First Time Getting a Colonoscopy

If you’ve had a colonoscopy you can probably skip this one, unless you have some concerns about how this works in an RV, which I will be talking about.  Don’t worry, it won’t hurt my feelings. Also, I am NOT a medical professional, so this is simply a first hand account from a regular person.  When it’s your turn to get the procedure done, read the paperwork, talk to the doctor, and follow their advice.,  I simply offer this as a first-person account from a patient.

I decided to write about it for a couple of reasons.  I like writing about firsts.  There is a clarity of vision that happens when you do something for the first time and this to me is a pretty big first.  I knew when I turned 50 this procedure would need to take place and since I am an analyst by nature I started asking friends who had gone through it for information.  It’s a pretty personal subject,  and when almost everyone I talked too said something along the lines of “it’s not that bad…pause…the prep is the worst” I simultaneously felt better about it (after all, they had survived) and concerned about the dreaded prep. So when my time came I decided to go ahead and write about it.  Yes, there is poop involved, but I write about poop all the time, and more importantly the procedure seems to me to be a rite of passage, where we transition from “young people healthcare” to “older people healthcare.”  That’s just my take on it, but it seems like a dividing line milestone of sorts, and as such deserves attention.  Plus it turned out to be much more complicated than I originally envisioned and that is always worth a post.

I am going to start with how difficult it was to schedule this procedure.  If you have a “regular” job and live in a house, and have a doctor, scheduling one of these might be an inconvenience but isn’t that difficult.  For me, this was not the case and I started trying to schedule this last summer in Alaska, and almost 1 year later I finally am having the procedure.  In all fairness, Alaska was a difficult place to schedule something like this, and the closest hospital was a couple of hours away.  But after that we had the beet harvest (40 straight days of work with no scheduled days off), Christmas Trees (6 weeks of straight work with no scheduled days off), and then 2 months of gate guarding with no scheduled days off and a 24/7 schedule.  I thought about doing it while gate guarding since we were about an hour away from San Antonio, but I wasn’t sure how I could make the 24/7 schedule work with the prep.  Towards the end, when things slowed down, we probably could have made it work, but you can’t just schedule these appointments last-minute.

For example, here in Oregon I went to the doctor at the end of May, who referred me to the specialist, who contacted me 30 days later, and then scheduled the appointment for 6 weeks after that.  All in it took 3 months to get the appointment scheduled, so keep that in mind if you are a person who travels frequently.  One way around this of course is to have an established relationship with a doctor, who might be able to work with you to schedule the physicals and colonoscopies close to one another. Or, if you follow a route and know in advance when you will be in a place you might be able to hit the appointment on two different trips.  With our work schedule this was very difficult for us and ultimately I feel very lucky we were able to fit it all during the 4 months we are in Oregon this summer.  Being next to a major city absolutely helped.

After the specialist called to set the appointment, I had to do an initial screening.  Because I had no health issues, I was able to participate in an online screening which saved me an hour long drive into the city of a screening appointment. It took about 20 minutes (mainly answering health question) and then they sent a large packet of information.   Included were several forms that had to be filled out and 16 pages of instructions. Just to be clear, I am not a medical person and these instructions were specific to me.  Make sure you read yours thoroughly, because, in my case at least, it turned out the prep process started a week in advance.

Basically I had to stop taking herbal supplements (no problem as my multivitamin was fine), stop taking blood thinning medications (again no problem, I don’t take any), and finally stop eating visible nuts, seeds, and whole grains.  This one gave me pause.  As I read further that meant no popcorn (that’s a bummer), no jams or jellies (since Peanut butter and jelly is a go-to for me that wasn’t great), and finally no tomatoes.  What??!!  I love this time of year because there are only a couple of months where real vine tomatoes are available and my own plants are finally starting to pink up.  What a bummer.  And not surprisingly, as soon as someone tells you that you can’t eat something all you want is to have it.  Some fruit you can eat if you pick out the seeds, but I tried that with a tomato and was basically left with a shell because all the good flavor is in the middle where the seeds are.  Sigh..lesson learned.  Don’t schedule these tests in prime tomato season!

We also had to get a Suprep Kit which ended up costing a ridiculous $87. Basically it contained two bottles of liquid and a couple of plastic cups, I wonder how much extra they charged for those cups.  Our insurance unfortunately didn’t help at all with the cost of the kit and although the specialist office offered a free sample we would need to drive over an hour into town to go get it.  Ultimately we just bit the bullet and paid full price at the Walgreen’s 20 minutes away, and thankfully I had money in our HSA account to cover it.

Next I had to go to the store and get a list of items for the 36 hours I wouldn’t be able to eat.  Oh yes, I was surprised to read that starting at 7am the day before, clear liquids (and gummy bears) only and then no liquids at all 4 hours before the procedure.  I don’t think I have ever gone 36 hours without eating solid foods before and I was a little concerned because I am hypoglycemic.  I was diagnosed in college (took this test that almost made me pass out), but since then I recognize the symptoms and control through my diet.  Plus, the effects seem to have lessened as I have aged (and put on more weight) so really it isn’t that big of a deal.  Still, I have never gone that long without eating and wanted to make sure I had lots of options to choose from.  I also needed to get some tushy wipes, because well you know, there is lots of wiping and skin gets chafed.

This was another area where living in an RV had an impact.  Yes, they sell septic safe wipes, but Lee didn’t feel it was a good idea to put those in the tank in any event, so we came up with a workaround to use a trash can and a liner during this time period and keep the wipes out of our tank.  All in all I thought it might be pricey and I was right because by the time I was done I had spent $60. In all fairness, I went to the local market that is more expensive and I am sure I bought more than I needed, but I didn’t want to run out of the few items I could have.  The list of what I bought is below and the most disappointing part of the list was my need to stay away from anything cherry flavored because the dye might make the colon look inflamed.  Cherry stuff is my favorite and I am just not a huge fan of other flavors so my choices were somewhat limited.  Anyway here is the list

  • Two packs 7th generation wipes
  • Vasoline this didn’t help at all and later I sent Lee out to buy Desitin which worked MUCH better
  • Two 2-liters 7up
  • Two Powerade white cherry not a fan and two Powerade lemonade not great but ok
  • A six-pack of Propel berry flavored  which I liked much more but these power drinks are not cheap
  • Halls Mentho Lyptus recommended to help numb the taste buds before drinking the Suprep.
  • Crystle Light to mix with the Suprep seriously how bad does this stuff taste
  • Minions Popcicles.  Since cherry and grape flavored were not allowed I was lucky to find some Minions popscicles which only have yellow and blue Popsicle.  Not a huge fan of those flavors, but since it is on of the few “solid” foods I can eat I bought them. The lemon ones were really good and made me feel “full” at least for a little while. The blue ones were totally yuck!!
  • Two cans of chicken broth and two cans of beef bouillon.  These are important for protein and thankfully I had a Clear Japanese Soup recipe I have been wanting to try anyway.  Basically it is a can of chicken broth 1 tsp soy sauce and 1 tablespoon of sherry.  It was really yummy, but I wish I could have added some scallions and thinly sliced mushrooms. I checked on-line and soy sauce is allowed and it turns out white wine and beer are also allowed and I decided to roll the dice on the little bit of cooking sherry and by the way with alcohol allowed I understand how people get through this!
  • And finally four bags of gummy bears!.  The only thing you can eat that is solid is gummy bears and thankfully I am a big fan.  

Gummy bears and popsicles are the only thing you can eat that you can bite into and I wanted to make sure I had plenty of each.  I should stop and talk here about how weird it is not being able to eat something when there is food nearby.  This requires willpower and some mental concentration, especially because the RV is a small space and Lee was of course eating.  He did offer to leave at lunch and dinner and eat out if I needed him to (which was very sweet), but I felt like if I needed to I could just walk outside. He was nice enough to eat Hamburger Helper, which is not something I will eat, but I have to say on this particular day it smelled pretty good.

It did occur to me at this point though that I was very lucky to not have an eating disorder.  Food is a basic human need and as such for many people is tied up in their emotional state as well. During one of my pregnancies I gained 50 pounds and it wasn’t until then that I realized how much food and my weight impacted how much I felt in control. I was lucky that was a temporary situation, but I learned enough to know how serious eating disorders can be for people.  Which led me to think how difficult this must be for people in that situation and wonder why there isn’t an easier way to do this.  I understand the mechanics.  Things need to be cleaned out in order for them to take a look, but the process of cleaning you out seems pretty extreme and somewhat archaic.  I wonder how many people avoid the test because of what they have to go through in prep.

Thankfully for me my two big addictions, cigarettes and coffee (black which is how I drink it) were allowed, along with soft drinks.  It didn’t say anything about them needing to be clear soft drinks, by the way, and even said Coke was OK.  I am guessing that is because lots of people have soda addictions and getting them to give them up for 36 hours would be tough.  My paperwork didn’t say anything about alcohol one way or another.  I found the bit about beer and white wine being OK online, but since the last thing I want to do is add alcohol to this process it wasn’t a big deal for me.  I’m guessing they didn’t want to print that alcohol was OK in the paperwork, but since it is OK they left it out all together.   Definitely ask your own doctor about this if it is important to you and  if you decide to drink make sure you have lots of other fluids as well to stay hydrated.

I had scheduled the procedure on Wednesday at 1am which meant that starting at 7am on Tuesday clear diet.  So I thought about what I wanted my meal to be on Monday night and decided on Pzza Hut thin and crispy pizza.  What goes in must come out, so I wanted to make sure I stayed away from anything spicy!  It’s kind of a bummer that this is taking both of our days off, but Lee was pretty understanding about it and we settled in for some household stuff that didn’t require much physical activity.  I did do the recycling first thing in the morning, but by choice decided not to do anything else strenuous for the next two days.

While I was waiting until 6pm for the first Suprep dose, I read through all of my paperwork.  Everyone says they don’t remember the procedure, but it wasn’t clear to me if they didn’t remember it because they were knocked out or if it was because the anesthesia makes you forget.  Turns out that if you read between the lines of the release forms, you are awake during the procedure.  I had to sign a form stating they may not be able to finish the procedure if the patient was too “uncomfortable.”  So obviously you can feel something when it is happening and I wasn’t too crazy about experiencing something and then forgetting about it.  I am young enough though to have talked to people who had the colonoscopy before the “forgetting” drug was used and what they remembered didn’t sound that pleasant so maybe it’s for the best.  In my opinion these tests are incredibly important and if that’s what it takes for people to go back for a second test, so be it.

I also ate my gummy bears, tried some soup, and tried the different drinks I had.  Sugar was a bit of an issue.  I wanted things that were sweet, but if I overdid it I didn’t feel that great. When  you are hypoglycemic the body creates too much insulin if you overdo it on sugar and the body “crashes.”  I usually combat this with avoiding sugary things in the morning and only eating deserts when I have proteins and carbs already in my system.  That way the effect is minimized.  I obviously couldn’t do that this time around, so I tried to intersperse no sugar options with the more sugary alternatives.  In retrospect I really should have bought sugar free gummy bears, because I went through a bag of those in the morning and then had to stop eating them for a while.  The soup helped some, but not enough.  I could have bought a clear protein shake of some sort which would have given me the protein I needed, but the local grocery store didn’t have any of the clear versions and  since they are so expensive and I wasn’t sure I could handle the taste I decided to try broth instead.

Finally 6pm came around and with hesitation I opened the mixture I had to drink.  I mixed it with a bunch of water, per the instructions, and then drank the 16 oz down.  First of all it tasted of medicinal berries and although it wasn’t super pleasant it certainly wasn’t undrinkable or anything. I got it down in about 10 minutes and then sat to wait for the result.  The instructions said the effects would start in anytime between a few minutes and a few hours, so I put on a loose pair of sweatpants and stayed close to the bathroom.

About 20 minutes later I started to feel pretty nauseous and then the beginnings of a headache started.  I was focusing on keeping the drink down mainly and then my stomach started to feel a little upset.  It started with some cramping in the stomach area and I had some gas.  At this point I should mention we only have one bathroom, but thankfully we have access to another work bathroom if Lee needed it.  I’m pretty sure I will be in and out of ours for the next few hours so Lee needed some place to go if nature called.  I also started to feel a little light-headed, and it could be a complete coincidence, but my nose got stuffed up and I had to blow it several times.

41 minutes later I had my first bowel movement.  It was watery, stung a little, and took several minutes to finish.  Hey this post is about a colonoscopy, you should have expected I would talk at least a little about the bowel movements!  I continued to feel nauseous and a few times had to fight the feeling that I was going to throw up. Pretty soon though things settled down and honestly it wasn’t that bad.  It was almost liquid and although I had to go every 10-15 minutes the first couple of hours it settled down after that.  I did start to get a little sore though and I really wished I had gotten the Desitin instead of the Vaseline which I found largely unhelpful.  I also wish I would have sprung for some medicated wipes although I found some hemorrhoid pads in our closet which helped quite a bit. And on the plus side I wasn’t really very hungry, all that pooping was a decent distraction.

Even though things slowed down I didn’t quite trust it enough to fall asleep, so stayed up until about 11pm.  I was pretty tired and fell asleep right away, but then woke up at midnight and went to the bathroom one more time.  This time it really burned, and although I took a shower and tried to spray the area with warm water the burning sensation did not stop.  Essentially, I had a pretty bad case of “diaper rash” and my cheeks were seriously inflamed.  This time it hurt pretty bad and it took me over an hour to finally fall back asleep, because I couldn’t find a comfortable sleeping position.

The next morning I woke up at 6:40am and prepared myself to drink another batch.  I wasn’t sure why I needed to, since I was pretty sure nothing was left in there, but my mom (who is a nurse) has specifically mentioned not skipping the second dose, because people do it all the time and it’s not good.  This early in the morning the taste was much worse, so I added a little crystal light lemonade to the mix (which didn’t help the flavor much) and struggled to get it down.

I also sent Lee to the grocery store to pick up some Desitin. I am not sure why this wasn’t recommended in my prep package but I would have killed for some last night.  While he was gone I drank the drink in as large of chunks as I could, rinsing my mouth out with water between sections.  I also stood up while I was drinking it (think chugging a beer) which helped me get more down in each section.  And I popped one of the mentholyptus cough drops in my mouth which did help numb my taste buds a bit which was helpful towards the end.  My nose was also immediately stuffed up, which helped with the smell if nothing else and I guess that wasn’t a coincidence from the time before .

I felt incredibly relieved when I got it down and was on the toilet almost immediately. I  fought the nausea, sipping on the followup 32 oz of water I drank, and tried to get through the morning.  It didn’t help that despite everything I was hungry this morning but the last thing I wanted to do was eat anything.  What goes in must come out.  Plus I only had until 9am until I had to stop drinking liquids of any kind, so I focused on getting hydrated.

No liquids is way worse for me than no food, because I drink water almost constantly.   I also remembered to take my jewelry off and like I said just tried to get through it. On the positive side the Desitin provided some instant relief and Lee even made me laugh when he handed it to me. He’s been a real trooper through all of this. Finally we left to go to The Oregon Clinic and since it was a long drive I was nervous and took a towel to put down in the car and extra pants and underwear.  Thankfully I was fine on the drive although I did have to use the restroom a couple of times before the procedure.

The procedure itself went great.  They took me right in and prepped me for the procedure.  The nurse, Hope, was really nice and they verified my health history, took my vitals, and put in an IV.  They verified who I was and what procedure I was having done several times and it was obviously a well run organization. Turns out they do 60 colonoscopies a day in this facility and after two new rooms are built will increase that to 90.  Some people might not like that, but it actually made me feel better.  I figured with that much volume they knew what they were doing.  Plus the nursing staff made it feel personal and despite the efficiency in the process I didn’t feel like I was being rushed through.

I had time to ask questions and I did clarify whether or not I would be completely knocked out.  Turns out they do NOT use the “Twilight anesthesia” and Vercet to make you forget but instead completely knock you out.  That was actually my preference and I was super relieved.  When I asked about the language that stated they would stop the procedure if the patient was in extreme “discomfort” and she explained that was for respiratory distress I felt better about the whole thing.

Eventually they wheeled me down to the procedure room and I answered some more questions for that nurse and the anesthesiologist.  Right before the doctor came in the song “What doesn’t kill me makes me stronger” came on, which made me laugh, and I explained to the doctor how appropriate that tune was for my first time colonoscopy. Dr. Lumm smiled and then was all business as he explained what they were going to do.  He also told me if I got a clean bill of health I wouldn’t have to come back for 10 years.  Nice!!

They had me roll on my side, put the medicine in and I was out in less than 5 minutes.  When I came to I asked to be taken to the restroom and was able to go with little difficulty.  I wasn’t in any pain thankfully although gas is a pretty common side effect and I did pass some of that.  Hope passed me along to Ben to finish off and he took some vitals and then got me a drink of water.  Not long afterwards the Doctor came in and told me I won the “colonoscopy jackpot.”  No cancer, no polyps, and I didn’t need to come back for 10 years.  Awesome!!  He went over some things to watch out for and then was on to his next patient.  Ben finished telling me about the side effects I should be concerned about and then told me how to get dressed.  The funniest part of the paperwork was don’t drink alcohol, don’t drive, and don’t make any major life decisions. The last part totally made me laugh and in less than 20 minutes or so I was out in the waiting room with Lee.

I did feel a teeny bit rushed at the end to be honest, but I was also starving and wanted to get something to eat.  We stopped and got a McDonald’s breakfast sandwich and hashbrowns (my choice because I thought it would be easy on my stomach) and then drove home.  I am sitting here finishing this post and it is less than 1-1/2 hours from the procedure.  I feel really good and am glad that it is all past me.

I know what I wrote above sounds unpleasant, so why get these tests done?  According to the American Cancer Institute, “Colorectal cancer is the third most common type of non-skin cancer in both men (after prostate cancer and lung cancer) and women (after breast cancer and lung cancer). It is the second leading cause of cancer death in the United States after lung cancer. In 2016, an estimated 134,490 people in the United States will be diagnosed with colorectal cancer and 49,190 people will die from it…Studies suggest that colonoscopy reduces deaths from colorectal cancer by about 60 to 70%”   I’ll take those odds, and 36 hours of discomfort once every few years seems a fair price to pay for me. Yes, I hope they come up with an easier way, but in the meantime this is what we have.

So,  I hope what I wrote does not dissuade anyone from getting the procedure.  I hope knowing the details will actually encourage people to go through with it.  I think fear of the unknown is often worse than the thing itself and wanted to provide as much information as I could. My advice is to plan the two days out in advance, buy everything you need to be as comfortable as possible, and don’t forget the Desitin!  Seriously, the diaper rash symptoms were the worst part, and that stuff worked great.

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