The Colonoscopy Two-Step

Hearing certain words from your doctor can bring a small catch in your throat or a falling-away sensation in your stomach. An example? “You should have a colonoscopy.”

Some doctors may be more subtle, as if it’s just a suggestion: “I’d like to schedule you for a colonoscopy.” But they mean the same thing, that you’re of that age when a regular invasion of your colon becomes part of your medical routine, evoking unpleasant, even lurid, images of someone shoving a camera attached to a long tube up your rectum. Welcome to the beginning of the so-called Golden Years, the rest of your life.

My first was over five years ago, and my memory of it, still fresh in my mind, is that the prep, performed the day before, was actually the worst part. The provided prep kit contained a pint bottle of magnesium citrate and a gallon jug, empty except for a quantity of powder at the bottom. The directions were to add water to the jug, resulting in a solution called GoLYTLEY, bringing to mind Holly Goligthly of Truman Capote’s Breakfast At Tiffany’s.” But going lightly is not what results after drinking this vile-tasting stuff.

Came the day before – call it colonoscopy eve. The written directions admonished me not to eat anything solid – NOTHING, that day. Until after the procedure, I was on a liquid diet, only taking in what was in the prescribed list of allowable liquids (juices, as long as they are not red – no cherry, raspberry, et al – coffee or tea without milk, clear broths, popsicles, again no red). Further, I was told, the entire bottle of magnesium citrate had to be downed immediately after rising. Before long, there were two or three urgent visits to the bathroom to begin purging. Then, in late afternoon, as instructed, I began drinking the GoLYTLEY solution, one eight-ounce glass every fifteen minutes. To begin with, choking down all that awful-tasting liquid was a chore. And the resulting gurgling commotion in my bowel made the magnesium citrate two-step mild in comparison. I wound up practically camped out in the bathroom.

In contrast, the procedure itself wasn’t that bad, if I could ignore waiting for long minutes lying on my side on a table, my ass sticking out through the back of the skimpy hospital gown, while the two nurses who’d received me into the room looked on. This after they’d poked and prodded me into that fetal pose and opened my gown in the back, perhaps for their viewing pleasure. After that, I waited, feeling a cold draft on my backside while listening to the two nurses chatting inaudibly about something, which I imagined were jokes about the sorry state of my bare ass.

Finally the doctor entered the room to begin whatever he had in store for me. I had already been given a sedative intravenously to “relax me,” though I hardly felt relaxed or noticed anything different until the doctor began shoving the scope, supposedly too small to feel, through my anus. I felt a sharp pain and bucked, yelling, “Ouch.” The doctor mumbled something about more sedative, and the procedure continued. It was not pleasant, but it was mercifully short. Or else, I don’t remember much of it.

Fast forward to five years later. With my annual checkup approaching, I knew it was time for another. And sure enough, after my doctor’s perfunctory pokings and palpatings and listening at my chest and back with his stethoscope, instructing me to take “deep breaths,” or “breath normal,” he voiced the words I didn’t want to hear: “I see you’re due for another colonoscopy. I’ll schedule you in.”

Obviously I knew what to expect this time, but I decided to learn more. At home, I researched everything I could find (in my case, using Google searches). The result was that the second went a lot easier than the first.

To start with, the day-before prep wasn’t so bad. Reasoning that the procedure was more than 24 hours away, and bolstered by my research on colonoscopy preps at sites such as The Mayo Clinic, I partially ignored the draconian instructions I had been given of NO SOLID FOODS the day before. The more forgiving instructions of these other respected institutions said that a light breakfast the day before was okay, so long as I followed the rest of the regimen. So I had my normal bowl of cereal and a cup of coffee with milk. Then I didn’t take the magnesium citrate to start things moving until mid-morning, a few hours later. The rest of the day went okay, with only a few purgative bathroom visits.

I still faced the bad part I remembered so well, starting in late afternoon. Earlier I’d prepared the GoLYTLEY solution, and now I had to drink down the vile stuff, one glass every 15 minutes. But this time, again based on my research, I flavored it with Crystal Light lemon powder, and it didn’t taste half bad, almost like lemonade. It was still no fun swilling down that large quantity of liquid, and ditto going to the bathroom every 20 minutes or so. Still, it was a lot easier.

The procedure itself the next day, because I had been there and done that before, was absent the mystery of the first time, of, “What am I in store for?” I made a point of asking for more of the prescribed amount of sedative before we got started, based on my first experience. I mentally dismissed the part about exposing my bare bottom to the cold draft and the imagined stares of the nurses, and just lay on my side musing, probably helped along by the extra dose of calming drugs. And then soon enough it was over. I hardly felt anything, aware in a detached way of the mumbled conversation of the doctor and his nurse-assistant behind me.

Surprised at how little time had seemed to elapse, I was told I could get dressed and leave. It was then, when I stood up from the table, that I fully realized what an anesthetic wallop I must have been given. I felt quite drunk. Walking down the hospital corridor to the outside, I had to hold on to a railing to go in a straight line. My escort, the designated driver they require you to bring, kept trying to take hold of my arm to steady me, and I, like a typical drunk, kept waving her away, “I’m alright, I’m alright.”

My drunkenness cleared up somewhat by the time we arrived outside in the parking lot, but I was still in no shape to drive, which is the point of the insistence on a designated driver.

As my head cleared during the drive home, my lower abdomen began to feel overfull and uncomfortable. I knew that air is pumped into the lower intestine during the procedure to expand the walls, offering the doctor a better view. But maybe they had overdone it this time.

Finally I arrived home. All I wanted to do was lie down, which I did, moaning softly. Then something began happening, something was coming, which turned out to be the loudest, most enormous rippling fart of my life, perhaps lasting 10 seconds. I was only happy no one was around to witness the discharge of this noisy, gaseous effluvium into the air.

But I did feel much better afterward. There was that to crow about. Also, it was a long five years out before the next time.