Well it's been more than a year since I've written. It's been a whirlwind year, which saw the implosion of a relationship I had been in for 4 years in a most hurtful manner, the passing of my mom, subsequently reuniting with my boyfriend during the tumult of dealing with my mother's loss and getting engaged, and then moving to a new city. Finally, just a couple months ago, I started to pull out of that spiral and look at my life and what I needed to do to take care of myself again. My new insurance in January meant that I could return to the last doctor who did my colonoscopy and did a great job - hurray! So, today was that day. I had been worried about my health - maybe it's just the changes of getting older but things haven't been feeling right - and I knew this was something I should have handled a long time ago.
As someone with chronic ulcerative colitis, diagnosed for 27 years, the physician's thought usually is a colonoscopy every 1-2 years. The last one I had was in 2011; five years ago. This is primarily because of my complete distaste for it, as well as the new Gastro physician I had I wasn't very fond of doing the procedure. Often I am forced into doing it because I can't get my meds (Lialda) renewed without it, but through several doctor changes due to insurance moves and then additional maneuvering with my former gastroenterologist, I somehow managed to not have one for many years.
One of the hurdles for me is that I have an extreme overreaction to the procedure, so general anesthetic is required. I found this out in my late 20's, when two procedures - which mind you I had already done the bowel prep for - had to be cancelled because of the pain I was experiencing during the procedure. Now, things get fuzzy, I go to sleep - and wake up in recovery. This isn't for everyone - anesthesia is nothing to mess with - but for me it's mandatory. And if I have a GI who doesn't support it, I'll move along because I've been there before. Remember - it's always up to YOU to take care of yourself and your needs, and do what is right for you.
What most people dislike about the procedure - whether having an illness or not - is the prep. You drink a gallon of a laxative to get yourself cleaned out, and it's not fun. I've had much more luck the last two time with the prep Gavilyte-C, rather than what I used previously (Golightly...which is definitely a misnomer). I do have some suggestions for making it easier to swallow to share.
1) If it has a flavor packet, use it!
2) Mix it in advance with filtered water, and chill in refrigerator.
3) I chose to drink multiple glasses as it doesn't feel daunting to have a gigantic glass in front of me - so a small glass (8oz) every 15-20 minutes.
4) Use a straw - it really helps to avoid the taste, which I promise you, you will get sick of quickly.
5) Use a chaser - ginger ale works well! How I do this is to place the straw in the glass of preparation, and take as many continuous sips as I can (usually 8, which is about 4oz) and right after the last sip, then immediately take a sip of ginger ale (also through a straw) and swish in my mouth. It really helps me to get it down! Ginger ale counts as a clear liquid. 7up or sprite works well too.
For me, the prep takes about 2.5 hours. The goal I guess is 2 hours, but this is what works for me and avoids gas and bloating.
A big part of your prep being easier is the pre-prep - that is, stopping a lot of solid foods before the procedure. Prepare yourself with broths, jello (not orange or red), and things that qualify as a 'clear liquid' and start as soon as possible. Usually it's required the day before the procedure, but starting sooner than that will help, especially if your system is slow like mine.
This year, I had a 24 hour flu (which I usually get once a decade) which meant I had complete elimination of ALL of my food the Saturday before the procedure, which was scheduled for Tuesday. I wasn't hungry Sunday still so was mainly on liquids. Unfortunately by Monday I was really hungry, which is day I could have absolutely no food. So I stayed on liquids all day until my prep began. I noticed that I began clearing within 20 minutes, which is very fast in my experience, and without any cramping or issues - I assume because I had no food in my for several days.
My prep required 1/2 gallon at 6pm the night before, and then the other 1/2 gallon to be completed 3 hours before my 7am appointment...which meant waking up at 1am to start guzzling until 3:30am.
We got to the hospital outpatient surgery center - getting a little lost - and checked in. Everything was timely. My fiancé was there to drive me home, as it's required to have a ride home after. They took me back almost right away, and got me ready. Due to my interstitial cystitis which affects my bladder, I had to go the the bathroom about 5 times before I was wheeled in for the procedure.
Important things to make sure your medical team knows are any medical allergies, or previous reactions to anesthesia. I'm allergic to sulfa and augmentin. In addition, many years ago I had a very bad reaction to an anesthesia and so that isn't used any longer. My main problem is that I can't remember the name of it! The benefit with staying with the same doctor long term is they can look up what worked for you last time - so when he anesthesiologist came in to meet with me I told him my 2011 procedure worked great and to use that cocktail - which was a combo of propofol, ketamine and some other ingredient which escapes me. He looked it up in my chart to see what had been used. That was helpful as it was different than he would have selected on his own, and sure enough I had no issues at all with it.
Often will colitis they will take biopsies, because of the higher risk of colon cancer from the disease. In the past, I've had between 11-14. For some reason, they took 40 this time...sampling the colon in 5 sections and taking 8 in each section. Better safe than sorry I say.
As I'm writing this I'm laying in bed resting from the procedure. I was home by 11:30am, and just now starting to feel uncomfortable as the pain meds from the procedure have worn off. That's okay and expected. They told me things are looking pretty good, which I was very glad to hear as I haven't felt as great taking the Lialda as I did the Asacol (reported in my earlier blogs.) If all is okay with the biopsies, I won't need to return for 3 years for the next one. Woo hoo! It's the little things like this that make my day sometimes. :)
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