My First Colonoscopy

Okay, this probably isn’t the best subject to approach on my first blog back for a while, but my Mom said I should write the experience down so I can remember it the next time I get anxious about having a colonoscopy…

My family has a strong incidence of colon cancer.  My Oma died in 1987, only a year or so into her retirement, from colon cancer.  She’d been showing the signs but wasn’t willing to see a doctor about it until it was too late, and she was given a month to live.  I remember the day we found out very vividly.  My brother Brian and I came home from school to find my Dad on the phone in the kitchen, and when he turned around to look at us, his eyes were pink and he was upset.  I think Brian and I got upset because he was upset, and I’m pretty sure we had a family meeting in the back porch of their house where they explained the bad news.

We didn’t have a chance to visit Oma in the hospital, mainly because those were the days where kids in hospitals weren’t really encouraged.  I felt very guilty for many years after she died that I didn’t get the chance to tell her what she meant to me.  I remember months before she was diagnosed, in the autumn of 1986 I think, she took us to Randhurst for some reason, and she turned around to Brian and I (and maybe even Jeremy) and said something about knowing we didn’t love her as much as our other grandmother because she couldn’t buy us as much stuff.  The comment struck me between the eyes; I honestly had never felt like that, and it did hurt me a lot that she thought that was how we felt.  Oma had given us a lot of wonderful memories and experiences, and an unnatural love for Gummy Bären.  I only wish now, looking back on things, that I’d been able to tell her that, and I wish she’d taught us German too.

But these things were never to come to pass.

So our family has been urged to get colonoscopies.  My Dad is one of five kids, and so quite a few family members over the age of 40 have had their colonoscopies, with a few (if not most or all) having polyps removed.  Dad’s specialist told him that my brothers and I were all to have colonoscopies for the first time at 40 due to our family’s risk.

I hit 40 this year, and, despite wishing for an easier solution (maybe the invention of a Star Trek-like tricorder) to detect polyps or other problems in my colon without having to insert anything anywhere, it was my time for a colonoscopy.

My doctor and I had an ongoing conversation over the last few years about this, and he was (at first) convinced I wouldn’t need one until I was 50.  My parents were adamant I needed to go and get one at 40.  So I persisted and presented my case, and my doctor saw my point-of-view in the end, scheduling me for an appointment with the specialist.  The specialist confirmed that it would be in my best interests to have a colonoscopy at 40 due to the significant family history, especially given my Oma’s and father’s histories.

I bit the bullet and booked the colonoscopy in.  On the plus side, I found out my insurance would cover the full cost of the procedure.  (There is no nation-wide screening programme in New Zealand, and I would not be eligible for public health assistance, despite my family history, unless I was presenting symptoms or was over a certain age.)  There was a bit of a hassle between the insurance company and my specialist’s office, which saw the procedure delayed, but I think that worked out for the best, and the insurance won in the end.

I’ve heard a lot of stories about colonoscopy experiences, through my family and friends who have had them, and also online.  There’s a real danger by consulting “Dr Google” because medical advice on most sites seems to border on the worst case scenario, but I guess I’m macabre that way and can’t help but search away.  (I do admit, I take a lot of what I read with a grain of salt…)

The worst part, the re-emerging theme from friends and family became, was the preparation.  For those of you not in the know, the bowel has to be cleaned out before the procedure.  This is not only for hygiene purposes but also for the specialist to easily be able to identify any abnormalities during the procedure.

A week before the procedure, I had to stop eating anything with seeds or pips in it.  It sounds easy, but it’s a lot harder than one thinks!  I did have a wee whoopsie a day after I started and ate 3 small crackers with sesame seeds in them before I realised what I was doing.

I personally thought it would be best if I cut back on what I was eating too, and be a bit more selective about what I ate.  I’ve been on a diet for the last month or so, but I really got stuck in to eating white meat, lots of fruits and vegetables, and drinking a lot of water, reducing my intake the closer the colonoscopy grew.  This definitely helped during the prep.

Being quite a nervous person, I found myself not able to go to the bathroom the days before the really “harsh” prep started.  The dam burst, so to speak, before I even had my first Picoprep… More on that later.

The day before the procedure, I was allowed to have a light breakfast (Weetbix with milk), and then I could not have any more solid food.  Noel and I had stocked up on apple juice and Sprite, and Noel even made me chicken broth.  So, for morning tea at work, instead of having an apple, I had a glass of apple juice.  For lunch, I had chicken broth.  And, for afternoon tea, I had more apple juice.  I couldn’t have any milk (other than breakfast) or any liquids red, green, or purple in colour.

The instructions the specialist gave me said I needed to mix my first glass of Picoprep by 5 PM and drink it all down by 6 PM.  I mixed the Picoprep and warm water, stuck it in the fridge, then suddenly felt the urge to go to the bathroom, and, as I said before, the dam burst.  This may have made my prep experience a little better than most.

I had heard the Picoprep and water mixture wasn’t the best tasting or the nicest experience, and the instructions said I should drink it down “by” 6 PM, so at 5:45, sick of waiting around, I downed the whole glass in about 3 gulps.  It had an orange-flavour to it, but it filled my nose and mouth with that burnt plastic smell.  I downed 3 to 4 glasses of water immediately after, even though the instructions probably meant to take each of these over a period of time.  I wanted the water to get rid of the burnt plastic “smell”.

The instructions said it could be between 30 minutes and 6 hours before the Picoprep kicked in.  I’d put a 1.25 litre bottle of water, a book, and my fully-charged iPad in the bathroom, ready for it.  It took an hour before I started to feel things move, so I watched TV until I thought it was time, then head to the bathroom to hunker down for the night, if I needed to.

To be honest, the prep wasn’t bad.  I was expecting the inability to hold on or to be on the toilet for a while, but after an hour, I was pretty much done.  I spent an additional half hour there, just in case, but I decided to go back and watch TV with Noel and get some more to eat.  I had some more chicken broth and some lemon Jell-O.  Before we went to bed, I went to the bathroom again, and it looked like I was pretty much ready to go.

(Throughout this time, I drank plenty of water — probably 2 1.25 litre bottles plus 5 glasses or so — and Sprite to keep my fluids up.)

Mom told me to take a bottle of water to bed with me because she’d found during her prep that she woke up very dehydrated.  I followed her advice and whenever I woke up (a few times quite dehydrated), I took a sip or three of water before falling back to sleep.  I didn’t need to go to the toilet at all during the night.

The next morning, I had to be up at 7 AM to mix my next dose of Picoprep and put it in the fridge to drink by 7:30 AM.  Before the second lot of Picoprep had the chance to kick in, I had to go to the bathroom again, and I spent a lot of the morning in the toilet, more so to make sure I was getting everything out.  I was researching on “Dr Google” again to make sure what I should be seeing.  I also drank another 2 1.25 litre bottles of water, in addition to 4 glasses of water and 2 glasses of Sprite, during this time.

I have to admit, I was getting a slight bit of discomfort / burning, purely through going to the bathroom so much.  I guess this is normal, and supposedly Vasoline or other similar products can relieve that.  For me, it relieved it only a small degree.

My research on “Dr Google” said that the result of Picoprep should be pale, clear, and yellow.  Some people said a small amount of residue was okay, as long as there was no faecal matter.  It seemed I was there.

Even though I could drink water and Sprite up until an hour before the procedure (so 12 PM for a 1 PM procedure), I stopped at 11 AM, just in case.  I was finished with the bathroom about 11:30 AM, although I’m pretty sure I could’ve cut it out at 10:30 AM.

I dressed in sweat pants and a tee-shirt with a sweatshirt over the top, so if I was drugged up, I could put them on a lot easier than jeans or whatever.  We left at 12:20 PM to have plenty of time, but we made it to the clinic around 12:40 PM.  I was extremely nervous.

Being there early, a nurse and trainee nurse took me into a small consultation room to go over my information and to take my vitals.  I was nervous, so my blood pressure came back a bit higher than normal. The nurse confirmed a pale, clear, and yellow Picoprep result was correct, even if there was a small amount of residue.

After that, they took me into the patient waiting area, weighing me in a side room before showing me to a cubicle and getting me a gown, dressing gown, and little scrub booties.  I could keep only my socks on.

The gown was long enough and didn’t have a huge gap at the back, which was great, and I sat down and waited in the cubicle.  Another nurse came in and spoke to me for about 20 minutes, which actually calmed me down a lot.  The clock showed 2 PM before they came to get me (I assumed something was going on because the corridor next to my cubicle was full of people moving around… And Noel confirmed that ambulance personnel came in after 1 PM).

A nice nurse named Sharon (I hope… I was so nervous!) came to get me and lead me into the operating theatre, which was through the double doors to my cubicle’s right, and then a little kitty corner to those doors.  A student nurse was there, as was the specialist and another lovely nurse named Anne.  They all explained to me what was going to happen.  Anne asked me to lay down on my back on the gurney, which I did, and she placed a warm blanket over me.  She attached a blood pressure cuff to my left arm and an oxygen monitor to the end of my finger.  They also fitted me with an oxygen mask.  I tried to maintain a good sense of humour and talked to them about my Mom being a nurse.  It was a good conversation, and I think the humour helped a bit as well.

The specialist asked me if I was allergic to anything, and I said I was to Guar Gum and Xantham Gum.  He had a puzzled look on his face, and I said, “They’re in food.  I think you’re at the wrong end to worry about that.”  He had a big smile on his face then started to laugh.

The specialist asked me how sedated I wanted to be — and here’s the clincher — I told him I wasn’t very good with coming out of these sorts of things, so as mild as possible would be great.  He put the IV line in — and that did not hurt at all, only pinched — and he gave me a super-mild dose.  I was relaxed enough (finally) to be cool with the procedure but aware of what was going on.  They gave me the sedation at around 2:15 PM and said I would possibly feel a little sleepy, but I didn’t.

They rolled me to my side and asked me to put my legs up, which I did.  I barely felt the colonoscope (is that the name of it?) go in, and I didn’t really feel it working inside me, except a small amount of discomfort (very small) when it was going around corners.  I could see what he was doing on the screen.  Anne held my hand for part of it (she was so lovely) and they all explained what was going on.

At one point, he asked if I had used ibuprofen regularly, and I answered him I had been using it for about 6 years, but I had given up a month ago and was only using it very sporadically now.  He implied he could see this on my scan.

Then, before I knew it, it was over.  I couldn’t believe it!  I was finished before 2:30 PM.  The specialist said there were no polyps, nothing of concern.  There was one small angio-something-another that he took a sample of, but he said he was pretty sure it was nothing abnormal.  They injected me with the anti-sedative (I didn’t feel this either), then wheeled me to recovery, which was down the corridor and at the opposite side of the medical area I was sitting in before my procedure.

The nurse there told me to have a rest and get some sleep, but I felt wide awake.  My oxygen levels were low, so she encouraged me to breathe a bit heavier to get them back up, which they did.  My blood pressure was great (122 over 80!) and I felt like a million dollars.  I was so worried over this procedure that was really quick and really painless and really easy!

Another nurse came in and said that Noel was on the phone to my Mom, and was it okay for him to come in?  I told her that would be fantastic, and that I wasn’t tired.  She seemed really happy I had recovered so quickly, and she told me she’d get me some sandwiches and Sprite while I changed.  She did warn me to be careful because I could be light-headed (which I was, kinda), and I saw Noel come in, so I peeked out of the curtain and waved.  He was surprised I was looking so happy and with it.

I was trying to fold up all the blankets and things for the nurses, but they told me to leave it, and helped me into the family room area off the recovery room.  I ate two sandwiches and gabbed away to Noel, who I think was astonished that I was so alert, as he texted my Mom to let her know I was okay.

I was only 2 out of 3 sandwiches in when they asked me if I could see the specialist, so Noel and I went into another small room, and the specialist came in to explain the same things he did in the operating theatre and give me a written report.  And then he said I could go home!

I think I was so full of adrenaline that I was very happy to go home and gab away about the procedure and so on.  It wasn’t as bad as I thought it would be, and I honestly think that everyone who needs to get one done, should get one done.  I’m the world’s biggest baby when it comes to medical procedures, but this one couldn’t be more straight-forward, and honestly, the worst things that hurt were the IV port going in (and that was a quick pinch) and being sore from the Picoprep.  That was it!

The only thing I would warn people about is trying to do too much too quickly after the procedure, because your body will let you know.  I was ready for bed about 8 PM the night of the procedure, mainly because I think I’d chewed through my adrenaline reserves, and all that worry had melted away.

The Picoprep does continue to deliver (although not as much) after the procedure, and I wasn’t very hungry after either, so I took it slowly and ate really bland food for dinner.

I did get a really excellent night’s sleep that night.

The day after, I got up early to talk to my Mom, and then Noel and I went out to do some shopping for groceries and household items.  When I got home, I definitely knew I’d overdone it as I was extremely physically exhausted.  Again, I was falling asleep early, so we went to bed early.

Having the low dose of sedative (Hypnovel) did mean I remembered most of the procedure and what followed, but after and the next day, I did find myself a little more forgetful than usual (things like trying to put the house keys in the fridge and going into the kitchen to clean-up when I already had as I had meant to go into the garage to do laundry), but that was okay.

Colon cancer is a big killer in several nations around the world (New Zealand included), so it’s very important that you get this simple procedure done for your own peace of mind and to ensure you don’t suffer with cancer when this procedure could have helped prevent it.  I know it’s difficult for some people to face having it done, but seriously, it’s a short procedure and think about what you’d rather have: a few hours of discomfort in prep and during the procedure, or months of cancer?  I know what I’d rather prefer!