colonoscopy | it’s that icky prep

Like the upholder that I am, when I turned 50, I obediently had my first colonoscopy.

YUCK. Are we really going to talk about this?

Yes. Because I often invite my clients to reclaim their agency in their health care decisions.

And because everybody poops. And you shouldn’t neglect your guts. (Kudos to you if you caught the somewhat bastardized Pretty Woman reference.)

So I had my first colonoscopy and was told to come back in five years rather than the usual 10 because they removed a (totally innocuous) polyp. And then then pandemic hit exactly at the five-year mark, and I thought, you know what? I’m not sure I really want to go into the hospital just now, so with my doctor’s assent, I postponed it.

And because instead of paying for medical insurance, I belong to a medical cost sharing community that requires me to sign an agreement to live a healthy lifestyle and take care of routine preventive and screening procedures, when the pandemic began to settle down, I decided it was time to face the dreaded colonoscopy a second time.

news on the colonoscopy front

But wait! What’s this?

The good news: there’s a home screening option that can replace a routine/screening colonoscopy? Sign me up.

The bad news? Sadly, not available to everyone just yet. Dang it.

The good news for me, not so much for those who are younger than I am, is that a first colonoscopy is now being recommended at 45 rather than 50. Dodged that bullet. I told you there were a lot of benefits to being my age.

And: it saddens me that the medical profession has discovered yet another way in which we are now potentially unhealthy at a younger age than we used to be.

it’s not the colonoscopy procedure

What’s the big deal, you may be thinking. Yeah, the prep is uncomfortable, but it’s just 24 hours, and the procedure is quick and painless.

And there we have it: it’s not the procedure, it’s the prep.

The first time I did the bowel prep, I was told to drink a gallon of that hideous concoction.

Full disclosure: TMI ahead. What really freaks me out about the cocktail is this: how can I be drinking all this liquid, and yet I have no urge to urinate? Everything comes out a different way? What. The. Hell. There is no way this concoction can be natural nor good for me in any way.

By the way, those questions are rhetorical. I don’t need a lesson on anatomy/pharmacology/chemistry, so please don’t feel like you need to tell me.

it’s that icky colonoscopy prep

For years before I was a health coach, I was already making very healthy food and lifestyle choices, and other than a minimal dose of thyroid replacement hormone, I’m not on any medications. Putting all those synthetic colon-cleansing chemicals in my system just didn’t seem like a great idea.

In addition, the list of restricted foods is crazy-making for anyone who eats a healthy diet: starting two days before your procedure, avoid nuts, seeds, and salads. So long berries and walnuts in the oatmeal, farewell kale and other greens. For someone who eats lots of nuts as snacks and at least one portion of leafy greens a day, that feels like torture.

And Gatorade? Popsicles? Jell-O? Good Lord, I try so desperately to get clients to stop drinking/eating this stuff, it feels criminally hypocritical to even buy it. Those “foods” definitely don’t meet my label-reading criteria for whole foods: five ingredients or less, all pronounceable, all available as single ingredients in a recipe or grocery store. Okay, so apparently polyethylene glycol IS a single ingredient, sort of pronounceable, and available at some grocery stores—but you get the point.

I started wondering, is there a way to game the system?

Please note: I DEFINITELY DO NOT RECOMMEND you try this at home without first consulting your doctor! I’m simply sharing my experience.

I started by considering, how can I clean out my system using mostly natural methods? It struck me that we normally have to fast before a lot of procedures that require anesthesia. After many of these procedures, we’re told to return to our regular diet gradually:

Start with clear liquids.
Move on to puréed foods.
Then introduce soft foods.
Graduate to regular foods.

Depending on how our bowel movements resume, those stages can take hours or days or, in cases of major abdominal surgery, even longer.

So why not do that in reverse? The instructions already tell us to switch to clear liquids 24 hours before the procedure, so why not gradually go from my regular diet to soft foods to puréed foods to clear liquids over the course of a few days? If I could do that, the actual prep would proceed much more quickly and, ahem, smoothly.

Turns out I was right (for me): I was able to quit the prep when I was about 2/3 of the way through because, according to the description of “what things should look like,” I really was done.

And then I had to face a long, dark night of the stomach because I’d been too efficient! The second major lesson learned was to wind down my activity level and commitments in the days before the prep and ramp back up slowly afterwards: I had no idea how how little appetite I would have after the procedure nor that it would take about two days to feel fully normal.

I vaguely remember being told in recovery that I got an A+ on my bowel prep—highly satisfying to the valedictorian in me, I’ll admit. And I’m definitely taking the lessons learned into round two of colonoscopy prep, so wish me luck!

make the connection

I don’t recommend you try this method (or any other one you might find on the internet) at home unless you consult your physician first. My point is that there are ways to reclaim our agency over some of the choices we have in health care: