Colonoscopy and the Preparation
Updated: May 26, 2019
I've had six of colonoscopies now and the worst thing about it, as I'm sure most people will tell you is the preparation! In the nearly twenty years I have had Crohn's Disease the prep does not got any easier. It fills me with dread each time so I'm writing this post for the first timers to understand what happens.
MY FIRST COLONOSCOPY PREPARATION
The first time I had to prepare for a colonoscopy I had no idea what I was in for. In fact half way through it I had a tantrum and decided I wasn't going ahead with the colonoscopy but somehow I managed to down it all and get through the night. Now the biggest mistakes I made were:
Not drinking enough clear fluid so I became severely dehydrated
Not starting my low residue diet before the recommended time
Not having some decent things to drink on prep day i.e. chicken broth (clear), flavoured water, herbal teas etc.
By the time I had arrived at the hospital I had to be put into a dark room and lay down as was so poorly. I recall also being up most of the night sitting on the toilet so I was also exhausted.
TIP: Drink plenty of fluids even when you are taking the prep and drink heaps before you start the prep. Drink water up until your nil by mouth starts. Also I found non-sugar jelly snakes really good too during the prep (no red or purple dyes).
The colonoscopy procedure itself is not painful and you are given sedation so you don't remember a thing. All six of my colonoscopies I felt I was knocked out as soon as the injection of anaesthesia was put in my cannula. No sooner had they injected it I was waking up in recovery. I've only had one horrible experience with the anaesthetic that was injected and felt like my arm was on fire but the doctor said that was ok and before I knew it I was in ga ga land. When I woke up fro that anaesthetic I felt very sick so was given anti nausea meds.
Once you are awake you will get dressed and go sit in an armchair and be given some sandwiches and drink. You will feel like it's the best meal you have ever had after not eating for two days!
MY MOST RECENT COLONOSCOPY PREPARATION
This time I had it planned properly. My doctor gave me Glycoprep for 5.00 pm the night before the colonoscopy and Picoprep for 4.00 a.m. Yes! I had to do it twice. Doctors have preferred ways of doing the prep and each time has always been different for me.
Here's what I did:
I prepared the Glycoprep but I don't put it in the fridge as recommended as I don't like cold beverages.
I started at 4.00 pm rather than 5.00 pm in hope that I might be finished racing to the toilet by 10.00 pm. It worked in fact I got a good night's sleep with only one bathroom trip during the night.
I stocked up on non red snakes, clear coconut water and clear flavoured water.
I stopped eating all high fibre food two days before
On the day before the colonoscopy prep I told myself this is like a good cleanse and I made sure I drank lots of clear fluids and ate a few jelly snakes i.e. mentally psyche yourself up in a positive way
Once I began the prep I decided whilst I was doing it I would clean the car and do some housework before I had to sit on the loo for ages (I have a fast metabolism so my prep starts working within 30-40 minutes).
I was to take a cup full every 15 minutes. This stuff tastes revolting something like lemon flavoured salt water and with every swallow you take it gets worse so be prepared for this.
I downed my cup of prep quickly taking sips of water between each mouthful so that meant I could have about 12 minutes of freedom from this stuff
By the time I had gone over my first hour I was struggling and when I started to drink my first cup of the second hour I had to race to the bathroom and I threw the whole lot up! It wasn't pretty and I worried that I might not be able to continue and have the scope. I took the risk, let it settle for 30 minutes and started again. By this time I was well and truly on the loo too.
It took me actually four hours to complete my 3 litres and I still worried that I might be in trouble because of the amount I threw up but decided because everything coming out was clear it had worked. I decided after every mouthful to take a sip of coconut water and this actually helped a lot.
Once everything had settled down around 9.30 pm I went to bed and set the alarm for the 4.00 am drama.
At 4.00 a.m. the Picoprep is only one sachet of powder in a warm glass of water followed by 4 glasses of clear water. I found this stuff just as revolting but at least it was only one glass, I struggled to get the four glasses of water after it but did drink until 5.00 a.m. to keep hydrated. This time I had some stomach cramps and the evacuation started all over again but only lasted about an hour before it was clear again and then it stopped.
I then had to drive myself 40km to my hospital and I was fine. I had arranged for my brother and his wife to pick me up (you can't drive a car for 24 hours after) with one of them driving me and the other bringing my car back. I live in the country and since I had to be at the hospital at 6.45 am I didn't want to bother people to drive me in.
I can't stress to you the urgency that happens so stay close to the bathroom because if you think you will hang on you won't be able to. It's a good idea to have some old towels with you too.
Once you are admitted the nurses will ask you to change into a hospital gown and your belongings will go in a plastic bag with a label of your ID on it. You will be given a warm blanket if you are cold. The nurse will check your vitals run through some paperwork and then you will either go to a lounge and wait or be put on your bed. You will be asked many times to identify your name and date of birth etc.
The nurses will then put the monitors on your chest and the Anaesthetist will come and see you. This is when you will have your cannula inserted as well. Before you know it you will be wheeled into theatre, either moved to an operating table or stay on your own bed, asked to turn on to your left, be injected with the sedation and that's it! This time I had no grogginess when I woke up, I was a little confused as to where I was. A nurse came straight over to look after me and write up paperwork and the Anaesthetist came to see how I was then followed by my doctor who told me I didn't have cancer but I had quite severe inflammation. He told me something else too but I forgot straight away and I'm not due back to see him for a couple of weeks. He also took biopsies.
The reason for this colonoscopy is that I've had severe fatigue and pain in my lower right quadrant for 3 months now and a CT scan showed a mass of 4 cm by 3.7cm on my Cecum questioning carcinoma. It took me 3 weeks to get the scope so the last few weeks have been hell for me. But hey, I don't have cancer!
Now I've just got to get on top of this Crohn's Disease flare. Stay tuned.
UPDATE MAY 2019
WOW that last CT and colonoscopy missed something that could have taken my life! I ended up being very sick and needed emergency surgery 6 months after I wrote this post; a right hemicolectomy due to a complication of Crohn's Disease - Psoas abscess.
Basically I am lucky to be alive.
After my surgery I was still not well, and had a lot of pain two months after so my surgeon ordered another colonoscopy and gastroscopy. This time the prep was 3 x Pico Prep and I found it much easier than the previous prep. I cheated this time and actually had a little breakfast the day before as my procedure wasn't until late in the afternoon the following day.
As it turns out I now have more Crohn's back near the join of the large and small bowel plus I'm on medication for life for Barrett's Esophagus. This has not deterred me from making the most of life. We only ever have one chance.