I intended to write a “what it was like” post after my first colonoscopy was over, in the interest of making people feel more normal about colonoscopies. But now that the time is here, I find myself reluctant.
Partly it’s because of the very reason it’s important to make people more comfortable: colonoscopies involve EMBARRASSING ELEMENTS. I don’t really want to talk about them or think about them.
Partly it’s because I don’t want to accidentally talk you out of it. I’m really glad I had it done, and I think YOU should have it done when it’s your time; but if I tell you what it was like, perhaps you will be like my co-worker who is five years older than me but hasn’t had her first colonoscopy yet because she’s heard what it’s like and she doesn’t want to do that. On the other hand: I was glad to know ahead of time what it would be like. During the prep, it helped me to think, “This is how everyone said it would be. There are many, many people in the world right now who are also doing a colonoscopy prep, and we are all miserable together right now; it’s not just me.”
Well. How about if I tell you SOME of what it was like. I know we’re all supposed to be comfortable with bodies and body words and body functions, but there’s no law, and I will use euphemisms and elision if I want to. I’m sure you have OTHER friends who will be more explicit about it. I will tell you the SWISTLE version.
I have had an endoscopy before, and so you can start there if you want, because the endoscopy/colonoscopy I had this time was the same in many ways, though different in some important ways, the biggest one being PREP.
Many people told me the prep was the worst part of a colonoscopy, and I entirely agree: the prep made me LOOK FORWARD TO the colonoscopy, because then the prep would be over. For a week before the procedure, I was supposed to eat a low-fiber diet, which you would think would be easy since I already eat keto/low-carb, but what it actually meant was that there was almost nothing I could eat: I could eat eggs, meat, cheese, and yogurt. No broccoli, no spinach, no nuts, no low-net-carb (high-fiber) bread, none of my pitiful little keto treats except Rebel ice cream (the kinds without nuts) and Zollipops. And also I couldn’t take my multivitamin, so overall I felt ungood. A smarter person would have skipped keto for the week and at least enjoyed some white bread and pancakes and fruit cups, and that is what I will FOR SURE do next time.
The day before the procedure, I was allowed to have a light breakfast as long as it was finished 24 hours before the procedure, and then no more food, just liquid-diet things such as broth, jello, juice, coffee-with-no-cream. At 5:00 p.m., I started The Real Prep, and what I would advise if your prep is the same kind (there are several different kinds) is to just assume you are not going to sleep at all that night, so if you DO get some fitful dozing, you’ll feel happy and lucky. I also advise sleeping near a bathroom, and ideally not near anyone who is able to sleep normally; I slept downstairs in a recliner. The Real Prep started with mixing 14 doses of Miralax into two quarts of liquid (I chose Powerade Zero; I hoped the electrolytes would be useful), and drinking it over the next 2.5 hours. At 8:00 p.m., I was supposed to take four Dulcolax/bisacodyl tablets.
The nurse and my co-worker both said those things wouldn’t have an effect until around 11:00 p.m. or even midnight, but for me it was more like 7:30/8:00 p.m.; I wondered if it was because of keto. This part of prep was like having a stomach bug / food poisoning, without the barfing. You know what that’s like. It was like that. The nurse recommended using A&D ointment to reduce irritation, and I was CERTAIN we had some in the house but I could not find it, so I used Bag Balm. You might be tempted, ahead of time, to think “Eh, I don’t need anything like that, I’ll be fine, and ointment is kind of icky” but I encourage you to listen to Auntie Swistle and buy an ointment. Just have it in the cupboard, IN CASE you want it.
I was able to sleep a little, though I kept having stress dreams: I am trying to take a pre-appointment shower but people keep barging into the bathroom / the water won’t turn on / I can’t rinse out the shampoo / Paul is calling out that we’re late for the appointment and need to leave NOW but I haven’t washed yet; or, oh no, I am accidentally eating food, and now I have wasted the whole week of prep. And I kept waking up to use the bathroom. And I felt queasy.
At 3:00 a.m., I had to mix 7 doses of Miralax into one quart of liquid, and drink it in one hour. I’d thought I wouldn’t go back to sleep after that, but I did, though restlessly: more dreams, more waking up to run to the bathroom.
Starting at 4:00 a.m., four hours before check-in at the hospital and five hours before the scheduled procedure, I wasn’t allowed to have anything at all to eat or drink.
By the time we left for the hospital at 7:15 a.m., I was no longer running to the bathroom. I’d worried that there would be issues with the long car ride, but there were not.
When I arrived at the hospital, things were very similar to the endoscopy. I gave them the same paperwork I’d had to do for the endoscopy (health conditions, when was the last time I had anything to eat/drink, medications, etc.); I got a hospital bracelet; I was led back to the area with a bunch of little curtained waiting rooms. They asked me to pee in a cup for a pregnancy test. For the endoscopy, I only had to undress from the waist up; for the endoscopy/colonoscopy, I had to undress entirely, including swapping my socks for their grippy hospital socks, and I changed into a hospital smock. They gave me a blanket, and I settled into the hospital bed. A nurse came to ask a bunch of questions about the prep, and to put in an IV and take vital signs. Then I had visits from the anesthesiologist and the doctor, with paperwork to sign for both.
They’d warned me that the appointment might start late if the two people scheduled before me ran longer than expected, and that’s what happened: I was supposed to have the procedure at 9:00 a.m., but we didn’t actually start until 10:15; I was glad I’d brought a book. When it was my turn, it felt like things happened very quickly. I was wheeled into a procedure room. The nurse-anesthesiologist put a blood pressure cuff on my left arm and an oxygen monitor on my right hand. She put in that little nose-oxygen thing. She had me lie on my left side (that felt a little odd with the blood-pressure cuff), and they put a towel under me, which I found embarrassing and wished they could have done after I was unconscious, or perhaps have put in place when making the bed so it would already be there.
She told me they’d be using propofol, which I’ve had before (for the endoscopy and for my dental implant); she said people sometimes wake up a little during the procedure, but that no one who wakes up CARES that they’ve woken up.) I felt as if I would care, maybe not at the moment then LATER ON, THINKING ABOUT IT. The doctor arrived, the nurse double-checked my name and date of birth, and then the nurse-anesthesiologist said she was going to start the propofol, and that I might feel certain side-effects I can’t remember now (heat near the IV? prickles in my face? some things like that). After a few seconds, I remembered that I was going to see how high I could count before I fell asleep, and I counted to about ten and by then I was out; I felt a little funny but mostly just very pleasantly sleepy, and glad we were finally getting on with things and soon it would be over.
When I woke up afterward, but was not fully awake, the first thing I asked was had I woken up during the procedure. The nurse said, “A little—do you remember it?” and I did NOT remember it, which made me sorry I’d asked, and/or sorry I hadn’t been a little more awake so I could have asked some follow-up questions. (Did I…TALK?? during the procedure?)
They wheeled me into a little recovery area; I looked at a clock and saw I’d been in the procedure room for about 45 minutes. A nurse brought me a warm blanket and a hot coffee and a warm blueberry muffin, and I felt very perky and happy, and relieved to have the procedure over with and to have moved on to the stage that included a blueberry muffin. Another nurse came in to show me the preliminary results of the endoscopy and colonoscopy; a little while later, the doctor came in to go over them with me briefly, though she said she will send her full report to my primary care doctor, and also to me in a letter. After maybe 30-45 minutes total in recovery I was able to get dressed and leave. Biopsy results will be back…later, I don’t remember how long she said they take.
From check-in to leaving was about 3.75 hours; the hospital had said to allow 2.5 hours, which is perfect math with the 1.25-hour delay. Except that in my experience, hospitals have delays more often than not, so it would be a good idea to incorporate average delays into the estimated time, particularly since patients MUST have someone there to drive them, and it would be nice for that person to know that things might take significantly longer than budgeted.
On the way home, I made Paul go through a Taco Bell drive-through. And before we’d left for the hospital, I’d had him go out for a dozen doughnuts, so those were waiting for me at home.
In case it is relevant to your own feelings, I will tell you the Coping Thoughts I used to get over the sheer embarrassment of the procedure itself. I thought back to my endoscopy, and how there were a whole bunch of little curtained areas where other patients were lined up waiting—maybe a dozen altogether, all of us being processed, tick tick tick, ask the questions, roll them in, roll them out. All day long, this department does ONLY endoscopies and colonoscopies, one after another. All day long, these staff members deal with all the things that are upsetting or embarrassing to me, and none of those things are upsetting or embarrassing to THEM; all of those things are UTTERLY ROUTINE to them. BEYOND routine. They probably have to force themselves to remember that the situation is upsetting/embarrassing for the patients. It probably comes up at their little staff meetings: “REMEMBER that for OUR PATIENTS this procedure can be…” etc.
And I thought about how MOST of the upsetting/embarrassing things would happen while I was unconscious, and that there was actually no reason or benefit for me to even THINK about what happens between the part where I am getting propofol in my IV and the part where I am eating a blueberry muffin under a warm blanket: I can let the professionals think about that, and I don’t have to think about it or imagine it, even a little bit. I can look forward to the prep being over, and I can look forward to the propofol, and I can look forward to the blueberry muffin; really, there is so much to look forward to, at a colonoscopy!