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Gut bacteria , gut flora, microbiome. Bacteria inside the small intestine, concept, representation. 3D illustration. Gut bacteria , gut flora, microbiome. Bacteria inside the small intestine, concept, representation. 3D illustration.

You’ve Got Guts

I’ve spent much of the last year obsessing, freaking out about, and avoiding the inevitable: the ten year anniversary of my first colonoscopy. Although you might think this is a subject better left unspoken of, people seem to actually speak of it at length, perhaps because it’s an experience at once intensely private, and yet universal. At least, the recommendation to HAVE a colonoscopy at 50 and another one every decade after, is universal . I can’t speak to whether compliance with the recommendation is universal, but that’s the ideal. One of my favorite humorists, Dave Barry, wrote an iconic piece about this subject which, if it is not already ensconced in the Smithsonian Museum, certainly should be.

As for anyone who chooses not to comply with the colonoscopy directive, I have one thing to say: I feel you bro (or sis, as the case may be). No one wants someone sticking the equivalent of a fiber optic cable into one’s personal intestines and peeking around. There’s something that just feels invasive about that at the … well… gut level.

But interestingly,  as I can tell you after finally having the  ten-year anniversary of my original first colonscopy today, the actual colonoscopy part is not that bad. Or rather, I assume it’s not that bad. I wouldn’t know because I wasn’t there. I mean, my intestines were there, but my conscious mind was not. My very nice, kind and reassuring doctor put a little vial of something into an IV, and before you know it, I was waking up from a delightful nap  and being told it was all over. I was allowed some time to return to the earth plane, a return made  pleasant by the haze of unreality that enveloped me thanks to the miracle  of legal drugs.

Then I was presented with a very comprehensive typed report on not one but two of my digestive zones, upper  and lower, complete with some rather lovely digital pictures with names like Pylorus, Gastric Fundus, and Splenic Flexure (the three stooges?)  It’s not every day one has the opportunity to view such naked pictures of the inner workings of one’s personal digestive zones.

This is the machinery that keeps us alive, folks.  It’s long and complicated and twisty and usually covered in nasty shit ( I use the term literally).  And yet here I was handed a lovely souvenir album of my doctor’s fantastic voyage through my inner regions, all of which had taken place while I was sleeping. Who knew they could do so much medical investigative work in (what seemed like) a mere five minutes?

But  while the procedure itself was a breeze (mainly starting from the part AFTER the injection of the legal drugs) the process leading UP to the procedure was not. First there was the years’ worth of worry as to whether, and when, to schedule this at all. Then there were the logistics of finding a day and time that worked for everyone: me, my doctor, and the surgery center. Then there was arranging with the pharmacy to order the (expletive deleted) toxic sludge that one is required to drink in order to empty one’s intestines of their usual business so they can be submitted for medical inspection. Last, and the opposite of least, is the task of convincing a kind friend or relative  to take a day out of their life to accompany  one on this almost impossible mission.

Why is it Mission Almost Impossible, you ask? The prep! The prep! As any one who has ever done this will know, the prep leading up to a colonoscopy is  an experience one submits to only because the alternative being held over one’s head is the threat of death. Many of us,  halfway through the prep, may wish we had just  said, “Ah, the heck with it. I’ll take Death for $2000”.

In my case, the prep started out deceptively benign. They have come out with a new colonoscopy prep that is both less voluminous and less rancid than the version from  ten years ago.  I poured a small amount of  a clear liquid into the provided cup, added tap water, and drank what tasted like particularly pungent cough syrup made in a country with no manufacturing supervision laws.  (On the contrary, I am sure this item is manufactured right here in the USA under rigorous scrutiny by the FDA. I’m just saying what it  TASTED like, ie, liquefied dog food  from China adulterated with grape-flavored melamine. Not that I’ve actually ever tasted that).

I took the first dose at 4 PM the day before my procedure. A few hours later, the “fun” (by which I mean, the violent removal of the contents of my entire intestinal tract) began. This was actually not as bad as I had feared. I had stocked up the bathroom with extra soft toilet paper, wet wipes (this is really what you need), Desitin (the diaper rash crème for babies),  and a series of highly irreverent humor books.  These included:

You will not have time to read three complete humor books during your colonoscopy prep. However, if you are, like me, an unrepentant bookaholic, you will seize the occasion to buy books you really want to read but whose level of sardonic raunchiness would be hard to justify under less exigent conditions.

In fact I suggested to the proprietor of our wonderful new bookstore here in Riverside, Cellar Door Books, that  we should put together a  Colonoscopy Prep gift basket including books like this (I could get even raunchier  and include books like:

My gift basket idea could also extend to include allowable treats  and necessities for the colonoscopy preparation day, such as clear hard candies, lemon drops, jello packets, gingerale, desitin, and wet wipes. A veritable cornucopia of culinary and literary delights.

But, dear reader, I digress. The first dose of prep went down pretty well, leaving only a slight residue redolent of rotting hydrocarbons to traumatize my gastropharyngeal  orifices. I also managed to drink the additional two 16 oz bottles of water we were warned to consume within the next hour, with no problem. All went well until it was time to go to bed, with the alarm set for 3 AM when I would get up to take the second dose of Bowel Bulldozer.

However, now I lay me down to sleep: not. As a warning, I should mention that I almost never manage to get all the way to sleep on the first try. I am one of those people (you parents of toddlers will recognize the type) for whom jumping off the edge of the world into the sleep state requires a large warm up (ie, achieving a state of severe exhaustion) followed by several running starts: one to get up and make sure the alarm is turned on, the second to get a drink of water, the third to check the schedule for tomorrow, the fourth to go to the bathroom, the fifth to check Facebook, ok that’s five going on seven. But eventually, I do lie down and go to sleep. Which reminds me of the other book I bought yesterday, Go the F To sleep, which is waiting for the first expectant set of first time generation x or y parents that want to claim it. Be the first to claim this book for yourself, your children or grandchildren  (via the comments section to this blog post) and I will send it to you. Or get it at Cellar Door Books (if you are in Riverside) or else download it yourself from amazon. And prepare to die laughing. Warning: do NOT read this book to actual children under any circumstances, ever. This is a  children’s book for grownups. Because we’ve earned it, we get it, we deserve it, and it has language not suitable for small children, dammit.

(The book has now been won, but here’s another incentive to comment: how many movie and TV show references can you find hidden/embedded in this blog post? There are quite a few. I hope you can find them! Can’t wait to see what you come up with!)

So yes, that  “Go the f to sleep” character is me. Guilty as charged. The child, not the parent. That is me on a regular night.

However,  this was not a regular night. Why was this night different from all other nights? Because I was going to have a colonoscopy in the morning, and I was going to have to get up in an hour and a half to drink another gallon of EPA superfund-strength motor fuel (notice how much worse the prep tastes every time I describe it? Because it was like that).  Every time my head hit the pillow, my nose stopped working.

Yes, my nose.. the part that is supposed to allow air, including oxygen, to enter through holes that God made in my face, and from there by some complicated mechanism I will leave to my medical friends to describe, descend to my lungs. Except that when God was making me He got a little busy (distracted no doubt by my angelic beauty) and forgot to punch one of those holes all the way through my nose. So I have what is called a deviated septum, otherwise known as, I can’t breath through my nose, even on a good day. And this was not a good day. This was a terrible, awful, horrible, very bad, night.

I lay down to sleep, and air stopped coming in through my nose, and I freaked out. I bobbed back up out of bed like one of those 1950’s plastic bobbing birds my dentist used to keep perched on the side of a water glass. I opened my book called”Healing Visualizations: Creating Health through Imagery” and tried reading the parts about breathing difficulties. The book said that if you can’t breathe, you will die. Good to know.

I recorded the breathing visualizations on my iPhone voice recorder, closed my eyes, and played them back while saying “Ommmmm”. It did not work. My nose was still closed, but now I was also berating myself for being neurotic and not sufficiently evolved in the proper New Age way, to solve all my medical problems instantly through self-guided meditation.

I went  online to google “how to unstuff your  nose”. Steam, vaporub, saline nasal spray. I was thinking about which one to use, but I was too anxious about how I was going to die on the colonoscopy table from lack of oxygen, and they were going to have to make one of those trachea holes in my throat, and I would end up on the national news, but not in a good way. What did not help was that I chose that moment to google “colonoscopy horror stories” which led me to web sites written by new age health gurus (most of whom I generally agree with), about how colonoscopies are dangerous, and destroy your gut bacteria, and people have died from them (as was going to happen to me, the next day, after my emergency tracheotomy from having a stuffed up nose). I then amused myself by googling other peoples’ experiences with various brands of bowel prep. I then decided that I might as well take the second dose now rather than waiting an hour till 3 AM since I was clearly not going to sleep anyway.

I also did a few other things, such as clear all the dishes out of the sink (this is a very important piece of the story, and constitutes what we learned in high school English as “foreshadowing”, so pay attention), and started a load of laundry, and cleared off my desk. If I was going to die tomorrow after my emergency tracheotomy from having a stuffy nose, I wanted the authorities who would have to break into my place afterwards to say, “My! Didn’t she have a neat apartment! Laundry done, desk cleared, not a dish in the sink!”  I hoped they would include that part in the news story too.

I took the second dose of bowel prep at 2 AM, which was within  the guidelines of taking it ten to twelve hours after the first dose. My voluminous research on the subject (conducted while being massively neurotic at 2 AM) showed me that the instructions for colonoscopy preparation vary widely from doctor to doctor. My doctor had not told me that I should not eat or drink anything after midnight, but others did. Since I would be having anaesthesia I decided this was a good policy, however, it was after midnight and I was supposed to take Prep number 2 (no pun intended). So I did.

“Just chug it down, woman”, I told myself. “Belly up to the bar”. I was so hungry from not having been allowed anything to eat all day but chicken broth, jello (sooo disgusting, don’t even go there) and ice pops, with a few Jolly Ranchers thrown in (Not red! Not red!) that I was actually looking forward to the prep as a source of something to put into my stomach.

My stomach, however, did not agree. Soon after consuming the prep, I began to feel like a person who really does have a space alien growing inside them, but doesn’t know it, and can’t understand why they  feel this incredible sense of… doom. Meanwhile I was having a very hard time getting even one more sip of water down. This was not good because the prep package was imprinted with dire warnings in bold type about how one MUST consume two additional 16 oz glasses of water within an hour of each dose, or else one’s electrolytes would go off the charts, 911 would be called, and there you would be the next morning, plastered all over the front page of the Press Enterprise  for the whole town to see(and not in a good way).

There was no guarantee they would print the part about my dishes and laundry being done and my desk being cleared, especially if the  newspaper was  running short on space due to having large advertising revenues or stories much more lurid than mine. (In fact the LA Times ONLY prints stories about Riverside that are fit for the National Enquirer, such as the time someone wanted to open a cryogenics storage facility to store people’s cadavers on ice until the technology would be available to bring them back to life through recombinant DNA. Anyone who was in Riverside in the mid-1980’s can attest that I am not making this up.) So it was unlikely that my clean desk and clear sink would make the national news, though my stupidity at having a colonoscopy when I already had a life-threatening deviated septum, probably would.

I kept trying to drink the water. Water is life. Sip. Sip. Tick. Tock. Time was going by VERY slowly. Or was it very fast? I was starving, but bloated. I could not take another sip, but I also felt that if I did not get some real food soon I was going to keel over, and it would not be pretty. I realized I was too old to be doing this kind of thing. I decided that it would be better to just die quietly and forget about it.

And then I threw up.

Never have I felt such a sense of catharsis. Sorry if it’s too much information, but it is my duty, as your correspondent from the annals of everyday life,  to share the darkest, deepest secrets of the colonoscopy experience. And contrary to popular opinion, those darkest deepest secrets are NOT found in the inner recesses of the transverse colon. They are found in barfing your brains out in the sink at 3 AM.

Fortunately  it was a metal sink, and it was empty, (foreshadowing! See?) and everything that came out was pretty much just water. Or rather, toxic sludge water that I was apparently allergic to, because I miraculously started being able to breath through my nose again,and stopped being filled with the sensation of impending doom that comes from not being able to get enough oxygen, as soon as I got done throwing up. Also I no longer felt as if  a tiny mutant alien was getting ready to hatch inside me and burst out through my stomach. Which just goes to show that even  though one may be the neurotic hypochondriacal product of 5000 years of inbreeding (more on that in a moment), that doesn’t mean one couldn’t ALSO be allergic to sulfa which was causing an actual, physiological, allergic reaction.

Fortunately, my body was smarter than I was. While I was busy doing meditation exercises and berating myself for being neurotic, my smart smart body was just saying, “dump this stuff, for Pete’s sake”. Eject, eject.

I could breath through my nose! I no longer felt a sense of  impending doom! I did not spend the night on the toilet reading  humorous descriptions of  other people’s dysfunctional childhoods!

I went to sleep and slept like a baby.

No more prep for me. I am allergic to sulfa, for one thing. I think that sulfa is the main ingredient of this stuff, in some form or another. So perhaps that’s not for me.

One thing I gleaned from scouring the internet  at 2 AM, was that some people have found their own alternatives to the dreaded colonoscopy prep. Some have instead tried using “high colonics” which is a way to have the bowels irrigated with water lavage. It requires no fasting, no drinking of non-consumable substances, and no nights spent reading sardonic humor on the potty. (That one I could go for, actually).  Research has shown it to have a 98% success rate as compared to 95% for the nasty drink version. You just go to the place that does this ( a hygienic, reputable, licensed place, of course), get the bowel bath, and then sprint off to your colonoscopy, where they cover you with warm blankets and give you legal drugs. Almost like going to a day spa.

I am pleased to report that my colon got a glowing bill of health, and my esophagus too. In fact, I had a condition in my esophagus ten years ago, that is not there now. Good job, organic fruits and vegetables! Good job, supplements!

I have not decided if I will do another colonoscopy in my life time or not. First of all, I have to live 10 more years.. which does seem likely, but one never knows. Live or not, I don’t have to THINK about it for another 10 years. Hopefully by that time they will have invented a less invasive but still accurate way to check out our insides. But if they haven’t, the idea of clearing out the colon using natural water, under professional supervision, seems a lot more pleasant than drinking toxic motor sludge derivatives manufactured in a sweat shop in Outer Slobovia, using ingredients imported from the Planet Xenon.

The most important information we all seek from such an inner voyage of exploration, of course, is to know whether we are going to be around for the next colonoscopy in ten more years. Our intestines can easily harbor things that can kill us, and I don’t mean creatures that hatch from inside like in the movie Alien. I mean polyps and tumors and growths, oh my.

I was very relieved to find that my intestines were harboring none of that (and no tiny gestational space aliens either). They were just ordinary, middle-aged-lady intestines doing their job every day. It’s a  job that no one really stops to think about, unless our intestines stop doing it correctly. Oh, THEN they get our attention, alright. Mine have gotten my attention on many past occasions. I have had a  lifelong tendency to be the Princess and the Pea, reacting to ordinary  household items such as onions, wheat and rice. After eating such an offending substance  I feel like I’ve been hit by a truck , hurting all over for no apparent reason, turning into a 95 year old lady overnight. Once I find out what the offending substance is, and eliminate it, I get my 45 years back thank you very much. Onions: just say no.

This is what 5000 years of inbreeding will do to your genes. I’m lucky that there are no actual inherited genetic diseases in my family line.. at least, none that I know of. I know others, from various ethnic groups,  who  are not so lucky.But even so, 5000 years of marrying  your cousins leads to people who look healthy on the outside having weird and subtle conditions that have no name, and that one only discovers after becoming violently ill upon eating the pomegranate crawfish cruditees at a cocktail party. It’s not pretty, my  children. Don’t try this at home. (Disclaimer and Apology: Some of my  best friends have married their cousins, and everyone turned out fine. I am not talking about any PARTICULAR marriage to any SPECIFIC cousins. I am talking about the extended long term practice of marrying one’s cousins for FIVE THOUSAND YEARS. And those of us who have been doing this, know who we are, darlings).

Instead of marrying one’s cousins for 5000 years, a much better strategy is to marry someone else’s cousins (collectively, I mean. No marrying more than one cousin at a time, no matter WHOSE cousins they are). This produces a phenomenon known as hybrid vigor, which is why everyone in Brazil, the most ethnically diverse country on earth, is drop dead gorgeous.  Hybrid vigor works for plants, animals, and humans. It produces healthy digestive systems that allow their owners to eat normal things like onions, tomatoes, and wheat. So go ahead, take a walk on the wild side. Go for it and get that colonoscopy. And marry someone else’s cousin. I dare you.