So yesterday was a fun day….
Those of a timid disposition might prefer to look away now, but if you’re going to be undergoing a colonoscopy at sometime in the future (and you will…), I just thought I’d blog about what it involves.
Yesterday was my second colonoscopy. Eight years ago, I was diagnosed with ulcerative colitis after 12 weeks of diahorrhea and bleeding that left me 30lb lighter and pretty sick. That time, the procedure, prep and recovery were all quite different, so clearly an update is in order.
To start with, the prep for the prep. The hospital will generally give you a diet sheet telling you the light diet you can follow before you take the dreaded laxative. Well, you can if you want to, but I wouldn’t advise it – what goes in has to come out, and it’s going to come out at considerable speed once you get that stuff down you, so the less your body has put through, the better. Also, the cleaner your colon is, the more the GI will be able to see, and the less any risk of a bowel perforation (this is very rare but when it does occur, it’s generally in a colon that’s not fully empty).
Last time, I ate normally the day before the colonoscopy and followed the suggested diet on the day itself, taking the laxative in the morning and then imbibing only clear fluids, as requested. This time, I started DAYS ahead of time. With my colonoscopy due on Thursday morning, I ate my last meal containing meat and legumes on the Saturday and my last meal of whole vegetables on the Sunday (aubergine and tomato curry). That was also my last day for fruit. On Monday I ate only sieved home-made potages (parsnip and cinnamon in the morning and mushroom and nuoc nam in the afternoon), followed by yoghurt and jelly for dessert. Then on Tuesday, following a breakfast that included yoghurt, I stopped all dairy and switched to clear fluids and jelly only, with the addition of a little white bread with the bouillon (I don’t normally eat wheat).
I’d stocked up ahead of time to make this whole thing more bearable. You can’t have anything red or purple, as it can give a false positive result, which means no blackcurrant or cherry juice, etc, so you’re left with mostly orange, lemon and lime flavour things. My prep shelf contained beef Oxo cubes, Marmite, Kub clear chicken bouillon cubes, veggie bouillon (has to be put through a tea strainer to take the herbs out), peach cordial, elderflower cordial, lemon cordial, white grape juice, clear apple juice, quince jelly, orange shredless marmalade, rose jelly, camomile tea, limeflower and peppermint tea, electrolyte mix, pates de fruits in pale colours, Chivers lemon jelly, and – the most crucial ingredient – gummy bears.
You can’t get proper Jelly Babies where I live, but these were the next-closest thing, and they were a godsend as after three days of liquids, you’re desperate for something to chew on. The gelatin just dissolves when it hits the temperaure of your digestive system, so it leaves no residue.
Thus passed Tuesday and Wednesday too, until 5.00pm, when I took the new prep – Citra-Fleet. This was the part I was apprehensive about, and I had a peppermint on hand to suck afterwards, but in fact it was fine – just a lemon-flavoured drink that was easy to get down, rather than the Devil’s sputum of the Fleet Phospho-soda eight years ago, which I’d puked up almost immediately.
Once you take the Citra-Fleet, you have to begin drinking in earnest, with two litres of water recommended. I drank three, plus two after the second dose in place of the recommended one litre, changing the flavour each time to make it a bit more interesting, so I glugged down five litres of water in about seven hours.
The diahorrhea part of the prep is only troublesome if you’re not used to having the shits (not an issue for anyone with a bowel disorder), but it is pretty forceful. You need the loo about an hour after the first dose and then it hits you about every 30 minutes or so until you can’t quite believe the force at which your gut’s contents are being evacuated. But you don’t get the hideous cramping you get with ‘proper’ diahorrhea, although you may get some. I only got cramps in the small hours, as I had to stop drinking at midnight, and was unable to replace my lost fluids. Eventually, your evacuations run almost clear or pale yellow and you know you’re empty.
Another tip I’d picked up from helpful UC-ers was to have plenty of moist toilet paper on hand and to use Sudocrem EVERY bowel movement and not to wait until it was needed. This was cracking advice (no pun intended), and completely prevented any soreness.
The first dose of Citra-Fleet gave me about six bowel movements in three hours as opposed to the 12 I had last time – this is what happens when your gut is emptier. I took the second dose at 9.00pm, which had about half as much result, though by now, I was just losing pure fluid – it is, to be blunt, like pissing out of your arse (at about the speed of a fire hose). It seemed pretty much all done with by about 11.00pm, which was great, because I normally go to bed at 10.00 and I was knackered.
But then came a new part of the prep – the Betadine wash, to prevent MRSA. You have to do your whole body with this, especially groin, armpits and navel, and even shampoo your hair with it. Twice. Luckily, although it is bright saffron-coloured and doesn’t smell too hot, it leaves your skin feeling pretty smooth. I then had to dry with a clean towel, dress in clean nightwear and hit the sack (I’d already changed the sheets that morning, so they were clean too). Not feeling ultra-confident about the night, I also laid out a clean towel over the sheet and made sure to wear PJ trousers to give me a bit of protection (now is not the time to find you’ve only got one clean pair of knickers, as I did).
The Fleet hit me again at about 3.45, and then some (the whole process does, however, leave you with renewed respect for the holding power of your anal sphincter…). Straight back to bed, it hit me again almost before I lay down, which was a pain. But once back to bed a second time I slept like the dead until my early start, then I had to wash with the sodding Betadine again before leaving for the hospital. By this time, I was a bit of a space cadet (I would definitely recommend having someone around the place when you’re doing the prep as it’s not inconceivable that you could pass out).
I’m a nervy type and had worried I’d be scared stiff, as I loathe hospitals and anaesthesia, etc, but actually I was fine. I took an Alprazolam all the same, having OK’d this with the anaesthetist ahead of time, and dozed all the way to the hospital. The DH, I should pont out, was driving – you should definitely not drive, and you have to arrange pickup. I’d also dressed in very comfortable, stretchy clothing, and wore a Tena slip just in case (not needed, as it happens, but it does give you some reassurance).
Once at the hospital, of course, I immediately needed the loo – which was out of order. Not the best thing in a gastro-intestinal unit, I pointed out – and then they showed me into a nice big room with two beds in it and told me to get undressed.
This too is new. Last time, I went straight from the waiting room into theatre, was told to remove the lower half of my clothing, and trotted off to the gurney in my bare feet and teeshirt, feeling like a prat. This time, I’d dressed in a long tunic to give myself a bit of privacy but it wasn’t needed. Instead, it was off with the togs and into a lovely open-backed paper gown in a fetching shade of navy blue, along with paper knickers (which does give you a bit more coverage). My clothes went into a built-in wardrobe – the hospital is brand new, in fact not entirely finished, and is very well equipped – and I gave my wedding ring to the DH to wear. French hospital rooms are ensuite, so the bathroom was on hand.
I then mostly dozed until they came to do the paperwork, then I used the loo once last time (a pointless exercise) and got back into bed and they wheeled me (no transferring gurneys) straight into theatre, where they asked me once again all the questions they’d already asked me. I was so sleepy it made them laugh, and then I just lay with my eyes shut while they stuck monitors all over me and needles in my arm. I heard the words: "C’est parti," presumably about the anaesthetic. And then it was about 30 minutes later. And then it was about another 15 minutes later and I vaguely realised I might possibly be in a different room and that I had some gas pains. And then they wheeled my bed back into my original room and offered me a choice of breakfasts.
The DH, who had been stretching his back, turned up, and we had a bit of a chat, though I was still a space cadet. The breakfast hot chocolate (there was a choice of tea, coffee, hot chocolate, French bread, butter and jam, and orange juice) was the most ambrosial thing I’d ever tasted and I tucked into the bread and butter with gusto, but lost my appetite about halfway through, so ate the jam with a spoon. The sugars brought me back to myself and I became compos mentis again.
Another woman was wheeled out from behind a half-wall (I couldn’t see her), and another wheeled in, whose her husband then waited for her while she was in theatre. I was slightly sensitive about this, as they pump you full of gas and, as the nurse pointed out, ‘there’s only one solution’ to get rid of it. Luckily I was able to let it go quietly. But I also needed to pee and for that I had to call a nurse and have my resting and standing blood pressures taken, at which point they let me walk to the loo by myself and asked the gentleman to leave for a moment, since I was in my skimpies.
Then more paperwork, more dozing, reading a book I’d brought with me (no valuables allowed, so the Kindle was at home) until I was officially bored. I kind of wished I’d brought my bedsocks, as my feet were cold.
Then the consultant came in and said I was fine – not only fine but that there was no sign of ulcerative colitis. "You don’t have it," he said, "there is no inflammation and no ulceration. God, you’ve got a long colon, though – I had to go for kilometres!".
I was a bit stunned by this, and asked if I just have irritable bowel then, and indeed he thinks so. So I am back to my original diagnosis of 30 years ago, which is rather fantastic. And nice to know that although I may be afflicted by constipation and diahorrhea and bloating and all the rest, there is no actual colon damage.
After that, it was a simple question of checking out, dressing and getting home, followed by lazing around the place watching the X-Files on DVD, and snoozing in bed on and off for the rest of the day. I followed a light diet of soup, yoghurt, white bread and butter. Today (Friday), I’m feeling a little bruised and gassy, as you might expect from having your colon stuffed full of air, but am otherwise fine. And I still have the trots, which I guess is par for the course. My last colonoscopy involved polyp removal and biopsies, so there was bleeding for a few days, but there’s nothing of that sort this time.
One last new thing is that the hospital made a follow-up call to check that not only was I well, but that I’d been satisfied with the level of service. Very nice of them and one more reason to be thankful for living in such a civilised country.
I’m also lucky enough to work from home, so had a bit of a lie-in this morning, and am only working gently, but if you work outside the home, I’d recommend taking a day or two off to get back to normal again.
And hopefully that’s that for another decade.
NB: when it comes to a colonoscopy, your mileage may vary, especially if you’re American, as Citra-Fleet is not available in that country and the available laxatives apparently taste vile. In the US, the procedure is also normally carried out under less sedation.