Tips to get through this

July 17, 2014 11:04 PM

In less than a week I have a colonoscopy scheduled and with all the health problems I have, it's going to be hell. (which are reasons why I'm getting the test.) What are some tips to get through this?

I've looked on some other forums and found some good advice. I'm having horrible anxiety about this. I have a colonoscopy and upper endoscopy scheduled for 1pm Wednesday (I would have LOVED a morning appointment, but they are booked out over a month and I can't wait.)

I've asked questions on here before about all this medical hell. So message me if you need any more backstory, although it's not quite relevant to this questions. anonmefi14 [at] gmail.com

Problems:
I have horrible emetophobia (fear of vomiting)
I get severe nausea and stomach pain when I don't eat
I have a super fast metabolism and am very small (so not a large stomach) I only weigh about 106
I have reactionary hypoglycemia/borderline hypoglycemia so I need to monitor my blood sugar and get enough protein and calories
They want me to do the 2 part prep (night before and morning of) - MoviPrep
I've had an upper endoscopy before so I know how icky I feel after and how tired I was, which made it hard to eat for a while after the test
I have really bad heart palpitations/PVCs - we thought it was thyroid but so far those test are normal. The heart rhythm problems flare up when I'm without food/calories/blood sugar is unstable.

Plans:
I got my GP to give me more Zofran (Anti-nausea)
My husband will be home for prep day, appointment day, and day after
I'm going to have a whole setup in the bathroom so I can camp out including my cell phone so I can contact my husband, clear fluids, the prep, laptop, wet wipes, water, etc.
Grocery list includes clear non-red fluids likes sports drinks, chicken stock, jello, hard candies, ginger tea, apple juice, mint tea, and gum.
My after prep grocery list includes apple sauce, lentil soup, chicken nuggets, and lunchmeat to ease me back into eating.

Questions:
- Is there anything else I'm not thinking of?
- With the 2 part prep (night before and morning of) should I just try to get down as much prep in the AM as I can within the 2 to 2.5 hours after I get up? The instructions say to start the prep 4-5 hours before your appointment (the prep is scheduled to take 2 hours).
-Is 7:30 AM an okay time to start? I just really don't want to be stuck on the toilet and miss my appointment.
- My goal is to get as much prep as I can and monitor how cleared out I am. My dad didn't finish his prep and he was fine. I also have a small stomach so 8 oz every 15 minutes for 2 hours is not a reality for me, but I don't want to stretch out the AM portion of the prep so I'm late to the appointment or anything. I could take longer the night before to finish that half of the prep if I need to.
-I'm worried about the weird hour(s) from 11am when I should stop everything by mouth to my 12:15 arrival time and 1pm appointment time. Can I have hard candies for my blood sugar?

- Words of encouragement? Other tips? Will I die? How to ease back into eating?

I'm just so worried as I get really weak, lightheaded, and sick without enough calories and food. Even just a few hours or getting to lunch late. Especially easing back into eating after something like this is going to be really hard. Help?

posted by anonymous to Health & Fitness (25 answers total)

I went through this recently and found it significantly less awful than I expected. I did both parts of the two part prep the night before, per my doctor. I was tired afterwards, and slept for the rest of the day. I was more thirsty than hungry, and eased back into food with broth. I'd ask the doctor, but you'd probably want to avoid hard candy (especially if it has dye). They might be able to recommend something that won't interfere with the test, but ultimately you need the test to be as accurate as possible for the best hope of a clear diagnosis. Best of luck to you.
posted by judith at 11:53 PM on July 17, 2014 [1 favorite]

I had a colonoscopy about a month ago and then another colonoscopy and an upper endoscopy the week after. I don't have any of your other conditions but I do weigh almost the same as you and had heard a lot of horror stories before hand, especially about the bowel prep. It was fine, really. No big deal at all. I didn't get any cramping with the bowel prep - I just had to go to the toilet IMMEDIATELY maybe 3 - 4 times and they visits were over very quickly. There was no discomfort after the procedure and they gave me a sandwich and juice as soon as I woke up which I was pretty excited about it. I get nauseous when I don't eat but find that taking a few sips of water and focussing on something else really helps it to pass quickly.
posted by Wantok at 12:01 AM on July 18, 2014

I have had three colonoscopies. The last one was Monday. I have never vomited or even felt nauseous.

There are two kinds of prep that I know of. The old style one involves drinking about a half G of diethylene glycol mixture, and it is uncomfortable and the stuff tastes horrible. The newer one uses something based on sodium picosulphate (Picosalax) and I found it easier (less to drink, tastes ok). It sounds like the newer one is what you're getting so take that into account when you read other people's stories. Ask your health provider about this.

You will not die. If people died on a regular basis, this would not be an accepted screening procedure.

It's actually kind of funny in a bleak way. The worst injury is to your dignity, if you let it. Really it's just an inconvenient day and a bit where you spend a lot of time on the toilet, then you get some really good drugs, you forget everything that happened when people stuck a camera up you, and then you have a meal that is AWESOME because you are hungry. Don't be scared. I had a huge steak on Monday night and it was great.

If you are concerned about needing the hard candy, ASK. I suspect the issue will be pigment, but clear it with the people doing it.

Final words of advice courtesy of my bowel-cancer survivor dad: Don't leave any doors shut between you and the toilet. Amen.
posted by i_am_joe's_spleen at 12:07 AM on July 18, 2014 [6 favorites]

You are pretty much going to live on the toilet for a few hours, so your plan to make it as comfortable/interesting as possible is a good one.

I didn't feel nauseous at all. I was a bit hungry after, but not nearly as ravenous as I was lead to believe.

They'll tell you to fart away after you come to, but for whatever reason that didn't happen until well after I came home, which my husband didn't appreciate but fuck 'im, really, we're looking for cancer here.

You won't die from this. It won't be your favorite thing, but probably not your worse experience, either.

Good luck!
posted by potsmokinghippieoverlord at 12:29 AM on July 18, 2014

Instead of hard candies, consider gummy bears!

“I tell all my patients that gummy bears dissolve at body temperature to a clear liquid, so they are okay to take with the prep and give you something to eat. This is my patients' favorite pointer.” – Debora M. (Via)
posted by misha at 12:32 AM on July 18, 2014 [3 favorites]

I've done this and honestly it was fine for me, no cramping no vomiting nothing. And I had a serious issue at the time with my stomach.

I ate up very happily afterwards with no soreness,. I think your prep is a great idea, but be aware not to let your anxiety of the process become a self fulfilling prophecy. Best of luck!
posted by smoke at 12:43 AM on July 18, 2014

I've had actual surgery for a torn descending colon. Scalpels, stitches and all that. I was scared to eat afterward. I asked the doctor who performed the surgery and he told me to eat as I normally would. I ate, because I was hungry and because you gotta eat. The next day I apprenhesively pooped after a procedure much more drastic than a colonoscopy and everything has been working fine for the last nine years.

A colonoscopy is a very ordinary examination. You'll be fine anonymous.
posted by vapidave at 2:20 AM on July 18, 2014 [1 favorite]

I read this many times before my own colonoscopy, but never really believed it. You will be fine. It is scary, the prep is annoying, but I found it very interesting, in a weird way.

You might find salty liquids easier to drink than sweet ones. Store-bought chicken stock is good; I made a batch of homemade stock the day before, and mixed the prep (Pico-prep, similar to what you have) with it. Then I just chilled out with a movie, and a bit later (45 minutes?) my stomach started rumbling. That's when you want to head over to the bathroom.

I have a very fast metabolism, and i was not hungry at all the day of the appointment. It's strange, your body just goes in a different mode. I was more tired than anything, so I napped most of the day.

Are they giving you a sedative for the colonoscopy? I had both a colonoscopy and a gastroscopy at my appointment, and I have zero recollection of either one whatsoever. It felt like taking a really, really good nap. I wasn't sore at all.

As for easing back into food: bring something light with you, but keep in mind that if you're coming out of a sedative, you might be completely ravenous (as I was). I had to stop on the way home for a sandwich. It was the best food I'd ever tasted.
posted by third word on a random page at 2:36 AM on July 18, 2014 [1 favorite]

I had same apprehensions as you. I have severe emetophobia.

Looking back, I wish I didn't read 5 hours of internet people experiences. Some made it seem so horrible.
My endo seemed a little worse than my colonoscopy.... afterward, I mean. But it wasn't that bad.

Before prep, I took a xanax to get the guts to do it. i used the new two step prep. I did prep one using a straw so that it was quick. Step two, I couldn't do because I was freaked out. It was very salty and yuck. Doctor told me to pick up a bottle of magnesium citrate if I wasn't able to handle the prep. I only had about half of that bottle. It was much better taste-wise. As long as you're eliminating clear liquid, you should be fine.

Tell the anesthesiologist to add phenergan or zofran with your anesthesia or bring some to take when you wake up.
I didn't have any issues afterward. Try not to panic and good luck!
posted by KogeLiz at 3:12 AM on July 18, 2014

I wonder if a motion-sickness sticker would help. It's a small, medicated patch that they stuck behind my ear before I had a spinal. I had no vomiting, and I'm usually a notorious post-anesthesia vomiter.
posted by SillyShepherd at 3:20 AM on July 18, 2014 [1 favorite]

A friend who has had many colonoscopies gave me the tip that light beer is a clear liquid that's a little heartier-tasting than jello, and, for her, takes the edge off. Her doc gave the ok on it. Just don't overdo it on an empty stomach.
posted by tchemgrrl at 3:20 AM on July 18, 2014 [3 favorites]

Have you had either of these tests before? They're usually not as big of a deal as you'd think.

Usually, once you start chugging down all those laxatives that kind of becomes your focus, and you don't worry about eating so much. (Trust me, when you are crapping every few minutes you won't be in the mood for a big supper.) You also feel kind of full, just from consuming so much damn liquid.

I had a colonoscopy and upper endoscopy together a couple of months ago, and I have heart issues too. My heart was fine. If it'd gotten too fast, they would've had stuff around to slow it down. The prep and actual procedure wasn't such a big deal. I woke up groggy but was soon feeling OK, and IIRC by the next day I was feeling relatively normal.

BUT, about two days after the procedure I experienced truly horrific abdominal pain that sent me racing to the ER, genuinely convinced I was dying. It turned out to be a mega-bubble of trapped gas that they'd pumped into me, during the procedure. It sounds comical now, but let me tell ya: I was in so much pain that I reached a point where if I had to choose between dying or continuing to hurt like that, I would have picked dying. No lie. When the doctors finally gave me morphine, it was like going to heaven.

I don't say all that to scare you. I've had these procedures before, without that problem. This particular doctor was a dick, and I wouldn't be surprised if he botched something. Also, your anatomy is different, and maybe you'd never have the same problem. (And worst case scenario, it IS just one night of hell, and morphine takes the bad ouchies away.)

But I'm telling you about it because I'd really like to spare you from a similar ordeal, if I can. Tell the doctors you have a "friend" who experienced what I did, and ask them what they can do to prevent it from happening to you. Maybe tell them you are prone to trapped gas, so they need to take extra precautions. Convince them to do EVERYTHING they can to prevent a trapped gas nightmare like that, and have them talk you through everything you can do to prevent gas or relieve it if it happens.

Again, please don't worry yourself sick, going into this. I can almost guarantee it won't be a huge thing, like you're scared of! Think of this like a long trip to visit relatives who watch a lot of Fox News. It's a boring pain in the butt, but then it's over and you forget about it and get back to your freaking life.

But just to be safe, before they knock you out you should grab your doctor's nuts real hard, and don't let go until he swears he'll do everything he can to prevent you from ending up in the ER with trapped gas. (Not to be sexist, assuming your doctor is a man. But "grab your doctor by the boobs real hard" just doesn't have the same ring to it, and it could lead to unfortunate misunderstandings.)

Can you tell I've been awake for way too long?
posted by Ursula Hitler at 3:51 AM on July 18, 2014

After the procedure is done and you can eat again, take probiotics and eat yogurt with active cultures. The prep cleans out your good bacteria as well as everything else, and I found that probiotics really helped get my guts back to normal afterwards.
posted by Rosie M. Banks at 3:52 AM on July 18, 2014 [2 favorites]

When they give you the stuff you have to drink, they might also give you some flavor packets to make it more palatable. If you have a choice, pick the flavor that you most dislike (I chose cherry, because I hate artificial cherry flavor). Do this because your brain will forever associate the flavor with the unpleasant experience, so you don't want to ruin something you like.

You'll be in there for a while. A laptop with Netflix will help.
posted by Faint of Butt at 4:21 AM on July 18, 2014

Aww, I just spent 20 minutes writing a response and lost it. I'm on the once a year colonoscopy plan (for about 10 years now) and have also had colonoscopy plus endoscopy.

1. Everything you wrote -- call the physician who is doing the procedure and ask him/her. Please don't just adopt what you read in this thread without checking it with him/her.

2. Follow their instructions to the letter. Finish your prep according to the instructions they give you (regarding your concerns above). If you don't, they might have to cancel the procedure and you will have to do it all again later.

3. Blood sugar issues--please, ask the physician doing the procedure how to handle this.

4. My instructions always include directions to not eat lettuce, celery, seeds, or anything that might be difficult to lavage from the colon for a WEEK before the procedure.

5. You'll probably need to start the "day of" prep around 6 am, but ask them, not us, and I am not allowed liquids after I finish. They ask me exactly when the last time I took liquid before I have my procedure.

6. You won't need to be in the bathroom the whole time. Nearby is fine.

7. The anesthesia for me at least is pretty cool: it's the one day of the year that I'm completely relaxed, if a bit loopy.

8. Re: gas (above). Normally you can get rid of it in the normal way. They will tell you: if anything seems amiss afterwards, call them, call the physician on call, don't hesitate.

9. I personally avoid fried foods when breaking my fast afterwords. Clear soups like chicken noodle or wonton work best for me. Pho would be good too.

10. This is all for the greater good. Welcome to the "club"!
posted by apartment dweller at 4:23 AM on July 18, 2014 [1 favorite]

Also: if you can pick your prep, I'd suggest Golytely. IIRC it's just this kind of salty stuff, and it's gross to get it down but the flavor doesn't become so overwhelming. If you go for something fruity it will taste OK the first few glasses and then it will gradually taste less OK and then it will be like demons are pouring fruit-flavored evil down your throat.
posted by Ursula Hitler at 4:49 AM on July 18, 2014

In a previous askme Mefite rednikki had some great advice about prep. There are some tricks mentioned that I haven't seen in this thread.
posted by travelwithcats at 5:02 AM on July 18, 2014

All fine advice above. I've had several colonoscopies while quite ill and underweight. It's not THAT bad but it's not fun. The tip that I haven't seen here yet is that you should start eating a low residue diet now and, as much as you can tolerate, eat lighter than usual for a couple of days before prep day. You'll clean out much faster on prep day and (apologies to the zealots above regarding finishing the prep) if you're on a low residue diet and your bowel movements are clear, you can stop the prep.

They give the same amount of prep liquid to a very large man and a very small woman -- I have always been completely cleared out and usually use about 2/3 of the prep liquid. Caveat, this is only if you follow the low residue diet -- high fiber foods can "stick around" in your intestine even when your bowel movements are clear so you'll need to finish the prep if you aren't able to follow the low residue diet.
posted by telegraph at 5:12 AM on July 18, 2014 [2 favorites]

I do these once a year and I always get a "anxiety" pill from my doc not because of the procedure but because the prep makes me crazy. Really, who drinks and poops all the stuff without some anxiety? Not me.
posted by OhSusannah at 7:38 AM on July 18, 2014

BTDT. Absolutely no problems after, and got some pretty pictures of where the sun don't shine!

Prep was not as bad as I had been led to believe, and the fasting less of a problem than I expected (I like my tucker!).

You will be fine, but nthing the check with your doc on advice from here. I had an RN ring me a day or two before I started prep to walk me through the sheet of 'do's and don'ts', and it all turned out to be NBD. If you haven't got that sheet, or don't get the phone call - don't hesitate to ring them yourself. While it (mine) was a blip in my week, I wouldn't want to have the blip twice because I stuffed up the prep.
posted by GeeEmm at 8:17 AM on July 18, 2014

Get some vaseline, and put a dab on your anus every time you wipe. The diarrhea from the prep can cause severe irritation; it was the worst part of the prep for me. If you eat anything at all, it should not have dye, because everything will be going right through you, and green jello is just, no, also not great for the test. You can get unflavored jello and add white grape juice or ginger ale, also ask your doctor about chicken broth, or even make some sugar water. If there's a chance you won't complete the prep, maybe eat only low-residue foods the 2 days before. I agree that you should talk to your doctor's office; you so don't want to repeat the test.

Re: emetophobia - sipping a small amount of water or ginger ale really helps me relax the muscles that want to make me vomit.
posted by theora55 at 8:55 AM on July 18, 2014

The drugs that make everyone else loopy, or even out cold, merely made me not feel any pain or discomfort, so I "got" to watch the screen as they were performing it. I cannot emphasize enough how right Theora55 was about green jello. No one told me not to eat it, and seeing green inside my guts terrified me until the doctor laughed and said "Now you see why we forbid eating anything red. Red could mean any number of things." Yes, the prep is a total pain, but the whole procedure is not nearly as awful as a lot of people make it out to be. It's like before you have your first mammogram...The expectation is often so much worse than the actual procedure. Good luck, and hang in there.
posted by Meep! Eek! at 11:08 AM on July 18, 2014

Have a stock of reading material that you loose yourself in, Science Fiction is mine but several magazines (more than you think you'll need) or just whatever you can drop into to be distracted. As Meep! says, it's the expectation. And just plan your pre-time to be close to the restroom, but comfortable and as distracted as possible. Set a timer for the medicines and just get distracted.
posted by sammyo at 11:21 AM on July 18, 2014

When they say nothing by mouth for 2 hours, they mean NOTHING by mouth. They will not want you taking hard candies or gummy bears or any sugar-containing substance, or even water. The reason is because they will likely be giving you procedural sedation during the colonoscopy - some people do it without sedation but I believe it is quite uncomfortable.

Sedation should not be done with stuff in your stomach, even clear fluids, because you may not be able to protect your airway, and you could aspirate your stomach contents into your lungs, which would be more dangerous to you than being borderline hypoglycemic when you get to your appointment, because you can be given sugar by IV within a matter of seconds. If you start feeling like your blood sugar's getting low, ask them to check you and I'm sure they could have it checked and treated within 5 minutes flat. Go early to the location of the procedure if you think you're going to get hypoglycemic in the hour from 11 to 12:15 so you'll have someone nearby who could check your blood sugar or start an IV on you if needed. Advise your physician about this issue.
posted by treehorn+bunny at 11:29 AM on July 18, 2014 [3 favorites]

If it's an option, and of course check with your doctor, you might look into the Gatorade prep. I found that one much easier than any of the others I'd done. I'm pretty bad at the not-eating part too, but an afternoon appointment with the Gatorade prep meant that I only had to skip dinner the night before, and I dealt with that by eating a huge lunch with a lot of fat in it.

I see that someone upthread wrote that she liked Golytely, and I know that everyone's experience is different, but I thought that was the most horrible stuff I'd ever choked down.

Good luck with it.
posted by still_wears_a_hat at 2:06 PM on July 18, 2014