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Rear Window: One Man's Guide to Prepping for a Colonoscopy

They say the colonoscopy is the easy part. It's the prep that can keep people from this life-saving procedure.

By Robrt L. Pela

Editor’s note: Next Avenue has published more than 500 articles in 2021, and as the year is winding down, our editors wanted to share with you some of our favorites, like this one.

"I'm going to write an essay about my most recent colonoscopy," I told my husband over morning coffee last week.

A stack of rolls of toilet paper, which the author reccommends as colonoscopy preparation. Next Avenue
Credit: Getty

"That should be easy," he replied. "You can pull that one out of your —"

"Don't," I interrupted. "Too easy. Anyway, colonoscopies are serious stuff."

"But you always make them look so effortless," he said.

It's true. Although I'm barely 60, I've had five colonoscopies in the past 15 years and have mastered that awful day-before prep with a minimum of discomfort.

Along the way, I've developed a lousy attitude about people who don't get colonoscopies, because they're horrified at the thought of someone placing a camera up inside them or can't abide the idea of a full day of not eating or of swallowing a half-gallon of liquid laxative and then, well, you know.

"It just seems so undignified," my friend Lisa moaned when I mentioned I was getting ready to have my insides photographed again.

"You dressed as an intrauterine device for Halloween last year," I reminded her. "Please don't talk to me about dignity. And anyway, since when is decorum more important than not dying from some horrible disease?"

I was ready for each of Lisa's excuses. She'd heard that colon cancer is slow-growing, so didn't that mean more opportunities to treat it once you got it?

Sure, I replied, but who wants cancer, no matter how lazily it progresses?

Lisa's health insurance deductible was huge, she countered, and didn't cover 100% of a colonoscopy procedure. I reminded her that she spent thousands every year on Funko Pop fashion dolls, after which Lisa said she had to go water her houseplants and hung up on me.


It's Not a Big Deal

I was sorry Lisa, who's just my age, had fled before I could reassure her that a colonoscopy isn't a big deal. I wanted to tell her how it's the only screening test that can help prevent cancer and a great way for a doctor to examine her colon for polyps that can turn into cancer if they're left untreated.

I would have explained that the knockout drugs are so great, she'd miss the whole procedure — when the doctor inserted a thin, flexible tube with a tiny camera on the end, called a colonoscope, through her rectum and on into her colon; the part where the doctor examines her insides on a video screen and how, if her doctor finds a polyp, she'd be fast asleep and would miss him or her snipping the little bump off her colon to keep it from growing into something that could kill her.

Prepping for the Colonoscopy Prep

I hadn't gotten to share my tips for making the day-before bowel evacuation less unpleasant.

It's just as well; Lisa would have called me an overachiever, because a few days before my prep, I like to drink digestive teas (Yogi Stomach Ease is a nice one) and eat smaller meals because it's easier to empty out a half-full colon. During this same time, I cut back on high-fiber foods like nuts, whole grains and raw fruits and vegetables because they can leave colonic residue that makes it harder for my doctor to see colon polyps.

"I know now to book the earliest Monday morning colonoscopy appointment I can, because the day of the big event is spent recovering from anesthesia and the day before is best spent sticking close to home."

The first time I did a pre-colonoscopy purge, I'd failed to read the doctor's instructions ahead of time and found myself dashing around the pharmacy late the night before, searching for the laxatives I needed and scrounging sanctioned treats like low-sodium chicken broth and Jell-O that wasn't red, orange or purple.

I'd learned my lesson. Now I know to buy a giant package of the softest toilet paper I can find, a box of flushable baby wipes, and to have a stash of popsicles — something I otherwise never eat — on hand, as well as a jug of apple juice (Martinelli's is nice) and a bag of gummy bears (though no red or purple ones).

I know now to book the earliest Monday morning colonoscopy appointment I can, because the day of the big event is spent recovering from anesthesia and the day before is best spent sticking close to home, preferably in a bathrobe so there's no fumbling with zippers or buttons.

My favorite trick is to drink the half-gallon of liquid laxative — the consumption of which is, for me, the worst part of prep day — through a straw. I place the straw over my tongue and as far back in my mouth as possible, then suck as fast as I can to get the stuff down quickly, without tasting it.

After glugging that much liquid, it's hard to force down any more. But drinking a lot of water is imperative during colon-purge day because so much of what you're taking in is coming right back out. I line up a dozen 17-ounce bottles of distilled water on the kitchen counter and make sure that by bedtime I've drunk them all.

A cousin of mine has his own colon-prep-day trick: He makes his laxative into popsicles the night before and gobbles them at times assigned by his doctor. I had planned to try that this year, but I'd forgotten to buy popsicle molds. Maybe next time.

The Big Day

This time around, I failed to drink all of my waters, which became clear the next morning when the nice young phlebotomist had a tough time inserting my IV port. "Your veins are flat," she told me as she poked me for a third time. "You should have drunk more water."

"Ow," I replied.

"The nurse had pressed them into my hand as I was leaving: pictures of my pink, glistening colon, yawning and winking at the camera."

Not long after, I was wheeled into the dark coziness of an examination room, where the anesthesiologist asked me to lie on my side and began explaining something about something and the next thing I remember is being walked to my husband's car by a woman named Ruthie who was dressed in scrubs printed all over with tiny Bart Simpson faces.

I awoke later that afternoon on my living room floor beside an empty ice cream container and half a bear claw the size of my head. The television was on; Shirley Jones was wearing maroon crushed velvet and lip-syncing to someone else's playback.

Did I fall asleep watching reruns of "The Partridge Family?" I texted my husband, who'd gone back to work after dropping me off at home. Did I eat a pint of Haagen-Dazs?

No, he texted back. You ate two. Please stay off the balconies. Remember we live on the 14th floor. I left those photographs of your insides on the sideboard.

Oh, those. The nurse had pressed them into my hand as I was leaving: pictures of my pink, glistening colon, yawning and winking at the camera and arranged in neat rows like yearbook portraits or the images on a Post Office Most Wanted poster. The photos were oddly personal and hard to look at, full of visual information I didn't necessarily want to know.

Two days later, I received my pathology results. The doctor had found and removed a benign lipoma, according to his notes, but I was otherwise possessed of a "normal colon to the cecum."  All was well, he wrote, and suggested I return for my next colonoscopy in five years.

I phoned the good doctor's office. "I can't wait five years," I explained to the nice fellow who took my call. "I have a family history of colon cancer and my health insurance will allow me to do colonoscopies every three years."

And anyway, I said, I had heard about laxative popsicles, and I wanted to give them a whirl.

Robrt L. Pela
Robrt L. Pela is a Pulliam Prize-winning writer who has worked at magazines including Psychology Today, The Advocate, Phoenix Home and Garden and Men’s Fitness. For the past 30 years, he has been a columnist at Phoenix New Times and a correspondent with the NPR member station KJZZ. His last book was Filthy, a biography of the film director John Waters. He and his husband live in Phoenix, Ariz., and look forward, post-pandemic, to returning to their homes in Niles, Ohio and Bargemon, France. Read More
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