Introduction
I recently had my first colonoscopy. I know a bunch of
people my age who ought to have had theirs as well but are procrastinating. If
you’re fifty or over and haven’t had yours yet, read this to know what to expect (and consider this your wake-up call). If you have had one, what better
way to commiserate and have another good laugh at what you’ve been through? And
if you’re not fifty yet, this’ll be a good dose of schadenfreude and a sneak
preview of what you have to look forward to.
What is a colonoscopy?
A colonoscopy is a procedure a doctor carries out to screen you
for colon cancer. Colon cancer is the third leading cause of cancer deaths. The
lifetime risk of getting it is 1 in 23 for men and 1 in 25 for women. Early
detection is key. Colorectal polyps are fairly easy to find and remove before they can
develop into cancer. Details here.
What exactly is the
colon?
The colon is one of those weird organs down there in your guts.
It removes water from digested food and creates stool, which it conveys to the
rectum. As this is already getting gross, I’ll leave it at that.
How does the doctor
see in there?
Doctors have got a “back door” they use, through which they
thread in a camera the size of your finger.
Which finger?
I forget. To be honest, I haven’t dwelled on that, for
obvious reasons. But in all seriousness, the process is a hell of a lot less
invasive and awful than chemo, surgery, etc.
Who should get a
colonoscopy?
Anybody over fifty should get one, plus anybody with other
risk factors like family history of colon cancer, or trouble with digestion, or
if a doctor recommends it for any other reason.
Is there any
legitimate excuse for a person over fifty not to get a colonoscopy?
Of course not. Don’t be lame, just get it done. As you’ll
learn from this post, it’s really not that bad.
What is the
preparation for a colonoscopy?
For a week, you have to eat refined food like white rice,
white bread, pasta, etc. instead of good high-fiber stuff like whole grains,
brown rice, beans, etc. (So, for a week you get an interesting tour into how so
many clueless Americans eat.) Also off-limit are seeds, nuts, popcorn, iron,
fish oil, and vitamin E. Then, 24 hours before the procedure, you’re not
allowed to have any solid food. You can have light-colored juices or broth, or
even Jell-O (but why bother)?
The other thing you have to do is completely remove every
particle of food, and its downstream waste products, from your system. You do
this by drinking four liters (more
than a gallon!) of a prescription laxative drink.
Is this pre-op process
straightforward and well-documented?
Well, that depends on where you’re having your colonoscopy
done. The place I went to sent me a big packet of paperwork, and then I got a
phone call saying, “We screwed up your paperwork so we just sent out a second
batch. When you get the first packet, throw
it away. Only read the second packet.”
Well, I received both packets on the same day so I had to
figure out which was the evil twin. One set of documentation failed to specify
when and where the procedure would take place, and who would perform it, though
it did include a “Visit Date” that was wrong. The other packet at least had the
procedure date, time, and location, though it also had a (different) wrong
“Visit Date” listed. It also provided the doctor’s name, which was helpful, though
it also provided a second doctor’s name that was wrong.
I called up to ferret out which packet was the correct one. Turns
out, the packet lacking the when-and-where information was actually the right
one. Having sorted this out, I requested clarification about the timing of the
laxative drink, GoLytely. The directions say to drink 8 oz. every 10-15
minutes, and to “Take 1st dose (1/2 gallon) at: 4pm the day before” and “take
2nd dose (1/2 gallon) at: 5-6 hours before the procedure.” Well, my procedure
time was 8 a.m. Did this mean I had to get up at like 1:30 a.m., and then roust
myself again every 10-15 minutes until done, to finish 5-6 hours before, or do
they mean at least 5-6 hours before? I
asked if I could just be done with all the drinking—and its explosive result—before
bed. (No, I didn’t put it so bluntly.) The gal answered, “Uh, well, um, I think
… yeah, before bedtime should be fine … just, uh, go with that.” She really
didn’t inspire confidence.
I called my big brother for a second opinion and he said,
“Yeah, I got up every ten minutes for half the night—it was a total drag!” Keep
in mind that you’re not just drinking this gross drink. You’re also rushing to
the toilet. So this timing thing is important, and I’m here to tell you from
personal experience, getting it all done before bed (in my case midnight) is A-OK.
The doctor’s office didn’t send me away for incomplete evacuation, which had
been my greatest fear (this having happened to someone I know).
Is the laxative drink
really that disgusting?
At no point did the gag reflex kick in. That said, it’s
pretty damn disgusting, perhaps even more so than bong water (but at least
you’re braced for it; I’m pretty sure nobody has ever drunk bong water on
purpose, at least no resolute non-pot-smoker like me). Here is a video of my very
first 8-ounce shot of GoLytely:
It may or may not help to mix it with the flavor packet. I
was on the fence about this, and my decision wasn’t helped by the packet
instructions, which clearly say “Not for direct dispensing to the patient,” as
thought the pharmacist is supposed to mix the flavor packet with the drink powder
before I leave the pharmacy. Could there possibly be any skill involved in this
operation? I can’t imagine, and yet the instructions are very clear on both the
packet and the jug of drink mix:
The lemon powder smelled like that disgusting Country Time
Lemonade mix. If I did decide to flavor my drink, I pondered, why limit myself
to the lemon option? I could mix in the flavor packet from some Top Ramen, to
have, like, shrimp flavor, or beef, or a combo. But ultimately I decided to
drink it neat.
The first flavor to hit my tongue was like someone else’s
saliva, but salted and slightly fizzy as though fermented. Then the aftertaste
hit me like a thump: very chemical-tasting, like bleach or solvent. So yeah,
GoLytely really is gross, but again, nothing that would make you hurl. The
problem is, you have to drink nine 8-oz. glasses of this, ten minutes apart,
for the first “dose” (i.e., session), and then, hours later, another eight
8-oz. glasses of it, so it gets mighty old.
By the way, my instructions didn’t tell me how many glasses
to drink in the first “dose” so I had to do the math myself:
You said something earlier
about the “explosive result” of this beverage. Can you elaborate?
Well, over an hour into my first “dose,” when I’d had eight
8-oz. glasses (i.e., 64 oz, almost two
liters) of the miracle elixir, nothing had happened yet. I texted my brother
with this worrisome update, and he wrote back, “Oh boy. Just you wait!” He
wasn’t wrong. Five minutes later, I decided to take the throne and see if
anything would happen. I’ll spare you the details, but an hour later I was
still there. The word “hydrant” isn’t exactly right, but it’s close.
Hours later, after the second round of GoLytely, I again started
feeling some serious stirrings down there, and suddenly (oddly) started to
shiver. I ran for the bathroom, up a couple sets of stairs, with all the
urgency of an action hero fleeing a building that’s about to explode. I made
it just in time … it was so close I didn’t have a chance to close the door. My
wife, from one nearby bedroom, and my daughter, from the other, burst out
laughing simultaneously upon hearing the whooshing sound. If you don’t think
this all sounds pretty funny, click this link immediately, and go read that post, before continuing with this report.
How will I know I’m
ready for the colonoscopy procedure?
Trust me, if you’ve completed all four liters of the
laxative, you’ll be ready (so long as you didn’t “cheat” and eat anything in
the 24 hours before your procedure time). The official directions imply that
you don’t need to drink all four liters if you have “clear rectal discharge,” but
I find this to be a) gross, b) a needless thing to determine, and c) a great
name for a rock band.
All this being said, in my case I can report that after my
last toilet visit (which was, remarkably, at like 5 a.m., over five hours after
my last glass of GoLytely), it looked like I’d only peed. So complete was the
elimination, I lost four pounds. That’s after drinking about nine pounds of
GoLytely. Do the math…
Will the nurses be
hot?
This is a dangerous question to answer, but arguably the
most important one in the entire report. Needless to say, your mileage may
vary, but in my experience, these nurses were considerably hotter than the one
who helped with my vasectomy. Perhaps this is by design … to encourage periodic colonoscopies, they’d want
to make the whole ordeal as pleasant as possible, whereas with a vasectomy
nobody wants to instill the wrong kind of, uh, attention.
Will I unexpectedly get
disqualified from the procedure and sent home?
As touched on earlier, if you don’t follow the instructions
and evacuate your system, you could be sent home. Other than that, I guess the
only problem could be if your vital signs don’t look good. I had a tiny glitch
in this department. After taking my vitals and wandering off, the nurse came
back and said, “Um, are you a very active person?” At first, given recent
events and current circumstances, I thought she was referring to my bowels. But
then I understood, and said, “You mean, working out a lot? In that case, yes.”
She replied, “Okay. I ask because your pulse was only 45 so we thought you
might be on some … medication.” I assured her 45 bpm was normal for me, and it
was smooth sailing from there.
Will they stick me
with a big needle?
Of course they will, it’s a doctor’s office and you’re there
for a “procedure!” They run an IV to administer the anesthesia. But they’re
total pros. Two nurses discussed which vein to use … not because they couldn’t
find a good one, but because my skinny arms presented an embarrassment of
riches. “My husband is just like you,” one nurse said. “He’s got such great
veins, I sometimes ask him, ‘Can I please run you an IV, just ‘cause it’d go so
well?’”
Will they give me a
drug to make me forget everything?
This will depend on where you get the procedure done. My
brother, when he had his colonoscopy, did get the forget-everything drug (I
think it’s typically Versed, aka midazolam) and didn’t like the aftermath … it
really messed him up for the entire rest of the day. Myself, I hate the idea of
any drug (even alcohol) messing with my memory. My brother mentioned that some
people need colonoscopies somewhat frequently, and opt to skip the Versed. So I
asked my doctor about this before the procedure, and he said they don’t use it
anyway, and that the anesthesia I’m getting wouldn’t have any post-op
aftereffects. “You could go for a run two hours afterward,” he said.
What is the actual
procedure like?
They had me roll over on my side. This was probably the
worst part because my ass was hanging out of the back of that backwards gown
they make you wear, and it was kind of cold. The anesthesiologist warned me
that it would hurt a bit when he injected the drug into my IV, but the pain was
ridiculously minor, like being whacked lightly with a flower.
I lay there, deeply doubting that I would in fact fall
asleep, because no anesthesia could be any match for the cold air hanging over
my tuchus. So, preparing to be bored, I let my gaze fall on the patterned
curtain a few feet from my face. The curtain seemed so unfamiliar. I
wondered, did my wife buy new curtains at some point, and if so how am I just
noticing? Moreover, why am I still in bed when I should be heading over to the—oh,
shit! I overslept! I missed my colonoscopy and now I’ll have to reschedule and
go through the GoLytely purge all over again! Total disaster!
Then I thought, wait a second here. Those are not bedroom
curtains. That’s more like a hospital curtain. Oh, and I’m not in bed. I’m …
oh, right, I remember where I am. This is where the nurses and anesthesiologist
and doctor were getting ready to do the procedure. Meaning it’s over. I must
have … slept through it. Just like I was supposed to, duh!
Is there an aftermath?
There was so little indication anything had even happened, I
had to take the doctor’s word for it that the procedure had actually been
carried out. I was handed a bunch of paperwork, which I only remembered to leaf through a few days
later. It covers what they did, what they found, etc. My favorite sentence? “The
patient is competent.” That’s the nicest thing anybody has ever said about me. I
won’t comment much more about the report or the findings because that’s really
none of your business. Plus, there are possibly (sometimes? often?) lab results
that have to come back before one can conclude anything for certain.
I expected some physical discomfort after the procedure, but
in fact there was none. They’d advised me to break my fast with a small, light
meal, but I ignored that. I was starving and had a giant lunch, which went down
without a hitch. I will say I was really, really tired for the rest of the day.
I highly recommend taking the whole day off of work, as I did, for your
colonoscopy.
How do I get home?
This is the one time I won’t tell you to get around by bike.
This is also no time to get an Uber or Lyft, or even a cab (if you’re lucky
enough to live in a place where you can just hail a cab from the sidewalk like
in the movies). The clinic I went to requires that you show up with a chaperon
to drive you home. Great idea, because you won’t want to hang around waiting
for a ride, trust me.
Do I get a trophy?
What do you think this is, a kids’ soccer team where
everyone gets a trophy, even the kids who just stood around? No, you don’t get
a trophy. But you can get a certificate from Dave Barry; as he describes here, “If you, after reading this, get a colonoscopy, let me know by sending a
self-addressed stamped envelope to Dave Barry Colonoscopy Inducement, The Miami
Herald, 3511 NW 91st Ave., Miami, FL, 3317. I will send you back a certificate,
signed by me and suitable for framing if you don’t mind framing a cheesy
certificate, stating that you are a grown-up who got a colonoscopy.” Now, I don’t
know if this offer is still good, or if it’s transferable from “Miami Herald”
readers to albertnet readers, but you can download the certificate here and just forge Dave Barry’s signature. I won’t tell!
How long until my next
colonoscopy?
Wow, you can’t wait to get back, huh? Well, the rule of
thumb is every ten years until you’re about 75 or 80, after which they just put
you on an iceberg and give you a nice push. That said, your future colonoscopy schedule
will depend on what, if anything, they found the first go round.
This all sounds like a
lot of hassle. Are you sure this is really necessary?
I watched a man die of cancer. He discovered his the hard way. Trust me, you
don’t want that.
Damn dude, I thought
this post was kind of funny until just now. What the hell?
I know too many 50-somethings who have been putting this
off. Don’t be one of them. Just get this done, and then we can share GoLytely
stories and have a good laugh!
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