Colonoscopy Tips & Tricks

For some, this post will be TMI; however, the number of people that will benefit from this information outweighs any possible embarrassment on my part.

Colonoscopy preps are the absolute worst. Every time I get scheduled for one, I never seem to  remember how much they suck; I just want to go and get it done. I start out feeling perfectly fine about the whole thing. And then I go to the pharmacy where they hand me this large bottle of powder, and I remember.

I do NOT enjoy colonoscopies, nor do I know anyone who does. Now, I was lucky enough to have an uncle who had a couple procedures done before I was ever scheduled, so I was already somewhat familiar with them, but many people who are going in for a colonoscopy do not have any previous exposure. So, I have decided to write up some tips, tricks, and general information about colonoscopies based on my own experiences.

[Please note that I am only 25, and–at the time of writing this–tomorrow will be my fourth colonoscopy. Absurd, I know. No one seems to be able to tell me what is wrong with my gut/digestion. I’ve also had two capsule endoscopies (camera-pill), with no luck. Despite my previous exposure to colonoscopies, I was scared out of my mind when I had my first in 2013. Though, to be fair, I think was more frightened what they’d find, and anxious to find an answer for my illness, rather than concerned with the actual procedure itself, but I digress.]

The information below is the result of my meager experiences. It is important to keep in mind that everyone’s experiences with medical staff and procedures will differ to some degree, and your own experience may be quite different.

 

Things to do BEFORE “prep” day

  • Stock your bathroom–Make sure your bathroom is stocked with toilet paper, a clean trashcan, moisturizing soap, and something to keep you occupied, as you are going to spend a ridiculous amount of time on the toilet.
  • Plan your meals–You are going to want a variety of liquids to keep your body functioning the day of your colonoscopy, as you will not be able to have anything solid! (Some gastroenterologists will require that you are on a liquid diet for 2-3 days before your procedure. It is always best to listen to what your doctor tells you to do as it may affect your procedure.) DO NOT CONSUME RED FOODS/DRINKS! Other colors may be restricted as well, per your doctor’s. instructions.[My first colonoscopy, I could not have anything red, orange, purple, or blue. I have included a list of appropriate food suggestions below.]
  • Prepare to be a hermit–Perform any errands that might be necessary before you have to start your prep, as you probably will not want to leave the house once prep begins. You really will be spending most of your time on the toilet.
  • Ask Questions–If you have any questions for your doctor or for the endoscopy center, make sure you ask them. Do not be afraid to ask them a million questions; it is their job to make you feel at ease and to help you understand exactly what it is that you need to do and what will happen during your procedure.
  • Ponder your wardrobe–Have comfortable clothing to wear as you will not want to wear anything too binding. Also make sure you have several pairs of clean underwear, once you get going, accidents can happen with (hardly any) notice.

 

“Foods” to Prepare Remember NO red!!!

  • Jellos/Non-Dairy Gelatins — [I like to keep lemon and lime on hand. Before my most recent colonoscopy, I also had apricot. Apricot does not really have a strong flavor, so it wasn’t my favorite, as I enjoy the flavors.]
  • Gatorades and/or Pedialyte — Yes, Pedialyte is marketed for children, but it is also fine for adults. It is generally flavored nicely, and it can help soothe an angry tummy. [I like to have Pedia-pops when I have been really sick. It helps me to rehydrate slowly.]
  • Juices — Any translucent juice without pulp. For example: Apple juice, white grape, white cranberry, etc. DO NOT, however, have normal grape juice, red cranberry, or a juice that has bits of fruit floating in it; this can cause you to not clean out properly before your procedure, or may dye your intestinal walls, which may mean that you have to do it all over again on another day (and, seriously, who wants to do this twice?).
  • Popsicles — Again, anything without red dye and without pulp should be fine. The root beer flavor has red dye–watch out for that! Some browns are not true brown.  [I personally like the banana twin pops.]
  • Broths – Make sure you get broth that does not have any bits of the animal still floating in it. Also avoid any powders that have added herbs in them. [I made this mistake and accidentally bought one with parsley in it, which likes to cling to the walls of your intestines when you are empty.]
  • Clear sodas – Lemon, lime, ‘dry’/’sparkling’ sodas, ginger ale.
  • Teas and/or coffees WITHOUT dairy — Try not to consume the dregs/flower bits. -[My favorite is ginger tea, because I get very nauseated during the prep, and ginger can help settle your stomach.]

 

Bathroom Stock:

  • PLENTY OF TOILET PAPER!! I cannot stress this enough.
  • Medicated cooling pads and/ or liquid witch hazel — to soothe your rectum when it begins to feel raw and abused, or in case of hemorrhoids.
  • Moisturizing hand soap — Your hands will get extremely dry with both the dehydration of the prep itself, as well as the repeated hand-washing.
  • Vaseline (Petroleum Jelly)/body-safe Oil — Never underestimate the power of proper moisturizers
  • Pads/Adult Diapers (Optional)–If you have ‘accidents’, and don’t wish to keep putting your clothes through the laundry. Sometimes, it’s fantastic to be able to throw sullied things away. (Don’t tell the environmentalists. << inserted by an environmentally conscious friend.)

 

Prep Day

Your doctor or the hospital will give you instructions on how to conduct your prep. My first time, I had to take four prescription laxative pills, wait four hours, then start my golytely. I had stayed up late the night before, so an alarm woke me up to take the pills; I took them and fell back asleep. I woke up with the worst stomach pains I had ever had. I ran to the bathroom and cried as my body cramped up, trying to release my stool. I will warn you now that the first poop is the absolute worst, and smell is really bad. And…I’m afraid it doesn’t get much better.

If you have a powdered prep like Golytely, mix it several hours before you need to start and put it in the fridge. I would suggest using the flavoring packet if you can because it really doesn’t taste great. If you are using Miralax, pick a gatorade flavor that you will be fine with hating by the end of it. If you are using Magnesium Citrate drinks, you will probably want them only chilled slightly, and you will want an extra. My stomach tends to reject Magnesium Citrate for some reason, and my step-sister has dropped one and broken it before, so it is always good to have a back-up.

For the majority of people, the cramping pain goes away once the stool softens.Personally, I get a cramping before each BM–which is often. My uncle describes this process as “peeing from your butt,” and I cannot think of a better way to put it.

You start out with almost a hardened-cork of a bowel movement. It is hard and it hurts. If you tear a little bit and have a bit of blood on the toilet tissue, use one of the medicated wipes or a little bit of witch hazel on your toilet paper to soothe your rectum. The cramping that you get (if you get it) will continue to increase until you start having soft bowel movements. This progresses to a toothpaste-like consistency for a little bit, and then you may get a burst of air. I’ll be frank, this will feel like your rectum is vomiting. The wet bit is coming.

Your body’s initial response (or at least mine) is to try to stop you from having an accident, even though you are on the toilet. It may be hard at first to get your muscles to relax enough for you to release the fluid. The first couple times this happens will be very strange indeed. [By this point, I am normally wearing a pad constantly, due to the frequency of accidents.

Once the build-up of stool is out of the way, the real craziness begins. Every. Single. Poop. Will be fluid, and it will be often. So many times have I thought I was finished, washed my hands, and suddenly the urgency is there again. Now, there will come a point where the toilet paper starts to feel like sandpaper (naturally). This is when you are going to want to use vaseline or some other body-safe moisturizing oil, such as coconut oil. Dip a bit of toilet paper into the container of petroleum jelly/oil and wipe it on. This serves to save your poor behind from so much agitation with the dry tissue.

[To me, this feels very nasty, so I take another piece of toilet paper and wipe along again to move a bit of the jelly off. This practice has helped me immensely.] Because of the number of times you go, you will also want a moisturizing hand soap, because a normal hand soap will dry out your hands very quickly.

*Since I am hypoglycemic, my blood sugar will plummet about halfway through my prep, and there isn’t much of anything I can do to boost it back up. Many times I have to tell them to check my blood sugar at the hospital before they take me back for the procedure. I generally end up having a bag of dextrose, which is basically sugar water in IV form during the procedure. Because of my hypoglycemia I will start to feel very sick, I will get shaky, and I will start to feel like I am freezing. If any of these things happen, don’t get too frightened. If you are diabetic or hypoglycemic, check your blood sugar if you can, if you are low, call your doctor and see what they recommend.*

Blood sugar will not be a problem for most people. However, my body doesn’t hold onto the juice or even jello long enough for my body to absorb the sugar, and so I end up doing something that you really SHOULD NOT do! I take some pretzels and I suck on them one at a time, careful not to swallow any of the pretzel itself. It doesn’t raise my blood sugar much, but the tiny bit it does helps my body to settle down so that I can finish my prep. (Please treat this kind of solution as a last resort if you have this problem, and follow your doctor’s instructions.)

You are going to feel like you are starving. That’s just how it is. BUT, no matter how much you feel like this, DO NOT EAT ANYTHING!!! You really don’t want to have to do this all over again and have your initial prep be for nothing. Do not give in to your cravings. If you are wanting something savory, drink some broth; if you want sweets, have jello. Clear, hard candies really help with this ‘starvation’. Most preps will let you have hard candy as long as it is not any of the restricted colors. It is something that you can suck on for a while, and at the end it is something harder for your teeth to chew… though, your dentist may have something to say about that.

You may feel dehydrated. Gatorade and water are great for this, but it WILL move through you quite quickly. You should note that if you chug a gatorade or a bottle of water, within 10 minutes you are going to be going to the bathroom again. There is nothing solid to absorb it in your gut. So, if you want to take a nap before the procedure, make sure that you do not drink anything within 30-or-so minutes of trying to sleep as you will just need to get back up, as you might have an accident while sleeping.

 

Procedure Day

Drink nothing after the time the medical staff tells you. For some people, it is a set number of hours before the procedure. For others, the rule is nothing after midnight the night before. Three of my procedures allowed me liquids up to 4 hours before, but my first procedure was a lot worse. I wasn’t allowed fluids of any kind after midnight. My colonoscopy was not scheduled until after 1pm, and I waited at the hospital for another hour before they were ready for me. Fourteen hours with no water made me extremely dehydrated and the nurses ended up having to stick me FIFTEEN times (not exaggerating).

[When they finally got a good stick in my vein, the nurse somehow poked the needle through the IV line and it started to leak. They told me that they would have to poke me again. I was so fed up by this point I told them, rather angrily: “If you take that IV out, I am walking out of here. You are NOT going to poke me again.” They accused me of having an anxiety problem. In the end, they taped the line and it held well enough to work for the procedure.

That being said, my other three procedures went by fine. My second one, the nurse was able to  get it in one go, and I didn’t even feel it. So, don’t be too scared by my story above.]

You’re going to want a designated driver. Every colonoscopy that I have had done, I was under some kind of anesthesia. You cannot drive yourself if you have anesthesia. They generally will not even admit you for the procedure if you do not have a driver with you the whole time.

They will take you back into a room and have you change into a gown, nothing on under it. For some, this can be very embarrassing, but–I am sorry to be harsh–you need to get over it. For the doctors there, your naked body is NOT special. They have seen it all. They do not look at you in any sort of sexual way.

If you are being put under for your colonoscopy, a nurse will come in and start an IV line. They may or may not run blood tests. This is different for each location, or if you have special considerations. When they are ready for you, they will come and wheel you into the procedure room.

This room can look a little scary at first–there are wires and monitors and tools, etc. all around you…bright lights, people moving around–It may seem a little chaotic once everyone gets in there, but try not to worry. They will ask you to roll onto your left side and pull your knees up to your chest (fetal position) which will give them better access once you are put under.

Someone will bring in some medicine to make you sleepy, but don’t worry, you will have people monitoring you the whole time to make sure you are okay. Your eyes will close, and the next thing you know you will be back in your room wondering what happened.

Now, some locations do the anesthesia for a colonoscopy a little differently, so I am going to walk you through what I remember with my first colonoscopy, and my latest.

Narrative:

My first colonoscopy, I arrived at the hospital and waited, as you do. Eventually, I was taken back into a room and given a really ugly gown to change into. My ex-wife (married at the time) was there with me. I changed and waited for a while longer.

The first nurse came in to ask some questions with a trainee nurse to start my IV. The Trainee gave me my first five pokes before she asked the other nurse to step in. I was poked three times in my left elbow crevice, twice in my left forearm, twice in that hand. Three times in the right crevice, twice in my right hand, and then three times in my right forearm before they got it. Ridiculous.

As I stated above, I was fairly unhappy with them, especially when the IV started to leak and they wanted to change it out. I honestly thought my ex was going to hit one of them.

They then took me back to a room that I cannot really remember. I was asked to lay on my left side and curl up with my right knee bent to my chest. And then there was a large white syringe, and I was getting fuzzy. The clear syringe started, and they made me open my mouth and started to put in this funnel sort of thing before I was fully out, and there was music. (Full surgical anesthesia was used.)

I was back in my room and I couldn’t see clearly. My ex took a video and I only remember bits and pieces of the whole thing before a certain point. But, somehow, I woke up thinking that I was Taylor Swift (whose music I really do not enjoy). I told my ex that I was not really a good little southern girl, that I was really from New York and that I slept with the person who carried my guitar. And I did NOT know who my ex was, which made her fairly upset. **If you have never had anesthesia before, this will undoubtedly be a learning experience for you. ENSURE you have someone else with you! They will be able to speak to the medical staff on your behalf while you are not quite aware.**

Several times, the machine I was hooked up to stopped beeping, and my head would thrash about for several seconds. I found out years later that I was actually having an allergic reaction to one of the anesthesia meds that I was given (Versed), which causes seizure-like activity when administered without a high dose of paralytic.

It took me over an hour to wake up enough to be able to leave. The nurse was not kind at all during this, and kept telling my ex to stop worrying about what was going on. I probably should have been kept for observation because of my reaction, but they were not the best hospital ever.

Now, that was the worst experience that I have had at a hospital.My second procedure was much better, and they used a lighter anesthesia than the other hospital. It comes out of your system very quickly and you wake up almost feeling completely normal. Much preferred.

My latest procedure went fairly well. I was taken to a room, a nurse came in to ask me some questions. I waited maybe fifteen minutes before a tech came in to take me into the procedure room. The tech was a little all over the place, which made me a bit nervous, but the anesthesiologist’s calm demeanor helped me to relax. I answered several more questions, was asked to lay in position and was given a nice dose of Propofol. The anesthesiologist said, “This may burn a little, but you won’t care in about 30 seconds.” I felt the meds hit my brain and mumbled, “oh, yeah.” He asked, “It burns?,” and I said, “Nope, I’m floaty; goodnight,” and I was out. That is the clearest I have remembered a conversation with an anesthesiologist.

I was aware of sounds as we were coming out of the procedure room. I remember being wheeled into my room, the tech talking to my ride. I remember trying really hard to open my eyes. I was really cold. Come on, you can do it, just tell them you are cold. Nothing. Come on, just open your eyes and tell them you are cold. Again, nothing. Oh my god, this is so frustrating; I just want a blanket. Sigh. I kept pushing to talk or open my eyes. The tech left, some time passed, a nurse came in to ask my ride what I might like to drink when I wake up.Come on!!! Tell them you are cold. — “Cold.” Nurse: “What was that.” “I’m cold.” FINALLY! I still couldn’t open my eyes, but I said it.

I got a blanket and finally got my eyes open. I was told later that I told the nurse several times both before and after the blanket that I was cold. Seems like my mouth was trying to catch up with my brain. I had to keep reminding myself to stay on my left side so that I could pass gas.

Speaking of gas….

 

Aftermath

You may wake up feeling groggy. Your driver has been given instructions to make sure that you stay laying on your side. During the procedure, they filled your colon up with air so that they could see clearly what was going on inside you. They cannot just suck this air out–as that can damage your intestines–it has to come out on its own. The best way for this to happen is for you to lay on your left side. It gives a mostly-direct path for the air to move along. If you roll over onto your back or your right side, the air will start to move back up your intestines and get trapped in pockets that will cause very bad cramps. I highly advise against it.

Generally, they will make you stay in recovery until you have passed several big pockets of gas. If you have some cramping during this time, it is normal. Also, if you pass fluid or wake up in a damp or wet bed, this is also normal, as your body sometimes doesn’t release all the fluid from your prep. If you ask nicely, the nurses will generally be willing to change the pad that you are laying on so that you are more comfortable.

Once you finish waking up, your hunger will begin to return full-force. Depending on what was found during your colonoscopy, you may be able to leave and go eat. However, you may end up being put on a continued liquid or soft diet. It is important to listen to what your doctor tells you.

You will continue to pass gas throughout the day, and you may want to continue wearing a pad or adult diaper, because there could still be more fluid that hasn’t made it out, and your body could still react as if it still has a present laxative. After my third colonoscopy, I had two accidents several hours after I left. This is not abnormal.

For the rest of the day, try to take it easy. If you were under anesthesia, you will not be able to drive or make any legal decisions for at least 12 hours. Personally, I like to go home and sleep, because I don’t really get much sleep the night before, due to the prep instructions of my local hospital. [I have to wake up at 5 am and drink the last 1/4th of the prep fluid, then I visit the toilet for the next 1-2 hours. By the time I get to the hospital, I have probably only had between 1-4 hours of sleep in total, so I am ready to go back to bed.]

I hope that this has helped you to feel more comfortable with your procedure and answered some of your questions. If you still have any questions, feel free to comment below and I will answer as best as I can.

Good luck!

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