My Colon Preparation Left Me Feeling Washed Out

Even though I’ve been visiting my general practitioner twice a year for as long as I can remember, I’m still not exactly sure what general practitioners do. I’ve come to think of them as flagmen or caretakers for your well being. As my flagman, my general practitioner has referred me to different specialists to diagnose and treat several medical problems. He’s also prescribed various medications for my health and well being. One was a pharmaceutical to lower my elevated blood pressure, another to maintain a satisfactory blood pressure reading, and a couple of others to reduce the cholesterol level and uric acid level in my blood.

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It had to be at least ten years ago when I first suffered an episode of gout. The big toe on my right foot started having a slight discomfort, and because of the upcoming long weekend, I refused to acknowledge the persistent ever-growing pain. On Friday morning before the long weekend, I was overcome by a sudden unmanly moment and confided to a couple of coworkers that I was suffering from a painful big toe. They chorused gout and proclaimed that if I was planning on firing up the barbie and drinking a few to celebrate the long weekend, then I should see my doctor. I took their suggestion and rang my general practitioner. After explaining the three-day pain in my big toe was increasing exponentially by the minute and my barbie and backyard cricket plans for the long weekend to him, he said that I should immediately come into the office. After glancing at my red, inflamed big toe and giving it two pushes with his thumb, he announced, bet it feels like your toe is soaking in boiling water instead of being jabbed with a thumb.

Physician Assistant Specialist: You’ve got gout; the curse of living like a rich man. Living an affluent lifestyle and eating large helpings of red meats and seafood, and consuming generous amounts of alcoholic beverages.
Me: Crikey. Hang on a minute mate; I’ll be the first to admit you won’t see a bowl of porridge and a slice of stale bread spread with lard on the table, but I’m far from a beef wellington, custard tarts, and pies made with copious amounts of butter and sugar type of fella. And it’s not like I’m chucking back twenty glasses of chateau cardboard every day.
Physician Assistant Specialist: When there’s too much uric acid in your body, it can crystallise and deposit in the joints; usually in the big toe.
Me: Listen, mate, I like a pie and sauce now and then, and I’ve come to appreciate a few ice colds in my time yu know, but that’s far from an affluent lifestyle.
Physician Assistant Specialist: When you get home, take the pain relievers and the prednisone, and sit with your foot elevated. And avoid a diet of red meat, liver and kidneys, and seafood. If it’s not gone in a week, come back and see us. And go easy on the beer.

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It’s about a ten or fifteen-minute drive from the hospital to our house. In the short drive home, my big toe progressed from feeling like it was soaking in boiling water to being hot and swollen, and whenever I put my foot on the ground, I suffered intolerable pain. I crawled up the front steps and into the house; the pain was intense. I lay exhausted on the couch with my foot elevated and swallowed my just prescribed medications. That was my start to a long weekend without a few snags on the barbie, a game of backyard cricket, and beer.

During my twice a year visits, the flagman for my health reviews my blood pressure and orders a blood draw to check my uric acid, cholesterol, and triglyceride levels; and announces the countdown to my colonoscopy at the end of every visit with, it looks like five years until a colonoscopy John, well John 4 ½ years until your colonoscopy, and so on. I don’t think of a colonoscopy as something you put on your calendar, as you would, a birthday, St Patrick’s Day party, or attending the AFL Grand Final at The G, so I forget the countdown as soon as I leave the examination room. On my last visit, the flagman did the countdown to my colonoscopy and announced; looks like we’re due for that follow-up colonoscopy John.

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The day before my 10:15 am colonoscopy arrived, and I started my preparation chanting what would be my mantra for the next 30 hours.

The bowel and colon must be empty; the gastroenterologist needs to see the polyps a plenty.

I started the day with a clear liquid diet. To avoid dehydration, I dutifully counted every glass of Gatorade and Apple Juice I swallowed. I cleared the fridge of milk and milk-based drinks, red, blue and purple beverages, beer, protein drinks, and juices containing pulp to help with resisting the urge for a glass of Milo or any of the other prohibited liquids, and this made room in the fridge for the mammoth container of prepared electrolyte bowel prep solution. My goal was to have the cleanest colon the gastroenterologist has ever seen. A colon he couldn’t stop talking about in the break room for the rest of his working life. At 6:00 that night, I started drinking the bowel prep solution. Every 10 minutes, I downed an 8-ounce glass until half of the prep solution was gone. The instructions were to finish the other half 6 hours before the procedure. After downing the third glass of the prep solution, the bowel movements started. I lost track of the number of times I spent in the loo over the next few hours, but I made sure during each visit to check the liquid I was expunging; my goal was a watery stool that anybody could see through.

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I had trouble finishing the second to last 8-ounce glass, which would have been eight glasses of bowel prep solution in about two hours. And that caused me to think back to the good old times of summer when the snags were sizzling on the barbie, there was a game of cricket in the back yard, and we were busy throwing back a few ice colds with the mates. In the day, it was nothing to go through half a dozen long necks of Melbourne Bitter without breaking a sweat. A long neck holds close to 26 ounces of the golden amber, and now here I was, struggling to put down 64-ounces of prep solution.

I started my colonoscopy day at 4:00 in the morning by drinking the last nine 8-ounce glasses of bowel prep solution and then digging the car out from the mound of snow caused by the snow ploughing trucks clearing the street of the 7 inches of snow left by the overnight storm. I did one last check of my stool before heading off for the procedure, and I let loose with a shout of bloody ripper. It was a clear yellow fluid without sediment. The first stop at the hospital was patient check-in.

Patient Check-In Person: (With a polite tone) And how are we feeling this morning.
Me: Grouse. I was out of bed at 3:30 to drink the solution every 10 minutes so I could hang out in the loo every 9 minutes expunging liquid, and then at half six I started digging the car out of a heavily compacted snowbank, and now I’m going to have a tube stuck up my bum.
Patient Check-In Person: (Looking at a computer screen) Last name?
Me: (while my patient history was being accessed from a mainframe somewhere) I was joking about feeling great. You know, I woke up during my last colonoscopy.
Patient Check-In Person: Date of birth?
Me: I was joking about being great; I haven’t eaten in 24 hours.
Patient Check-In Person: I see you’re here for your colonoscopy, we just have a few waivers and consents for you to sign.
Me: I was joking about feeling grouse; I only got about 5 hours of sleep last night.
Patient Check-In Person: If you take the elevator to the third floor they’ll check you in; have a nice day.

I was laying draped with a hospital gown, prepped for intravenous infusion anaesthesia, and waiting to be rolled on my mobile bed into the procedure room when the anesthesiologist sat beside me.

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Anesthesiologist: And how are we feeling this morning
Me: Really great. Yu know, I still remember waking up during the last colonoscopy. It’s funny how you remember little things from 5 years ago. Could you give me something to make sure I don’t wake up this time?
Anesthesiologist: If we give you anything to put you into a deep sleep you’ll have to have a tube down your throat because you wouldn’t be able to regulate your own breathing. Besides, it’s quite normal to wake up during the procedure.
Me: Normal?!!!!
Anesthesiologist: I’ve had two colonoscopies and woke up during both of them, but I don’t remember the experience.
Me: Now that’s the way to go. What a commitment to patient empathy; having two colonoscopies so you can walk the talk with your patients.
Anesthesiologist: My mum had colon cancer.
Me: So you know then what’s it like to wake up with a tube up your bum.

I was conscious when they wheeled my mobile bed into the procedure room and parked it alongside a wall-mounted 50-inch television screen. I was in the centre of a flurry of activity; nurses were arranging equipment and materials, positioning and stabilising me with pillows, and chatting with the gastroenterologist. He was dressed in a full length yellow waterproof latex apron, a clear face protective safety shield, and arm protection nitrile gloves. I heard the gastroenterologist ask, are we ready to go, which caused me to turn toward him and utter; no, not yet, I’m waiting for the deep sleep to start. I remember hearing a muffled I wasn’t asking you, I was talking to my nursing staff.

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I was drifting into a twilight zone as I turned toward the wall and the 50-inch television screen. The anaesthesia kicked in with me looking at an extreme close up of my bum. I didn’t wake up during the colonoscopy. The only memory I have of the procedure is smiling at someone I thought was the Gorton’s seafood fisherman before he stuck a snake-like, multi-layer flexible tube with a light, camera, and a tool for removing polyps up my bum and the length of my colon.

I’m thinking about starting a colonoscopy event calendar to clip onto the fridge. This way, I can appreciate the dwindling months until my next colonoscopy. Whenever the flagman for my health announces the countdown for my colonoscopy, I’ll stop at the supermarket, buy a packet of Gorton’s frozen 18 ct Breaded Crunchy Golden Fish Sticks, cut out the fisherman logo, and paste it on my colonoscopy calendar. Ten fisherman logos would signal five years, and it’s time.

 

Dr William Wolff, Colonoscopy Co-Developer, Dies at 94

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