The following were originally published in 2012 in three parts on three separate occasions as I ruminated, prepared for and underwent my first colonoscopy at age 50.  They were republished together as one post on December 2, 2015. Enjoy

PART 1

When you turn 50, all sorts of people, some you barely even know, will feel it is their duty to inform you it’s colonoscopy time, which incidentally is like hammer time – minus the silk vest and genie pants – because it makes me want to scream YOU CAN’T TOUCH THIS.

Anyway, these folks are nowhere to be found when you need to be reminded to get your teethed cleaned or a tetanus booster, or it’s time to change the batteries in your smoke detectors, but turn fifty and they’re crawling out of the woodwork, clanging the colonoscopy bell. They’re the same impertinent types who think it’s okay to touch a woman’s belly just because she’s pregnant. NEWS FLASH: it’s not…and stop being so pushy. My colon is my business.

People who’ve had colonoscopies (and apparently this includes everyone over the age of fifty except me) wear it like a badge of honor. They love to recount their own colonoscopic adventures, and while the details may vary from person to person, one thing remains constant. These wistful editorials always and inevitably conclude with, “You know,” nudge, nudge, wink, wink, “the colonoscopy itself really isn’t that bad. The worst part is the prep.”
Are you kidding? THE WORST PART IS THE PREP?

Am I expected to believe two or three days on a liquid diet and some laxatives, even the really super-industrial-strong-enough-to-clean-out-a-septic-tank prescription variety, is worse than someone sticking a camera (attached, mind you, to the end of a tube long enough to circumvent the globe) in my butt? I may be gullible, but I’m not THAT gullible.
I don’t care how small the camera is. I don’t care how thin and flexible the tubing is. I don’t care if the laxatives are strong enough to propel me into the stratosphere. I don’t care. I don’t care. I don’t care. There simply is no way you are going to convince me the prep is worse than the procedure. Call me crazy, but I don’t like people sticking things in my butt, even if it is medically necessary.

It’s a conspiracy, I tell you, concocted by smug colonoscopy alumni with their we-had-to-do-it-so-you-have-to-do-it-too attitudes. I recently told an over-fifty friend of mine as much when she started nagging, and do you know what she said? DO YOU KNOW WHAT SHE SAID? She said QUIT BEING MELODRAMATIC.

“Look, either you have cancer or you don’t,” she argued. “If you’ve got it, having a colonoscopy will save your life, and if you don’t, well, you’ll be relieved. So make the appointment and QUIT BEING MELODRAMATIC.”

Melodramatic? Moi? I suppose she had a point. I certainly don’t want to be a statistic, one of those should’ve-had-a-colonoscopy-could’ve-avoided-colon-cancer statistics. Turn fifty and a colonoscopy is a necessary evil. I was poised to agree when unfortunately she added, “Plus you’re asleep the whole time anyway. You won’t even remember it.”

ASLEEP THE WHOLE TIME?!

A little knowledge is a dangerous thing and a little more knowledge is even more dangerous. I knew about the camera and the long, flexible tubing and the point of entry, but I DID NOT KNOW I WOULD BE ASLEEP.

Go ahead, drop a healthy glob of shaving cream in my hand and tickle my nose with a feather when I’m asleep, but stay the heck away from my butt if you know what’s good for you. I may sound paranoid, but once the work is done, what’s to stop the doc from slapping a tattoo back there just for the fun of it? Or taking a few extra snapshots and posting them on facebook? See… not so crazy after all.

Still, I suppose I need to schedule the darn thing. I’ll do the prep and I’ll sign the consent form, but I will not consent to sleeping through it. No one, including some top of his med-school class anesthesiologist is going to force me to sleep through my colonoscopy. I’ll be the one washing down my preparatory laxatives with 5 Hour Energy Drinks. I’ll be awake during my colonoscopy…and I’ll be back to tell you about it. You can count on me for the truth about colonoscopies.

PART 2

Apparently it is common knowledge that men and women who are at average risk for colorectal cancers should undergo screenings at age 50.  I know this because when I turned 50 there was no shortage of people lining up to remind me it was time for a colonoscopy.

“Happy Birthday, Ant!  Hey, have you scheduled a colonoscopy yet?”

Sheesh.  How about I blow out the candles on my cake first?

When I finally wrapped my head around the idea of having a colonoscopy and called the gastroenterologist to schedule one, I was informed 1) I would need to make an appointment for a consultation first and 2) my doctor’s first available appointment was three months away. The office staff person apologized for the long wait, but all I could think was phew…this gives me plenty of time to get mentally prepared for voluntarily submitting to a camera being stuck in my butt.

They say time flies when you’re having fun and it does. Instead of mentally preparing myself for my inevitable colonoscopy, I elected to merrily go about my business and put it completely out of my head for most of the summer (the latter being infinitely more fun than the former). Three months flew and before I knew it, I was completing a five-page medical history on the eve of my GI consultation, all the while calmly expecting it would be another three months before I eventually would undergo a colonoscopy.

Not only was I wrong about the timing (the colonoscopy was scheduled for three days later), I also was advised that I was eligible for the buy-one-get-one-free colonoscopy/endoscopy combo deal AND under no circumstances was I going to be allowed to stay awake for any of it.

“Antoinette, since you suffer from chronic reflux, I’m recommending we do an endoscopy along with your colonoscopy. It’s standard for people with reflux and you’ll already be asleep for the colonoscopy so it makes sense to do the endoscopy at the same time.”
“What…WHOA…didn’t I mention I’d planned on being awake for the colonoscopy?”
“No.”
“Well, can I mention it now?”
“No.”
“Really?”
“Yes.”
“Why not?”
“While it rarely happens, there is a risk for intestinal perforation during the colonoscopy, but it happens with far less frequency when patients are asleep than when…”
“Never mind. Put me out.”

Dr. W——m went on to describe the procedures to me. She would insert long, flexible tubing into my rectum for the colonoscopy and down my throat for the endoscopy (not the same one, thankfully). I couldn’t help thinking we should invite my gynecologist to join – get the pap smear done while we’re at it. Anyway, she must have sensed my growing angst because as she handed  me the prep instructions, she smiled compassionately and offered, “I’ve been through it and really, the worst part is the prep.” So I’ve heard.

Fast forward two days. A clear liquid diet is the prescribed menu for the entire day preceding a colonoscopy.  In case you’re wondering, and even though one might argue that you can see clear through a glass of Pinot Grigio to the person sitting across from you in a dimly lit restaurant, white wine is not a clear liquid, but Jell-O is. Go figure.

At 3:00 pm, per doctor’s orders, I took two Dulcolax tablets and dissolved 238 grams of aptly named Miralax (short for “miracle laxative”) with 64 ounces of Gatorade. At 5:00 pm, per doctor’s orders, I began drinking the Miralax-Gatorade concoction in 8 ounce doses, at 10 minute intervals.  I did this 8 times – until every last drop was gone. At 8:00 pm, per doctor’s orders, I took two more Dulcolax tablets on the off-chance that 15 days worth of laxatives crammed into two hours might not do the trick.  Then I waited…

Let me tell you. When it’s time for a colonoscopy, you’ll receive all sorts of advice from people who want to share their stories. They’ll tell you things like which  Gatorade flavors taste best and not to get too far from the bathroom, and blah, blah blah. However, there are a couple of things no one tells you.  These things are very, very important,  so pay careful attention.

DO NOT LOOK IN THE TOILET. No one told me, but I am telling you. Do not, under any circumstances, look in the toilet after making a deposit. The first few visits are pretty much what you’d expect, but after that there’s no telling what you’ll find.

“PAAAAT,” I screamed for my husband from my perch on the commode,” THERE’S A PLANT IN MY POOP!”
“Relax,” he shouted back,” you eat a lot of salad and we had broccoli for dinner last night.”
“THIS IS NOT A LEAFY GREEN VEGETABLE NOR A FLORET. THIS IS A VERDANT, FLOWERING PLANT. COME LOOK… IT HAS ROOTS!”
“That’s okay. I believe you.”

For nearly 15 hours I continued to pass various species of plants, sediment, and other pieces of debris. Among the identifiable was an eraser (I recall accidentally swallowing it in sixth grade while chewing on the end of my pencil during a particularly stressful math test), a mosquito or possibly a tse-tse fly, and what appeared to be the remains of a bratwurst I’d eaten at a Braves game back in 2007 or possibly a chunk of my appendix – both equally disconcerting. Take my advice. Do not look in the toilet.

Finally, and possibly the most important thing no one else will ever tell you about preparing for your colonoscopy. In fact, it’s so important that if I was allowed only one piece of advice to give you, it would be this:  it’s never just gas.

 

 

 

 

PART 3

It’s official. I am now a card-carrying member of the Prep-Is-Worse-Than-The-Procedure Club member. I never thought I would turn coat, but I did. Prior to going through the ordeal, I found it unfathomable to imagine there could be ANYTHING worse than having a camera stuck in my butt, but there is…and it’s called “The Prep.”

The Prep, a.k.a. bowel cleansing, is a necessary evil. In fact, it is the single most important precursor to a successful colonoscopy. If your Prep isn’t up to par, your doc may miss one of those minuscule polyps and lesions that can lead to cancer. This is why patients are required to empty the contents of their colons on the eve of these procedures, and why I dutifully went about cramming 17 days worth of laxatives into three hours (per doctor’s orders – not my idea), which resulted in the most purgative, high-velocity, high-volume, longest running episode of diarrhea I have ever experienced in all my life. I’m not kidding. I think I may have pooped out a tonsil.

I know what you’re thinking, enough with the Prep. We want to hear about the colonoscopy. Here’s the thing. There simply is not much to tell. Honest. I know I said I wasn’t going to do it, but I did. I slept through the entire procedure and I can’t remember a thing past my lips going numb, my tongue growing six times its normal size and spittle rolling down my chin as I tried to form the word NO in answer to my doctor’s question, “Are you beginning to feel the effects of the anesthesia?”

You might remember my bold proclamation, something along the lines of UNDER NO CIRCUMSTANCES WILL I BE ASLEEP DURING MY COLONOSCOPY. I’d never had anesthesia and was very anxious at the possibility of something going dreadfully wrong.  It may seem irrational, but I was petrified I might never wake up. That is until the morning of the procedure, at which point I was more petrified I might never stop pooping long enough to fall asleep. Ever.

I pooped all night…ALL NIGHT I TELL YOU. Between toilet jaunts accompanied by personal hygiene coupled with A and D Ointment applications, I never fell asleep. NEVER. By the time I arrived at the hospital I’d been awake for over 30 hours, half of which I’d spent pooping, and was begging for a shot of something – ANYTHING – to knock me out.

I know. I know. You held my hand while I ruminated over making an appointment for this thing. You listened while I whined and moaned about laxatives and liquid diets. And now you want  (if you’ll pardon the pun) the “poop” on the procedure. Okay. Okay. Keep in mind I do not remember much, but I’ll do my best.

They tell you to bring a buddy along when you’re having a colonoscopy so I brought my husband. We arrived at the hospital in plenty of time to walk the fourteen miles from the parking lot to the GI lab, including one stop along the way to poop (me not him). I checked in at the front desk, was handed the HIPAA thing and told to have a seat in the waiting area. I pooped. I sat down and did not read the HIPAA thing, opting instead to dig around in my purse for my Kindle. I pooped. I was called back to the desk to register, which involved providing the exact same information I’d provided the week before when I pre-registered by phone. I pooped.

A kind nurse escorted me to the patient holding area. It was this big room with the thermostat set at something like 42 degrees, and divided into lots of smaller, individual examining rooms.

“HERE YOU GO, SWEETIE.” She handed me a hospital gown, “TAKE OFF EVERYTHING AND PUT THIS ON WITH THE OPENING IN THE BACK.”

In lieu of solid walls, curtains separated the examining rooms from one another, affording very little privacy. I guess I wasn’t the only one who elected not to read the HIPAA thing because I could hear every word of the conversations taking place in exam rooms on either side of me. It is why I self-consciously whispered, “May I use the bathroom first?”
“EXCUSE ME, HON?”
Slightly louder, “I need to use the bathroom first.”
“ARE YOU STILL GOING?”
“Yes.”
“IS IT LIQUID OR ARE YOU PASSING SEDIMENT?”
(Why do nurses shout at you like you’re deaf or not fluent in English?)
“I’m not sure. I stopped looking.” (Once I passed my appendix last night.)
“NO WORRIES, HON. GO AHEAD AND GO, AND THEN GET UNDRESSED FOR ME.”

A few other notable things happened in the patient holding area. It took three attempts, but my nurse was able to get an I.V. started and offered “a little something to help me relax.” I declined, prompted by the fear that any sort of muscle relaxant might impede my pinching my butt cheeks together tightly enough to keep from pooping on the gurney. I received a visit from the anesthesiologist, followed by visit from my gastroenterologist who, along with my shouting nurse, whisked me away to whatever you call the room where the actual colonoscopies are performed.

I have no idea how long I was in that room, nor what happened when I was in there. It’s as if that little chunk of my life never happened, but it did and the good news is I woke up.  Even better, I’m told I have the colon of a twenty-five-year-old, and better still is I won’t need another colonoscopy for a decade.

So there you have the truth about colonoscopies. The prep really is worse than the procedure, but it’s all good… in the end.

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