Sunday, March 6, 2011

Colonoscopy! What Fun!

     Well, tomorrow I have a colonoscopy scheduled for Monday, March 7. Have any of you had one or more of those? This is my second one. My first was done 5 years ago just for colon cancer screening purposes. I was prepared for the preparation as they say. No eating and lots of laxatives to clean that colon out. Most of my patients had a great deal of trouble drinking down the gallon of ethylene glycol that flushed the colon out. If you have had one of these before, you know that you need to start this about 4 in the afternoon the day before your test, drinking this gallon down in 8 ounce glasses every 10 to 15 minute. And as you can imagine this stuff is not the greatest tasting stuff in the world. Some people would get very nauseous when drinking this stuff. My gastroenterologist uses a slightly different prep which may be slightly easier. He precribes 4 Dulcolax laxative tablets by mouth at 11 AM the day before. These start to work later in the day simultaneously with the ethylene glycol. Therefore he uses only 1/2 gallon of that solution. For most people anything that can reduce the amount of that fluid that you have to take is better. From about 5 PM on that night before the subject (my patients in the past, me this time) will basicly be in the toilet. There is usually not pain with this preparation but there is certainly lots of rumbling and going on in that belly. Usually it is over by bedtime though. Then you get up bright and early and go have the test.
     The first time I had this test 5 years ago, I did not respond to the sedative. In addition to Demorol for pain, they use a drug called Versed to sedate the patient. Though it allows the person to follow minor commands during the procedure, the person usually does not remember the procedure afterwards. It is called conscious sedation: you have amnesia and are not "awake" to what is happening almost immediately after the injection until you arrive in the recovery area. Then you feel fine and once it is certain that your stomach is OK and you are fully awake, you are allowed to go home where you might be kind of drowsy the rest of the day. You do need someone to drive you home in case your reactions are slowed by these drugs. That is what is supposed to happen. However, in my case last time, I never "went to sleep." I remained conscious, fully aware, and remembered the whole procedure. I even watched the action on the monitor screen. My procedure also took quite a while because the gastroenterologist was having trouble getting the scope into the right end of the colon, the cecum. He tried every method he knew, taking the scope back a long ways and trying to get it to enter the cecum several times, pushing on my belly to try to advance it from the outside of the body, turning me over even on to my stomach, etc. Nothing worked; he never could get into the cecum. He said he could see it but couldn't enter it to be sure he was seeing everything he should. This is why I am having the procedure again after only 5 years. So I am hoping that the same thing doesn't happen again. That is I hope he can get into the cecum and that it doesn't take such a long time to do the test. And I hope that the Versed works for me this time. I received the same drug when I went for my melanoma surgery, administered in the day surgery prep room and I was out before they even wheeled the gurney out of the area. So we will see.
Wish me luck.

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