Melvin & Me, Part 26: Colonoscopy with a Colostomy

It's that time again, where I'm gearing up for another colonoscopy.  I'm supposed to have one every other year, since with my Crohn's I have a higher propensity to colon cancer than your average bear.  Parts of me don't mind--this one I'm particularly looking forward to so that my doctor and I can really see how my body is doing since my colostomy surgery.  But, the prep is going to be the same frustrating mix of ugh and misery regardless.

For those unfamiliar with colonsocopy as a whole, I would refer you back to this blog post, which outlines the basics from the last time I had one.

Here's what's different--this is my first colonoscopy I've had with an ostomy.  I have no anus to put the camera up anymore; my rectum is permanently sealed.  EVERYTHING comes out of the ostomy.  So how can I even have a colonoscopy?

Whelp, I still have a colon (albeit three fifths of one) and it still needs checking.  The exit may have moved, but the process is otherwise the same.  Rather than laying on my side to allow the team to access my butt, I think I'll be laying on my stomach, exposing Melvin by either taking off the entire bag unit or removing the bag from the flange--this hasn't been made specifically clear, even though I've asked a couple of folks.

Unfortunately, the process if very familiar, but in the same breath, everything is different now.  My prep this time is a whole bottle of Miralax and some Ducolax tablets and as much clear liquid (nothing with red or purple dyes) as I can suck down.  The day before is a purely clear liquid diet, which means I reserve the right to be hungry and cranky in my basement, with exclusive rights to the bathroom and tv.

With the prep process before, when everything was "normal" in terms of typical egress, I had a couple of moments every time to rush to the bathroom, where I felt the heavy rumble settle ominously in my pelvis and new that I needed to find a toilet immediately.  Lots of frantic shuffles to the bathroom.  But I have no sphincter control for Melvin:  everything comes out as it's ready, as peristalsis moves it through my system.  This eliminates the need to run to the bathroom, but the new concerns are A) ensuring that there is not a leak, since this would be a CATASTROPHIC leak and B) emptying the bag frequently.  In some ways, it is more convenient, but still annoying.  The ominous rumble is still there (and general malaise from shedding so much fluid), but I can saunter over to the bathroom to empty out the sloshing bag as I need to.  And my butt isn't chaffed at ALL.  This time, the anxiety has been the unknown rather than urgency.

Here's what else is different:  the truly scarred and angry parts of my colon are gone, the areas that were unyielding and particularly painful, this new reality coupled with my intellectual curiosity means that I have requested to be awake for the procedure.

Other countries do this as the norm--without the anesthesia, you can return back to your day immediately after.  It's more of an uncomfortable pressure than it is a true pain, assuming that you don't have the kinds of problems that I had around my sigmoid colon and rectum.  I have very contently been unconscious for those that were sure to be painful.  But this one, I want to see.  In fact, at Mayos prior to the last connection surgery, we did a mini-scope in the office to check where I had been partially reconnected and I was fine through that process.  I want to talk about things in real-time instead of the pictures afterward.  My doctor recommended that maybe we use some elements to get started, but that she would be fine with me being awake for the end, basically the pulling-out part of the camera where she is also taking the biopsies.  I want to really see how things are looking as they are moving with my breath and my hand against my abdomen pressing down.  These parts of my body that have caused me such anxiety, pain, frustration, and all else, I want to see them for how they are, have compassion for their real face.  Comment on the pseudopolyps (basically pillars of scar tissue), the color of certain spaces, watching it move, I am truly excited about this.

Almost makes the misery of the prep worth it.  Almost.  Well, we'll find out soon enough--I'm heading there early this afternoon.  Just a little more prep to power through yet this morning, with all the nausea and blech that implies.