I know, you’re thinking “How could having a colonoscopy be on anyone’s bucket list??? Ugh!” But after I thought about it for a few minutes, it was an obvious choice to add to mine, right next to visiting Stonehenge and learning how to play the piano. (Trip accomplished, piano being tortured on a daily basis…)
I’ll be the first to admit that having a colonoscopy wasn’t on my bucket list when I turned 50 — and nor was dying of colorectal cancer. Since screening is the easiest way to help detect early signs of cancer, my bucket list grew by one item: Have a colonoscopy. I’ll also admit that turning it into a bucket list item made it feel like a more positive experience rather than being just another one of those yucky things I was supposed to do when I turned a certain age.
The first screening I had was before there were alternatives to colonoscopy, described by Ruth in a recent post, so I had no choice in the matter. And because the doctor discovered a polyp during that colonoscopy, I continued with colonoscopy as my screening method of choice earlier this year (but I’ll revisit it with the doctor next time).
I’ll admit it, the first colonoscopy was a bit of a trial. I was anxious about it for days beforehand, mainly because I didn’t know what to expect. I was already feeling sorry for myself! A good lesson in why it’s better to live in the moment; I wasted days of possible tranquility.
A colonoscopy takes some preparation on the part of the patient (more on that later). For me, there were two days of dread anticipation: the day of preparation (prep day), and the day of the procedure. As it turns out, there are ways to lessen the discomforts of both days, but I didn’t know that then. It isn’t a subject that most people talk about…
The goal of prep day is for you to empty your colon. To achieve this goal, you need to avoid adding more food to your colon and to flush out what’s already in there. Your doctor’s instructions might differ from the ones I received but they’re probably very similar:
- Purchase the recommended laxatives (in my case, it was one 8.3 oz bottle of Miralax (generic is Polyethylene glycol), and four Dulcolax tablets (generic is bisacodyl).
- On prep day, drink only the recommended clear liquids from the time you get up in the morning until midnight. Your doctor will give you examples of which liquids are allowed; mine included broth, jello (no red), carbonated drinks, clear juices, coffee or tea without milk or cream. I was not allowed solid food, dairy products, non-dairy creamers, and cloudy liquids such as orange, grapefruit, or tomato juices.
- Mix the entire contents of the Miralax bottle with 64 ounces of water. You can refrigerate the mixture if you want to. On a schedule that started at 3:00pm, I began taking the Dulcolax tablets and drinking my way through the Miralax solution.
- The final instruction: “For the remainder of the night, stay close to a bathroom.” Pay close attention to this one!
Everyone reacts to the prep differently. If you’re lucky, it will take effect quickly; if you’re like me, it will take a few hours to take effect. In either case, when it does take effect, you’ll have an urgent need for the bathroom over the next few hours. It will feel like a bad dose of diarrhea, but without feeling ill, and it won’t last long.
The medical team does the work on procedure day, not you! There’s not much for you to do except show up at the facility wearing loose clothes and no jewelry. Be sure to follow whatever instructions the doctor has provided regarding existing medications you might be taking, and so on.
My doctor’s office used what they call “conscious sedation” rather than deep anesthesia. I don’t know if this is the case for all colonoscopies. The sedation was deep enough that they require the patient to be driven home. A good call on their part because I was a bit loopy when I woke up. But I didn’t feel a thing during the procedure and had a good sleep to boot! There was a little discomfort from the air that gets introduced into the colon during the procedure, but it didn’t last long and it wasn’t bad.
When I got home, I went to bed and slept on and off for about four hours, after which I felt a little delicate but perfectly fine. Funnily enough, I wasn’t even hungry until the evening!
Tips and tricks
Don’t wait until prep day to buy the laxatives. Buy them in advance, and then forget about them until you need them. You don’t need the anxiety of discovering at the last minute that the store is closed or out of stock.
On prep day, try not to sit around feeling sorry for yourself. If it’s a work day, just go about your business as usual but maybe head for home a little earlier than normal. If you’re at home, try to distract yourself: go to a movie, go for a walk, or read a book. Try to remember that until the late afternoon, it’s just a normal day (but without food). Drink as much as you can tolerate; it will help with the process later in the day…
If you have the option, try to book an early appointment on procedure day. Remember that you may not eat or drink anything after midnight (including water unless your procedure is after 12:00 noon). One time, my appointment was scheduled for 1:30pm and I’ll admit that by the time I got to the facility, I had a headache and was feeling very miserable.
If you have the option, schedule the procedure so that the prep day works out better for you. For instance, if you typically have a social get together with friends or family on Sundays, try not to schedule a Monday procedure. Not every facility performs colonoscopies every day, so your choices might be limited.
A nurse gave me this tip: instead of mixing the laxative with 64 ounces of water, mix it with 16 ounces, and force yourself to drink the first two glasses. (It doesn’t taste good but it’s over quickly.) Thereafter, you can drink the balance of the 64 ounces as plain water. I’ve tried this once and the results seemed to be the same, but I didn’t do it most recently. (To be honest, I forgot about it; I probably would have otherwise.)
If you are bothered by the taste that the mixture leaves in your mouth, freshen up by brushing your teeth (and tongue) in between drinking each glass.
Like so many things in life, it’s the last 10% of the effort that’s the hardest. It isn’t all that challenging to drink the first several glasses of the mixture. For me, it was the last 16 ounces that made me want to run away. I was so tempted to pour the last few ounces down the sink. If you find yourself tempted to cheat on the preparation, resist the urge. The only person you’d be cheating is yourself. You want the medical team to find even the smallest problem that might be lurking in your colon, so give them the best chance by following the instructions, and drinking up every last drop.
The microbiota in your gut takes a bit of a beating as a result of all the elimination. In fact, it will be just about depleted so, as soon as you can eat, be sure to include plenty of good fiber (prebiotics) and probiotics.
The good thing about having a routine colonoscopy is that you only need them once in every five or ten years.
Are they fun? Absolutely not.
Are they awful? No, they aren’t.
Are they useful? Yes, they absolutely are, so do yourself and your family a favor by addressing a potential problem before it becomes critical.
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