Now, aren't you glad you subscribe to this blog? (Aw, c'mon. It could be worse: I could have included pictures.)
Since I'm still 50 - albeit barely - I knew I had to schedule my screening colonoscopy. (If you have no risk factors, you're supposed to get it at age 50.) I'll turn 51 next week so it still counts as on time. What do you want from me?
Everyone always says the prep is the worst part - mainly drinking all that vile-tasting stuff that supposedly tastes less vile the colder it is. Tim did his screening colonoscopy a few months ago (a year-and-a-half late, which for him and medical stuff is really quite good and therefore a testament to my nagging skills. Believe me.) It seemed the worst part for him was the chills from drinking a gallon of cold liquid in a very short time. Always one to find any easier way, I wondered how I was going to pull that one out of my butt (sorry, couldn't resist), but I needn't have worried. The answer was already there: pills.
Fortunately, a friend who has to have a colonoscopy every year since he was 40, happened to mention that for the last few years, his gastroenterologist gave him a pill prep. Yep, no vile-tasting stuff. Just a bunch of pills (oral laxatives) + half the liquid = same results. I went on the internet and read a study that showed 90% of people who'd had both preps said they'd rather do the pills. I was sold. Unfortunately, my gasterenterologist was not.
When I called to make the appointment and asked for the pills, his scheduler said he doesn't have his patients do them. I never tell people I'm a doctor - I don't want the hassles. ("What should I do for this pain, here?" "I"m a psychiatrist, just the neck up, please." "Oh, in that case... " Shesh.) But now, I felt the need to confess (or pull rank - whichever you prefer).
"I'm a physician, so if you can explain why he doesn't want patients to do the pills, I'll understand."
"Oh, you're a doctor? In that case, I'm sure it's fine if you do the pills." Yes! It's times like these the whole medical school things seems almost worth it.
Apparently, he doesn't like patients to do the pills because they seem to think doing them equates to being able to eat with abandon, ie not do any clear liquids. Really? So, let me make it perfectly clear (like the liquids you'll be drinking most of the day before): What you ingest nourishment-wise is exactly the same, no matter which prep you choose.
Now, some helpful tips:
1) Do the pills (Osmoprep). The only disadvantage is that you have to do the prep twice: once the night before, and once a few hours before the procedure (although the second time is fewer pills and less liquid). Since you can't have anything at all by mouth for about 3 hours before the procedure, this means for an 8 am colonoscopy, you'd have to start your morning prep at 4:30 am (the morning prep is done over a 1/2 hour). If I had to get up at 4:30 am, I wouldn't have been able to sleep for weeks beforehand, anticipating that nightmare. Instead...
2) Schedule the procedure for late morning. Mine was at 11 am, so I started the second set of pills at 6 (I could have started as late as 7:30, but wanted to make sure I was... done by the time I had to get into the car) - still terribly early for me, but no 4 am.
3) Keep reading material by the toilet and once the prep starts working, just plan to stay awhile. What can I say? I'm the Queen of Multitasking. Tim was amazed - as always - that I could sit for that long. He said his legs would go numb. That brings me to another hint: put your feet up on a small ottoman or your legs will go numb. (I really am an expert at inertia, ain't I?) If you don't want to sit that long (what's wrong with you, anyway?) at least stay near the toilet. I started having... results... about an hour after taking the last of the pills the first time and after 45 minutes the second. The night before, it was largely over in about 4 hours. The morning of, about two hours. Disclaimer: I have a Jewish colon and results may vary. But, I can definitely promise this: If I didn't have cramps, you won't either.
4) It's better to start with the baby wipes than end up feeling like you're wiping your butt with a lit road flare.
The procedure itself is nothing. Easy for me to say, I don't remember much of it. (Bowing to the Versed God, here.)
I'm sure you know that colorectal cancer is about the only cancer that can be prevented by regular screening and if your doc finds a polyp, he can take it out right then. If diagnosed early, it's 90% curable. Once you have symptoms, it's likely already at an advanced stage. What I didn't know, is that colorectal cancer kills more women every year than ovarian and cervical cancers combined. Hopefully, you wouldn't dream of skipping your annual, so if you're 50 - do this.
The drugs are great, too. (According to Tim, the first thing I said when I woke up was, "This is nice.") I asked for light sedatation, as I wanted to watch on the screen. I guess I'm really not over my TV addiction.
I don't have to have another colonoscopy for 10 years. By then, who knows? Remember Fantastic Voyage? Maybe gastroenterologists will miniaturize themselves, surfing through our colons, searching for anomolies.
I can just hear the Jewish ones, now: Oy, not so fantastic, but it's a living!
The only advantage to getting up early - and one I don't plan on repeating any time soon.