It’s okay to talk about poop, especially if it keeps you alive.

We are currently working on normalizing things in our public lives. There are intentions to normalize mental health care; people are talking about their diagnoses, therapy, medications. We are normalizing talking about trauma (when it is safe to do so), rather than whispering about it, like it is something of which to be ashamed. Breast feeding. The spectrums of sexuality and gender. The various body types and shapes. We are working to normalize things about which we used to keep quiet.

So, I have a question:

Shall we normalize preventive care? Is it cool if we talk about mammograms and prostate exams and colonoscopies?

Spring of 2019, my doctor looked at my chart and said apologetically, “Oh. You’ve turned 50. Time for a full physical and colonoscopy.” Now, colon cancer is one of the health risks in my mother’s family, so I’m not messing around with it. I expect to watch my son parent his son, Timmy, and I expect to have a friendship with Sage much like what I have with my mother. I’m not leaving early because I refused to manage preventive care.

My physician referred me to a gastroenterologist, and we set up the appointment. Since my whole life flipped upside-down last summer, my colonoscopy appointment had to be canceled because I was moving to South Carolina.

And, whereas I’m not always so quick to find a new doctor in a new town – until I need one. I didn’t have a doctor when Covid-19 hit, so that complicated and slowed things down quite a bit once I did try to get in to see a (fantastic) nurse practitioner. At my new patient appointment, she looked at my chart and said, “Oh! You’re 51. Have you had a colonoscopy yet?” We set up an appointment for mid-July.

My incredibly healthy mother takes seriously the health risk of colon cancer in her family, so I knew I could ask her what to expect with the prep one must do before a colonoscopy. But, Dear Reader, I wonder if you have such a person. It occurs to me to write such a blog post because my high school and college friends are my age. The friends I’ve made because our children are friends are about my age. It’s about time for all of us to be checking on our colon health. And that only sounds weird because it’s about poop and our backsides. It’s not strange to talk about dental health or heart health, but we don’t talk much about our colons. Frankly, I don’t need to talk much about them either, but I don’t think they should be so taboo.

If I promise not to be gross and detailed about colonoscopy prep, will you promise to read on if you are putting off this important test because it gives you the squeebs?

The Prep

My appointment was on a Friday.

A week before, I bought the supplies I would need:

Dulcolax pills (laxative)

Miralax powder (laxative)

Every single flavor of Gatorade that is not red or purple.

I don’t generally drink Gatorade, and I knew I had to drink a lot of it, quite possibly when I didn’t feel like it during the prep process. So, I wanted to know which flavor(s) I liked the very best. I drank some every day and decided the flavors I liked. (Red and purple are not options because the dye in them may be mistaken for blood during the exam.) Winners: Cool Blue and Glacier Cherry

Let’s talk (de)hydration: The process of emptying your digestive tract is the process of dehydrating oneself. So, if you are not a person who usually drinks a lot of fluids every day, I’d suggest drinking a lot every day of the week before your colonoscopy. It’s probably best to begin the process properly hydrated.

Having decided on the flavors I liked best, I bought two 32-ounce bottles of the flavors I’d chosen.

Wednesday, I didn’t eat any foods that like to stick to the sides or in nooks and crannies of our digestive tracks: nuts, seeds, popcorn, etc.

Thursday (day before exam), I was only to drink a liquid diet. I had popsicles, jello, beef broth, Gatorade, water, and a soda. I thought I would be so hungry I’d be aching. I wasn’t. That morning, as instructed on the paper they give you, I mixed the whole bottle of Miralax powder into the two 32-ounce bottles of Gatorade and put it in the fridge for the day.

Yes, you read that right. 14 doses. You drink 14 doses of a laxative – after you take laxative pills. The goal is a perfectly cleaned out colon and intestines. This does the trick.

When I got home from work that evening, my amazing daughter had arrived. You see, you can’t drive yourself to a colonoscopy. You can’t take an Uber or bus, either. Your driver must stay with you, and in the days of Covid-19, that means staying in the parking lot with you’re A/C running for a couple hours (with deep apologies to the planet). I have local friends who would have taken me to the doctor’s office that day, waited for me, driven me home, made sure I was safe, and a couple of them did offer. But, for this first time, not really knowing what to expect, I wanted Sage. And she came. Because she’s magic like that.

Thursday evening at 6pm, I took the Dulcolax pills as directed, and I went about doing laundry and unloading the dishwasher and such. I also set up my bathroom for my sustained use of it that evening. I brought in a small side table and a tabletop tripod for my phone, for watching many episodes of The Crown. I made sure to have the best toilet paper, too. My table was also where I kept my mask (Sage and I had not quarantined prior to her trip here, so we were masked when we were in the same room.) and my Miralax-laced Gatorade.

In maybe an hour or so, I had to poop. It was just regular poop. (Seriously, I have thought about the ways to talk about this: poop, bowel movement, number 2, and others. We’re using poop. It’s settled.)

As instructed, at 8 pm, I opened the first Miralax/Gatorade bottle and took a drink, expecting it to be disgusting – or at least have an odd consistency. After all, there was half a bottle of powder in there. Nope! It tasted/felt exactly like Gatorade. I was so relieved! I could do this!

It took a while for it to take effect. And during that time, Sage and I just chatted in the living room. It was so nice to have her with me. (side note: If you live alone and have a dog that needs to be walked/let outside to relieve itself, you may need a friend around during prep. There are many hours you cannot leave the bathroom. Some of those hours, you cannot stand up from the toilet. You’ll think you can, but you will be wrong.)

Once it started to work, I went to the bathroom and, well, made myself comfortable for a while. I watched The Crown and drank my Gatorade while my body got rid of everything in my intestines. By the time the process is finished, I was passing only water. Yep, it sounded like I was peeing, but…I was not.

Pro-tip 1: If you are short, and your feet only touch the floor when you are on the toilet because you are pointing your toes a bit (like me), then you will want a small platform under your feet. I simply rolled up a bath towel in such a way that it was maybe 3 inches high and rested my feet on it. This relieved the pressure on the back of my legs.

Pro-tip 2: Even if it is summer in the South, when your body is behaving like it is sick (when else do you have severe diarrhea?), you might feel cold and shivery. It wasn’t bad, but I grabbed my bathrobe and wore it backward like a Snuggie.

Pro-tip 3: Start earlier. This first time, I did it just like I was instructed. I had explained the instructions to my mother, and she said, “You might want to start earlier than 8 pm. It can take a while, many hours.” Here’s the thing about my mom: she’s right a lot. This time was no exception. I was up until 3:00 a.m. On the toilet. Next time, I’m leaving work early and starting mid-afternoon.

Pro-tip 4: Even if you’ve finished your 64 ounces of Gatorade, keep drinking some water. Nothing to drink past midnight, an empty intestinal tract, and an appointment not until 11:00 a.m. meant I was quite thirsty.

The Appointment

Sage brought me to the appointment at 11:00 and stayed in the parking lot waiting for me.

I checked in at the front door with a Covid-19 symptom and temperature check.

Some papers to sign.

Then, I was called back to an area with lots of small rooms which were curtained off. My very capable and kind nurse, Jill, took my vitals, asked about meds and allergies, made sure I had done the prep as prescribed. She left while I changed into the hospital gown (open in the back! ) Then, she put an IV port in the vein on the back of my hand and started some fluids, just for hydration.

The nurse anesthetist came in and asked some questions about meds and allergies, told me the procedure would take about 20-30 minutes, and I would be sedated for it.

My bed was wheeled into the procedure room, where my doctor was waiting. We talked a bit, and then the nurse anesthetist asked me to lay on my side with my top knee bent up a bit. She held up two syringes or vials or something and said, “This first one is (I can’t remember what she said it was for.), and this next one will put you to sleep. It should take about 30 seconds.” She was wildly exaggerating because within 3 seconds, my face was tingling, and that’s all I remember until I woke in that same little curtained room I had started in.

My doctor popped in to say he’d taken one polyp out, he’d call next week with the results of a biopsy, but everything looked clean and the polyp doesn’t seem like anything to worry about. They called Sage on the phone to drive around to the discharge door, and the doctor went out to speak with her about whatever care instructions he had for me. The nurse walked me to Sage’s car, and we went home.

Here are the key take-aways:

At no point did anyone touch my butt in any way at all while I was awake. There was zero embarrassment factor.

I had no pain at all. I wasn’t uncomfortable later in the day as a result of the procedure. I was tired – from being sedated and getting to bed at 3:00 am.

The day of the procedure itself is seriously like a doctor’s visit combined with a solid 30-minute nap.

Depending on your health risks, you will be advised to repeat this process every 5 or 10 years. If they find pre-cancerous cells or anything that appears dangerous, then I suppose you are asked to repeat it and start on treatments. But, honestly, if there are pre-cancerous cells in your colon, you really want to know. ASAP.

Hey, friends who are my age, make the appointment. Do the thing. It really is okay. You’ll survive a colonoscopy, I guarantee it. I cannot say the same about colon cancer. I love you, and I want you around. Make the appointment. And then call me if you want to laugh awhile.

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