Friday, December 31, 2010

Notes on a Colonoscopy

Colonoscopy. A visual examination of the colon (with a colonoscope) from the cecum to the rectum; requires sedation.

Colonoscope. An elongated fiberoptic endoscope for examining the entire colon from cecum to rectum.

– A couple of web definitions

Most people are afraid of colonoscopies. I read that somewhere. And the fear, I think, centers on the idea of having a probe shoved up your ass.

Colonoscopies ain’t no fun, that’s for sure – but they aren’t that bad. Fear of the probe, and anticipating it, is far worse than the procedure itself.

As is the cancer that colonoscopies detect.
Some years back, my doctor informed me that given my medical history (both my parents having had colon cancer) I should have a colonoscopy forthwith, and every five years thereafter. He promptly issued a referral, and the procedure was scheduled.

I had my first colonoscopy a week later. The attending doctor was a friendly man with an engaging smile and an unpronounceable last name. He sedated me and inserted the colonoscope, burned off a few benign polyps, and sent the bill to my insurance company.


The twenty-four hours leading up to the procedure was the worst part of the entire experience. I had a lot of nervous tension, due mainly to fearful anticipation. Equally unpleasant, I had to drink a substance called Nulytely, trade name of a polyether compound used as a purgative. The stuff is incredibly effective. For three or four hours, the wise drinker of Nulytely does not venture further than a very short sprint from the nearest toilet.

I remember almost nothing of that first colonoscopy. The doctor said he administered a mild anesthesia, but it bludgeoned me into total insensibility.

Five years later I got to do it again. I drank the Nulytely and reported to the medical center the next morning. As before, the anesthesia knocked me out – but I swear I became aware of my surroundings, dimly and briefly, midway through the procedure. I remember a dull pain, and the sensation of having a garden hose coiled up in my bowels.

Afterward, the doctor pronounced my colon all clear. Clean as a whistle past the graveyard.

Another five years elapsed. For my third colonoscopy, I kept notes as I began drinking the Nulytely:

I’m supposed to drink a big jug of this stuff to flush out my intestines. Four luscious liters. The colonoscopy is scheduled for first thing in the morning.

And so it is bottoms-up now, before bottoms-up tomorrow. I’m beginning about four hours earlier than the recommended time. If I hadn’t been through this before I’d be a good boy and ask no questions; would follow the guidelines to the letter; would, as Oliver North once stated to Congress, salute smartly and charge up the hill. But the instructions – drink half today, half tomorrow morning – differ from previous ones, when I had to drink it all the day before. This variation has me uneasy. I don’t see how I could possibly drink that stuff the morning of the procedure. Imagine, blasting all over the examination table!

So I’m drinking it all today. “The adventure begins!” I remark to an empty room, and slug down the first eight-ounce tumbler.

I’m drinking the Nulytely on an empty stomach. As with many medical procedures, doctor’s orders include not eating anything the day before, except (if I want to) some Jello (but not red Jello). I don't want any Jello.

The container I got at the pharmacy held the Nulytely in powdered form. I added water to the fill line and shook vigorously. “Nulytely is best served cold,” the instructions said.


What that means is, it kills the taste.

I exaggerate. The taste of the stuff isn’t really all that bad. There are several flavors; I chose lemon-lime. What’s bad is that I’m supposed to slam down a glass every ten minutes.

As I write this, it is coming up on 3pm and I’ve had four glasses. You may note that doesn’t add up. At 2:20, after the third glass, I skipped out of the house for a while to fulfill my obligation as a volunteer crossing guard at my kid’s school.

Time for another glass.

I’m afraid to fart. I’m afraid that a seemingly innocent expulsion of mostly inert gas will have more substance than anticipated.

The plastic jug holds four liters of this swill. In just a few hours’ time I have consumed nearly half of it. It is going much faster than I expected. 

Now that I’ve had numerous glasses, the unpleasantness of Nulytely is asserting itself. It isn't so much the flavor. It's a cumulative effect – the flavor and its sticky sweetness, and the aroma, and most of all the vast amount I'm obliged to drink, all on an empty belly.

To make it more bearable I’ve begun spacing out the dosages from every ten to every twenty minutes. I’ll still finish in plenty of time, and it will still have the desired effect.

No longer afraid to fart. I can’t be! The Nulytely is making me rumbly. The eventual world of shit that will explode from me is beginning – first with the gut rumblings, followed by vaporous expulsions.

First massive explosions! More to come – a lot more. Oh boy!

The above entry marked the end of my contemporaneous notes. From that point on I was too busy sitting on the toilet to write anything down.

My description of the next few hours can be quite graphic, and for some, quite disgusting. I once described them at a social function, and one listener looked ready to vomit.

So I’ll describe it here in only the most general terms – those hours when, as I said, the wise drinker of Nulytely does not venture further than a short sprint from the nearest toilet. I discharged more than I knew I could hold. After a while it was mostly Nulytely. Though I expelled from the back, the splash sounded like urination. That stuff really cleans you out!

When the colonoscopy is over, you’re still so totally doped up that you cannot safely operate heavy machinery. By law, you must be driven home. A caring spouse is ideally suited to this task. You can eat again, and this spouse, friend, or significant other is also ideally suited to bringing you mounds of your favorite foods as you sit groggily on a couch, watching something on TV you would never ordinarily watch – Oprah Winfrey, say. Or in my case, some speculative crap on the History Channel.

I’m still a few years away from my next colonoscopy, and when the time comes I’ll have it without hesitation. They can and do save lives.

I should probably mention that people with no family history of colon cancer typically only have to have colonoscopies every ten years. I have to do every five years because both my parents had colon cancer.

I should also probably mention that both of my parents survived, and as of this writing (final day of 2010) are still around.

1 comment:

  1. You crack me the hell up.
    And I am never having one of those. Ever.