The Impending Purge

There are allusions to “bonobo scat spattered walls” here at the Refuge. Time to go one better. I am scheduled for a colonoscopy tomorrow. This will be my second such procedure so I have an idea of what to expect. I haven’t found any problem with the procedure itself, but the prep is tad, shall we say, messy. Here’s what it looks like:

Three days prior, no more fresh fruit or vegetables, and no nuts. This kills me because that’s about one third of my diet. OK, so I can live on canned fruit for a while, but morning cereal without my usual blueberries, strawberries, etc. is depressing. Oh, and no dried fruit stuff either due to skin and/or seeds. There goes more snack food.

So now the “fun” stuff. The day before the procedure (today) it’s a clear liquid only diet. And Jell-O. Joy of joys. At 2 PM I am to take 2 Dulcolax tablets to “get things moving”. At 6 PM, I am instructed to mix an entire 238 gram bottle of Miralax in a 64 ounce bottle of sports drink (I chose lemon-lime) and drink 8 ounces every 10-15 minutes until it’s finished. So that’s nearly two liters of laxative-spiked Gatorade in maybe an hour and a half. Here’s the part I love on the instruction sheet: “Expect everything you drink to pass through the rectum”. That’s an understatement. If past experience is any guide that should read “Expect everything you drink to rocket out of your anus at near hypersonic velocity. You may wish to flush mid-rifle to ensure that the bowl doesn’t overflow.”

And just in case that’s not enough, it’s two more Dulcolax tablets at 8 PM.

I think it would be easier if they just had you sit on a firehose. If there’s anything left in there after this procedure, I’d have to guess that it’s welded in place.

Obviously, there’s nothing to eat or drink after midnight. In fact, that’s one of the first things they ask when you check in: “Have you had anything to eat or drink since midnight?” The instructions are quite explicit, so asked if anyone ever answered “yes” to that query. The nurse said that it sometimes happens, and in fact, one fellow answered “Yes, I had a chili-dog for breakfast this morning.”

Needless to say, his procedure was cancelled for that day.

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  1. #1 by kemibe on June 9, 2009 - 10:17 am

    My dad had a colonoscopy recently and had to spend the day before drinking GoLytely or some such. I always want to pronounce that “golly telly.”

  2. #2 by Rev. BigDumbChimp on June 9, 2009 - 10:50 am

    “Expect everything you drink to pass through the rectum”

    that’s fairly frightening

  3. #3 by Doc Bushwell on June 9, 2009 - 12:40 pm

    This reminds me that I have yet to make my appointment for my second colonoscopy. Writing about patients with advanced stages of colon cancer has put the discomfort of “prep day” into perspective. Still, be assured I’ll bitch about it.

    I may direct my friend — a surgeon in northern New England who also performs colonoscopies — here for comment from the doc’s viewpoint (so to speak).

  4. #4 by SurgicalSteel on June 9, 2009 - 1:25 pm

    I’m Doc Bushwell’s friend the surgeon – I probably do about 15 scopes a week. I warn my patients that GoLytely is the most misnamed concoction in creation, because you won’t ‘go lightly,’ you’ll go harder and heavier than you can possibly imagine and until you think you can’t go any more – and then you’ll go more. And the stuff tastes like sweat.

    Miralax is marginally better, because the volume’s lower (the GoLytely is 4 liters as opposed to 2) – but the Dulcolax makes you cramp like there’s no tomorrow, and the prep sometimes isn’t quite as good as the GoLytely.

    Easiest to take was the Fleet’s Phospho-Soda, because you could pretty much down it like a shot and drink the fluid afterwards. Trouble was, it was available over the counter and no one read the warnings about ‘this may cause renal failure.’ That led to a black box warning from the FDA and the product being pulled from the market. I miss the Fleet’s Phospho-Soda. Some of the cleanest colons I’ve seen came from that product.

    Back in the Dark Ages when I was an intern, patients still came into the hospital for bowel preps prior to having colon surgery. One of the most ghastly parts of internship was going around to see how the bowel preps were going – or not going, as the case may be, and to occasionally place nasogastric tubes to pour the stuff in.

    At our tiny hospital, we’ve even come up with an phrase which yields an amusing (to us, anyway, we have juvenile senses of humor) for what’s left in the colon after an inadequate prep: Colonic Residue After Preparation or CRAP.

    So – as much as everyone justifiably complains about the prep (it’s awful, but there’s really nothing better), it’s better to do it and have your endoscopist be able to do an adequate job than to have a report come back which is medicalese for ‘Don’t blame me if I missed something, I couldn’t see for shit.’

  5. #5 by Jim Fiore on June 9, 2009 - 1:58 pm

    I think I used the Fleet Phospho-Soda on my first colonoscopy 5.5 years ago. I don’t really remember. I seem to have flushed those memories.

    Just a few minutes to go before I down the Dulcolax.

    Kev, regarding pronunciation, that reminds me that whenever I see GoRVing.com ads I think “Gor Ving”. A decent name for a cartoon monster from Scandinavia I suppose.

  6. #6 by Jim Fiore on June 9, 2009 - 6:08 pm

    OK, I just downed the first glass of Miralax-o-ade. Something tells me I won’t posting again for a day or two.

  7. #7 by Sven on June 9, 2009 - 9:00 pm

    My wife just had hers today. Good luck with yours tomorrow.

  8. #8 by monado on June 11, 2009 - 12:18 am

    It’s supposedly the ultimate in introspection–if they let you watch the screen. That big blue thing is your liver.

  9. #9 by Jim Fiore on June 11, 2009 - 7:52 am

    You can see your liver through your large intestine?

    I was out cold during mine. Nice big flat screen monitor, though. Doc removed one small polyp, everything else looks good.

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