Thursday, August 7, 2008

Colonoscopy Through Stoma

My gastro doc uses the Half-lytely bowel prep. It's two liters (1/2 gallon) of water containing an osmotic laxative. It's designed not to dehydrate the user nor to add fluid to the body. So you can drink a gallon without (usually) any hydration issues. The effect is called "colloid osmotic pressure" or Donnan pressure after the famous British chemist Frederick Donnan, FRS.

Yesterday morning, I filled the plastic jug with tap water and mixed it until all the powder had dissolved. I added the lemon-lime flavor packet. The prep kit comes with two bisacodyl tablets (stimulant laxative) which I did not use since I have IBS. My gut needs no prompting to get moving.

I switched to a drainable bag which is absolutely needed since the liquid exits quickly and without warning within an hour or so. I drank one glass of prep every 15 minutes - about 8 glasses total. My bag filled up about ten times - each about 200ml, so the total out is a close match to total in. Ain't science wonderful. After about four hours things calmed down and the bag stayed empty.

This morning I had the colonoscopy. I brought some appliances with me. I was invited to change into the obligatory patient garb. I lay face up and a nurse placed an IV line into a hand vein and began a saline drip. I was wheeled to the endoscopy room where I met my red-headed lady gastro and the anesthesia nurse. The happy juice cocktail was Versed (midalozam) & Demerol (pethidine). Versed is short-acting relaxer and sedative and Demerol is a opioid pain med which sedates. I am pretty sensitive to this combo and it turns me off very well - no memory at all of the procedure - amnesia is common with the cocktail.

I woke up to an offer of juice and cookies. I was still under the influence of the happy juice. The Versed wears off quickly but Demerol wears off over several hours - I can still feel it. Whoopie.

I found that they did not remove the flange - only the bag of my 2-piece. It's convenient for the staff but there's a small chance they could miss something by leaving the flange on. A nurse told me that some docs work right through the bag. I think something could be missed that way as well. Overall, it was an easy and painless procedure.

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