should always alert doctors about in the future.

Once the recovery room crew determined I was more or less lucid, DH brought me home. He stopped first for donuts, then headed to Jack-in-the-Box for a croissant sandwich (a favorite of mine which I deny myself for years at a time, but sounded like a good idea since I hadn't had anything to eat since 10:30 Monday night). I stayed in the car and took a bite from a donut while he went to JITB and discovered that I had no saliva. I chewed the donut until it was a gummy lump but had to spit it out because I didn't have enough saliva to swallow it. Which was no great hardship because I also didn't seem to have any sense of taste, either.

As the day has gone on, I have been able to eat. I remembered that after my MPS stress EKG they told me to eat something fatty as it would help eliminate the tracer from my system. I ate the croissant sandwich as soon as I could work it down in hopes that it would have the same effect on the anesthetic that's still pumping around. I don't know if it worked or not, but as the day has progressed I've felt better and better and am going to try to take another bite of that donut pretty soon.

When they warn you about this procedure and what to expect, they don't make a big enough deal about the amount of air they pump into the colon so that they can get good pictures. It's now almost nine hours later and I still am uncomfortably bloated, although that is finding resolution as the day goes on.

All in all I'd recommend giving this two full days. One for the prep, one for the procedure and recovery.

I wasn't a Tony Snow fan, but no person of 53 with little kids should have to die of something like colon cancer. Colonoscopy is saving thousands of lives every year. This process is inconvenient and a little icky, but you are totally out for the procedure itself and the rest passes (pun intended) in short time. Definitely NOT something anyone should avoid.

2 comments:

Megan said...

I'm proud of you! Good on you for taking care of your health.

I'm another one who hates surprises, and you add anxiety about anything doctor or medical related, and I'm a mess. When I had to have my breast biopsy, I couldn't find ANY detailed, personal explanation of what exactly happened during it. I would have loved a description like this for that procedure, and I'm willing to bet that someone will read your account and be much calmer about the procedure.

leechbabe said...

Great description of the process.

At 33 I'm due to have my 5th colonoscopy later this year, had my first when I was 17yo. You've done a great job describing exactly what happens.