"The Hard Part"

THE HARD PART

AUGUST 2013

On the Wednesday I faced the actual procedure—the day my doctor planned to navigate a small camera through my colon as I lay half-naked on my side, an intravenous needle in my left arm, my brain swimming in chemicals—the two nurses in the operating room informed me that the hard part was already over.

And they were right.

On the previous day, my diet had been restricted to fluids only. After my morning coffee, I had eyed the clock on my kitchen wall until the prescribed hour of noon, when I swallowed a pair of Dulcolax laxative tablets with two full glasses of water, then followed up with another Dulcolax duo and two more glasses of water an hour later. Then I had proceeded to wait.

The instructions had said that the laxatives would prompt me to have a bowel movement in one to six hours, at which time I was to begin consuming a second round of laxatives. I was to drink a half-gallon of a blandly sweet concoction called the Half-Lytely Bowel Prep Kit. Cherry flavored. In the same way that cherry-flavored mineral water tastes like real cherries. I was to drink eight to ten ounces of the stuff every ten minutes until it was gone.

You do the math.

During this drinking spree, I was allowed to consume only clear liquids, nothing with any color and nothing that was not in liquid form.

I chose 7-Up, with which I chased my doses of Half-Lytely, hoping that the carbonation would cut through some of the Half-Lytely’s tongue-coating, wince-inducing nourishment. I swigged the soda, even though my stomach was swelling tight as the head of a snare drum, even though I craved solid foods instead, and even though my intestinal tract was gurgling loudly and churning painfully.

And when the laxatives cumulatively kicked in, I shambled to the toilet about every 20 minutes for about three hours to noisily and very wetly evacuate my bowels … until I feared I had nothing left to give. At about 11 p.m., I collapsed wearily onto my bed and slept almost immediately, waking at 6 a.m. and thinking of food I could not eat and liquids I was not allowed to drink until after my procedure, which was scheduled for noon.

It was a strange thing, being induced to empty my digestive passageway and then talk about it with a note-taking nurse while a needle-wielding nurse stabbed my arm for the I.V. It was strange, too, to be told to remove my pants and underpants, to leave on my socks and t-shirt, and to lie beneath one thin blanket on a wheeled hospital bed.

I don’t remember much after the sedative entered my bloodstream. I was told later that I had been cooperative and seemed as comfortable as one can be while being probed in such a manner. I don’t recall the entrance of the doctor. I just remember waking up, rolling from my side onto my back, having a nurse remove the I.V. needle and cover the hole in my arm with a small piece of white tape, and seeing the doctor return to report to me once I’d pulled my pants back on and dropped gently onto a chair next to the bed.

My doctor said that, overall, everything looked good, but that he did find some diverticula and one polyp, which he said was about a centimeter in diameter and had been removed and would be sent off to a pathologist to check for cancer. Finding that polyp, he said, was why procedures like this colonoscopy were done in the first place.

I have a family history—my father had prostate cancer and severe diverticulosis; my mother had diverticulitis. I am 55, and my age made it incumbent upon me to be screened for such problems in myself.

The pathology report a few days later was okay but not perfect. Patients with sparkly clean colons can placed on a screening schedule for every seven to ten years. Patients with polyps—even one like mine, which was precancerous and in a very early stage but too big to ignore—must accelerate their return trips to the Half-Lytely Bar & Grill. I’ll need to repeat the procedure in only three to five years.

I know I should be grateful for the knowledge I gained and the care of my physician. And I am.

But “bowel prep” is a miserable experience, and so my gratitude is tempered. In three to five years, I’ll once again await a procedure that virtually no one wishes to undergo but which truly arrives after the hard part is already over.