Colonoscopy with Klean-Prep

Instructions

From what I read and heard, the day before the test — the prep day — is the worst part, and the actual procedure is not a big deal. I was instructed to take four litres of Klean-Prep mixed with water, a lemon-lime drink, or some other clear (ie. non red or purple) liquid. I was to start at 2:00 pm on Tuesday, but they said if you have trouble drinking large amounts of liquid (and four litres is about the size of two large party-sized pop bottles), you could start earlier. I planned to start at 12:00 pm, and I was supposed to drink a cup (1/4 litre) every ten minutes.

Doesn’t sound too bad so far, right? Drinking a lot of liquid, okay, maybe it will make you go pee a lot, but otherwise, what’s the problem?

The taste, of course. Everything I read said that the stuff tasted horrible, even with its “new improved vanilla flavour!” Really though, if I hadn’t read all that stuff, I probably wouldn’t have had that much of a problem with it.

The first cup

The first cup went down quite quickly at 12:20 pm (okay, okay — I was a bit late because I was playing FarmVille). But after that, I lost motivation.

This week is my university’s reading week, so that means I have the week off, which worked out well considering the colonoscopy was scheduled before I even knew when reading week was. My dad coincidentally also took this week off to work on the house. So, awesome, right? Someone would be there to take care of me before/after the hospital. Unfortunately, my dad had to go into work. So, there I was, all alone, with no one to encourage me (or force me) to drink the stuff. I called up my mom who said it would be okay if I waited until she came home and she would be there to support me. I told her I would get one litre down before she came home.

Unfortunately, four hours later, I still only had one cup down. I hadn’t started running to the bathroom yet (which is what the stuff is supposed to make you do — by the time you’ve finished drinking it all, you should be having clear, watery stool). I really don’t have an excuse for not getting any more down; I certainly could have, because the first cup was really not all that bad. It was just overwhelming to think that I still had more than three litres to go.

Most of what I read online said that if you’re under 120 pounds, you should only need to take three litres. (I’m currently 97 pounds and still not gaining any weight, despite eating all the time — speaking of which, you’re not allowed solid food for 24 hours before the test, and man, was I hungry! Right away, too. And of course, every commercial, every show seemed to be about food! I would have loved to have just been able to lick a cookie to get the taste of the prep out of my mouth). I’d read online that most people weren’t able to get more than three litres down with no mention of their weight (and I figure most people probably weigh more than me), so presumably three litres would be about enough for anyone.

But I didn’t get three litres.

I don’t really want to say how much I did get, because I don’t want to encourage people to take as little as I did and still try to have the procedure done. Your colon needs to be squeaky clean because the test is basically putting a long hose with a camera at the end into your colon and checking it out for irregularities (eg. cancer, polyps, inflammation). If your colon isn’t clean, they can miss stuff. According to one of the nurses at the hospital, your colon should look like the inside of your mouth, all nice and pink. No brown stuff floating around. And finding red stuff is bad, which is why you can’t have red liquids (or cherry popsicles or jello — which are, of course, my favourite flavour!)

Apple juice, Sprite, Gatorade

I managed to get a few more cups down, mixed with apple juice and water; the first cup was mixed with Sprite and water. When I was on the apple juice mix, I thought the Sprite one tasted better, but when I went back to the Sprite later, I was longing for the apple juice. It’s all about the same, I suppose. I had some Gatorade Rain to wash it down with — a drink I’d not been too fond of in the first place, but by the end of the night, man, did that Gatorade taste good.

Crying, chugging, and going to the bathroom

Much crying and sitting and staring at the cup later, my dad gave me a Sprite mix in a bottle of water and told me to try chugging it, rather than taking it through a straw like I had been doing. Chugged. Threw up. Proceeded to not try again for at least an hour.

And really, you’re supposed to take this stuff fast so that it doesn’t get absorbed into your body. That’s why I still hadn’t gone to the bathroom. I had done a normal bowel movement in the morning before I’d started the prep. I hoped the fact that I hadn’t eaten anything solid for more than 24 hours before the test and the fact that I’d only had Cheerios (and chewed ’em up real good!) and the fact that I’d emptied out before the test would mean less to empty out later. I’d read stuff online about diarrhea explosions (which I’m no stranger to, or at least I wasn’t before my surgery) and terrible cramping and whatnot, and I wasn’t much looking forward to it — but I would much rather be enduring that if it meant that the prep was all gone.

I had been in my parent’s bedroom so I could watch TV and be near the bathroom, but my mom decided it was time for her to go to bed, so I was kicked out. My dad wanted me to go downstairs with him so he could yell at me some more make sure I took the rest of the stuff, but I was saved by a bowel movement, finally. And it was watery! Hurrah! I didn’t think I’d want one of those kind of poops again, after that being all I had for months before my surgery.

Anyway, the poop was better, but not clear. I’m going to be a bit more descriptive here than you might want, so there’s your warning. It was watery, and it felt like I was peeing out my butt, and it was a fairly constant stream.

Finishing

It was getting late. I was sitting on the toilet with my head on the end table I’d dragged into the bathroom, and I was falling asleep. I eventually managed to straighten up and tell myself, alright, if you can drink this whole bottle (two cups), you can go in your nice, comfortable bed and sleep.

It took me a few hours, but I did it. Well, almost. There was a little tiny bit still left in the bottle; I could have got it down with two big chugs, but I was just so exhausted. I ended up chugging most of the bottle with only a few gags and no more throwing up. It really is easiest to just chug it like a bottle of water. But I have trouble chugging normal, tasty drinks.

Going to bed

I quietly snuck into my room, hoping my mom and dad wouldn’t wake up to yell at me some more. A few minutes later, my mom knocked at my door and asked how I did; was I still drinking, pooping? Yes, I was still pooping, but I was not drinking any more. “How much did you get down?” she asked. The final tally was one and 3/4 litres. Less than half of what I was supposed to drink.

I can’t explain why I can’t drink large amounts of fluids or swallow pills. Well, maybe I can; I think about it too much, and this mental block stops me from doing it.

“Are you trying to stay sick?” my mom asks. “Are you trying to sabotage this?” my dad asks. (“Yes, I’m trying to sabotage it,” I replied sarcastically, but I’m not sure if he caught on or not. I’m usually pretty good at knowing not to say dumb things that will just get him mad, but every once in awhile, a snarky comment can slip out.)

They can’t believe I couldn’t do it. They’re disappointed, angry, frustrated, stressed. They tell me that these doctors have prepared an operation room for me, there’s people waiting on me, counting on me to do what I’ve been told to do. These procedures cost money; thousands of dollars — thousands of thousands of dollars!

I can be stubborn. Usually, when people get angry at me and try to make me do something, I think, “Well, they want me to do it, so I’m just not going to do it!” But that thought had never crossed my mind that night. I really was focused on getting it done, and not because my parents were or weren’t making me.

I don’t blame them for being frustrated with me, but all they were doing was making me feel bad, which didn’t make me want to take the stuff; it just made me want to cry and not take the stuff.

Anyway, it was now 2:00 am. I was actually expecting it to be at least an hour later when I left the bathroom, so I was quite proud of myself for finishing the bottle so “quickly”. My colonoscopy was to be at 9:30 am, and I wasn’t supposed to eat or drink anything for four hours before the test, so I wasn’t even allowed to take the Klean-Prep for much longer, even if I was actually able to.

The morning

I slept for a few hours, and I got up at 8:00 am. I don’t think I got up to go to the bathroom during the night other than a bit after I finished drinking. I didn’t know if anyone was even planning to wake me up to take me to the hospital since I probably wasn’t clean enough to have the procedure done. My mom had even said to me last night that she wouldn’t be coming with me. I went downstairs and spoke as little as possible, but I asked my mom what was up and were we even still going. “Of course we’re going!” she said incredulously. Okay, okay, it was just a question.

The hospital

My dad ended up driving us to the hospital and dropping me and my mom off. I thought it was because he was the more pissed one, so he got to stay home since someone had to be there with me if I did have the procedure, but really, you were only allowed to have one person with you since the waiting room was so small.

I wasn’t even feeling hungry anymore, but after a few hours in the waiting room, I was starting to feel it again. I’m not sure what time I was called in, but it was at least after lunch. Almost all of the other people there — obviously all there for the same thing — were older men. And then there was me, the little girl.

Getting ready

I was told to go into the room and take off all my clothes except my socks, put on the hospital gown, and then lie down and get comfortable. I waited for a few minutes, getting my blood pressure taken, that kind of thing. I was told before the procedure that I would be given some drugs through an IV and I would be “consciously sedated”, so I would be relaxed, but not asleep (though some people do fall asleep). This worried me, because I did not want to be awake during the procedure.

When I was young, I saw a TV show about someone having a surgery that they were supposed to be asleep for, but they ended up waking up while the doctors were cutting into them or whatever, and the patient wasn’t able communicate to anybody that they were awake; I think that show is what stemmed my whole fear of hospitals and doctors. So this procedure would kind of be like me facing my worst fear.

The procedure

The procedure wasn’t really a problem. The worst part was the very beginning, when the doctor stuck his finger in there, I guess to open it up or feel around or something. And then in goes the camera hose, I guess. I couldn’t really look to see what he was doing, because if I moved, the thing could perforate my colon, and I could die and stuff. I did, however, watch a little bit on the TV screen, but I wasn’t allowed to wear my glasses during the procedure, so it was blurry. I’m not sure how long the whole procedure took, maybe fifteen minutes at most? I could feel something moving around in there a little bit, I think. They blew air into my colon, which I was told I would then need to “blow back out” when I was in recovery (no problem; I’m a champion at that). There was one point where he took a sample of part of the colon and my hand was on my stomach, and I’m fairly certain I felt what he was doing, so I immediately removed my hand.

So yeah, I was awake for the whole thing. I feel like they didn’t even give me drugs, since I wasn’t even slightly out of it after. That’s the only part I don’t remember: them giving me drugs. I don’t think they would forget a thing like that, but I dunno, I just didn’t feel it. I didn’t feel any pain really at all, just slight discomfort.

When the doctor said it was all done, I asked him if it was clean enough, and he said yes. I said I hadn’t taken all of the prep, but I didn’t say how much. I had told several nurses earlier when they asked, and they wrote it down, but I’m beginning to think doctors never read what’s written down, considering how many times people in hospitals ask you the same questions over and over.

Recovery

So they did the colonoscopy, despite my utter failure at doing the prep. I laid down in recovery for a while, and mom came in from the waiting room. While we were waiting before the test, I talked to her a bit, tried to keep some conversation going every once in a while, and she even spoke to me without being prompted, and she put her head on my head when I put my head on her shoulder, so I figured she’d gotten over being angry at me. So, I talked quite a bit more to her afterwards and asked, “Are we cool?” She said yes, but if they had not been able to do the procedure, that would probably be a different story. I’m so glad they could, because I can’t deal with my parents being angry at me.

When I felt good enough to walk (which was right away, really), they let me go into the next room and have some apple juice and some sort of fruity bread, and then I got dressed. After they removed the IV nozzle out of my hand, I could go. And so, we did.

Going home

All done. I was just so happy! I think my parents are still a bit angry with me, but they’ll get over it eventually. It’s done, after all.

Next time I have a colonoscopy, I’m asking for Pico-Salax, which I’ve read you only need to take two litres of, I think. Much more manageable, and less overwhelming.

So, all in all, it’s true what you’ve probably read; the colonoscopy itself is nothing to worry about, and the prep is the worst part.

I’m not a doctor, and I can’t really say if any of what I did will help, but here’s what I would suggest: If you don’t think you can get the four litres down, aim for at least three, and start early. Eat very light, easily digestible food for as many days as you can stand before the test, and don’t eat at all for at least 24 hours before the procedure. Take a laxative; they prescribed one for me, but it was a pill, so no-can-do for me.

I really don’t recommend taking as little of the Klean-Prep as I did; I was lucky. I’m also very small (like I said, I weigh 97 pounds since I lost a lot of weight due to having undiagnosed Crohn’s disease for the past year), so I guess there wasn’t as much to clean out. Plus, like I said, I had already emptied out before I started the prep. It’s probably a good idea to drink a lot of water if you aren’t getting all the prep in. I didn’t do that, but I knew I should have. Basically, my story is a “what not to do” with a lucky, happy ending. Well, at least until I get the results, I guess.