Colonoscopy

<tl;dr>It wasn’t that bad.</tl;dr>

(These are notes are mostly for myself for next time.)

T – 10+ days: Pick up The Kit.  The kit is a 4L container with GoLytley powder, a flavor packet, and a prescription  ondansetron, an anti-nausea drug that I would cherish later. Out of pocket costs for this: $2.31.  A nurse called to check that I’d done this, reviewed the information packet, and had arranged for someone to take me home on the day of the event.  She proceeded to ask me a bunch of odd questions about pacemakers and other stuff that didn’t apply, then asked if I had any questions.  I could hear a sigh when I responded in the affirmative…

T – 5 days: Last Fiber for a while.  I loaded up on the Mega Super Branny Nuggets with Extra Nuts, Grains and Seeds for breakfast.  Lunch was a melange of cherries, blueberries and strawberries.  Dinner dim sum with garlic steamed green beans for dinner.

T – 4 days: Low fiber diet.  Although there was a short list of allowed and unallowed foods, I found it more helpful to find some menus online and pick out stuff that I thought would be okay enough.  Being told do not eat fiber or red/blue foods made me crave them more.

• B: Rice Crispix (“0 fiber!”), milk and a banana.
• L: Rice Crispix, milk and a banana.   Two meals in a row was a Bad Idea, as I’d bonk later with my body in full WTF mode.
• D: Cheddar bacon cheeseburger with fries.  I can do this!
• Shot of Miralax.

T – 3 days: 

• B: Rice Crispix, milk and a banana.  While zoning out, re-reading the guidelines for the 47th time, I noticed bananas were on the “do not eat” list, which contradicted the menu I found from another hospital.  (N.B. they have small seeds.)
• L: Tuna and cheddar on white sourdough toast.
• D: Eggs, bacon and cheddar on white sourdough toast.
• Shot of Miralax.

T – 2 days: drink a lot of water throughout the day.

• B: Rice Crispix with a can of peaches.
• L: Cheddar slices and a can of pears.
• D: Skipped, as I was feeling bloated.
• Shot of Miralax.

T – 1 days: Clear liquid diet.  The guidelines said I could have a low-fiber breakfast, but I was still bloated from the night before.  I skipped it and kept drinking lots of water and tea.

• 10:00am (ish) – mix Golytley with a gallon of warm water.  Do not use the flavor packet. Shake until it’s totally dissolved and put it in the fridge to chill.
• 10:00am – Clear liquids from here on out.  Tea with sugar is fine, coffee with milk, no.  Since there’s a risk of getting dehydrated later, drink plenty of fluids.
• 16:30 – Begin consuming The Potion.  I found it helpful to fill a bicycle water bottle (~22oz) and add a packet of Crystal Light sugar-free lemonade, serving it with crushed ice (super cold) and a straw.  I was apparently expecting supremely awful, but it wasn’t that bad.  Consuming that much cold fluid made me cold.
• 17:00 By the first bottle, I was feeling nauseous, a possibility they had warned me about.  I took one of the ondansetron tablets, watched an episode of The Expanse, then resumed the regimen.  Half a water bottle later, more nausea and the second ondansetron was popped.  Watched another episode, and resumed.
• 19:00 – 3L consumed.  So much for this starting to work within an hour…
• 20:15 – Thar she blows!  I was glad I had a stack of magazines handy.
• 22:30 – Nappy time.

Day 0:

• 04:15 – Drink another 1L.  Since it took ~3 hours to work its magic, I wanted to get a head start on the last bit.  I sucked this down moderately quickly.
• 07:30 – Thar she blows ][. 
• 09:30 – Arrive for my appointment.  They had three of us in adjacent areas, asking the preliminary questions, taking vitals, and getting me suited up.  Apparently someone else had not adhered to the diet, and was invited back for a second day. Everything was running late.  I would have been totally fine taking a nap at this point, but with other patients in adjacent areas being prepped, I only had ten-minute low-fiber naplets.
• 10:30 – Counted 9,738 dimples in the ceiling tiles.  Nurse set up an IV with fluids. She periodically popped in to answer my random questions and indulged me in a discussion of the sedatives provided (fentanyl and midazolam).  There is a range of comfortable from “aware” to “unaware.”  I opted for unaware.
• 11:30 – Terms and Conditions. The doctor introduced himself and went through his standard spiel on the efficacy (90-95% thorough, which is pretty amazing considering there are a lot of twists and turns), risks, and warning about not driving or entering into any legally binding contracts for the rest of the day.  Having voraciously consumed reputable web sites’ information, I had no questions and was wheeled into Bay 1.  When applying the finger monitor, the nurse thought my hands were too cold and got me a few more blankets (which was super kind).  Fentanyl started and …
• 12:45 – I woke up to a presentation of snack crackers and cranberry juice.  Yes, please!   As soon as I could walk, they let me go home (not driving, obviously) with a very useful information packet summarizing the visit with photos taken at major sites along the defecation superhighway shown above.

They removed a single, small pedunculated tubular adenoma that was benign.  However, I am supposed to return in five years for another.

MSRP was about $4300, insurance price $1600, all of it covered as preventive care.  It’s unclear how much of the return visit will be covered under the same, but I have some time to plan.