Talking About Colonoscopy

Reminder!  This coming weekend I’m Guest of Honor at Conduit, in Salt Lake City, Utah.  Hope to see some of you there…

A week ago, I had my first colonoscopy.  This is one of those coming-of-age rites that – like most coming-of-age rites, if you think about it – most of those subjected to it don’t really look forward to participating in.  What they want is to have it over and done with.

Prep Instructions Day by Day

Prep Instructions Day by Day

In my case, though, I was sort of lucky.  Not only had Jim had the test before me, I’d been designated driver, twice, for one of our friends.  So I’d had a chance to get about as close to the procedure as you can without doing it yourself.  That actually helped.

So I decided that – even though some of  the details aren’t exactly pretty – to share what having a colonoscopy is like so that when it’s your turn, you can say, “Hey, I’ve heard it’s really not that bad.”

A colonoscopy actually starts with the prep.  This starts five days before the test with going off drugs you can’t take because they’re blood thinners.  (No worries.  You’ll be given a list.)

In my case, the only one that really affected my lifestyle was aspirin.  Aspirin is my painkiller of choice.  This spring my allergies are rampant.  Going for five days without being able to dull a headache wasn’t fun, but it was manageable.  Hot drinks do a lot for sinus headaches.

Two days before the test, certain slowly-digested foods are eliminated: nuts, seeds, and corn.  The list I was given didn’t clarify whether things like peanut butter were okay, but I decided to play it safe. I’d been thinking about making humus for our Sunday night game, but that has tahini, which is sesame paste.  This part of the prep did make me realize how many nuts and seeds are in my routine diet…

The day before the test is when the big challenge comes.  It starts with a clear liquid-only diet.  Again, you’ll be given a list.  It will include sodas like ginger ale and sprite, clear fruit juices, and chicken or beef broth.  It should also include jello and popsicles.  However, what color you get is really important.  No red.  No purple.  No blue.  No pink or orange.  However, yellow and green are fine.

Coffee and tea were included.  Yay!  I don’t take cream in my coffee, so I had no worries there.  And life with coffee is much easier.

My test was on a Tuesday, so the weekend before, Jim and I did some thoughtful shopping.  I’m not a huge fan of apple juice, but we found a nice juice blend that was light and clear and tasted more or less like peach.  We bought three boxes of jello: lemon, lime, and sour apple.

I like to cook, so I made my own chicken broth, making sure to add vegetables for flavor, but no herbs that might mar the “clear” nature.  I chilled it and removed every spec of fat (as well as the meat and the veggies, of course).  The end result had lots of flavor and even a bit of body.

The night before, I ate a snack before going to bed, hoping to stave off the inevitable blood sugar crash.

Monday morning it was tough not having chocolate with my coffee, but I substituted lime jello to pump up the sugar.  I managed to do my e-mail and even write.  The piece about toads in the pond was written then.  I had my usual Monday chat with my friend Sally and think I was at least moderately coherent.

Then late Monday afternoon came and with it the big challenge: drinking a gallon of Golytely as quickly as possible.  Again, the instructions I was given were a little vague.  They said to drink a full “glass” every twenty minutes until the stuff was gone.  They did not specify the size “glass.”

Let’s put this in perspective.  A gallon is 128 ounces.  Divided by the standard eight ounce drinking glass, that’s sixteen glasses.  Now divide that by three (as in every twenty minutes or three times an hour).  You come up with 5.33 (repeating).  Or, in other words, you’ll be at this for the next five or so hours!

I decided I wanted to be done sooner.  I did some experimenting and found I could get twelve ounces of water down pretty easily.  I marked that on a sixteen-ounce tumbler and resolved to try for at least twelve ounces, sixteen if possible.

I started at promptly at 4:00 p.m.  The Golytely tasted a bit like Gatorade: sweetish with fake lemon over salt.  I downed sixteen ounces, pressed the timer, and picked up my book.  I was reading Dune, which seemed ironically appropriate.  Twenty minute later, I downed another sixteen ounces, grabbed the timer and headed for the bathroom.

If you’ve ever read a somewhat old-fashioned novel, you’ve encountered the expression: “His bowels turned to water.”  Usually that means to experience complete, crippling terror.  No terror was experienced, but the rest is a really accurate description.  The instruction sheet had said: “…will make you go to the bathroom many times and cause diarrhea.”  That’s the understatement of the century.  This wasn’t diarrhea; it was transformation.

Because the earlier prep and liquid diet had already cleared the system out a good deal, it wasn’t even really uncomfortable.

By drinking sixteen ounces at a time, I managed to get the worst of this ordeal over in about three hours.  I found that if I drank even a little fruit juice after each glass, it took the salty-sweet taste of the Golytely away.  The bowels-to-water thing abated about an hour after the last glass of Golytely, although it didn’t go away completely for a couple more hours.

I actually began to feel a little hungry, which was both a pleasure – I no longer felt as overfull – and annoying, since the closest to something solid I could have was jello.

A few words about jello.  I’ve heard people say that they can’t eat jello after this.  I won’t go that far.  I found it a relief to be able to convince my stomach, even briefly, that it was getting filled.  One of the things I found toughest about the clear liquid diet was that so much of what was recommended was sweet.  I have a moderate sweet tooth.  I like chocolate, but usually dark.  I prefer fresh fruit to pies or jams.  For me the sour apple jello was salvation because it lacked the overt sweetness of the lemon or lime.

By bedtime, the worst of the digestive upset was over.  I wasn’t even that hungry, which surprised me.

The final ordeal was going without any liquids from midnight on.  This was a bit tough because even at night I tend to drink a lot.  (Remember, I live in a very dry climate; also, my allergy drugs contribute to a dry mouth.)  However, I wasn’t going to quit so close to the goal.

Please note…  Going without water was the final ordeal.  The actual procedure was a breeze.  Jim drove me over to the clinic.  I had gotten the earliest possible appointment and so there was no delay.  Everyone was very kind and seemed to understand that by now I had reason to be a bit muddleheaded.

I’d been worried about feeling embarrassed – especially when I learned the procedure was being done by a male doctor.  I mean, we’re indoctrinated not to let strangers see certain parts of us and this was a real violation of that taboo.  I was surprised by how I didn’t feel embarrassed at all.  This wasn’t because of cool, detached professionalism either.  Jim and I chatted with just about everyone, from the nurse trainee who was observing through the anesthesiologist and the doctor.

I think it was because everyone took for granted what was being done, so no one felt at all strange.  It’s embarrassment that causes embarrassment most of the time.

Eventually, IV in one arm, covered in nice, warm blankets (right out of the dryer), I was wheeled to the procedure room.  I felt a little weird when I realized that, although I’d never ridden on a gurney before, I felt as if I had, because a camera-eye view of such is a routine part of medical dramas on TV.

In the procedure room, a pop piece I didn’t know was playing in the background.  As it was finishing, the anesthesiologist came in…  I should clarify here that I was part of a pilot program using anesthesia rather than the more usual sedation.  As I’d never had either, I can’t really tell you how they compare.

The anesthesiologist asked me to roll onto my left side, warned me that the blood pressure cuff would tighten almost painfully, and told me she’d be starting her part as soon as the doctor was there.

David Bowie and Queen’s “Under Pressure” came on the sound system.  I was musing about the irony of that as the blood pressure cuff eased off.  I heard one of the nurses greeting the trainee nurse, reading off my name and identifying information…

And then I heard Jim’s voice.  For a brief moment, I wondered if the procedure had been called off and he was being told why.  Then I opened my eyes and realized I was in the recovery room.  Jim was talking to the nurse.  By the time they had me sitting upright, the doctor came in to tell me all had gone well.  No polyps.  Come back in ten years…

I started tearing up then.  Why?  Because there’s an alternate universe in which someone I loved didn’t die of colon cancer.  If he’d had this test…  But then, we never know.

Nothing is certain except that we can make choices…  I might get hit by a bus tomorrow, but I won’t have let fear – of embarrassment, of discomfort, of the unknown – have kept me from doing a small thing that removed one unknown.

And maybe, someday, even those who get bad news will know there are better treatment options.  That’s why I contributed a new story (“Knights Errand”) to the anthology Fantasy for Good, the full proceeds of which are donated to the Colon Cancer Alliance.

And now, when it’s your turn, you can say, “Hey.  It really isn’t so bad.  Jane says so.”  And if you’ve already had the test, don’t give into the urge to dramatize…  It really isn’t too bad – especially when you consider the alternative – is it?

11 Responses to “Talking About Colonoscopy”

  1. Paul Genesse Says:

    Thank you for sharing your story.

  2. Louis Robinson Says:

    I’m surprised that you were surprised by the surgeon. I’d have expected you to have met at least once for a pre-op consultation.

    And I can also testify that these things are nothing to get excited about. In fact, the surgeon had one of the monitors moved so that I could watch too 😉

    Have to see what my daughter says about anaesthetic use – it strikes me as an unnecessary risk intended to benefit the staff, not the patient. OTOH, the way some people get excited about the simplest things…

    • Jane Lindskold Says:

      I did meet the surgeon — about ten minutes before the procedure. He was very nice and invited questions. I knew he’d be male because that was on my paperwork.

      As far as I’ve seen, some form of anesthesia (or sedation) is the usual procedure here. I’ve heard of people doing without, but I’m guessing that was at request.

      • Louis Robinson Says:

        Sedative, yes. You do need to be pretty laid-back or it can create problems. And the use of sedatives is non-trivial in itself.

        It was the anaesthetic, specifically, that surprised me – they muck about with too many systems to be a good idea when not truly needed. One reason that there’s a growing move towards the use of local or regional anaesthesia even for some fairly major surgery is the difficulty of predicting how any given individual will react to a general. And when it’s badly, like the girl with the curl it can be horrid. [BTW, it’s actually the sedative that ‘puts you to sleep’, not the anaesthetic]

  3. Paul Dellinger Says:

    A friend of ours is having an endoscopy and colonoscopy at the same time, because she has trouble with anesthesia and didn’t want to deal with it twice. (My wife asked her if the doctors planned to meet in the middle!)

  4. Chad Merkley Says:

    I had to have one last fall. Apparently the sedative made me talk at random through most of the procedure. I have no memory of this.

    It isn’t that bad. As Jane said, it’s the prep that not fun. But the doctor found and removed two polyps from my colon, so I get to be checked every three years.

  5. Julie Hagan Bloch Says:

    I had a colonoscopy a few years ago. The worst part for me was having to get up to go to the bathroom so many times. I was tired and wanted to sleep! The procedure was not a big deal. I was not anaesthetized (at my request). I got to watch the screen as my own personal intestines movie went on. I saw a lot of pink. 🙂 A couple of times they had to sort of inflate the intestine so the little tube with the camera could get around a corner, and it was uncomfortable, sort of like a gas pain, but it wasn’t a big deal. It really wasn’t. And I got to go home afterwards really soon, which was good. And best of all, I got a “no worries, come back in 10 years” result.

  6. Terry O'Brien Says:

    Interesting coincidence: I was going to have a colonoscopy just this past Tuesday.

    Going to … that was the intention.

    The instructions said to drink 64 oz of Gatorade or something similar to wash down the bottle of powered laxative. When I got to the hospital, the massive amount of sodium from the Gatorade caused my blood pressure to skyrocket. Now I’m forced to look forward to beginning the whole procedure again once that is dealt with.

    BTW: I don’t know if you remember, but we met back in 1995 at GenCon, at the party Erick Wujcik organized that was originally to honor Roger. I was one of Erick’s Amber playtesters and I was so looking forward to meeting Roger. I wrote a blog post on what I wanted to ask Roger at that time:

    • janelindskold Says:

      Hi Terry… The salt got to me, too. After fasting, I gained five pounds!

      I can’t say I specifically remember meeting you. My memory is a bit squirrelly for that time, but the title of your essay looks familiar. Did Erick reprint it? I’ll check the link out.

      I miss Erick, too! He was such a vivid person.

      • Terry O'Brien Says:

        Erick never saw my essay. I only wrote it when I saw George RR Martin’s blog about the Zelazny memorial just a month or so. I may have said something about the situation to him but I can’t really remember.

        I miss Erick, too: we never did get to finish a lot of the plots from the GenCon Amber campaign.

      • janelindskold Says:

        Hi Terry…

        I went and read your piece after I sent the above. Realized then that it was a new piece. To answer your questions… Despite the fact that he didn’t use a computer, Roger was fascinated by them and the developing “cyberspace” community. DONNERJACK, which I finished for him, shows some of this fascination.

        So, I think Merlin’s profession was more due to Roger’s feeling — one very current at the time, especially in cyberpunk — that computer specialists were the new mages than to any one person. So, any influence would have been indirect.

        Unfinished games because you lose a key person. A special sorrow.

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