Saturday, August 30, 2014

A Cleansing Experience!

It's been a very long time since I've posted here - more than 5 years long!  But I have this blog; I remembered how to get to it; and I've got something to say.

I've decided to be more proactive with my health.  It all started with my hip!  For several years, every time I went to the doctor, I'd say something about my leg or my hip bothering me.  It usually didn't "hurt" and when I'd say that, the response would be something to the effect of we are all getting older.  Finally one day I went to the doctor and said, "My hip hurts and my knee makes grating noises when I go up stairs."  Magic words!  "My knee makes grating noises"!  So an x-ray was ordered to look at my knee and since I was doing that, they might as well look at my hip also.  Fast forward a couple of weeks to get the results.  My knee was bone on bone and my hip was worse!  I needed a hip replacement.

Already I was beginning to be more proactive.  I didn't want to go to the next doctor on the referral list.  So I did a lot of research.  I discovered that, almost without exception, everyone thinks the doctor who did their surgery is the best - unless they had problems.  So I researched some more and narrowed it down to a couple of choices.  One was in Sacramento.  He was rated in the top 10 hip replacements doctors in the US.  The other was a doctor in Reno who was recommended by a relative who is head of the PT department in a Reno hospital.  I would have to wait several months for an appointment, but he was worth the wait!

So I decided to get a second opinion first.  I knew I couldn't go with the Sacramento doctor for a number of reasons:  I'd have to stay near to Sacramento for 6 weeks; get a Sacramento GP to follow me while in the hospital; and he didn't accept our insurance!  I couldn't wrap my brain around being gone for 6 weeks and paying out of pocket for the surgery, but I did want to know what he said.  So while I was waiting 4 months for my appointment in Reno, I made an appointment in Sacramento.  (It only took a couple of weeks!)  I'm very glad I went to him.  By this time I had developed a limp.  He showed me my x-rays and pointed out what was going on in them - here's where your knee is bone on bone; see there's nothing left in your hip joint; and you have a scoliosis in your lower back!  He confirmed that I did need a hip replacement.  And, by the way, you should be using a cane!  The most interesting part of the visit for me was the pain assessment.  When he asked what my pain level was, I replied that it was probably a 3.  He then told me I was incorrect and that my pain level was at least an 8 and probably a 9!  I feel (or register) pain differently than most people.  So if I think I'm hurting, I'm REALLY hurting!

First step in my campaign to be more proactive is to emphasize how I'm feeling!

Recently I read, and was inspired by, a friend's bog post about her taking steps to become more proactive with her health.  I started thinking that I was past due for a colonoscopy and my doctor hadn't mentioned anything about scheduling one.  (Come to think about it, I'm the one who suggested my first one!)   So I suggested that I was overdue for one.  It seems that I can't get one in Susanville these days.  No one does them locally.  So I had to go to Reno to get one.  I didn't take the time to research GI docs in Reno, but my doctor referred me to his GI doc.  I decided that was an okay recommendation.

When they scheduled me for August 29th, I didn't take into consideration that it was the day after our anniversary.  I decided that there was no way I was going to drive to Reno in the midst of a colon prep so that is why we spent our 43rd anniversary in a hotel in Reno.  In thinking about it I decided that I didn't really want to spend a lot of money on a hotel room that I knew I wasn't going to enjoy.  So we ended up with a relatively inexpensive room at Circus Circus.

Let me tell you about the bathroom in our room - since that is where I spent most of my time!  It was the biggest bathroom I've seen in a hotel room.  The toilet was in the middle of the back wall.  If I leaned really far to the left, I could just touch the bathtub.  If I leaned really far to the right, I could touch the sink counter.  If I extended my left leg, I could reach the wall with my foot,  My right foot touched only air because the room got bigger for the doorway.  And the toilet was very low!  It was only slightly more comfortable than squatting - and only slightly easier to get up from!  I am very thankful for my ADA compliant toilet at home!

The prep for my procedure started several days before when I had to stop taking my fish oil supplements.  Then 2 days before I had to stop eating "beans, corn, tomatoes, cucumber, nuts or foods containing seeds such as poppy, sesame, or sunflower."  Of course everything I wanted to eat had one of those things in it and I was already feeling deprived!  The morning of our anniversary started my clear liquid diet.  I could have Jello, Popsicles, broth, sports drinks, clear juices, sodas, and water,  but not anything that was red, purple, green, or dark, or had any pulp.  Do you know it's almost impossible to buy Popsicles that aren't red, purple or green?  So basically my diet was lemon jello (yuck!) and chicken broth (because beef broth is dark!).  Not very satisfying!  And be sure to drink 8 oz of clear liquids every hour!

We left for Reno a little after noon so we could be checked into our room in time to begin the "real" prep.  At 3 pm take 2 laxatives with a glass of water.  Between 5:30 and 6:30 pm drink 32 oz of specially enhanced Gatorade!  At 9 pm take another 2 laxatives.  Then try to get some sleep!  Every time I made a mover towards the bed, other things started moving and I was back on the toilet!  Finally after midnight things started slowing down and I was able to make it to the bed and even get a couple hours of sleep.  Then at 2:15 am my alarm went off.  I had to drink another 32 oz of specially enhanced Gatorade between 2:30 and 3:30 am.  And after 4:30 I couldn't have anything!

Then throw in the mini-feud between my hip doc and my GI guy!  GI guy says don't take any antibiotics prior to the procedure because the latest guidelines say it's not necessary!  Instructions from hip doc say I need to take 2 grams of Amoxicillin 1 hour prior to dental work or GI procedures.  A couple of weeks ago when I saw my hip doc,  I asked how long I had to continue to take an antibiotic before visiting the dentist.  He told me all my life unless he sends me a notice telling me differently.  At that time I didn't think to ask about colonoscopies!  Anyway I made the mistake of calling my GI guy's office and saying I needed to take the antibiotic and would be needing a couple of sips of water to do so!  Nurse on the phone was very upset.  You can't do that!  GI guy doesn't want that and it's not necessary.  So now I call hip doc's office to ask specifically about a colonoscopy and am told that I NEED to take the antibiotic.   Then about the time things have started moving, GI guy nurse calls and wants to know who my hip doc is and tells me GI guy isn't happy that another doc is trying to interfere with his work.  And don't take the antibiotic!  After consulting with my pharmacist husband, we decide that I will take the antibiotic.  I like and trust my hip doc and haven't even met GI guy yet!

I should also talk a little about the Tush Wipes included in my prep kit.  That's what they are called!  I received 5 individually wrapped, one time use Tush Wipes! Five!  What do you do with 5 Tush Wipes considering I spent 8 hours on the toilet?  Ration them very carefully!  You don't want to use them too soon or you won't have any left when you really need them.  On the other hand you don't want to have any left over and regret not using them.  In the end it turns out I didn't do a very good job of rationing them.  In the early hours of the morning, I thought I was going to have some left over.  Then more waves hit and I was out of them much sooner than I wished!  Really!  10 would have been a better number to include.  Or I should have thought of going to drugstore and getting some for myself - along with some Depends!

Maybe I should mention the people in the room next door to us.  I don't think they slept at all during the entire time we were there.  They probably went to sleep about the time we checked out at 8 am.  Every time their door opened, it sounded to me like our door was opening and it opened at least 4 or 5 times every hour all through the night!  And people knocked on the door all night long also.  And it sounded like they were knocking on our door.  And by this time I'm sitting in the nude!  Even though I brought extra underwear in case of an oops or two, I didn't bring enough!  If I had brought every pair I own, it wouldn't have been enough!  I was praying there wouldn't be a fire alarm!

Morning finally arrives, we check out, and I'm ready to check in for my procedure with my reams of paperwork.  The girl at the desk asks in a very perky voice, "How are you this morning?"  How am I this morning?!  Tired!  Hungry!  Thirsty!  My back hurts from sitting on that low, uncomfortable toilet most of the night!  My legs hurt from trying to get up off that low, uncomfortable toilet!  My head aches from worrying that the people next door would actually find a way into our room.  I'm anxious about the procedure and meeting GI guy!  And my bum is raw and bleeding! So I answer, "uh, okay."  Then she looks up at me and says "That was a foolish question.  You are tired, hungry, and nervous."  I said, "You forgot the part about my bum being raw and bleeding."

Then I get taken into the back where I get asked lots more questions and finally meet GI guy.  It turns out that I like him and he didn't give me any trouble at all over taking the antibiotic.  He asked if this was my first colonoscopy or if I've had one before.  When I said I had had one, he asked what it was like.  I told him that I remember saying "umph!" a lot and hearing "give her another one plus one" and that I was told I had sharp corners and I didn't really wake up for a day and a half.  He told his assistant that he would be using a pediatric colonoscope on me.  The assistant looked at me and all my bulk and raised his eyebrows as if to ask, "Pediatric?" and GI guy said, "yes, pediatric!"

It took two tries to get an IV in me because it had to be in my right arm.  My left arm has much better veins.

I remember less about this procedure than I do my previous one and I woke up much more easily this time around.  GI guy spoke to Fred because "I wouldn't really remember what he said anyway."  and it's true.  I don't remember a lot of what he said although I do remember him saying that, yes, I do have sharp corners!  However he gave me (through Fred) a wonderful, informative set of discharge instructions with photos!  It contains things like take it easy and don't drive or make important decisions for 24 hours; resume my regular medications and diet - except I now need to be sure and eat a high fiber diet and take fiber supplements of my choice!

Results:  "Multiple non-bleeding diverticula were seen in the sigmoid colon and descending colon.  Diverticulosis appeared to be of moderate severity.  A single flat 10 mm polyp of benign appearance was found in the proximal sigmoid colon at 35 cm .  A piece-meal polypectomy was performed using a cold snare in the proximal sigmoid colon.  The polyp was completely removed."

Recommendations:  Besides the high fiber diet "Recall procedure pending pathology results with pediatric colonoscope under Propofol."  You mean I have to go though all this again?!

I really wish I could remember more of what GI guy said afterwards!  I remember him saying that I should have follow-up procedure done more frequently than the currently recommended 10 years because of my diverticulosis (which I didn't know I had!) and the presence of a polyp - even if it is benign.  I think he said something about every 3 years.  And he said something about why he would use Propofol next time instead of Fentanyl and Versed.  I wish I could remember!  Even though the experience wasn't one I want to repeat, I'm glad I listened to the voice telling me I should do it.

What's next in my attempt to become more proactive?  I think I'm going to see if I can find a dietician to work with me on planning a high fiber, low calorie menu.  That should help prevent my diverticulosis from becoming diverticulitis; make it easier to recover when I decide it's time for knee replacements; and put less strain on my back so I won't have to have back surgery in the near future.

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