Bottoms Up!

Luckily for us, doctors have at their disposal many types of screening tests, often enabling them to find small problems before they become big ones. Some tests – such as a finger prick to test blood sugar – are easy; some require a bit more preparation and planning. There are tests that give us no pause or hesitation because they require little effort on our part, there are some that are quite costly and cause us to think twice, and there are those that are the butt of jokes and much procrastination on the part of patients. Yes, there is a pun in there somewhere since I am referring to colonoscopies.

A colonoscopy is a procedure used to see inside the rectum and colon. During the exam a colonoscope (a long, flexible lighted tube with a video camera) is inserted into the anus, guided through the rectum and into the colon (AKA large intestine) to the opening of the small intestine. The large intestine is inflated with carbon dioxide to make it easier for the doctor to examine the tissue. Then the tube is slowly withdrawn so the doctor gets another look at things on the way out. A colonoscopy can detect inflamed tissue, ulcers, or abnormal growths. Growths, called polyps, can be removed and tested for signs of cancer.

Since I “occasionally” fall into the “do what I say, not what I do” category, I’ll admit that when I had my first colonoscopy in early February 2009 it was about five years later than it should have been. My father had colon cancer, so I should have had my first exam by age 50. Some people can go 10 years between exams. However if you have some risk factor, or a previous history of problems, your doctor may recommend more frequent screenings. The negative hype around colonoscopies is just that. The experience really isn’t that bad. Just consider it an opportunity to drop a pound or two and take a nice nap on a comfy gurney.

Here are some tips we’ve discovered over the years to make the preparation easier:

· Remember to follow your doctor’s printed protocol. Each doctor has his/her own preferred procedure.

· Make sure you understand which of your medications and/or supplements need to be stopped before your test. Some medications (e.g. ibuprofen, aspirin, naproxen, iron) will need to be stopped a week before your procedure. If you have special concerns (e.g. are taking warfarin) talk to your doctor at least a week before the colonoscopy.

· If you live on the islands – consider spending the night before the exam on the mainland to do your prep. There is nothing worse than being in the ferry line at 5 am and having to dash for a bathroom. Sometimes there isn’t much time between “I think I had better run to the bathroom” and “Oops!”

· You will probably have to drink something (such as PEG – polyethylene glycol). If so, you should drink down each dose as directed (usually about 8 oz) and not sip it. Sometimes it helps to drink each dose through a straw, to minimize a potentially salty taste. Another hint is to take a sip of apple juice after finishing each glass of PEG – it helps to clear the taste away.

· Get some Vaseline and use it! Coat the business end of your bottom and reapply as needed throughout the prep. This will help protect the tissue on the tushie since it will see a lot of action in a short amount of time.

· Take along extra-soft toilet tissue and some soft baby wipes. They will feel better than the hotel brand of TP.

· When the inevitable elimination begins, remember to “dab, don’t wipe”. A lot of wiping will make your bottom sore.

· Take along some good reading material, a puzzle book, etc. – something to occupy your time while ensconced on the throne.

· Plan ahead. Read your protocol and take along whatever snacks are allowed. For me it was green or yellow Jell-O, clear drinks, and clear bouillon. Definitely nothing with red, orange or blue food coloring.

· I found it helpful to start a soup diet a couple of days before my colonoscopy. It made the clean out easier and I wasn’t so famished when I was at the fasting stage of my prep.

· Have some water and light snacks in the car for the trip home. After you wake up, you might find yourself thirsty and hungry.

· You won’t be able to drive yourself home from the procedure. Remember to thank your chauffeur. For me it was my daughter. Thanks, Megan! This month you get to take your dad. Lucky girl!

This month’s article has now come to an end. (Sorry, I couldn’t resist.)