“But I hate anything that tastes like fake cherries.”
“Oh, it’s not so bad,” the pharmacy clerk replies casually, placing a flavor packet, marked Go-Lytely (go lightly?) and an empty gallon jug on the counter.
“When my doctor said I had to drink lots of liquid prior to the colonoscopy I had no idea it was – well – this much. That’s a gallon! What do I do with the leftovers?”
“You have to drink the whole thing.”
Very funny, mister. It’s hard, but I resist sprinting past the Trojan Magnums, down the analgesics aisle, and around the hemorrhoid preparations to a Halloween-sized bag of mini Snickers, for my own version of stress relief.
“You aware of any drownings associated with this prep?” I say sarcastically.
“Oh you won’t have time for that, you’ll be too busy running to the bathroom.” He slaps his hand on the countertop, amused with himself.
“Sounds like I need to move my TV and six months’ accumulation of New Yorkers into my bathroom.”
“It’s not so bad. You’ll be fine.”
“You say that like someone who hasn’t had the pleasure of self-inducing diarrhea. So how did it go for you?”
“Hmm, haven’t reached the magic age of 50 yet.” He rolls his eyes, looking like he might skip that decade. I don’t bother to tell him I passed 50 ten years ago. “Seriously,” he adds, “you have to do it, you know.”
I slide my credit card through the slot on the terminal, thinking about the irony of paying for pain. I need to have a screening colonoscopy, an analysis of the last five of the twenty-seven feet (give or take) of squiggly intestines stacked like sausages in my abdominal cavity. I have to know if I have foreigners growing, like polyps, cancer, or perhaps roots from the seeds of the jalepenos I pile on my nachos.
I’ve been dreading it all week – longer, if I’m honest. “Sorry, Dr. Murphy, can’t do next Wednesday, my dog has to have his teeth cleaned and his anal sacs expressed. Not going to work the following Thursday either; I have five root canals. Actually, I’m tied up from 8 to 6 Monday through Saturday for the next year or two.”
“Look,” Dr. Murphy had said impatiently. “Even though you show no symptoms of colon disease, we need to see how you look inside. Think of it like a smog check for your car, a simple diagnostic test from which we gain valuable baseline data. No escaping it.
Back home, I open the instructions and start reading: STOP ALL ANTI-INFLAMMATORIES one week before your procedure. CLEAR LIQUIDS ONLY, for 24 hours before beginning the prep. Yes! I can still have my gin and tonic! I read on. NO ALCOHOL. But it’s clear, I protest. Okay, clear liquids only, no alcohol. Lemon Jello? I gave up Jello when my mother blended it with Cool Whip, poured it over a graham cracker crust in the bottom of a spring form pan, and pronounced her creation a cheesecake.
My appointment is on Thursday, so at midnight Tuesday I have to stop eating solid foods. I stock up on little cups of Jello and vitamin drinks. I wake up Wednesday morning to lemon Jello while my husband crunches his way through a bowl of granola piled high with blueberries and plump strawberries. He doesn’t look in the least bit apologetic as he sprinkles the mix with my favorite, whole toasted almonds. Over the course of the morning I eat several cups of strawberry Jello and drink a couple of bottles of purple vitamin water. Then I reread the instructions. The only thing I have swallowed, besides water, that I can see through is the lemon Jello – and that was kind of murky. Panicked, I call the advice nurse.
“How do you feel?”
I lie. “I’m coping.” The thought of having to start all over is filling my stomach with knots.
“You don’t sound like you’re coping, you sound worried. What’s happening?
“You know where it says in the instructions to drink only liquids you can see through – I didn’t do that – I ate strawberry Jello and drank purple vitamin water.”
“You’ll be fine. Just don’t eat or drink one more thing you can’t see through.”
I resist making a joke about clear plastic wrap. At least I would have something to chew.
Instructions advise me to start drinking Go-Lytley in the early afternoon, so my system settles down before I go to bed. I read somewhere that my stomach is about the size of my balled-up fist. I look at the jug – I look down at my stomach.
I look back at the jug.
“You’re gonna make me miserable, aren’t you?”
Do I have to do this? Yes, you have to do this. Okay. I have to do this.
NO. I CAN’T!” I shout at the jug.
I call the advice nurse again.
“Honey,” she says, sympathetically, “this is really upsetting you, isn’t it?”
“I’m not very good at this kind of thing. I’m looking at this jug of laxative” – I don’t tell her I am talking to it – “and I see hours of misery and cramping. I know it is for a good cause and all, but can I just gripe about it for awhile?”
“Go ahead, let me have it.”
“Isn’t there a simpler way to do this? Couldn’t my doctor wave some kind of a gizmo over my abdomen, ferret out abnormalities that way? What about those tiny cameras people swallow? Popping a handful of those would be way easier than sloshing my way through this gallon of phony cherry drink.”
I hear a smile in her voice. “Those cameras are effective in the small intestine only. Although some gastroenterologists are doing virtual colonoscopies, the method your doctor prescribed is still the preferred way. With either approach, you still have to be cleaned out on the inside.”
“So when was the last time you had to do this and how’d you get all that liquid in your stomach without hurling into the kitchen sink before it reached your colon?”
“I drank it as fast as I could.”
“You and my husband. It took him 44 minutes.”
After what felt like a long silence, she said, with awe in her voice, “Forty-four minutes, and he timed it?”
“That’s my honey. He has a thing about efficiency. Once an industrial engineer, always an…”
She interrupted, “You’re making this harder than it has to be, sweetie. Besides, you won’t have to repeat it for another ten years unless they find polyps and your doctor decides to follow you at five-year intervals.”
“I’m hoping for the ten-year recheck. It’ll take five to forget today.”
I fill the jug with water, mix in the “elixir of cherry,” stick my nose into the container and take a whiff. I pinch my nostrils with one hand, figuring if I can’t smell it, I can’t taste it. Since I have to do this, I might as well pretend it’s a “mocktail.” I fill my favorite crystal martini glass – the big one – to the top. I look forlornly at the jug. It’s still so full. Having cut off air to my nasal passages I can’t taste the cherry, but I do taste something like seawater. With no reconstituted sea horses writhing in my martini glass, nor plankton circling my teeth, I swallow. Quickly, I take another glassful but this time my stomach revolts.
Wait a minute, sista! What are you trying to do to us down here?
“If I listen to you, we’ll be at this till next Sunday. My appointment is tomorrow morning. I must be all pretty and pink inside or I’m going to have to do this again, so shut up!”
I get a lot of reading done.
“Roll onto your left side, bend your knees,” my doctor instructs. “I’m going to insert a flexible colonoscope all the way into your large intestine.”
“I’m warning you. No wrong turns, I have a quick gag reflex.” He looks at me like I must be crazy.
“As I slowly withdraw the colonoscope, I will examine the lining of your bowel. The combination of a painkiller and light sedative should eliminate any discomfort. You can watch the procedure on the monitor if you want.”
I watch the inside of my gut; it’s comparable to watching grass grow. I fall asleep wondering why nobody said a word about the smiley face sticker I plastered on my butt.
“Nothing abnormal. You look great.”
“Tell me Doc, how was my prep? Did I do a good job?”
“You deserve an award. No cleaner tract have I ever seen. Not only did I get good pictures of the inside of your gut, I got one of the smiley face, too.” He grins, patting me on the shoulder. “Remember what I told you about the air?”
“Not exactly. What about the air?”
“To get a better view of the lining of your colon, I inflated it with carbon dioxide gas. You might notice some discomfort, but it’ll pass. Most people don’t suffer much.”
“Can I make it to my friend’s car without embarrassing myself?”
“Oh, sure,” he replies confidently. “You’re not likely to leave a trail of post colonoscopy-bombs on your way out. It takes longer than that, usually. But when your body decides to cut loose, you won’t have much control. No elaborate social plans for the evening. Front row seats at the symphony – not a good idea.”
I feel a little dizzy. Now I understand why someone has to take me home after the procedure. The after-effects of the sedative and the sense that I swallowed a hot air balloon that could carry me over the Napa Valley would have distracted my driving. Regardless of what Dr. Murphy said, I feel like I’m heading for some kind of an eruption and I hope I can make it home without blowing a hole in my favorite pair of blue jeans.
As I board the hospital elevator with my friend Terri, the bloating gets worse. I manage until we get to the fourth floor, when the exchange of people getting on and off the elevator takes an exceptionally long time. My discomfort is becoming unbearable. At the third floor my anxiety skyrockets as a woman with a massive “It’s A Girl” bouquet fumbles with her squeaky pink and white balloons, one getting caught in the closing doors. By the second floor I am near panic, consider getting off to take the stairs, but scare myself into staying, fearful that security will be called as reports of an explosion in the stairwell instigate a hospital-wide evacuation. I tighten every muscle in my body.
“Come on, sphincter, don’t fail me now,” I implore.
“You talking to your sphincter?” Terri asks, incredulously.
“I’m begging my sphincter.”
She giggles. I don’t dare move a body part. My cheeks, the ones on my face, are hot and red. The others are doing their best, but it may not be good enough. Terri is having a field day.
“I once read about a vet smoking a cigarette while working on a cow,” she whispers. “The cow farted. After the explosion the barn burned to the ground.” She laughs. I stiffen.
At the second floor, visitors and patients get off, replaced by hospital personnel: a lab technician balancing a tray of blood vials, a hospital administrator-type in rolled up shirtsleeves and tie, and a nursing assistant in a daisy print scrub top, looking too cheerful.
“I—can’t—hold—it—anymore—Terri, I’ve got to say something, give these people a warning.” She sidesteps her way to the opposite corner.
“Folks, I just had…” KAWAMIE BAMMY! What escapes my body is a sound I didn’t know I could make. If I were a twelve-year-old boy, I would win the farting competition, go down in neighborhood lore as the one to beat. Thankfully it doesn’t smell, but I swear it jiggles the vials of blood. Beyond embarrassed, I attempt to explain. “I just had a …”
“Colonoscopy,” the technician says, steadying his tray of vials.
Smiling, the nursing assistant says, “Not to worry, nobody got hurt.”
The administrator sighs. “Me, I’m so used to hot air, I didn’t even notice.”
Author’s Comment: “Smog Check” started one evening when for some reason or other I was reflecting on colonoscopies. I know, I know, not something most people want to think about. It occurred to my health educator self that writing this might be of benefit to others anticipating the test or having gone through it. I was careful to keep the piece medically accurate. Although I wasn’t particularly amused while downing sixteen cups of disgusting cherry flavored liquid I was surprised at the humor I found in the experience – later.