Why do this?
I know, I know, I should have had my first colonoscopy back
when I turned 50. But I ignored the mention of it from my family doctor back
then, and since I saw him very infrequently it didn’t come up again for a
while. When he retired and I had to choose a new primary care physician, she
mentioned it again, but wasn’t insistent because she was more concerned with
properly managing and tracking my cardiac issues because of the heart attack I’d
had at age 56. So it got put off again. About two years ago she retired and my
most recent primary care physician became much more insistent and wrote me a
referral. So, here I am at age 68 finally doing what I should have. I’ll give
the results toward the end of this blog later today and then I’ll post this –
so keep reading to find out.
I made my first visit a month ago. It was essentially a
pre-surgical physical – check my vitals, get my medical history, answer any
questions I had, and let me know what would be taking place – then scheduling
the actual procedure. They also issued the prescription for the “preparation”.
I picked up the prescription a few days later, read all the required material,
but didn’t spend too much time with it. I also had a series of phone calls from
a company that makes sure that I picked up the prescription, that I was
following the instructions, etc. It’s a nice service and does a good job at
keeping you on track – and makes sure that you are NOT planning on skipping out
(which evidently some people do).
Preparation
The real job of preparing started three days ago (on Friday,
it’s now Monday morning as I’m starting to write this). For two days I had to
essentially eliminate fiber from my diet (you know, that stuff that you’re
supposed to eat lots of because it’s good for your colon). No nuts, no seeds,
no raw vegetables, etc. So I skipped the baby carrots at supper (which I like),
made my sandwich with white bread (which I don’t like) instead of the 12-grain
bread with the seeds on top (which I like), etc. Made me intensely aware of how
much fiber-rich stuff I like when I had to look at it and not take any. But it
was only for two days, right?
Day 3 was worse. “NO SOLID FOODS, CLEAR LIQUIDS ONLY” was written in
bold red letters in the instructions. That also means no dairy products and
nothing containing red or purple (like cranberry juice). That meant that I was
restricted to the bottles of apple/peach juice that I’d purchased the previous
week. Soda/coffee/tea chicken broth, and gelatin are also allowed so I did have
a little diet soda to supplement the juices. But my stomach wanted real food!
After church, when the rest of the family was having their lunch I went to
another part of the house where I couldn’t see/smell what they were having. I
found things to keep me occupied while I ignored the rumbles from my stomach
that really wanted to eat!
After 2:00 I also cut back on the liquids as I knew that I
was going to need space in my stomach for the next phase of the preparation. My
digestive tract had no idea what was about to come its way!
At 6:00pm, as instructed, I began the first round of the
prep. They had prescribed a product called SUPREP Bowel Prep. The contents of
the box were innocuous enough – just two small 6-ounce bottles of a clear
liquid, a cheap plastic 16-ounce glass/cup (a “polypropylene mixing container”),
and an instruction booklet. The primary ingredient is a combination of sodium
sulfate, potassium sulfate, and magnesium sulfate. As described in the booklet:
“Sulfate salts provide sulfate
anions, which are poorly absorbed. The osmotic effect of the unabsorbed sulfate
anions and the associated cations causes water to be retained within the gastrointestinal
tract. [This,] when ingested with a large volume of water, produces a copious
watery diarrhea.”
The instructions ask that you dilute the contents of one of
the 6-ounce bottles by adding another 10 ounces of water to fill the 16-ounce
container. After drinking all of it, you must then refill the container twice
more and consume another 32 ounces of water (for a total of 48 ounces of
liquid), and it must be completed within one hour or less! That’s a quart and a
half! Then you wait a certain amount of time before the entire thing (plus whatever
else you may have in your digestive tract) is going to come speeding out the
other end.
The liquid itself had a slight fruity smell, kind of like a
diluted kid’s cough medicine. But you only take a little bit of cough medicine,
you don’t chug the whole bottle! So even though this is diluted, the sheer
volume of drinking that 16-ounce glass full of it is a little daunting. Ice
water is my beverage of choice (I keep a large insulated mug of it on my desk
all day), so I’m used to drinking a lot of water. Even so, after the first full
glass and ¾ of the next glass, I had to stop – my stomach was full. I finished
the 2nd glass about 5 minutes later, then waited another 15 minutes
before chugging down the final glass of water. I’ll score the taste 7 out of
10, and the drinking procedure similarly – but then what do I have to compare
that to?
I then lay down in bed to do a little bit of reading while
waiting for the results. My bed is only 15’ from the toilet and I didn’t feel
comfortable going much further away (and I was right). It took about two hours
for the stuff to work its way through my system – all the while I kept hearing
gurgles, so I knew it was working.
Just before 8:00 it hit! Because I hadn’t had a bowel
movement since Saturday evening (when you don’t eat much there is nothing to
help push out whatever is in there), the first part was a fairly normal bowel
movement. But right behind it was like a fire hose. The entire volume of water,
which would normally get absorbed as it makes its way through the intestines,
was pushing its way through unabsorbed.
It took about 1.5 hours before I finally felt that this
phase was done. I’d manage to get up from the toilet, start reading again, get
only a few pages done, then hear some gurgling and quick lay down the book and
sprint to the toilet. By 9:30 I was ready to finally lay down, pull up the
blankets around me and get some sleep. I had to get up only twice more after
that, but with long intervals. So, I’d rate the effectiveness of the product a
full 10 out of 10 – it really cleans you out.
After a normal night’s sleep (albeit not as long as I would
have liked), my alarm went off at 5AM (!) to start round two (there were two
bottles, remember?). As I suspected, everything went much quicker this time. By
the time I was taking my third 16-ounce drink (about 15 minutes after
starting), the fire hose from the other end was already starting.
Without any prior materials from the past days in the way, it just runs all the
way through in record time. But I was prepared for that and had brought my
smartphone into the bathroom with me and was planning on just sitting on the “porcelain
throne” for the duration.
But just like starting more quickly, it also ended sooner.
After only an hour I was basically done – cleaned out – empty from one end to
the other. I even had time to climb back into bed, pull the blankets up to warm
back up, and rest a bit before my alarm went off at 7:20.
Procedure
After packing up the grandboys (daily responsibility doesn’t
take a day off), my wife and I took them with us on the trip across town to the
gastroenterology center for my 10:30 check-in. While I was there she went to
the shopping center across the street. Not long after arriving, they called my
name and I went through the door into the surgical center. This is a busy place
– they have about 10 waiting/recovery areas in addition to the procedure room.
Much as expected – sign a few forms, blood pressure,
temperature, remove all but t-shirt and socks and don the typical
open-in-the-back, figure-how-to-tie-it-behind-your-neck “gown”. They then stick
in an IV where the sedation drugs will go shortly and the oxygen tubes in your
nostrils to help you breathe later. A quick visit from the doctor, then the
anesthesiologist talks to you as well before she wheels you a few doors away to
the procedure room. By this time I no longer had my glasses, so I couldn’t see
well enough to describe any of the equipment – however I knew that one of the
items was a camera and implements on the end of a long tube. A quick roll over
onto my left side, adding the put-you-to-sleep drugs into the IV, and 30-40
seconds later I was in la-la-land.
I came to sometime later (don’t know how long since I didn’t
have my watch on or my phone available). But I’m guessing that it was 45 minute
to an hour. The rooms that had been occupied when I went in were now empty and
the fellow just being wheeled back to his room was quite obviously having
trouble with sleep apnea (my wife says that mine is much better than it used to
be (a product of my weight loss) but this guy could have woken up anyone!).
The nurse said to me, as she was disconnecting the various
tubes, etc.), “your new doctor did you a real favor based on these results.” (I’ll
discuss them more below). I also had a bit of “gas” to pass – actually just
some of the air they pump in to inflate your intestine so they can see better.
It passes quietly and without incident just lying there in the recovery room.
After another brief visit from the doctor to give me a quick
oral summary (I guess that’s how his day goes – squeeze in pre and post-op
talks to each patient while the procedure room is being cleaned up and prepped for
the next patient). Then they drew the curtain so I could get dressed. Meanwhile
they called my wife to let her know that she could come and pick me up. They
escorted me back to the waiting area where she arrived shortly thereafter and I
went home.
First item of business – have something to eat – I’m
starving for “real” food. Can’t drive for the rest of the day, but that’s fine
with me.
Results
The results of a colonoscopy can vary from (1) we didn’t
find anything, see you in 10 years (which in my case would be never since they
typically don’t do screenings after age 75), (2) we found a couple of polyps
and removed them, see you in 5 years, (3) we found more than a couple of polyps
and removed them, see you again in 1 year, to (4) you have colon cancer and we’re
going to schedule you for surgery. In both cases (2) and (3) the removed polyps
are sent off for biopsy just in case, but the doctor’s experience tells him
that it’s not cancerous.
My results were, unfortunately, the third case. All of them
were removed and sent off for testing, but I’ll have to do this again in a year
just to see if any more have appeared.
So, while not what I was hoping for, this is exactly what a
colonoscopy is for – to see what’s going on and take care of things before the
polyps potentially develop, albeit quite slowly, into something far worse. I
have no family history of colon cancer, but this way I can avoid being the
first one.
Recommendations
If you’re over age 50, or you have a family history of colon
cancer – just go ahead and get one. The worst thing is the volume of water you
have to drink in such a short amount of time – but it’s just water. And while
there is a feeling of embarrassment at knowing that someone is going to be
shoving a long piece of tubing up your rear end, you sleep through the whole
thing so it’s really not a big deal. As for getting not the best results like I
did – while it means that I have to do this over again next year, it’s a far
better alternative than not getting things taken care of now and having a much
worse situation five years from now.
So go ahead – just do it!
