Do Not 'Go Lightly' into that Good Night
How to Survive a Colonoscopy without drinking liquid chalk
Unbeknownst to me at the time, actor Ryan Reynolds and I both went in for colonoscopies on the same
day (different facilities). Deadpool had one polyp removed, and although I don’t like to brag, I had two. He scheduled his after losing a bet with Wrexham co-owner Rob McElhenney. I go in every five years thanks to losing the genetic lottery when it comes to colon cancer (it’s killed two grandmothers and a first cousin, so far). Reynolds’s adventure is on film, and mine (as far as I know), is not.
Because of my stubborn inability to drink anything that's not remotely to my liking, this test has always been unnecessarily difficult.
(Everyone my age remembers the gallons of sludge poor Katie Couric had to chug down in her kitchen to prep for her on-air colonoscopy on the Today Show in 2000. Her on-camera-colon stunt was for a good cause in memory of her late husband, but her [reported] $60 million dollar contract might've also helped her choke down that chalky residue of misery and degradation cut with liquid cherry-flavored Pez.)
Pill Prep for many years used to come with a Black Box Warning acknowledging you were taking your life into your own hands and you'd hold harmless and release anyone who dispensed it to you from lifetime imprisonment. Very few docs would prescribe it, and you more or less had to step into a dark alley, whisper a password, and someone would usher you onto what loosely appeared to be the set of Tim Robbins' 1990 movie, Jacob's Ladder, for your "procedure." (Keep up; we're gonna go fast now.)
This year was my first time at-bat with a relatively new FDA-approved entry called SuTabs. I didn't have to cross any northern or southern borders to buy it, I just picked it up at the usual drive-thru window. No one asked me for a password (I had just watched the premiere of this season's Handmaid's Tale, so I felt ready).
Now that the whole ordeal is behind me (so to speak), I hesitate to say, Ask for It By Name (mostly because no one's paying me to say that), but sure, go ahead, Ask For It By Name. I strongly suspect it will improve people's willingness to take the test, and maybe save a few lives along the way. (It's the least I can do.) Because while no one in their right mind wants to hold their nose and choke down gallons of rapidly ossifying liquid chalk, almost no one minds taking a few handfuls of pills these days; in some circles, it's probably encouraged. This should in no way be confused with medical advice, obviously. Consult your health care professional. They'll probably say it's fine. If they don't, it's probably better to listen to them instead of me.
Even with the tablets, you'll still have to prep, but instead of drinking several gallons of the devil's own concoction of salty lime efflent, you'll just swallow a few dozen pills, and a positively unwholesome waterboarding amount of water.
I am not one to ever engage in (or be amused by) Farrelly Brothers scatological humor, so I'll do my best to skirt the periphery of this whole process with the delicate decorum my mother raised me to display, while still giving you all the necessary information that your doctor, nurse, and pharmacist won't bother with.
ACT I: Shop
First, you're going to need to go shopping. You'll need supplies for a week or less to get you through the home stretch, to include:
- Lemon Sorbet (get Jeni's, or Graeter's, or any comparable "luxury" brand; anything that costs over $10 should be acceptable. If it costs less than that, odds are 50/50 it will taste like Lysol, and that's what you get for not listening; God knows we're all living on a budget these days, but THIS is not the time to economize).
- Watermelon Jolly Ranchers (green or yellow are acceptable; reds, purples, and oranges are not. I don't make the rules.)
- Lemonhead candies
- Instant cups of Grits (if you're in the south) or maybe Cream of Wheat if you live in the... (I'm not sure where you people live? Minnesota?)
- Could you just buy the instant packets? you ask. Yeah. Sure. You could. But why do you want to make your life hard? Who hurt you?
- Outshine Lime Frozen Fruit Bars (no, you may not have the tangerine; well, you can, but later. Right now stick to lemon and lime.
- Assorted Noodles (Ramen etc)
- JellO, Green or Yellow (do NOT get the sugar-free kind; you've had sugar-free gummy bears?)
- Kids' Snack Packs of diced peaches
- Avocados
- Bananas
- Eggs
- Assorted broths (clear only)
- Assorted citrus for your noodles and broth: lemons, limes, ginger to grate, etc.
- Assorted hot teas (no red, purple, or orange)
- Assorted cold drinks (ginger ale, sprite, and if you can stomach them, sports drinks — greens and yellows only, no purples or reds or oranges)
- Powdered lemonades if you like them (I do not).
- Clear juices if you like them, like apple or white grape (I do not).
- A sizeable supply of your preferred bottled water (trust me: your Brita is never gonna keep up with this level of volume). I recommend Voss or Evian, both in glass bottles (obviously). If you're going to drink out of plastic, you might as well just lap it up out of your dog's dish.
And, in the baby aisle:
- fancy hypoallergenic aloe baby wipes with vitamin E (take them home, and put them straight in the fridge in a bottom drawer nobody ever uses. Don't ask questions, just do it.)
Now, under normal circumstances, no medical professional would ever advise you to live on white foods, but for a few days or so prior to your test, you'll do exactly that: chicken, turkey, fish, rice, pasta, potatoes, bananas, light soups (chicken noodle, egg drop, etc). Hopefully you're not diabetic. If you weren't before, you might be after this. (Don't ever eat a white-diet without first consulting a doctor, or at least your crossfit guy or yoga instructor.) If you don't want to cook or don't like to cook: DoorDash accordingly. (Although I had one rough evening with Dasher Mutraza who forgot my dinner, but DID deliver the sorbet. So you should allow extra time for errors.)
ACT II: Five Days Out
Begin your white-diet a few days out — I managed about five days. That's a week without my daily brussels sprouts, my broccolini, my steel-cut oats, my nightly bedtime honeycrisp apple ritual with Ambien Walrus, my special cannelini and radish salad — all the food routines I hold dear. It's counter-intuitive, but you're getting all the fiber OUT of your system during this horrible perversion of a cleanse.
I mostly subsisted on fish, sushi, soups, potatoes, bananas, and avocados.
This phase was hard for me because I eat a LOT of plants on any given day; your mileage may vary.
ACT III: 48 Hours Out
Stretch your restriction muscles a little. Instead of chicken, for example, just have noodle soup. Have eggs maybe, but skip your usual whole grain toast. Sub in a nice low-residue English muffin.
Have a banana. Do not have a salad... or a steak... or a porkchop.
When the men in my family go for any prescribed medical procedure, they eat steadily until precisely one minute before the prescribed midnight deadline. At 11 pm, they’re firing up the grill. I accompanied my uncle to his last procedure, and the nurse was trying to determine when he had finished his last meal. He’s hard of hearing and couldn’t quite make out all the questions through the masks. “THEY WANT TO KNOW WHEN YOU STOPPED EATING,” I helpfully shouted into his left ear. He looked at me like he was embarrassed to be genetically related to someone so simple-minded, and clipped out loudly and slowly as if to accommodate my dimwittedness, “I SAID… WHEN… I … WAS…FULL.”
ACT IV: Prep Day
You're coming into the Home Stretch.
Granted, you're going to spend the entire day strung out on clear liquids and pills, and no one's even going to offer you a record deal or a new cautionary Hulu series at the end of it, so it's not going to be great.
You're going to be happy you shopped though. You can make a lot of courses out of clear liquids if you're desperate: broth for lunch, jello for your salad, and sorbet for dessert. See? Later you can have a PediaLyte popsicle or a Lime Outshine Bar for a snack.
Delicately speaking, sure, you will be making a few extra trips to the bathroom over the course of the evening. But because you've observed the white-food cleanse, you shouldn't need to set up camp. It'll be just you and your aforementioned impeccably chilled aloe wipes.
ACT V: The Last 100 yards (literally)
A word of advice: even if you're not a morning person, always try to be the first procedure of the day. From the first procedure on, they will be running behind, and it gets worse with every single case as the day progresses. Worse, you don't want medical professionals at their most tired and cranky when they get to you.
Get in.
Get out.
For the same reason: try not to schedule Monday procedures. What are the odds that everyone on that team has fully recovered from the weekend and is happy, clear-eyed, and delighted to be shoulder-deep in guts?
Don't schedule on Fridays either. If there's going to be a complication (God forbid), it's going to happen in the first 24 hours — after everyone has gone home. Your regular doctor has gone home. Everyone in the scope center has gone home. And the ERs are filled with drunks and GSWs on the weekend. Your little complication may seem significant to you, but it's no match for a gunshot wound when it comes to triage.
Get in and out on Tuesday, Wednesday, or Thursday, and go early.
You'll go in, you'll get undressed, toss on a robe, do a semi-thorough history with a nurse who'll pop in an IV and then somebody will wheel you back to "the Suite." (If you are not early, you will sit on the gurney, lightly gowned, for two to three hours.)
The GI guy or gal and the anesthesiologist will introduce themselves, and then you'll go on a little "trip” you won’t remember, to a place you never wanted to go.
Scope results will be provided to the responsible driver you brought with you.
You will be too high to know or care what the medical professionals are saying.
You should choose a Driver who’s a Luddite with a flip phone, who’s both unable and disinclined to film you.
ACT VI: Speaking of Recovery
A word about propofol.
Many patients rave about it — "so light," "so refreshing."
I was not a fan, and do not see the recreational appeal.
I haven't ever been roofied (as far as I know), but I think it feels a little like this.
All I know is I woke up with a dull, throbbing headache that lasted all night, and a vague sense of unease that something bad had happened....but that I should remember it wasn't my fault. That I did nothing wrong.
