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Mon, Jul. 20th, 2009, 08:08 pm
Trauma: My Life in the OR

This entire next post is devoted entirely to the medical procedure I just had done (a colonoscopy and upper GI series), so if you are easily grossed out or simply find this stuff distasteful, STOP READING NOW. Why am I posting this for all to read? Well, it was helpful to read everyone else's colonoscopy accounts prior to my own, so I figure this is one more account to add to the general pool of knowledge. That and I seem to have no sense of shame or embarrassment.

I had many apprehensions about my doctor before I ever went through the procedure. First off, I'm leary of every doctor that excepts DC's free medical care for low-income people (i.e. Alliance network) until I get to know them. Doctors who take low-income people either a)really care about their work, or b)suck. Then again, it's not like I had any choice at all about my doctor. You go to whomever they tell you to see.

The initial consultation did not allay any fears. No one likes to admit where they are prejudicial or stereotyping someone else, but to be quite honest, when he walked into the room all I could think was, "oh no, it's a Zulu fucking WARRIOR". My GI doctor is a VERY tall, VERY big, and VERY African guy. Like, scary big, if he ever decides to quit being a doctor he could be a bouncer instead. Tall enough to almost be a basketball player but shoulders are a little too broad. The kind of huge guy where you worry he's going to do something awful to you if you piss him off. That said, I already knew DrZulu was going to do something awful, in fact, he informed me after the consultation that there was 100% chance of him shoving something up my ass(a camera).

Turns out my doctor is a really good doctor, and heck, he's probably really nice if I ever got a chance to talk to him, which will never happen because he is also a very busy and very rushed doctor. He gave me a prep sheet but didn't have time to explain the colonoscopy, but that's okay since I have Google and some medical background.

I don't know why I even had this strange, irrational fear of being molested while under sedation. I had this even before I met the doctor and I can't imagine being molested while under sedation is any worse than being sodomized by a camera under sedation. What's a little touchy-feely compared to the certainty of an anal probe? Yet I was retardedly relieved when I realized, upon being wheeled into the operating room, that of course you aren't going to be anywhere near alone with one person under sedation. There HAVE to be nurses and attendants, something I should've known right off if my stupid irrational fear had let me think about it for a second.

Before we get into the details of surgery, however, we need to backtrack to the night before, the horrific preparation stage involving a full gallon of GoLyteLy. DrZulu didn't give me any tips for getting it down (something I also discovered at the last minute via Internet, when I found I was UNABLE to keep it down at the very first glass). GoLytely is nothing more than saltwater (to keep your electrolytes balanced) and polyethylene glycol, used as a laxative. It's also used in things like paint and possibly antifreeze. Most people complain about the salty taste, but that part was easy for me. Unfortunately, I could both taste AND smell the horrible chemical-ness, which I likened to hot rubber or asphalt.

Every single glass, from the first 8 oz., I'd start to chug like directed, and by the second or third gulp my gag reflex would vomit a little of this stuff back into my mouth, and then I'd force myself to reswallow it and finish chugging the glass. Some of the websites suggested Crystal Light being added (even though you aren't supposed to add flavorings) but I can't have sweetener anyway. Finally developed a system of 1) numb tongue and tastebuds with ice cube, 2) hold breath, 3) lick lemon slice, 4) glug, start to gag, reswallow GoLytely vomit in back of throat, glug rest of glass, 5) wash out mouth with ginger ale and hold crushed mint under nose (because I could smell the chemical vapors coming back up my throat through my sinuses). Then sit on toilet for 10 minutes (while your innards come out), flush, and go get another glass of evil from the fridge. I feel bad for my apartment neighbors, who must have thought the plumbing was broken with the toilet flushing every 5-10 minutes for about 6 hours.

You are supposed to finish a gallon in 3-4 hours. In 5 hours, I made it through 3 liters and then started to vomit uncontrollably. I was not able to finish the solution no matter how hard I tried, even after waiting 30 minutes and trying again. Thankfully, it was still enough to be effective.

My final comments on this evil substance: "Waterboarding is nothing, if you want to torture someone make them do a GoLytely colonoscopy prep."

Colonoscopies are performed under what is known as 'conscious sedation' meaning you are supposed to be in-and-out of consciousness but you aren't supposed to remember anything. That also didn't happen. Waking up during the operation? Absolutely not fun.

Here's what I remember:
The nurse gives me drugs through the IV in my hand. Everything gets all warm and fuzzy, but I'm vaguely aware of the insertion and a crampy gas feeling in my abdomen. This is due to the fact that they pump gas into your colon to expand it for a better view. The doctor tells me I need to pass gas to relieve the sensation, while a nurse tries to tell me it's okay, it's a natural function etc.

I replied distantly, "I can't" which was true at the time, immediately after which I pass gas and the crampy sensation goes away. Then I lose consciousness.

I awoke, if that's what you call it because my eyes may or may not have already been open, and I'm looking at the colonscopy screen, watching him move around my insides. He's removing a huge polyp on the screen. My first thought is, "hey, that's really cool" and a moment later I realize it also, really, REALLY HURTS. Everything on the Internet says you can't feel a polypectomy because there aren't any nerves in your colon. THEY LIE. I realize there is this high-pitched whining sound, like a puppy crying, and I realize it's coming from my mouth but I can't stop it. I'd be screaming but I can't make my mouth open. I'm also in incredible pain because, damnit, he can't seem to get the loop properly around the polyp, it keeps slipping out, and every time it did I felt something stab me somewhere. The nurse runs up to my head and starts stroking my hair, "you're doing great, you're okay". I almost cry now thinking about how wonderful it was to hear at the time, and how kind, and if I find out who that was I'd like to thank her personally.

Right after that, I hear the doctor tell the nurse to "give me more (something garbled)" and the nurse looks up and goes "Really?" in this amazed voice. He replies "yeah, (garbled)" and she gives me more drugs and it got hazy again.

Next thing I remember, my eyes are closed but someone is putting a plastic thing in my mouth and telling me to bite on it. The doctor says, "if you have to drool, don't swallow, just let it run on the pillow". I assume it's some device to keep my mouth open so I don't chomp down on a camera. I never actually felt the camera go down my throat, but I guess it did because a second later the plastic bit was being removed.

The doctor says something about having removed two polyps (I only remember one) and that he wants to speak to me before I leave. I thought he was talking to me, but I wasn't actually supposed to be conscious at this stage. He was actually telling the nurse.

I vaguely remember being wheeled into the recovery room. I was struggling and thrashing, like trying to wake up from a bad nightmare. I couldn't get any words out although I know I was moving around. I stopped struggling for a few minutes and tried to compose myself. Then I started strugging again, and was able to get out, "the doctor said he wanted to talk to me before I left". The recovery nurse was not expecting me to be talking (or even vaguely awake at this stage), she actually said, "wow, you remember things!?"

She asked me if she could get me something to drink and I asked for apple juice. I drank two little cups, then she asked me if I was ready to get dressed. She helped me stand and walked me to the bathroom with my clothes and told me, "you must be really strong inside, they gave you alot of medicine". It took me a long time to get dressed (she checked on me once but I was fine, just slow), and I used the bathroom and was alright to leave.

The doctor came by to talk to me, and as soon as I saw him I asked, "you said you removed 2 polyps, right". "Yes," he said, then seemed to mutter to himself, "you're probably not going to remember any of this conversation," and then showed me the pictures of my polyps. I pointed at one and said, "that's a big one, that's the one I remember waking up for. I don't remember the other one." He told me they'd have to biopsy the polyps and that they didn't find any ulcers or anything else, and gave me a paper with a follow-up appointment for the biopsy results and his phone number, because I honestly believe he didn't think I was going to remember ANY of the post-operative discussion.

According to the paper, they gave me a total of 175 mcg. of Fentanyl and 8mg. of Versed. (I weigh about 130lbs.) This is apparently quite a bit.

I also recieved a prescription for some hydrocortisone suppositories, because the smaller polyp was really close to my rectum and probably where all that scary blood in my stool was coming from (not hemmorhoids as previously suspected). AgtOrange drove me to CVS when we discovered they cost less than $20, rather than wait all day feeling like crap at the free pharmacy. I proceeded to puke apple juice in the CVS parking lot (in broad daylight), by the wall of the handicapped space. For some reason, in my state, I figured it was better to puke in the handicapped space because less people used it. No one yelled or made fun of me, possibly because I was still wearing hospital bracelets on both wrists.

AgtOrange turned away. "Nothing to see here," he joked, and then turning back to me, "it even smells like apple juice." Which it had to have, because there was literally nothing else in my entire digestive tract.

Suppositories, by the way, are gross. I've been using the ingenious method of Q-tips to insert them, because I have no desire to stick my finger up my butt. Not long after, however, they give you a feeling like you have to go, and when you do go (you're supposed to hold hydrocortisone for an hour if possible, so you can absorb the medicine) it's like crapping grease... which doesn't flush well. And it re-solidifies once it hits the cold water in the toilet. Now I'm afraid of flushing all that liquid grease and then having it solidify in the pipes and clog the drains. I have nightmares about having to explain to the maintenance man just how all that 'grease' got into the toilet. Maybe I can point him towards my blog.

So that's what happened. Hope you aren't completely and totally grossed out my now, but if you are, DON'T SAY I DIDN'T WARN YOU. It's another week before my biopsy results come in, and I'm starting to get a little worried. I also found out that when they do find a polyp, they recommend a second colonoscopy in another year, which I'm not sure I can go through again.

My lower abdomen still hurts, by the way, almost as if I didn't have the procedure. I'm hoping that goes away if I give it a little time to heal. If not, I'll let the doctor know during my follow up.