Surviving a Colonoscopy

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 2^nd 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!