I am going to write a very blunt description of my experience of a colonoscopy, focused on my issues as a survivor of sexual abuse. This is for people who want the details.
I went to a new doctor and she asked me about what screening I had done. Yes, I have regular mammograms. No, I did not have the recommended colonoscopy screening for colon cancer at age 50. I explained I felt that I couldn’t handle the prep because giving myself an enema would be too closely connected to memories of childhood sexual abuse. She said that she thought it was possible to prepare by taking laxatives only, no enema. Her husband had had a colonoscopy and she didn’t think he had had to do an enema. So I said make me an appointment with the doctor you recommend and I will discuss whether it can be done in a way I can handle. The doctor was a general surgeon who does the procedure at the hospital (every Thursday), not the more common gastroenterologist who does the procedures in their office.
My first impression of the doctor was negative, because the office was filled with posters for weight loss surgery (it is a general and laparoscopic surgery practice). Interestingly, when the nurse took me to an examining room she started to tell me to step on the scale and then said just tell me what you weigh. That seemed like a good sign. She took my blood pressure almost immediately and when it was on the high end of normal I said that was pretty good for how anxious I was. She started to say that there was nothing to worry about, but I think she did ask me why I was anxious. I said I was a survivor of sexual abuse. She reassured me that the doctor would listen to my concerns.
She apparently told the doctor. He asked me about my concerns (without referring directly to sexual abuse) and I said I couldn’t handle doing an enema. He said that wouldn’t be necessary. I was also concerned that the laxatives would be too strong, as the only other time I was cleared out for a procedure I almost passed out from the pain of the cramps. He said that I could stop taking the laxatives when what came out of me looked just like what went in me (in other words, clear fluid). I was concerned about high blood sugar during the day of clear fluids only, when I would be drinking juice, and he said that one day of high blood glucose wasn’t something to be concerned about. But he seemed tolerant rather than hostile towards my interest in very carefully managing my blood glucose.
I also asked him carefully about the anaesthesia. It is a form of deep sedation, not a general anaesthesia, but he assured me that when I woke up it would be as if no time had passed. He said they use a newer medication, Diprivan, where you feel energetic and a little high the rest of the day rather than wiped out. I was concerned because my daughter woke up crying from the sedation to have her wisdom teeth removed but he said that effect (called the Versed blues) is not seen with this other medication. I’ve since learned that some insurers are refusing to cover this medication for colonoscopies because it is more expensive than the lighter sedation sometimes used. For a strong argument that is it the way to go see Counting Sheep.
When the nurse came back in to go over the prep sheet with me, she had a standardized sheet that included an enema. I said the doctor told me I didn’t have to do that. She went out and checked with him and came back and said that is correct. I crossed it out on the sheet before I signed it and she made a copy of what I signed. Because of the holidays I scheduled the procedure for almost a month later.
The prep started with nothing but clear liquids for the whole day before the procedure. I drank about two cups of white grape or apple juice every three hours and that was not quite enough to keep my blood glucose where I wanted it (95-110). I took a 50 minute run in the early morning and taught my class in the late morning but I went home in the early afternoon and took it easy the rest of the day. By keeping my blood glucose fairly level I didn’t feel horribly hungry, but it felt strange not to eat.
At 3 pm I took two laxative tablets (Dulcolax). I felt a little nauseous but nothing happened until I started the next part. At 5 pm I mixed an entire 255 g bottle of Miralax powder into a 64 oz bottle. I was supposed to mix it with straight Gatorade but to cut the sugar I mixed it with 32 oz. of Gatorade and the rest water. The pharmacist had told me to use full-strength Gatorade because I needed the electrolytes (and the sugar wouldn’t have a chance to be absorbed). I think I made the right choice. I measured my blood glucose several times and the highest it hit was 118. I didn’t feel the process was pulling fluid out of me, only that the fluid was passing through me.
The dissolved salts had no smell but a strong effect on the bitter sensors on the tongue, so it was unpleasant to drink 64 ounces of the stuff at the rate of a cup every 15 minutes. After half an hour or so it began to take effect, first some runny stuff, once some fairly normal solid stuff, and then just fluid. I may have spent 45 minutes or so mostly in the bathroom, but I had no cramps. I expected it to be like a bad case of diarrhoea but it was not so bad–no cramps, not that nasty acid stuff, and I didn’t feel sick. I stayed close to the bathroom the whole evening, but I never felt I might not make it there. By 8 pm I was passing clear fluid and the frequency of visits to the toilet was going down, so I decided not to take the 2 additional Dulcolax tablets the instructions called for. The doctor had said that if I was not prone to constipation I probably would not need all of the prep and the pharmacist said that if I got to the point where I was passing clear fluid and a little sandy stuff in the bottom of the toilet bowl I was done.
I slept surprisingly well. I didn’t have to get up to go to the bathroom more than I usually do, and hunger didn’t keep me awake (which sometimes happens to me). I woke up early and anxious, partly because we had snow overnight and it was supposed to turn to freezing rain. What I found when I went out was just slush, so my husband and I headed to the hospital (with me driving, as I grew up in the north driving on snow and he grew up in Texas). My appointment was for 7 am.
I was taken to a cubicle with a curtain and a rolling bed where I put on a cloth gown open in the back. I was told I could keep on my socks. I asked if I should take off my bra and I was told I could keep it on. The anaesthesiologist came in to talk to me and I discussed two things with him. I told him I was a survivor of sexual abuse and I was a little worried I might panic. I said if I did the best thing was to have my husband comfort me. I said I was worried after seeing my daughter crying after oral surgery and he said that happens to one of 10 people with Versed but he didn’t expect a problem with the drug I would get because you wake up alert, not groggy and confused. I also told him that it can be hard to start an IV in me. The nurse said she would start it before he left in case there was a problem, but she got it the first try.
Quite quickly a nurse wheeled me into the procedure room, but then there was a long wait for the doctor to come. I was hooked up to an automatic blood pressure cuff, three heart sensors stuck to my chest, and a thing around my finger to measure my pulse and oxygen saturation. I watched the monitor for a while–there were three traces and I couldn’t figure out what the middle one was. Then I proved it was charting my respiration by holding my breath. I tried watch the trace to make my breath even, but I realized I was breathing deeper than I needed. I had brought with me an iPod of soothing music, with earbuds, and they let me keep it on the whole time. They were going to let me keep my glasses on until the doctor came in, but then someone else took them off just before he arrived.
I was quietly listening to music when the nurse-anesthetist came back in. He told me that the medication would burn going into my arm. It did–I said yow, it burns and I have a strong metal taste in my mouth. The next thing I knew I opened my eyes and said “is it over?” The nurse in the recovery room asked me what I wanted to drink (I had orange juice and then milk). The doctor came in and reported that I was all clear, just have it done again in 5 to 10 years. I asked about polyps and he said none. He had told me I wouldn’t remember what happened in the recovery room but I do. I didn’t feel sleepy but I wouldn’t say I was alert–I felt as if there was a wall of cotton between me and the world. After a little while I got dressed. I asked for something to clean myself with before I got dressed–I wasn’t dirty but wanted to wipe myself. I was given a warm wet washcloth and towel, which was nice. I felt ok getting dressed, but I was glad that someone pushed me in a wheelchair to the hospital entrance. We left about 9 am. My husband and I stopped for breakfast and I ate a big breakfast.
I’m taking it easy today–the instructions said do not drive (or cook) for 24 hours after the anaesthesia. The idea is it leaves your judgement impaired, though I don’t notice that. I did drive a short distance to pick up something at the postoffice and felt fine, but my body does want rest. I feel absolutely no soreness from the procedure–I have only a theoretical knowledge of what was done to me, nothing in my body to indicate it. I do have the world’s worst stomach rumblings as food hits my system again. I’m passing gas and little bits of fluid, not frequently but enough to make me want to stay near a bathroom. I’m eating normally, but then I have a cast iron stomach.
The experience was overall much less difficult than I expected.
Update: I feel very depressed the next morning. I’ve been researching the medication but can’t tell if it is a side effect. I’ve edited in links to what I learned about the medication.