Colonoscopy Time (Part 2)

Purgatives and Extras

Purgatives:

 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.

Extras:

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.

Enema?

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. 

Awkward?

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.)