Colonoscopy – Tips and FAQs

The following post is based on my experience. Since my Crohn’s Diagnosis in 2015 I have undergone 4 colonoscopies and 2 endoscopies. It may seem scary but it isn’t. The prep is worse than the procedure. It does not hurt, but the prep is unpleasant. Here are my tips to help make the prep a little easier.

Colonoscopy

Kate’s Top 4 Tips:

1. Read Instructions and Follow Directions
The instructions are detailed with how you need to structure your diet prior to the prep as well as the timing of each prep drink. This is not the time to wing it, follow it to ensure your bowels are ready for the procedure.

2. Be Prepared
After you start your prep you will not want to leave the house, so ensure you have the following to make prep run a bit smoother (pun intended).
– Easy access to toilet. Ensure you are at home or staying somewhere with a private toilet;
– Clear liquids (and Icy Poles). Ensure you keep your fluids up to stay hydrated as you will be losing a lot of liquid throughout prep;
– Vaseline or Pawpaw cream (start applying it on and around your bum hole before you start prep) Don’t be stingy, lather a generous coat on your anal hole. With the large amount of wiping that will go on over the next 12hours you bum hole may crack or get wiped raw;
– Soft toilet paper/ wet wipes (try and avoid excess wiping to reduce irritation);
– Entertainment (books, magazines, TV shows, movies).

3. Be Comfortable
Wear something old and comfortable. Prior to the procedure they will provide you with a hospital gown and hospital undies (super comfy). Also, be aware… throughout the prep and after the procedure you may experience poo in your undies.

4. Have Someone with You
The gastro will come and debrief you once you have woken up. However, you will still feel a bit sleepy and your brain will not be fully functioning so it is important that your chaperone listens in or take notes on the debrief because chances are you are going to forget 90% of the things you are told.

Colonoscopy

Frequently Asked Questions

What does the prep taste like?
There are a variety of brands for prep. My last prep I used the brand Moviprep. The first sip, probably tastes like a delicious lemonade. This good taste quickly subsides and it becomes a chore.

Do you need to finish it?
Yes. You may want to stop, but it is imperative to finish otherwise the scope may unable to be conducted due to the intestines not being cleared enough. Just think you’ve started you may as well finish otherwise you will have to start all over again at another date. Close your eyes, stay positive and get comfy on that toilet.

How long does it take for the prep to work?
It varies. For me my bowel movements started around 30min after I started drinking. For my sister and friend it took nearly 2hours for their bowels to start moving.
Be patient, it will come and when it does, you’ll know it. Ensure you are in close proximity to a toilet.

When can I return to work?
Consult your doctor. Depending on how you recover/ condition you can return the next day. It is recommended not to drive for 24hours. I would talk to your employer and prepare them that you may be absent the following day. I took two days off. The day before (for prep) and day of the procedure.

When can I return to exercise?
This is very individual and I would consult your doctor. I walked in the afternoon for about 40min before dinner. The next day I went for swim in the afternoon. I didn’t do anything high intensity (running/ weight training) until 36hour after my colonoscopy. By then I had refuelled my body sufficiently and had the energy to workout.

What should I eat after a colonoscopy?
After your procedure they generally provide you with some juice, sandwich and biscuits. My last colonoscopy I was starving, so I ate everything that I was provided (including  4 mini packets of Arnott’s Scotch Fingers, a ham and lettuce sandwich and an orange juice). If you have specific dietary requirements or don’t enjoy hospital food organise with your chaperone to bring you an after colonoscopy snack.

Prep

For further information, please refer to the following links:

https://www.bowelcanceraustralia.org/colonoscopy

https://www.bowelcanceraustralia.org/bowel-preparation-for-colonoscopy

Crohn’s Surgery – What to Expect

My First Time Hospital Experience

This blog post is based on my experience in lead up to and first time in surgery (and staying in hospital).

What: Right Hemi-Colectomy

When: Jan 2016

I’ll start by saying I used to have an extreme fear of needles, blood, doctor surgery’s, medical TV shows, sicknesses, people talking about needs/blood/surgery… oh man it would give me the heeby jeebies. I am not too sure where or when this fear developed, I just know that ever since I can remember I would avoid having needles or going to the doctors like the plague.

In January 2016, I required a Right Colectomy, removing approx. 40cm of my large/small intestine, including the ileocecal valve (along with my appendix). I will never forget hearing “you need urgent surgery”. I felt scared, helpless and upset.

Pre Operation

Living in Far North Queensland, I did not have a chance to meet my Surgeon face to face, however a conference-call with my surgeon (in Brisbane) was arranged with myself, my GP, my dietician. I am so thankful that my GP and dietician were there as my support team during the call.

My top tip for the conference-call is preparation and know what you want out of this initial consultation. For me preparation was writing down notes/ questions before the appointment. I also asked my GP and dietician to capture the important points as I didn’t want to be writing and listening at the same time.

Some of my questions were probably a bit naive or silly to some but I wanted to get everything off my chest. My questions were:

  • Will I need a bag?
  • Will it hurt?
  • How long will it take to heal?
  • Will it be open or keyhole surgery?
  • How long will I be in hospital?
  • When can I go back to work?
  • When can I start exercising again?
  • Will I have uncontrollable bowel movements after the illeocal valve is removed?
  • Will I be deficient in nutrients or struggle to absorb nutrients when you remove the section of intestine?
  • What is the likelihood of needing surgery again?

I also watched a bowel operation on YouTube (yeah, probably not the best idea but I had questions regarding that too).

In hindsight, a lot of my questions were unnecessary. My surgeon was truly incredible, from that first call he made me feel calm and safe. He answered all of my questions (even if some of the questions were a bit silly or irrational) with a sincere educated answer. Plus he said he was training for his first triathlon too so we had instant connection!

Day before Surgery

The day before surgery I had to fast, only consuming clear liquids. At this stage I was pretty much on a liquid diet (living off pumpkin soup and the supplement “Resource Plus”) so I didn’t struggle with not eating. The hunger did set in the morning of my operation.

Day of Surgery

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I made friends with a man schedule to have his bowel removed due to Bowel Cancer, we kept each other company discussing what our post operation meal would be in the waiting room. I was craving pikelets with strawberry jam and his choice was a big steak.

It was my time to go in (another tip: be patient There may be a lot of people in front of you, for me I waited about 4-5hour after arriving at hospital). The nurse gave me two pills to “calm and relax me” (sleeping pills I think). This photo was taken about 15min before I went in (below). I don’t even recall entering the theatre, I remember being outside the theatre doors in the hospital bed with my surgeon and theatre nurses chatting to me about sport and fitness and all of a sudden I was asleep.

Waking up in recovery was the most painful experience I have experienced to date. I wouldn’t even call it waking up as every time I felt conscious I was howling in pain and I believe my nurses kept putting me back under / upping my pain relief. It was all a haze, but I remember the pain.

The next thing I remember was slowly waking up in my hospital room just as my parents and partner were about to leave as it was very late that night. I was drunk on pain relief and I don’t think I made much sense. My parents told me later that I kept saying my lips were dry and making kissing and puckering up my lips. Before I knew it I was out of it again.

The first night was probably was the worst night in hospital. The pain was terrible, and it was my first night ever in hospital so I really didn’t know what to expect.

Before Surgery

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After Surgery

Hospital Experience and Tips

Machines beep.

During my first night the machines went off beeping in my room. This being my first time in hospital I did not know what it was beeping about. It was late at night and I had just fully woken up from surgery. My parents and partner had left so I had no one in the room.  I was very worried as I didn’t know what the beeping meant and I thought it was really serious. It wasn’t serious.

Appreciate the good nurses and provide feedback.

Like everyday life and other careers there are good people and not so good people. Be kind, be patient but expect the same from them. If you have a bad experience or good experience ensure you let the hospital know in the feedback forms. I experienced both amazing nurses but I also experienced a handful of ‘nasty’ nurses.

Pain Relief and Poop.

First of all, you will experience pain. You will need pain relief. I was in a Catch 22 situation where they wanted to wean me off the pain medication so I could have my first bowel movement as the pain meds clog you up. At the end of the day it comes down to your pain threshold. I was trying my absolute best to not keep pressing the pain med buttons. My first bowel movement was about 7 days after surgery.

Urine Trouble. 

I had issues from the beginning with my urine. The first night I had an extreme urge to urinate. The nurse explained I shouldn’t feel the need to urinate, it should just come out as I had a catheter in. I explained that I am holding it in and it is really uncomfortable. She checked the level of my urine and said it was fine and then left. I decided I couldn’t hold onto my bladder anymore and I just let go. I ended up urinating the bed. I called the nurse (which again took longer than one would hope) and explained I wet the bed. She checked my catheter and it had a kink in it. Just what I needed on my first night in hospital.  The nurse and another nurse changed the sheets while I was on it (not something you want when you are in pain).

Another urine tip… If it hurts to urinate (or if your urine smells funky), ask for a urinary tract infection test. Every time I went to urinate I would have to hold my stomach and have the worst pains. And my urine smelt so funky. I thought it was just the pain from the surgery however I had contracted an UTI.

Needles.

I started this post explaining my extreme fear of hospitals / needles. My partner had never seen someone have an anxiety attack until he saw me getting a drip put in me for my first colonoscopy. I can’t really explain what happens but basically I turn into this complete irrational person, turning pale, crying, shaking.

In hospital you will receive needles daily. To prevent blood clots I received heparin. Usually heparin is injected into your stomach so it doesn’t hurt as much however since my stomach was where my operation was I did not want it there, so I had it injected into my legs. I felt like the biggest pin cushion. The heparin needles do sting a bit and they are uncomfortable but it’s better than getting blood clots. The other thing about heparin is that it leaves you with lots of bruises. I had bruises on my legs up to 2 weeks after I left hospital.

I am so proud to say that although needles are still one of my fears, my anxiety attacks are close to none (except for when I receive a drip… they are the worst for me).

Visitors.

I can’t tell you how nice it is to have people visiting you while you are in hospital. Even though on several occasions I was asleep or out of it, it was nice to know someone was there. I was fortunate enough to have my parents and partner visit me every day and my best friend from the Gold Coast drove down to see me a number of times. They say laughter is the best medicine. Unfortunately it is the worst medicine after bowel surgery. Laughter causes a lot of discomfort and pain. Along with laughing; coughing and sneezing also causes a lot of discomfort. To help relieve the discomfort press a pillow on your bowel while sneezing or coughing.

Sleeping.

You will try and sleep a lot. Depending on the pain medication you will sleep for a couple of hours straight or you will be in too much pain to sleep. I dazed in and out of sleep and when I was awake I wasn’t really with it. Despite being not much entertainment for visitors and wanting to just go to sleep without pain, having someone there sitting or within eye sight is more comforting that you would think.

I found lying nearly upright on my back (there was no other option) was what made me feel the most comfortable.

I hope this post provided you with some insight into what to expect for your first hospital experience. It will vary depending on your hospital, medical staff, condition, surgery etc. Stay strong and stay positive.

Stay tuned for my Post Operation Recovery post where I will detail the first few weeks post surgery.