Friday, February 25, 2011

A simple, useful tool.

One of the most useful tools in your cancer-fighting arsenal can be obtained for as little as a dollar.

A notebook.

When someone has been diagnosed, they encounter a few things fairly often:  questions, information, worrying and waiting.  Yes, there are more than just those four.  But they do keep coming up.

A notebook can really help.

It gives you a place to record all the appointments you will have.
All the doctors and office numbers.  Who to call when in case of whatever. When you fill in forms, you will probably be asked for the name, phone number and address of your doctor.  And the fax number.  Possibly the email address.  When you are a cancer patient, you collect a lot of doctors and other medical professionals.  I recommend writing the contact info on one or two pages, right at the front of the notebook.  Along with what each one does.

You can write notes from meetings in the notebook.  You can write questions in it, so you have a better chance of remembering to ask them.  You have a place to put forms, pamphlets and business cards.  You may need to staple or glue them in, but still.  It saves rummaging for the things later, when you are trying to go someplace and really can’t spare the time.

One of the things that happen to the patient is an increase in stress levels.  This happens for their principal support person/care giver, too.  There is a hormone, called cortisol, that is IMHO, really annoying.  When you are stressed, you produce more of it.  It really isn’t your friend.  It packs weight on you, screws with your sleep patterns, and can make you forget stuff, and may even make you more likely to develop breast cancer. There are good descriptors at this link.  And of course here’s another paper that says stress makes cancer grow.

Lovely.  Does this help the patient?  Well, I suppose it does, but it also makes me think of the IT Crowd episode, in which the boss of the company declares war on stress.  And decrees that anyone who is stressed will be fired.  Because that’s going to help.

But forewarned is forearmed.  If there is something you can do to reduce your worry, why not try it? 

So, back to the notebook.

Write stuff down!  It may help!
If there is a change in your treatment, write it down.  If someone recommends you do something, but you want to check with your care team first, write it down. 

Your doctors will want to know your history.  Write it down.  When did you first notice symptoms?  When you’ve figured that out, write it down.  You can refer to it later. 
When did you have a test?  When will you get the result?  Do you call them or do they call you?  Write it down.

It doesn’t have to be fancy, or plain, or depressing.  I like a notebook with a flexible cover, but something with a cheerful or calming cover may be more your style.  Stick photos in it.  Drawings.  Things that make you feel happy. 

Or at least, less stressed. 

Wednesday, February 23, 2011

Yummy Lunch

OK, this is a feature now.  I think I need a proper title.  "Yummy Lunch" is today's place holder.  Pretty lunch?  Cutsey food?

  Eh.  I'll think of something.  Or perhaps someone will leave a suggestion?  ;-)

The past week saw the traditional February Thaw.  Temperatures warm enough for us to believe spring may actually come.  Then of course we remember this is Canada in February.  The warm temperatures are probably a trick, trying to lull us into false sense of warm.  Making us think about planting things and wearing summer clothes.

Now winter is back. -19 C.  Blowing and drifting snow.  People are saying nasty things about the groundhog.

In the spirit of summer hope, Peanut and Pumpkin took flower bedecked lunches.
Both were the same, but this photo turned out best.

Cucumber flowers sit atop left over BBQ chicken, which is contained in lettuce cups. I know you can't really see them.  Trust me, they are there.  A line of cucumber slices help hold the chicken and lettuce in place.  Grapes and red pepper slices and flowers provide more colourful veg.  The red silicone cup holds slices of Swedish Rye bread, cut with a large flower cutter.  The girls told me they were not soggy at lunch time.

More lovely lunches at:  What's for lunch Wednesday

Monday, February 21, 2011

Triple Chocolate Muffins

I mentioned the children love bananas.  And they do.  Except in baked goods.  I have no idea why. 

I am very fond of banana bread and banana muffins, and adapted a peanut butter and banana muffin recipe to one that is friendlier to my kitchen.  Peanut butter is not welcome in my house.  I know it’s supposed to be a good source of protein, but it is also a nasty allergen that can have a deadly reaction for some of Peanut and Pumpkin’s friends.  Therefore, it isn’t welcome here.

The recipe is still in the refining stage.  It originally required  2/3 cup of sugar, which seems like a lot for me.  I’ve reduced it to ½, but can probably use only 1/3. 


1 banana
½ cup sugar
3 Tbsp. vegetable oil
3 Tbsp. cocoa powder
3 Tbsp. hazelnut butter (because I like it, and the one we use doesn’t contain peanuts.  We have used sunflower seed butter, but it wasn’t the same)
1 egg
1 tsp vanilla
½ tsp. baking powder
½ tsp. baking soda
dash  cinnamon
¾ cup flour
¼ cup 1%milk, plus 3 Tbsp.
36 (or about 3 Tbsp) semi-sweet chocolate chips

In a food processor, blend the wet ingredients.  Add the dry (except for chocolate chips) and process briefly.  Scoop batter into 12 muffin cups, filling about ½ full.
Top with 3 chips per muffin, and bake at 350 for 15 – 18 minutes.


Put the muffins in the oven, begin cleaning up your work area, discover chips, gasp, check timer, pull muffins out of oven after about 3 mins. of baking, top with chips, pop back into oven and keep baking.

I actually prefer the Oops method, because the chips have a tendency to sink into the muffin as it bakes, leaving a molten chocolaty bit in the centre.  Otherwise the chips tend to sit on top of the muffin and say “Hey!  Look at me! Totally not a healthy thing!”

Wait!  Where's the third chocolate?

Well, you see, it's in the hazelnut butter.  That's one.  Two is the cocoa powder.  The chips make three. 

Triple Chocolate Muffins are quickly gobbled up.  Banana-Hazelnut Muffins, not so much.

Friday, February 18, 2011


Why is it that the bananas in the house are either barely yellow, completely eaten before I can get one, or have expanding black spots?


Peanut and Pumpkin love them.  Bananas are healthy1, and don’t require a knife, making them a favourite “I do myseff” snack when the children were younger.  As long as someone started them, of course.

A few years ago, one of my colleagues told me he switched his peeling from the top-of-the-stem-down method to the flower-end-up method after watching primates in a zoo.  He watched as a mother chimp (or baboon, I don’t remember exactly which of the smaller primates it was) showed her young one how to peel a banana.  He said the mother started with the bottom end; her young one imitated, and was successful.

So my colleague tried it.  Sure enough, he was able to successfully peel the bananas without the smushing that happens when you start at the top.

But that doesn’t help with the browning bananas on my counter.

Some of them will be peeled and tossed into the freezer once I’ve posted this.  Two of them are going into muffins for tomorrow’s breakfast.  Which means there will be a weekend post, maybe even with pictures and a recipe.  That should make up for the lateness of today’s post.

They are definitely outside the 100-mile diet.  Unless I make friends with an experienced gardener who has a palatial greenhouse, they are going to be trucked in.  I’m OK with that.  We can’t get locally grown coffee, either. 

1 - Healthy – According to (I got very frustrated trying to find this info on the Health Canada site, so went to a magazine instead.  Sorry.), bananas have 3grams of fiber, and are a source of vitamin B6, potassium and folate.  The article also says bananas have more potassium than most fruit.

Wednesday, February 16, 2011

Wednesday Post

Hmm.  I'm sensing a trend here.  For the [checks calendar] third week in a row, a food post.  On a Wednesday.   Perhaps this is a 'Feature'?


This was Peanut and Pumpkin's Valentine's Day Lunch.  Well, their Valentine's Day influenced lunch, since their school offers lunch on Mondays.

Heart shaped brown rice with peas decorated with a red bell pepper heart, meatballs in a romaine lettuce cup, with red pepper slices and another heart.  Kiwi slices are decorated with carrot flowers. Tangerine sections (only two, testing the waters here) are nestled in for snugness. 

More great lunches at: What's for Lunch Wednesday

Tuesday, February 15, 2011

Happy Dance!

My friend Gabriel's blog is back!

This is the man I mentioned in my first real post.  The husband of the lady who makes the wonderful empanadas mentioned a few food posts ago.

Earlier this month, he was hacked.  It was awful.  Four years of his work erased.  But now, he is back.

He writes about all sorts of things.  Life in Canada.  His children.  Food.  Cultural phenomena.  The Three Stooges.  Travel.  Photos.

I encourage you to check him out, here:

(And as soon as I figure out this button business, I'm going to add it to the side bar.)

Friday, February 11, 2011

Meet Cancer Bag

Cancer bag is the name given to the tote I used for going to hospital.  The idea came from my Mother's ‘Chemo Bag’, which I suppose is itself a variant of the go-bag (or get-gone, or jump-bag) many members of the armed forces (and their families) may be familiar with.

Cancer bag is, in it’s present incarnation, a backpack.  It is fairly light weight, yet strong.  It’s got padded shoulder straps and a carrying handle.  It has a few big pockets and some smaller ones.  And I don’t go to any follow-up appointments without it.

The day I went for my diagnosis, I grabbed a small bag and threw in a notebook, a  pen and a box of Kleenex.  I knew I’d be getting bad news.  I wanted to be at least a little prepared. 

Since that day, the contents of Cancer Bag have changed.  Cancer Bag itself has changed. 

“CancerBag Mark1” is a lovely Lands’ End zip top tote bag.  I ordered it online.   I had it monogrammed with my husband’s and my initials.  CancerBag arrived the day before I had to leave for surgery.  I was so worried about what was coming up that I was overly excited to receive it, and inadvertently frightened our postal carrier. 

The Mark1 has since been replaced by the above mentioned knapsack, but we still call the original CancerBag.   All one word.  It helps take the scary out of the 'C' word.  And when you are fighting cancer, you are also fighting fear.

I don't think this looks scary, do you?

We take CancerBag to the beach.  We take it on picnics.  We take it camping.  We take it to Great Wolf Lodge.  Everytime CancerBag goes someplace that isn’t a hospital, I win.

(Although I do get strange looks when I tell the children to put the sunscreen back in CancerBag.)

Wednesday, February 9, 2011

Another Wednesday Post? That must mean...


It's a lunch photo!  Peanut and Pumpkin had matching lunches again, but only one is pictured below.

OK, so the second lunch is kind of visible at the top of the photo.

The not-a-sandwich-sandwich is ham on tortilla, sliced into pinwheels, topped with a decorative carrot and nestled in a leaf of romaine lettuce that has had the rib removed.  The red cup has sliced kiwi, blueberries and a carrot flower.  Red pepper slices fill out the lunch.

Want more neat-o lunches?
Check out What's for lunch Wednesday.

Tuesday, February 8, 2011

OK crazy lady, what’s up with this ‘Bento’ business?

Back in the summer, my two lovely children, Peanut and Pumpkin went to camp.  It was a lovely camp.  Fresh air, sunshine, bugs, mud, snakes, fish, turtles, swamp, fields, forests, creek, canoes, all the things a camp should have.  As part of the camp’s environmental education and out-reach program, they encourage litterless lunches. 

The no-garbage lunch was my initial goal.  It wasn’t hard.  No juice boxes, no plastic wrap or baggies.  They both have stainless steel water bottles.  Sandwiches could be packed in reusable containers.  Ta-da!

Pretty soon (end of day one) the girls complained about sandwiches. 

They had taken them all school year long, and wanted a break.  But what to do?  What else goes in a lunch box?  Surely someone somewhere has had to take a lunch?  Someone perhaps that doesn’t ‘do’ sandwiches.  And not Cornish pasties or empanadas.

While delicious, I did not want to get into the habit of making them.  Besides, mine are nowhere near as tasty as Gabriel’s wife’s empanadas are.  Never will be.  And I’m fine with that.  Because if they were?  I’d make them more.  And eat them more.  Not good for the waistline.

[whistful sigh] but they are so very tasty….


Google search to the rescue!  Innerwebbs powers unite!  Form of…..ummm….huh.
About 262,000,000 results (0.10 seconds)

Uh-huh.  Narrow it down.  Let’s see.  What else?  It can’t have eggs or peanuts or nuts of any kind. And it can’t have waste.
Lunch no waste
About 366,000 results (0.14 seconds)

Most of the top links were to sellers of things like Laptop Lunches.  There are an awful lot of things like that on the market.  I looked at them and ruled them out pretty fast.  While they fit the ‘no waste’ bill, that was still a lot of plastic.  It didn’t look like the contents would travel that well unless the container was kept flat and horizontal.  How difficult would they be for little hands to open and close? And how do you keep them cold?  Yes, I live in Canada, but in the summer it gets hot and humid.  And did I mention the swamp?

More poking around led to Bento Boxes, and some lovely, lovely blogs.  I didn’t really want to order something online and have it arrive well after camp was over, so I improvised with containers I had on hand, and tried to follow the bento philosophy.

Filling them to be healthy and litterless was my primary goal.  Yes, it would be nice to make cute food, but that wasn’t going to happen any time soon.  The girls liked the lunches.  They were tasty and looked good.  And they weren’t sandwiches.  They asked me to take pictures of them and ‘send them to the internet people’.  I took pictures, but didn’t submit.  Until recently!

I try to send a bento-ish lunch with them at least once per week.  At the beginning of the school year, they drew lots of attention from some other students.  And the teachers, too!

The other kids think they look ‘neat’ and ‘different, but in a good way’.  Because we eat with our eyes before our stomachs, I try to get lots of colour into them.  Which means lots of fruit and veg.  Which makes reaching for 5-10 a day and eating the rainbow way easier.   


Friday, February 4, 2011

Colonoscopy time Part 3 – The Main Event

 At last, you are at the hospital.  Or clinic.  Hooray!  Now you get to check in!

I have an uncanny ability to find the imaging department in a hospital.  I think it’s because I’ve spent so much time in them.  Each place is a little different, but most hospitals have signs and volunteers.  And pumps of hand sanitizer.  I strongly suggest you use all three, especially if this is your first visit.

“No!” you shout.  “I shall not ask directions!  I can read!” 

“Ah, yes,” say I. “But the volunteers know which elevator to take.  And which is out of order.  And which hallway is closed because of construction.”  Twice volunteers have led me ‘the back way’ through the hospital to get to something I never would have found without them. 

Checking in
You will need to check in, letting the department people know you are there.  This step varies from place to place, but you will be asked for id, a health card, possibly a specific card for that hospital (one reason to allow extra time) and your order papers.  You will be asked if you have any allergies.  Tell them if you have allergies.  Or sensitivities.  Like, if you break out in a rash from contact with something, like Band-Aids.  That one can be important.

Some clinics are self-contained, with everything in one place, on one floor.  Others are more spread out.  You may have to check in with, say, outpatient procedures, and then go on to the endoscopy suite.  If someone is coming with you, they can generally just tag-along until you get to the IV part.  There may be a special waiting area for them, or perhaps they will be told when and where to show up to collect you.  One thing is certain; when your companion is someplace that’s not allowed, someone will speak up.

During check in, someone will ask if you know why you are there.  This is NOT the time to be sarcastic/funny.  It is part of the informed consent process.  They have to make sure you know why you are there.  Your procedure will be explained to you.  Don’t say “Oh I read all about it on the Internet”.  They hate that.  There’s lots of weird stuff on the Internet.  For all they know, you read an article that says the process will be carried out under the full moon by a specially qualified cat, who also plays piano.

At some point the following things will likely happen:

-You will be given a hospital bracelet or two.  One will have information identifying you.  You may also get a second one, possibly red, if you have an allergy that they really need to know about for the procedure.  Like the adhesive one I mentioned earlier.  If your only allergy is to cat hair, you probably won’t get a red bracelet.

- You will be asked to change.  You will probably be given a basket or bag and a bundle of hospital gowns and booties, and shown to a change area.  A really posh big-city type hospital may even have a special locker room!

There are many different kinds of hospital gowns.  Do not be surprised if there is a diagram in the change room, explaining what to take off and how to put the gowns on.  Follow the instructions.  Yes, sometimes they really do need the diagrams. 
(Ladies: if you feel more comfortable keeping your undies on, that’s probably ok.  You can always ask the person handing you the gown, or your nurse before you get onto the bed in the procedure room, or slip them off and tuck them discretely into…uh….you know what?  Tell the nurse.  Trust me.  They are used to that, especially with ladies of a certain age, who tend to be more modest.)

-You will have someone ask you your name and age and address, again, while holding a paper that already says this in one hand, and your hospital bracelet, which is attached to your wrist, in the other hand.  Again, not the time for funny.  This is the hospital’s way of confirming that the Mrs. Jane Doe in front of them is the Mrs. Jane Doe who is supposed to be having a colonoscopy with Dr.WhatsHisName today.  It prevents mix-ups.  Don’t knock it.

-You will probably be asked if you have any symptoms of a cold or the flu, or a cough.  You will probably have your temperature taken.  This is so they can do a basic assessment of general health before beginning.  There may be some conditions under which it’s not a good idea to proceed with the scope.  Since I’m not a doctor, I have no idea what they are. 

-You will have your blood pressure taken.  It will almost certainly be higher than normal.  The nurse may be asking you questions while this is going on, you may have had to sprint to get there on time, your gown may not be cooperating, you may be nervous.  This is all normal.  The nurse may want to take your pressure again, or try the other arm.  If this happens, try to relax and follow her instructions.
(I said her! Sorry Sam from GI Oncology!  There are some great male nurses out there, but mostly the profession is female dominated.)

-You will be given an IV.  Now, I am a good patient for my nurses, except when it comes to the IV.  I’m what they call a hard-stick.  I’m sure they have other names for it, too.    I could go on and on about IVs, but that’s probably best left for a separate post.

- You will get to wait a bit, possibly even between steps above.  For whatever reason, the department will be running behind.  Why?  Are they understaffed?  Are the doctors late?  Who knows.  Odds are good someone’s procedure is taking a little longer than planned.  Or perhaps a nurse has been diverted to deal with something.  Either way, you will wait.  Hospital time is another phenomenon that deserves its own post.

This is the really, really boring part.  You probably don’t have your stuff, so no reading material.  There may be magazines lying about, but they are hospital magazines.  There might be a TV somewhere, likely tuned to either the weather channel or a news station of some kind.

Oh! And yes, the instructions do say to keep drinking, but this does not mean you need to keep sipping your bottle of water right up to the procedure time.  The nurses will take it away from you.  Please do not cause a scene (yes, I’ve seen it happen).

The main event!
Yay!  Your name has been called!  You walk down to the colonoscopy procedure room.  And…

It is probably smaller than you were expecting. 

For such a scary sounding thing with so many steps, shouldn’t there be a giant room?  Perhaps with medical students looking on?


 It’s you, your GG and two, maybe 3 other people.  It depends on what we are doing today, and how big the room is.  Because I’m a regular, I tend to have students and new hires watch my procedure.  But that will be another post.

-You will get on the bed, and do what they say.  You may have to start on your back and have them raise the table, or you may start off on your left side, knees bent, everything covered up.  To start.

- Your IV  drip will be started with saline/glucose, if it wasn’t already. 
- A clip will be put on your finger.  I can’t tell which one, it depends on how the room is set up. 
- Oxygen may be made available to you.  Don’t panic.  It’s just easier to do it now.  You may not ever need it. 
-You will be introduced to the people in the room.   They are often called ‘The Team”. They will not expect you to remember their names.  They may make a joke about it. 

While they are getting everything ready, The Team may chat amongst themselves.  This will sound nothing like the medical shows on TV, and everything like what  people talk about where you work.   

Why is that?  Are they being unprofessional? Shouldn’t they be shouting “Stat!”, carrying clipboards?  Wearing stethoscopes?  Running?  And shouldn’t someone be biting her lip and looking dreamily while some older guy fumes about something?

Nope.  This is reality. 

This is the team’s day job.  Pretty boring?  Good. You, as a patient, want boring.  As my GastroGuy once said, “The thing you never want to be as a patient is ‘interesting’.  And never, ever, ‘exciting’.”

- Your Gastroenterologist (GastroGuy, or GastroGal, or GG) will probably confirm with you that you are who you say you are, and that he is who he says he is, and that you are going to have the procedure you expected.  Again, double-checking is a good thing. 

- You may be palpated.  That’s a fancy doctor word for poked with the flat part of the fingers.  If your doctor’s hands are warm, please mention this in the comments.  I’ve yet to meet a warm handed doctor.

- You will be told to reposition, and the team will artfully arrange the covers so that only the part they need to see is visible.  Also, they almost always point the camera at the floor, or a blanket or something right up until the last possible moment. 
Which is nice, because you really don’t want to see your backside on a 21 inch screen.

- You may be facing a monitor on top of a bunch of computer-related looking things.  You may see a jumble of wires and tubes.  Don’t panic.  They are all supposed to be there.  They have a purpose.  It’s OK if they look messy from where you are.

- You will have a digital rectal exam.  This does not mean they are going to use a digital camera and then look at the photo of your bottom. 

The medical term for a finger is ‘digit’.  Your GG is going to stick his (or her) finger in your rectum.  I don’t know which finger, but you can feel free to ask at the time.   It will probably be very cold and uncomfortable.   

- Your GG will explain the sedative to you.  Most people have something called ‘conscious sedation’.  It means you won’t feel pain, but will be able to feel pressure.  You see, they need to shove this tube with a camera and stuff in it into your rectum, then snake it all the way to the end, and slowly remove it, looking around the whole time, while also removing stuff that looks suspicious.

 And as we all know, you can’t push on a rope, unless it’s frozen.  And even then, it may not be that easy.

Your colon has 3 parts, from the rectum to the small intestine, they are: descending, transverse, ascending.  Here, take a look.  

See that bend?  The one between descending and transverse?  That is the most difficult one to negotiate, apparently.  People are different, and everyone’s bend is a little different.  Your GG needs you to be aware when the scope goes through this part, so that you can tell him if it hurts, etc.  He/she will probably explain this to you better than I can.

My GG was lovely at explaining this to me:  When it enters the vein, it will feel a little cool, as it is lower than your body temperature.  In about two heartbeats, you will feel like you’ve consumed several beers way too fast. 

Now, I don’t drink, so I was worried. 

He was right about the cold.  And in two beats, I felt very relaxed.  Limp even.  My eyes didn’t blink at the same time, and I felt like the room was spinning ever so slightly.  What I said was “Issh a gud thing immm laying down becahush I feel likesh I rally need to laa downsh.”  And then I don’t remember much.  Except:
My GG saying “And that’s our cue to start”, followed by, “I’m going to insert the scope now, you may feel a little pressure”.  I remember feeling the scope go in a little bit, and then things went black. 

Colonoscopy, itself
You may be facing the monitor during the procedure.  If you handle sedation like I do, you will “float to the surface” every so often.  If/when you do, you may talk.  I’m told this is normal.  And that they don’t laugh at you.  But they will ask you to please stop singing.  And they will tell you that they cannot “change the channel”, no matter how boring the nature program is.

Will it hurt?
I wouldn’t say that it hurts.  Not really, no.  It doesn’t feel good, that’s for sure. 
To move the scope along, your intestines will be inflated a bit.  Generally this doesn’t hurt, it just feels like, well, lots of gas in your intestines. 

The negotiation of the bend may involve a bit more movement, and your GG will want to know if you are uncomfortable or in pain.  Answer honestly.  And if you ever do feel pain, or like throwing up or something speak up immediately!  Don’t try to ‘tough it out’.  You aren’t helping anyone. 

Polyp removal doesn’t hurt.  It does feel weird, because you can feel pulling inside your intestines.   The best way I can describe it is like this:

Gently pinch the little flap of skin between your thumb and index finger.  Got it?  OK, now, tug a little bit.  Feel that?  You can feel the pinch, and you can feel the tug, but it doesn’t hurt, right?  That is pretty much it.

Removal of larger growths (should you be unlucky enough to have them) also doesn’t hurt.  In both cases, because there are blood vessels in your intestines, you may bleed a little bit.  Your GG and team will take care of that.

Another thing you may feel is the irrigation.  Blasting water at the sides of your intestines doesn’t hurt.  It feels cold, and you can feel the pressure, which is very strange.  Suctioning of air, water and residue from your purge doesn’t hurt, either.

About half an hour or so later, the whole thing will be over, and you will be wheeled into the recovery room.  Hopefully nothing of any interest whatsoever will have happened.

Really?  All that buildup?  And we’re DONE? 

Yep.  Really.

You will be left to recover in the recovery room, with the curtains pulled around your bed.  It is during this time you "deflate", and the sedation wears off.

The recovery room
As your doctor will have explained to you, your colon will be expanded via compressed air or gas during the procedure.  They are able to let most of it out before you leave the procedure room, but not all of it.  While you are in the recovery room, you should expel the gas.  You may feel very self conscious.  It seems really rude.  But it’s ok.  The recovery room is for this.  Everyone in there is in the same state. 

Nurses will check on you every so often.  Even if you can’t see them, there is someone pretty close by, keeping an eye on everything.  There is no need for you to rush off.  Take your time.  You do not have to hurry up and wake up all-the-way-fast-fast-fast.

When they are satisfied that you are ok, they will remove your IV, let you get dressed, ask you a bunch of questions, give you any papers your GG left for you, and ask you who is there to take you home.  They may even give you a small amount of gingerale or juice or something.  But not always.  It depends on the hospital, etc.. 

In the (very unlikely, I hope) event that something suspicious or even bad was seen by your GG, he may have a chat with you before you leave.  Or, if you have been anxious, he still may pop in for a quick chat, even if nothing is wrong.  Basically, if something isn’t right, someone will tell you.

By the time you are discharged, you should be fairly alert, and not feeling too bad.  A little bloated maybe.  You will be told what you can and can’t do after the procedure, and when you can eat.   You will be told what to expect following the procedure, especially if your doctor found and removed polyps.

You should under no circumstances drive home.  While you feel fine, and can see and everything, your reaction time will have been severely affected.  I know a gentleman who knocked over a bottle of water, then watched in shock as it fell and emptied completely before he could move his hand over and pick it up.  And that’s someone who has cat-like reflexes, usually.    Within a few more hours he was basically back to normal, however. 

If you have any concerns, talk to either your doctor or one of the recovery room nurses before you go home.  Since they are trained medical professionals who do this every day, they are far more qualified than I am to give advice on this bit.

You will probably still feel a little bloated the next day, and continue to deflate for a bit.

And that’s it.  For such a scary sounding thing, it’s mostly preparation.  And a half-hour or so procedure.  Kind of a let-down, isn’t it? 

I hope you find this information helpful.  Colonoscopy is a very important diagnostic procedure.  It really isn't as scary as some people make it out to be. 

But, what if?
-You need a pedicure? They don’t care.  And you should wear socks anyway.  Hospitals are cold.  Especially when you aren’t wearing pants.

-You forgot to shave? They don’t care.

- It’s almost time for the scope or IV and you need to visit the bathroom again?  There tend to be bathrooms available near the procedure rooms.  You are not the first person to require them.  If you have to leave a waiting area to use one, tell someone.  This way they won’t page you when you are indisposed.  But they may knock on the door.  Or try the handle.

- It is your ‘time of the month’?  Tell the nurse who takes your vital info.  The one who is taking your blood pressure, or going to give you an IV.  You may not wear a tampon during the procedure.  You might not be able to insert one afterwards.  Remember the sedation?  Wear a pad, and bring a spare or two.

-       Something else happens that I’ve not covered here?  Ask a nurse in the department.

Wednesday, February 2, 2011

What’s this? A Wednesday post?

And what happened to the colonoscopy how-to?

Don’t worry – that will resume on Friday.  This post is so I can participate in “What’s for lunch Wednesday”, a feature on one of the blogs I follow.
I’ll write a future post about how I got into the bento style stuff.

Pumpkin and Peanut had matching lunches Tuesday. 

 Peanut has chicken adobo in a yellow silicone cup (shaped like a cracked egg), with blueberries, a rice ball (made with brown rice), broccoli, carrot strips and a flower.  Also tucked in are Cherry Tomatoes.  Pumpkin has star shaped rice, and her chicken is in a blue silicone cup, with chickens on it. 

I am pleased to report that the lunches came back almost totally gone.  Peanut and Pumpkin are missing several teeth, which can make chewing difficult.

I used the  Chicken Adobo recipe from Happy Little Bento, but modified it a little for slow-cooker preparation.

Want to see more?  
Check out What's for lunch Wednesday!

Tuesday, February 1, 2011

Colonoscopy Time (Part 2)

Purgatives and Extras

 You may be given, or told to get, a really strong laxative.  Once upon a time, it was called ‘Intestinal Lav’, and it came in 1L boxes, like juice.  I’m sure this is still out there.  When I had my first scope, I had to take PhosphoSoda.  I used the pharmacist-recommended store brand, rather than name brand.  If this is what you have been prescribed, store brand is fine.  The taste is equally bad.   In fact the advice from the Pharmacist was “Try not to taste it.”  Now there is a fabulous thing called Pico-Salax.  It doesn’t taste bad at all! More about this later.

You may have been told to purchase an enema for administration at home, before your scope.  Here it is definitely worth it to spend the extra dollar or so and go for Fleet.  Again, more later.

I recommend splurging on a package of flushable wet wipes.  You may wish to add a tube of barrier cream of some kind.  If you have changed babies’ tushies, you know that when they have lots of outputs, their little bottom gets red and sore.  You would of course use something soft and damp to clean the sore little bottom, and a barrier cream to make it easier next time, and to make future eliminations less painful.  Prepare to do this for yourself.  Vaseline is fine, (zinc oxide not necessary) and can often be found in a convenient squeeze tube in the baby needs aisle. 

You will be spending rather a lot of time in the bathroom. A word search, crossword puzzle, Sudoku, or some magazines may make this a little more bearable.

You may wish to pick up a small package of disposable ‘adult hygiene products’ - the discrete ones, that look like underwear.  Since you (probably) have to ask the Pharmacist for the purgative, you can ask about these at the same time.  Don’t be embarrassed.  The pharmacist is your friend.  You probably won’t have an accident, but some people feel more comfortable sleeping in them.

Oh, and don’t worry that the cashier is going to judge you based on the above items being in your shopping cart.  I’ve been a drugstore cashier.  People buy this stuff all the time.   It’s really not a big deal.

Supplies assembled, diet followed, time to cleanse!

Assemble your stuff:
You will need your instructions, and whatever purgative you have to take.  Of course, you should always follow your doctor’s orders.  It just so happens my GG’s orders didn’t exactly match what it said on my box of purgative.  He told me this would be the case, and to follow his instructions.  Which I did.

Re-read your instructions. 
You may have seen an episode of MASH, in which the surgeons have to diffuse a bomb, but have a problem because the instructions are written out of order.   Sometimes instructions are written that way in recipes, too.  As a result, re-reading before starting is always recommended.

Drink your purgative.
Follow your doctor’s orders for this one.  You will need to consume liquid throughout the cleansing to keep yourself hydrated.  Make sure you choose your beverages carefully.   For example, I will never drink grapefruit juice again.  EVER.   You should avoid drinking anything with bubbles.

Will it really taste that bad?
Lav? Ughblechshudder sums it up quite nicely.
Phosphosoda? By far the most disgusting thing I’ve ever had to consume.  Like thick, salty, dish soap.  It coats your tongue and stays there.  Try not to taste it.   Don’t pay more for ‘Lemon-ginger’ flavor.  (What is it with manufactures of horrible tasting things and citrus?  Did an orange or lemon tree attack them as children?)
PicoSalax ? Not bad at all. The taste - to me, anyway- is a little like Neo-Citron that is just slightly off.  Slightly lemony, possibly a little soapy.  (Again?  Citrus?  Why not mint? Or better yet - tasteless?)   Sorry.  Moving on.

How bad will the effects be?
They will vary.  You will probably notice something happening within 20 minutes to an hour.  The advice I was given for PhosphoSoda was: before you down the last shot (3 in a bottle), have the bathroom door open, the lid up, and a crossword puzzle or Sudoku ready beside the toilet.

No matter what purgative/laxative you’ve taken, if you feel like you may have gas, go to the bathroom.

The cleansing will take a while.  Again, results vary.  Each person is unique.  Some people find they go to the toilet once an hour, for 10 minutes at a time, for a few hours.  Some go less frequently, but for longer.  Either way, you will be spending a fair amount of time in that room.

This is why I suggested puzzle books and magazines.  It gets really, really boring.  You get to really look at your walls and fixtures.  I wonder how many people decide to remodel their bathroom following a colonoscopy?

Can I eat anything?
No.  No you can’t.  You can drink clear fluids.  Popsicles and Jell-O are allowed, but not all colours.   Check with your doctor.  I know one person who isn’t allowed to have Gatorade, for example.

Please, please use common sense!  I met one lady who decided to consume beer for breakfast before her scope, reasoning that it was clear, liquid, and contained calories.  DO NOT DO THAT!  She was drunk.  Really, really drunk.  Possibly this is a lifestyle choice of hers, but it was definitely not appropriate. 

Also, her GastroGuy was not able to perform her scope that day.  She delayed the patients behind her.  She annoyed the patients in the waiting area.  She made some of them very uncomfortable.  She was a big problem for the nursing staff on more than one floor, taking their focus away from actual patients who were ill and really needed help. Don’t be like her, please.

You may be asked to prepare at home by giving yourself (or having someone give you) an enema.  I’d say this is the hardest part, especially if you have limited flexibility and/or no one to assist you.  If that’s the case, talk to your doctor
If you are up to it, I say splurge on the Fleet.  They know their stuff.  It is an awkward business to be sure, but theirs is easier to administer. 

The instructions tell you to do it yourself by lying on your side, drawing your knee up towards your chest, and inserting the lubricated tip (TAKE THE CAP OFF FIRST!) into your rectum, angled toward your belly button. 
Let’s just think about that for a bit.
Are you able to get into that position on your own?  Can you then reach your backside, and accurately aim something about 6 – 8 inches long?  Toward your belly button?  While inside a bathtub, or lying on towels on the floor?  This is why I strongly recommend discussing with your GG.  Your doctor will know which preparation method will yield the best results for your scope.

Finally it’s time to go to the hospital or clinic!  Hooray!

-       Do not wear perfume or aftershave.  You may be going to a scent-sensitive area.
-       Do not wear jewelry.  No, it’s not the staff losing track of your earrings that you have to worry about; it’s the people who wander through the hospital, willing to take them off you.  There was a case in Toronto of a dying woman being robbed in her bed.  
-       Do not take anything of value.  See above.
-       Wear comfortable clothes.
-       Wear socks.  Cute socks, warm socks, doesn’t really matter.  You will be in a waiting area without trousers.  You may get to keep your shoes, or you may have paper slippers.
o   Which reminds me:  Ladies, you will be in a waiting area sans trousers.  If you forgot to shave, that’s ok.  It is considered rude to inspect the other patients.  Also, you don’t need to wax your bikini zone.  Your doctor really doesn’t care.
-       Do not wear makeup.  During your scope, someone will be monitoring you at all times.  Makeup can make it harder for them to tell if you are having an adverse reaction to a sedative. 
-       Do not wear nail polish.  You will have an oxygen monitor clipped to your finger.  It doesn’t hurt.  It is really neat, that they can do this now.  Don’t make the nurses take off the polish for you.  And don’t yell at them if they do have to take it off.  They aren’t doing it to be mean.  They are doing it because it is important to make sure you are still getting enough oxygen, especially while you are sedated.
-       Do not take any foods; there will be time to eat later.  Everyone in the clinic is in the same boat.  

Fine. So, what can I take with me?
-       Your ID
-       Your Health Card
-       Your Procedure Request, or whatever other papers your doctor gave you. The hospital may need them.  They will probably write something on them, and either give them to you to take to the next room, or forward them themselves.  It’s a little different everywhere.
-       A list of medications, herbal supplements, vitamins etc.  Heck, maybe even bring the bottles in a baggie if you like. You will be under partial sedation.  The folks working to keep you out of pain want to make sure nothing they give you will interact with something you’ve already taken with an unfortunate result.
-       Anything your doctor has specified you bring with you. 
-       Someone who can drive you home.  This is so very important.  You will not be allowed to drive home.  You will feel fine.  You will be in no condition to drive.  I have seen someone (who was trying to sneak out), walk into a closing door because he misjudged the distance and/or could not put his arm out in time.  He was promptly ushered to ER for a suspected broken nose.  This is why some hospitals/clinics will not let you out until your driver shows up to collect you.  If you don’t have someone, ask about taxi services in advance.
-       You can take water but be prepared to leave it with your driver/companion.
-       Directions to the hospital or clinic, including parking information
-       Change and small bills for parking.  If you’ve never been to the hospital or clinic before, call before you go.  Or visit their web page.  Lots of hospitals have pay parking lots.  (Come to think of it, I’ve only been to one hospital that had free parking.)
-       Many hospitals have some sort of construction going on.  Make sure you have enough time to
a) Get to the hospital or clinic.
b) Find a place to park.
c) Find the proper department.
d) Check in.

Phew!  That’s a lot! What’s next?
Part 3: The Hospital/Endoscopy Clinic.

(By the way, at no time has anyone given me any product or promotional materials from any manufacturer or vendor of any of the products mentioned above.)