The Colonoscopy Chronicles, Part I

… in which the inside of my gut is completely flushed out. Literally.

1:37 p.m., Monday (August 31). As I write this, I am slurping my way through a small plastic container of lime Jell-O in my bedroom. I’m also lying on my back in bed, with my laptop computer on my stomach and the screen tilted so I can see it. I can’t see the keyboard at all.

I’m in this position because, as of this morning, gravity became the enemy of my digestion. Whenever I stand up, my digestive tract becomes a sluiceway in which all of its contents simply flow downhill, pretty much unimpeded.

I’m not having much fun today.

I woke up this morning with a nasty intestinal germ that I picked up from my kids. They got through the worst of it in two or three hours each, but not so with me: I’m stuck this way for the next 22 hours or so. Due to an unhappy coincidence of scheduling, today also happens to be the day when I’m supposed to prepare for a medical procedure tomorrow that will involve a doctor, my bottom, and a long rubber hose.

Downstairs, I have a box full of pharmaceuticals waiting for me; they’re designed to get me ready for my colonoscopy by doing the same thing to my intestines that this germ is already doing. Seems a little redundant, if you ask me.

By the way, did you know that gravity isn’t the only thing that gets food through your digestive tract? Muscles along the way also squeeze in sequence, to keep things moving along. Which is …

Erm, excuse me. I need to run.

3:06 p.m., Monday. Just finished drinking a mug of plain chicken broth. Still in bed. Not feeling all that sick anymore, but lying down is keeping the brakes on my digestive tract. I don’t know why I never thought of this technique in all my previous colonoscopies.

Come to think of it, you might be wondering why a 29-year-old guy like me needs a colonoscopy in the first place.

I have Crohn’s Disease — a chronic condition in which my bowels can get inflamed, start bleeding and do other nasty stuff. I was diagnosed when I was in middle school and have been in the hospital a few times with some pretty serious Crohn’s-related problems — but as far as this disease goes, I consider myself pretty lucky. Thanks to the doctors who’ve been treating me over the years, we’ve always been able to treat the disease with medication and without surgery (in some Crohn’s cases, the inflammation can get so bad that part of the intestine has to be cut out). In fact, the medications have worked so well that my Crohn’s has been in remission for years.

But, to my chagrin, that’s not enough to get me out of this colonoscopy.

Without having my medical records up here in bed with me, I’d guess that I’ve had at least four or five colonoscopies over the years — along with a whole battery of other unpleasant tests. Obviously doctors can’t ordinarily see inside my gut without cutting me open, so in the alternative there are all sorts of tricks they’ve come up with to help them see what’s going on.

Some of the tests involve a substance called barium, which shows up easily on regular X-rays and fills out the digestive tract quite nicely. Doctors can make patients drink the barium (imagine chugging a milkshake that tastes like chalk), or they can pump it up into the digestive tract from the other end. (That’s a “barium enema,” and I assure you it is even more unpleasant than it sounds.)

Colonoscopies and other endoscopies, on the other hand, involve a rubber tube that houses a fiber optic camera and little tools for grabbing tiny bits of my insides, on which they can run extra tests (to see if I have colon cancer, for example). How far up the chute they can go is determined pretty much by the length of the rubber hose; it has to be four or five feet long to reach all the way through the large intestine (i.e., the colon). Mercifully, I’ve always passed out from the anesthesia and have never seen them using the thing on me.

But for the scope to be able to see anything, I must first clean out my colon. Which means, in essence, rinsing the whole thing out.

Imagine cleaning guck out of a straw by shooting water through it. Yep, my gut is that straw.

5:56 p.m., Monday. Seeing how I’m never awake to experience my actual colonoscopies, the worst part of the experience for me is always the preparation. This time, thanks to my intestinal germ, I got a nice early start on that process.

But that doesn’t get me out of the pharmaceutical part of this process. In front of me is a 2-liter jug of clear liquid which I’m supposed to drink within the next 30 minutes or so. I added the “pineapple” flavor packet to the stuff when I mixed it up this morning, but experience tells me not to be optimistic.

(glug glug glug)

Ugh. Oh lordy that’s awful. Smells like pineapple but tastes like warm milk — even though it’s cold. It’s triggering my gag reflex. I’m shuddering just thinking about it.

The kicker is that this stuff — a bowel prep called “HalfLytely” — is actually one of the most palatable prep solutions I’ve ever used. And, believe me, I’ve used a bunch; patients have to use a bowel cleanser before every endoscopy, barium procedure, and so on.

I still remember the first prep I ever used, back around the time that they were first diagnosing me. I had to drink a whole bottle of something called magnesium citrate, which tasted a bit like fizzy Sprite mixed with lye. A helpful Wikipedian has noted that “chilling it in the refrigerator or pouring it over a glass of ice can help with the unpleasant taste.” Yeah, I tried that at the time — it didn’t help much. Then I wanted to vomit, and I was cold.

The next time, I swore off the magnesium citrate and was instructed to drink a giant jug (about a gallon, from what I remember) of something called GoLytely. Which is more or less like the HalfLytely, but I had to drink a whole heckuvalot more of it. With HalfLytely, the patient takes two pills to help along the process and then drinks half as much stuff.

Whoops. It’s been 10 minutes; I’m supposed to drink another glass of this stuff every 10 minutes. Another glass, down the hatch …

(glug glug glug)

“Ugh,” I say, shuddering.

“I’m sorry,” says Stacey, my wife. “The pineapple didn’t help?”

No, it didn’t. Every time I do this, I wonder if it’d actually be an improvement to leave out the flavoring packet and just imagine I’m drinking a half gallon of warm milk. (I’m sorry, I’m stuck on this — I can’t adequately explain how odd it is that an ice-cold drink tastes almost exactly like warm milk.)

Just across the kitchen from me, Stacey is serving up mac and cheese for our boys — and, boy, what I wouldn’t be give to be eating that instead.

Sadly, I must instead continue to flush out my internal waterworks with more broth, Jell-O, and another liter and a half of HalfLytely.

Oof. Time for another glass — here we go again.

9:44 p.m., Monday. This is pretty much the nadir of my experience.

Things did not go well with the rest of the HalfLytely. Merely typing the word triggers the shudders in me. But I did manage to get all two liters down and keep them down. All the way down, as it were.

I won’t go into specifics, but let’s just say the evidence indicates the insides of my intestines have been pretty well powerwashed and are about as clean as they’re ever going to get. At this point, whatever goes in one end flows right on through in about 10 to 15 minutes.

There is an up-side to this, as Stacey helpfully points out: Everything I’ve consumed today has been calorie-free for me. “Your slim boyish figure will retain its — slim boyishness,” she adds.

In all seriousness, Stacey has been appropriately sympathetic throughout this process, despite dealing with her own version of the intestinal bug that flattened me this morning. She’s been doing all the childcare; she’s been holding me and expressing quiet admiration and making me laugh.

This would also be a good point at which to note that — despite all my whining — colonoscopies are really not that bad. And they’re certainly a good sight better than colon cancer, which is why they’re routinely prescribed to folks a bit older than me as a screening. So don’t let me scare you away from a procedure that could help keep you healthy. If I can survive this as many times as I will in my lifetime, so can you.

By the way, did I mention that Stacey was the one who scheduled this colonoscopy?

COMING IN PART II: Enter the scope.

Article © 2009 by Michael Duck