Prep School

Let the games begin.  Every three years or so, it is time for the exam all of us over 50 dread – the colonoscopy.  I know what you’re thinking (besides TMI, Tina, TMI):  The test isn’t so bad, it is the prep we hate.  And right you are.

As a colon cancer survivor of 13 years, I know that having a colonoscopy saved my life, so I faithfully follow doctors’ orders and report for my exam as instructed.  Let me be your guide as you get ready to take on the challenge, and I’ll even drive you there and back if you are anywhere near my zip code, just so I know you will go!

The procedure itself isn’t bad (assuming the doctor doesn’t nick your colon or there aren’t any other complications).  You show up, strip down, roll over, and get the best 30 minutes of sleep all year.  I can almost understand why Michael Jackson found Propophol so appealing – until it killed him, that is.  Afterwards, you can’t drive a car or make big decisions, but that’s fine.  I won’t decide to buy a South American diamond mine that day.  It can wait.

The bigger decision starts for me the day before – the dreaded “prep day.”  My gastro guy requires that I use an entire container of non-tasting (really, it is) Miralax mixed with 64 ounces any clear liquid.  My beverage of choice was low-cal lemonade, which I will not be able to drink again for at least a year without recalling the rigors of prep day.  The ingestion of that much liquid, combined with the use of laxative pills, is designed to work something like Drano.  Take as directed and anything in your system will soon be out of your system.  Ah, but there’s the rub, and the rub hurts like hell.  Grab yourself a container of baby or adult wipes, and trust me, the ones you bought three years ago are now stuck together like a brick, so buy more before the process gets underway. 

The directions call for drinking 8 ounces of your beverage of choice every 20 minutes until you have consumed all 64 ounces, and they encourage you to drink any kind of non-red liquid (which, sorry to tell some of you, rules out red wine).  Good grief, only fraternity boys with a keg can drink that amount of fluid.  And after doing it, they will feel as shitty as I will.  (And then they will pledge not to do it again, but they will, as we know, break that promise…)  You have to get the stuff down so the Drano can work its magic.

The morning of Prep Day morning, after having read the instructions in advance so I would have everything I needed at the ready, I sat down to watch the doctor’s video, which, thankfully, features only a doctor explaining the procedure and no graphic depiction of any part of the process.  Maybe I should have watched it sooner so I would have known not to have taken my vitamins this week.  I knew I couldn’t take aspirin or Motrin, so only ice could be used to relieve the pain in my knee.  Now I’m thinking the ice might be put to better use…

The doctor in the video very calmly goes through the steps.  Mix the drink, keep it cold, try using a straw, slow down if you get nauseous.  Slow down?  Once it took me from 9 AM to 6 PM to down the requisite amount, and then it was time for the next dose.  Because my procedure was scheduled for 1:30, I also had to drink again on the morning of the test.  Being the total wuss that I am, taking the bottle of “citrusy-flavored” whatever they suggest is out of the question for me.  What goes down the next morning will come right back up.  So instead, I drank more Miralax (a mere 32 ounces this time) with BOC (beverage of choice, just nothing red), AND I had to finish drinking it no later than 9 AM.  Calculating the slow rate of descent, that means I was up around 5 AM to get it all down.  Like my desire to have my driveway after a snowfall be “down-to-blacktop,” I only want to “run clear” so the test can be done.  The worst thing imaginable would be to NOT be prepped properly and have to go through the process all over again.

This prep isn’t nearly as unbearable as the prep I used to do, which required drinking a mere 3 ounces of a hideous “citrusy-flavored” Drano-type product called Phospho Soda.  That stuff worked, alright, assuming I could get it down.  I don’t want to say the stuff was strong, but it has since been banned by the authorities so it is no longer used.  It caused possible kidney damage, I hear.  I wasn’t sorry to see it go.  But the Miralax really doesn’t have any taste, so the issue is merely consuming all of that liquid in one day.  Incidentally, for those who think taking pills is a better course of action, you still have to drink gallons of liquid anyway, so you will be facing the same issue as taking Miralax. 

The other side of the prep is the food side, or, more accurately, the LACK of food side.  I had my “farewell to food” at dinner on the day before Prep Day, or, as I like to think of it, “the day before the day before.”  According to the doctor’s orders, I could not consume fruits or vegetables, which made eating a challenge.  I tried to incorporate foods that wouldn’t stick around long, but if they would only let me eat a bowl of cherries and a bowl of chili, I could skip the prep entirely and still achieve the desired state of internal cleanliness.  On the day before, you consume only clear liquids.  Since broth or Jello have no appeal to me, I confined my consumption to drinking and followed directions banning all solid food after my hard-boiled egg at breakfast.  I just hoped whatever I ate in the last 3 months would be gone in time.

Not eating has its advantages.  You don’t have to plan, cook or clean up after you eat for one.  The kitchen stays clean, and it will be that way for about 36 hours.  I also count on the lack of caloric consumption having a positive effect at next week’s Weight Watchers weigh-in, but that assumes I won’t go overboard to compensate for a day without food.  Meanwhile, tracking my food intake required no time at all since there wasn’t any.  I guess you could say that I looked at the glass as half-full, but what is in that glass?

The plan was simple – take the pills, drink the stuff and stay near the bathroom.  I had programs all lined up to watch on the DVR and Netflix to keep me busy.  I avoided watching the Food Network, though I know that anything I watch on TV on prep day will undoubtedly be laden with commercials for foods that ordinarily wouldn’t even interest me.  When I walked through Walgreen’s before I started the process, I found the Doritos display tempting – and I don’t even like Doritos.  Even the newspaper seemed to have a preponderance of food-related advertising and articles, but it just might be that I was getting cravings simply because I was not allowed to eat.  Like fasting on Yom Kippur, if I get over the first wave of hunger, I’m usually good for 24 hours.  Since this prep was longer, not eating was a bigger challenge.  My sister and I like to view anything like this as a “silver lining.”  You get the flu and can’t eat for a day?  Silver lining: You lose weight.  Stuck in the house?  Silver lining:  You get extra laundry done.  I try to think of it all that way and see how silver my lining can be.

Several hours after this process began I was still able to tolerate the lemonade, as long as I kept drinking it from an icy mug.  The magic potion worked well after a slow start, so I can’t complain.  I felt weak but, with all that liquid I drank, I was more bloated than hungry, which is a good thing.  Even so, my stomach seemed flatter.  I wondered if we could stop at Weight Watchers for a quick weigh-in before the colonoscopy.  Oh, never mind.

The day of the test, the main road in Hillsborough was closed because of flooding, so my sister and I left extra early, got there in plenty of time and I was whisked away ahead of schedule.  As the medical team prepared for the procedure, I kept my eye on the anesthesiologist, the person who will make sure I get a quality – albeit short – rest.  He inserted the IV in my arm, and as I saw him push the plunger and release the drug to knock me out, I looked up and said, “Goodbye.”  The next thing I knew, a nurse was waking me up and telling me I was done.  It was over so fast that my poor sister never made it to Kohl’s before they called her to come and get me.

I am happy to report that the story has a happy ending.  I survived the test and not even one nasty little polyp could be found, so I am good for another 100,000 miles or three years, which ever comes first.  I got my sleep, I came home and drank a lot of water to flush out my system, and I reveled in the good news.

“Bottom line,” so to speak, is that if you are over 50 and haven’t been through the colonoscopy process yet, suck it up, swig it down and get it done.  It is a small price to pay to possibly save your life.  And call me if you need a ride.