Colonoscopy??!!

[alrightstill]

Ok.. so whose had em and how bad are they... ... REALLY?

I have my first one on Monday and am extremely nervous.  I picked up the GALLON(!!!) of "GoLytely" drink you have to drink beforehand - and I think thats when it all set in.   The pharmacist was like.. "Does the gastreologist KNOW you're a dialysis patient?"  (yes)  "And they're still giving you a GALLON to drink?" That just made me even more anxious and nervous!   

Thanks guys. 

[Meinuk]

I had a colonoscopy yesterday.  (Thursday) It was part of my center's routine Transplant workup, and I have no history of GI problems, so for me I went into it thinking that it was just a routine exam.  I had put off having one for years because I felt that as I have no history or complaints and I do have PKD with massive kidneys, I felt that colonoscopy was contraindicated.  Both my surgeon and the GI Specialist said, no problem, they've scoped the colons of PKD patients before.  So, I bit the bullet and did it.

I was told that I should have the scope on a dialysis day, (I am home hemo on NxStage)  So, I took Wednesday off from work, dialyzed 30L in the morning, ate a light lunch at 2:00 and had no food after 5pm.  I then started the GoLytely Prep at 6pm.  I mixed up the four Liter container earlier that morning, and refrigerated it.  (That is supposed to help the taste)

The GoLytely solution is a lot of fluid to drink (8oz every 10 mins) but it stimulates fluid production in your colon, so literally, the fluid goes right through you (after about an hour and a half)  The first sip was UGH.  The conventional wisdom it to try and chug the 8oz, well, I did, and I have to say that the first hour of drinking was a chore, and then it just got tedious - I was still drinking at 9:30 - every ten minutes (well, I got kinda lax with the time as the treatment started doing its job - and I also stopped chugging, my last few drinks took the entire 10 minutes to finish).  I didn't throw up, but I can see how people might.  And after training myself not to over indulge on liquids, drinking 8 oz every ten minutes was rather difficult, but after two hours, I knew that the extra fluid wasn't going to be staying around.

If you have concerns with any medication, please speak to your nephrologist but for me, the solution had no other side effects (other than the intended cleansing)  That lasted all night, and I woke early the next morning to take a shower, and get to the hospital for my 8am procedure.

After checking in at the hospital, I was let to a pre op area, took off my clothes (kept my socks on (I get cold feet)) Kicked back in a much better version of a dialysis chair (a medical recliner) and waited for a nurse to come over and start my IV.  She blew a vein on her first attempt and then called over another nurse who hit it on the second try.

I was then walked to a endoscopy suite (just an exam room with a few extra TV screens) My bags of clothing was put under the streacher that I was going to be laying on, and I shot the breeze with two nurses while we waited for the GI Doctor to come and do the procedure.  an oxygen sensor was put on my left index finger, and a 6 lead heart monitor was put on my chest, and an automatic BP cuff was put on my right arm.

The Doctor came in, wheeled my bed over so that I could see the larger of the two television screens, I signed the consent form, and then he gave me a dose of Versed and Fentanyl - I was very relaxed and a bit stoned, which we all know makes Anna a happy girl.  He then started the procedure, all the time explaining what we were looking at. 

Now, this is where I am different than other Patients - I want to know everything.  I wanted to be awake, and I wanted to see the inside of my colon.  As there were no complications, and no biopsies, it was and in and out procedure - no pain, no discomfort.  All in all the actual procedure lasted about 15 mins.

I then said thank you to my nurses and Dr, and was wheeled to recovery on a different floor.  I had to lay there for almost an hour before they would let me get up and get dressed, and even that was transitional.  First they take vitals, then they allow you to sit in a chair, then they take out your IV and allow you to get dressed and leave (after reading you your discharge instructions).

My friend Juliette came to pick me up.  (You are not allowed to go home alone) we went to Tom's Restaurant http://en.wikipedia.org/wiki/Tom%27s_Restaurant_%28Manhattan%29 for Breakfast, then wandered around the Columbia University Farmer's Market, then we went to get pedicures, then we went back to my apartment and ate some cheesecake, Juliette went home and I started a 30 Liter dialysis run.

All in all a pretty uneventful day.  The side effects that I felt was some gassiness just after the procedure, but as I type this the next morning, the whole procedure is nothing but a memory.  (and a bruise on the back of my hand where she blew the IV as a reminder)

[annabanana]

Thank you so much for posting this! My husband has a colonoscopy scheduled for 2 weeks from now. I will tell him about your post. 

[devon]

Funny thing!  I just had one on Wednesday.  Meinuk pretty well detailed the whole affair very well.  I can only add that I took 4 DucoLax at noon the day before and that meant I only had to drink 1/2 the fluid.  I was thankful because, in spite of the "cherry" flavoring, it was "yuck" tasting.  I would pour the 8oz glass, close my eyes and imagine I was drinking milk.  That helped a little.

The Ducolax started kicking about 4pm which happened to coincide with my son needing something to eat and wanting fast food.  DO NOT DRIVE after taking 4 Ducolax!   I had to stop 4 times in one hour to purge.  Thankfully, I was in an area full of fast food places!  The cramping was terrible as it worked it's way to clean out my system.  I started drinking the GoLyte-crap at 6pm and was done by 8pm.  By 11pm I was clean as a whistle.

The worst part for me was the preparation the day before.  The procedure itself was quick and interesting to watch on the large screen.  I felt little discomfort and a moment of pain as the camera worked to get around a corner.  But other than that, not much.  My bother drove me to and fro.  The best part was a huge late lunch at Saltgrass Steak House as a reward to myself and finally being able to eat after 24 hours of liquid diet.

Oh, get some clear broth and make up some lime jello (no orange, red or purple) the day before so you have something to eat while getting prep-ed.  I only had one can of broth in the pantry.  That evening meal of broth sure tastes good after a day of no solid food!

Good luck.  It'll be over quickly and "behind" you soon enough!  (bad pun!)

-Devon

[alrightstill]

Oh.. you guys are great.  Thank you so much!!!

I definitely want to be OUT for the entire thing.. Like, I don't even want to show them my bum willinginly.. I want them to roll me over or turn me over whatever.. AFTER I'm out.. haha. 

I wonder if I can do the ducolax pills too.  I have such a horrible time drinking things like that.  I just had a catscan a few weeks ago and pretty much threw up most of the barium sulfate almost immediately after it went down.  :-/ 

Thanks again so much for the stories.   Keep them colonoscopy stories .. uh.. flowing!

[devon]

You might call the center or doc and ask.  It was my doc who suggested this alternative to drinking the entire gallon.  He is very "up-to-date" with all the latest technology and methods.

Good luck.

I don't know if they'll knock you out completely for the exam but the meds they give you are really effective.  I was barely conscious.  They told me, "roll over on your left side" and that's about all I remember except for the screen images toward the end of the procedure.  Don't worry about "baring you butt".  They see lots of them in the course of a day.  Your's is just one of many. 

-Devon

[twirl]

You are going to lose a lot of fluid.....
When I had my first one I had to go back and they redid something because a few days later I started with the bloody poop again.
That is a rare occurrence. I had a one night stay in the hopsital, it was not bad.

Had another one a few years ago and other than all the bathroom trips it was not bad.

[paris]

I think drinking the solution is the hardest part.  I started throwing up about 3/4 of the way through the solution.  I have a great doctor; he called that evening to check on how I was doing.  Told him about the vomiting--he asked if things were "running clear"  and said I didn't have to finish the rest.     I had no pain, and little memory of any of the procedure.  I remember the nurse telling me in the recovery room that I needed to get rid of the gas-------my husband answered "she won't burp in public let alone---".    The worry beforehand is much worse than the reality.     Meinuk's account is extremely accurate

[paddbear0000]

I wonder what they do about patients who are diabetic (meaning, can't not eat for 24 hours) and have gastroperesis (meaning food doesn't digest at a normal rate)? Sometimes when I throw up, it's food I ate a day or 2 ago. I would imagine these 2 things would really cause problems when trying to do a colonoscopy.

[IrishGirl]

One of the centers I work at does colonoscopy's. In preop when we do our assessment, if we find someone with GERD, Hiatal Hernia or Gastroparesis, we give them IV pepcid and we have them drink bicitra sometimes. The Bicitra tastes nasty, but it will neutralize all the acid in the stomach. The Pepcid will do the same.  We can also do what is called "Chemical Stomach Emptying" and this involves just giving an IV medication, one is called Reglan. This will increase and speed up emptying of the stomach contents into the upper low intestines. Therefore the stomach is "safe" to go to sleep. Dont forget we have a little valve in our stomach that is supposed to shut...and since this is a sedation case and not a general anesthesia, the valve should remain closed keeping the contents where it belongs. The colons are not bad. I had done hundreds and had my own. You should be anywhere from snoozy to out, to "in and out but not caring" Its a nice light sleep just like at home in bed. Also, nobody has mentioned the part that saved me. I had to do this with all the folks I worked with! How embarassing is that? But remember, we all think our butt is special and its not. Also, the lights go OUT during the procedure. I typically have my patient nicely sedated and ask them to roll onto their left side. At that time the nurses turn the lights OFF. Its totally dark in there, except for the TV moniters and then my anesthesia moniters....so nobody really gets a nice closeup of your cheeks. I have never seen anything even remotely like a buttcheek but I am on the other side of the bed,. The surgeon and his tech are the only ones standing there and they have a scope with a light on the end. There is no real seeing of much, the blankets cover you up. The prep can be accomplished with pills or liquid and each surgeon has his preference. We always schedule the diabetics first thing in the morning and have them skip their insulin dose since they have no solids. We check a blood sugar when they arrive and we have our IV fluids to adjust the sugar if need be. You lose a TON of fluid with your prep and should make up for the fluids later by drinking if you can....or scheduling dialysis according to what your surgeon recommends to pull off the extra. But as you know, they like kidney patients dry. For this reason we see a LOT of really LOW blood pressures the morning of surgery....and they go lower with the sedation. For this reason we do tend to give them more fluid,. and we have medications on our anesthesia cart already drawn up into syringes that will boost the blood pressure during the procedure. We automatically have the Blood Pressure cuff going up every 2-3 minutes and if we see it trending down we can treat it and it comes right back up within about 30 seconds with IV meds.  You will have oxygen on your face, either by a nose prong or a mask, but no breathing gas for this procedure

[alrightstill]

Well, it's almost 2am I have to be at the doctors at 930am.. and things still aren't running clear!  (No pun intended.. I must be full of shit! wompwomp sorry).

But seriously!  I'm worried. I started the drink around 1pm, it wasn't as bad as I thought it would be.  I also noticed they had written to take 2 ducolax pills ontop of the gallon of GoLytely, so I took them around the same time.  By 4pm I started getting those horrible ducolax cramps and by 4:30 I was in the bathroom.

I'm still going.. but its just not clear yet.  I just popped 2 senokot so hopefully by the morning things will be clear and I'll have gotten at least 2 hours sleep! 

[alrightstill]

Well, it's almost 2am I have to be at the doctors at 930am.. and things still aren't running clear!  (No pun intended.. I must be full of shit! wompwomp sorry).

But seriously!  I'm worried. I started the drink around 1pm, it wasn't as bad as I thought it would be.  I also noticed they had written to take 2 ducolax pills ontop of the gallon of GoLytely, so I took them around the same time.  By 4pm I started getting those horrible ducolax cramps and by 4:30 I was in the bathroom.

I'm still going.. but its just not clear yet.  I just popped 2 senokot so hopefully by the morning things will be clear and I'll have gotten at least 2 hours sleep! 

Ok.. I take that back.  WOOOO!    

  Ready for my closeup!  hahahah

So everything from here should be smooth sailing.. I hope. 

[Lori1851]

Glad to hear your colonoscopy went good. My hubby has to have one on Thursday. He was given a prescription of some type of med to take like every 15 mins. No drinking the other stuff. We know he will have to have surgery real soon. his CT scan showed a really bad case of diverticulitis that can not be repaired. So,,,, I am assuming part or all of the sigmoid colon will be removed. The surgeon wanted the colonoscopy to see how things looked further up. If it ain't one thing its another here at the Cowen household. I just keep tellin myself it could be worse.

Loir/Indiana

[alrightstill]

Lori - sorry to hear about your husband.    I do hope things get better.. I know the "if it's not one thing its another" all too well. 

They can't seem to find anything wrong with me!  I'm a bit agitated actually. 

My upper abdomen has been swollen (2 different doc's said "oh, its not tooo bad" - but I think I know my body.. it's definitely not normal) and a bit painful at times.  They did a catscan and could see "a little bit of inflammation" (duh?) and ordered the colonoscopy as a precaution to make sure everything was ok in that end.. and well, it was. 

I told the doc I'm not satisfied though and i KNOW something just isnt right.    They dont seem to be too concerned which is concerning me even more.  I think it may be time for a "third opinion".



But back to the colonoscopy - it was fine.  I told the anestheliogist to make sure I'm completely out before the doc even touches me.. and he happily obliged claiming he would block the entrance. haha.  (Well.. it made me kinda chuckle laying there).

I was in the "recovery" room for about 15 minutes and then they allowed me to leave with my mom.  It's true what they say - the hardest part is drinking the GoLytely the day before!