“Happy last day of food!” Connie called to me as we left the health club.
That was because when I awakened the following day, I would be preparing for my first colonoscopy. I would be limited to clear liquids, no solids, for more than 24 hours. And if that weren’t bad enough, I also would be forced to drink one specific — four liter! — bottle of medicine-laced, nasty-tasting water meant to induce diarrhea.
So clear liquids with a clearing liquid chaser. Yay, me.
I like to do everything right, and I intended to approach prepping for a colonoscopy the same way. Correctly. Because the last thing I wanted was to go through the prep and arrive at the facility to find myself rejected on some sort of technicality. My goal was not only perfect prep but also (not under my control) the absence of polyps — so that I wouldn’t have to do another colonoscopy (or, more important, another colonoscopy prep) for 10 years.
A “prepper” or a “doomsday prepper” is someone who actively prepares for emergencies, disruptions in the normal social order, Armageddon, whatever, by stockpiling long-lasting supplies and learning skills necessary for surviving when life as we know it is over. A “prepper for a colonoscopy” is merely a pooper, stockpiling nothing, flushing everything.
The prep before the prep
I spent Wednesday eating normally, happy that my husband had steak prepared for dinner, something hearty to carry me through that night and the next day and night and the following morning of the procedure. I couldn’t eat enough.
I also spent Wednesday viewing the Emmi videos my doctor’s office urged (and nagged) me to view. Three lengthy videos (no pause button accessible) covering anesthesia, colonoscopy, and patient safety. The video told me about every type of anesthesia on the planet — and all the potential complications and risks — but gave me no inkling as to which type of anesthesia I would be getting. The colonoscopy video was more enlightening, since that was the procedure I was having. Each video concluded with a series of potential complications and risks, for which I was required to either click “tell me more” or “next” to move to the next slide. Either way, I am pretty sure the site recorded my every click, acknowledging that I had been warned and was therefore responsible while the health care system was off the hook. Stroke, cardiac arrest, internal bleeding, broken teeth, allergic reaction, brain damage, death and more. It was terrifying.
On Thursday, I wrote out my Advanced Directives — just in case.
Prior to the prepping, I had completed the most important preparation — making the call to my insurance company to determine how much of the colonoscopy was covered. I would be visiting a clinic for the procedure and would be billed by the facility, the doctor, and the anesthesiologist. Also terrifying.
A week before, the facility called me to confirm I was planning to make the appointment and then asked me if I had any questions.
“Just one,” I said. “Do I have to do this?”
Yes, I whined.
The woman on the other end said that was what she’d asked when she’d done it but that the prep is worse than the procedure. I know, I know. That’s what everyone says.
The prep that isn’t pretty
I spent Thursday drinking clear stuff. Got a bit of a headache, noticed that all my teeth hurt. Nerves. Logically, I knew that both the prep and the procedure would be fine, but I wasn’t able to make my body believe that. (Or else I was going through detox due to food withdrawal. When I was a teenager, I used to fast once a week for spiritual purposes, except that I allowed myself any liquids — like the milkshakes they served in the cafeteria at school. So, not really good practice runs for this legit fast more than 30 years later. Which, ironically, would give me the runs.)
I worked just over half a day so that I could hurry home to drink the more than a gallon of requisite diarrhea inducer.
The generic instructions told me to start at 3 pm, drinking 8 oz. of the liquid quickly, having subsequent glasses every 10-15 minutes, completing half the bottle in an hour and a half. I would then have to start again at 9 pm, same program, finishing no later than midnight. Since my preferred bedtime is 8 or 9 pm, I decided to shift my consumption to begin at 2, then again at 7, so I could get to bed.
I should have asked if that was OK.
But my appointment was for 8 in the morning, and since the office had originally offered me a 3 pm time slot, I figured everyone was getting the same instructions no matter what time the procedure would occur. Why don’t they offer generic instructions that fit every time slot — like “48 hours before stop smoking and drinking alcohol,” “24 hours before stop eating solids and drink only clear liquids,” and “15 hours before start drinking the diarrhea inducer”?
I typically follow instructions to the letter, but I didn’t see how starting early could be a problem. Empty of poop is empty, right?
I had added lukewarm water to the 4-liter container the night before and placed it in the refrigerator, as the video suggested that drinking the fluid chilled and through a straw was more tolerable. My friend Connie had suggested mixing it with ginger ale (soda, not beer), but the pharmacist’s instructions nixed that idea. Instead, I poured a swallow or two of ginger ale into a separate cup and used it to chase the eight ounces of nasty water.
A few glasses into the prescriptive liquid, the flushing began. My intestines, the toilet. Yup.
My husband was ever attentive.
“What’s for dinner?” he asked me about 6 pm.
Ha ha ha.
Ironically, one of the worst parts (other than actually tasting the fluid as I drank it, which I couldn’t seem to avoid) was that it made me cold. It was a lovely sunny, cool day in Florida, but pouring cold drink after cold drink into my body made me positively shiver. When it was time for the second half of the bottle, my husband and I moved down to our bedroom. I packaged the large drug drink and the bottle of ginger ale in a cooler and headed down to my heated blanket. Unfortunately, between drinking and pooping, I didn’t get under the warm blanket very often.
I had worried that my bottom would get raw with all the “pooping” and wiping, but fairly early in the process I realized that my butt had turned into its own internal bidet. Tinted water, then clear water emerging from my body allowed me to merely blot dry rather than wipe. Efficient.
As I drank the next to last glass of the medicinal liquid, I gagged. I wanted to quit, but my dear husband told me I had to finish it all.
Post prep but pre-procedure
I was glad I did, because the first question the nurse asked me the next morning was if I had consumed the entire jug.
Yes. (Whew. Thank you, Steve.) Go, Sara!
“What time did you start and what time did you finish?” she asked.
I told her and explained why.
And got scolded in return. (Apparently, empty of poop isn’t empty if you get empty early.) But she didn’t send me home and make me start again. (She probably sensed the pleading and whining that would ensue.)
“If the doctor tells you your colon was murky, that’s why.”
So much for trying to do everything correctly. I was still breathing a sigh of relief that I wasn’t being sent home.
She moved me to a little curtained room, where I had to strip and put on slip-proof socks and a hospital gown, untied and open in the back. Then begin the line of medical professionals, asking me many of the same questions, the most common being “what is your name?” and “what is your birthday?” Oh, and, “you are here for a colonoscopy?”
A different nurse started an IV, gave me Pepsid to avoid stomach discomfort and stuck a medicinal patch behind my ear to prevent motion sickness. I met and spoke with the doctor and the anesthesiologist, was allowed a visit by my husband (who failed to shoot a photo of me for this blog post), and then was greeted by yet another medical professional who likely drives race cars on the weekend. She drove my bed through the facility’s crannies and curves and corners until I was in the room where the doctor would complete the colonoscopy. (The real reason for the patch that prevents motion sickness was the transport not the procedure, I suspect.)
A woman I had not yet met introduced herself as the anesthesiologist’s assistant who would “make me drowsy.” But first, “what is your name?” “what is your birthday?” and “you are here for a colonoscopy?” All answers recorded on videotape. She took my glasses, asked me to roll on my side, propped my head on pillows. And then she started two hypodermic needles simultaneously in the IV on my hand, and the burning startled me. She told me that was normal and would pass. I noticed fog in the room…
The next thing I knew, I was awakening in recovery. My husband was right, it was the best sleep I ever had, although the nurse who greeted me indicated that belief was actually considered a “side effect” of the anesthesia. Huh. I’d like more side effects like that. The nurse also told me the results:
No polyps = no repeat colonoscopy for another 10 years. Truly, yay, me! Success!
“Did the doctor say my colon was clear?” (I didn’t want to suggest “murky.”)
“Yes. Everything was clear,” the nurse said.
(I saw the pictures later; the images were squeaky clean. Perfect, even. Ha! I did my prep correctly after all.)
She sat me in a chair, gave me some cranberry juice, handed me the bags holding my clothes and shoes, told me to get dressed while sitting, called for my husband, repeated to him what she’d told me, and then walked me out to our waiting car.
In which my husband drove us to a restaurant for breakfast.
Because it was time to restock the colon. 🙂