At my last physical, my family doctor told me to consider a colonoscopy to check for potential problems in my colon, given my family history (examples of colon cancer and polyps), my weight (never mind) and my age (fifty something). I didn't have any symptoms bothering me, but my gut told me to go ahead, in part because colon cancer is one of the top three most fatal cancers in Canada, and in part because I wondered what it would be like.
Four months previous, when I agreed to the date of the procedure, I had not considered the preparation leading up to it, particularly the day before, and the availability of support, which in my case, was my spouse. I realized this when the doctor’s office called me a week in advance to remind me and I actually looked through what I had to do. I canceled some meetings before and after the date. If you were one of them, now you know why. They also recommend you not travel for two weeks following the procedure, just in case.
The Week Before
The bulk of the instructions was a not-to-eat list of things that could affect the quality of the colonoscopy. And you don’t want to do it again if you don’t have to. Most of them were high fibre foods, which I have recently been trying to eat more of. They may be good things in general but bad for a colonoscopy because they can take longer to get through your innards and denser materials like seeds may be less likely to be flushed out with a laxative. These were the foods I was told not to eat:
- Breads with whole grains
- Fruits/vegetables with small seeds
- All types of nuts
- Popcorn/flax/ sesame
- Oats/ oatmeal
The most difficult adjustments were oats, because I eat steel cut oats for breakfast, and rice, which I eat regularly at other meals. Some lists I have seen specified brown rice, but I decided to play it safe and cut out all of it. I was a little confused about the small seeds, but found out this includes things like strawberries and blueberries as well as tomatoes. This was sad because I had just bought some awesome strawberries. I have an intolerance for many kinds of nuts and sesame, so no problem there, although I often snack on pumpkin seeds and chick peas.
An unexpected part of the list was iron supplements, though I don't take them anyway. Iron makes feces thicker and darker, and takes a while to pass out. Foods with iron are supposed to be okay. Another unexpected item was blood thinners. I don’t take them, but if you do, you're supposed to discuss the situation with the gastroenterologist. Seems to be a precautionary measure in case something happens during the colonoscopy.
The Day Before
People often suggest this part the bowel preparation is worse than the colonoscopy itself, so I was a bit concerned. From midnight of the day before my procedure, I was not to eat any solid food and drink only clear liquids. It is interesting and weird to think that Jello is not quite solid. If you go for that as an option, you’re not supposed to get red or purple drinks or Jello because if you have any left in your bowels it could be confused with blood and you don’t want any unnecessary confusion. I went through two packages of lime Jello, but could have eaten more.
The rest of the time, I drank cold, clear grape-cranberry juice mixed with some sports drinks. I cannot claim this concoction has any particular justification, but again, I had to make sure they were clear and light-coloured. I also had green tea and some clear broth. I alternated the cold and warm, sweet and salty for variety.
From 4 pm until 6 pm, bowel preparations began in earnest, as I had to drink large quantities of a laxative. I used CoLyte, a laxative containing polyethylene glycol and electrolytes, that I bought from a pharmacy without a prescription. It came as a powder in a container that looked like it was for antifreeze. I added 4L of water and left it in the fridge. I later realized I had not mixed it thoroughly enough, so it tasted okay at first and then really awful toward the end. I have seen different strategies for drinking it. The container says to keep going until it is all gone, but my instructions were do drink 2 L today and then the rest tomorrow, so that’s what I did. I had a cup every 10 minutes, and it took about an hour to finish 2L. Some recommend drinking through a straw so that not so much swishes in your mouth. I thought it wasn’t so bad at first, so drank it without a straw. In retrospect, that should have been a clue that I hadn’t done it quite right.
Even in the diluted form, I had to use the toilet about four times. Some people suggest just sitting on it the whole time. By 6, I stopped drinking any fluids altogether and went to bed feeling a little hungry.
The Day Of
I was supposed to finish the second installment of CoLyte between 6 and 8 in the morning. But first I had to walk the dog and make my daughter’s breakfast and lunch, so I didn't start until about 7 am. When I started the CoLyte this time, I realized it tasted more intense than the day before. That was when I noticed sediment on the bottom and realized it needed more mixing. A cold fruit juice chaser helped it go down. Not long after I finished it all, I frequented the washroom. I also felt cold. I must have been losing a lot of body heat as I kept flushing out my insides, which become more number 1 than number 2. Make sure you have lots of good toilet paper ready. I had to stop taking fluids four hours before the test, which was around 9 am. It took about an hour to finish flushing. When I took the bus into the clinic, I was feeling a little weak, so it might have been smarter to have someone with me.
At The Clinic
Before you arrive, you need to plan for someone to take you home because you might feel woozy. Your helper can confirm when to come back. I brought a change of clothes in case I had an accident, but fortunately I did not need them. When I arrived, they gave me a frock, open at the back, a robe and socks with sticky pads for traction. They packed all my belongings under my mobile bed.
A nurse stuck a needle in the back of my hand for adding the sedative later. She also attached sensors to be able to monitor my heart rate. She asked me a series of questions, including my birthday.
When it was my turn, another staff member asked me my birthday; I suppose to make sure I was alright and to confirm I was the right person. She wheeled me into the examination room.
Another nurse greeted me and asked my birthday.
She had me lay on my left side, and I am not sure what they were doing behind me or even what the scope looked like. They were giving me sedative and I felt a little woozy but remained conscious. I did not feel the scope go in. I was facing a monitor showing what the scope was seeing. It reminded me of National Geographic show on spelunking, climbing through tunnels. I was pleased with myself for having what seemed to me such a tidy bowel. They told me that if they had seen something, they would likely be able to remove the polyp right then.
Virtual colonoscopy is becoming more widespread, but you still need to clean out your colon, and if they find something then they need to get in there to remove it. Sometimes I did feel uncomfortable, like I had gas, but eventually it passed. Overall, the process took maybe fifteen minutes. They gave me a clean bill of health. At my request, they printed out a few pictures as momentos.
They wheeled me back to the holding area for about half an hour to make sure my vitals were stable. The nurse gave me juice and a digestive cookie. From my arrival to departure, the entire procedure took about two hours.
My wife drove me home and I was glad to eat solid food. I was tired but otherwise felt fairly normal. I was told I could do it all again in another five to seven years. So if you are sitting on the fence about getting a colonoscopy, I'd say it wasn't as bad as I thought it would be. If you are seasoned pro at this, then leave some suggestions in the comments.
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