Everything you didn't know you'd want to know about your colonoscopy

I turned 50 this year, and with that comes a whole lot of procedures that I never knew about.

 When we are growing up we learn all about the 'facts of life' in health class. It was a long time ago, but all I remember from those classes was the reproductive facts. I was lucky enough to have very open parents who also discussed the basic facts. What no one ever talked about was the tests we need as we get older like what to expect from a mammogram or a colonoscopy. They are diagnostic exams that detect signs of cancer in your breasts and colon. The suggested age for a mammogram is 40 years old and for a colonoscopy it's 50 years. Of course, if you have a family history or signs of anything wrong it's recommended sooner.

The chance of recovery (prognosis) is greater if cancer is detected early, especially with breast and colon cancer. Having a colonoscopy can prevent further problems by detecting and removing pre-cancerous polyps.

The American Cancer Society states there are signs of potential problems that you should see your doctor and discuss a colonoscopy sooner. Some signs are:

• A change in bowel habits that lasts more than a few days
• A feeling that you need to have a bowel movement that doesn't go away after you do
• Rectal bleeding
• Dark stools
• Cramping in the abdominal area
• Weakness and fatigue
• Unintended weight loss
• Back pain that doesn't go away or change with position. (This is why it's important to get assessed by someone who gets a good history and looks at your movement patterns.)

No one likes to talk about cancer let alone a colonoscopu because they are awkward topics. My cousin passed away 11 years ago from a rare colon cancer. I would rather talk about it and be awkward than ignore the symptoms and shy away from a test that scared me. There are complications with every aspect of life. Sometimes you need to weigh the risk vs rewards. Knowing what to expect, for me at least, helps to ease some fears.

So here's some info about my colonoscopy experience that I hope help you to be less scared.

• The doctor will prescribe you a medicine called Suprep Bowel Prep Kit It is actually a prescription and you have to drop the script off in enough time to pick it up. I got mine the day before, but the instructions tell you to read it 2 weeks before so if you don't like to wait til the last minute, get it sooner. It costs about $110. As of today there's a coupon that will get you a discount. I ended up paying $77.
• One week before the test you have to stop eating high fiber foods like seeds, nuts, peas, corn and any supplemental fiber that you take. I'd also suggest increasing your water intake gradually at least one week out. Trust me. Water is your friend.
• The day before you have to be on a clear liquid diet. No one was amused when I asked if vodka counted😀, but along with the obvious no alcohol or food, you need to avoid anything colored red. I found chicken broth to be very soothing and easy to drink throughout the day so I didn't feel like I was starving. (Newsflash..you will not starve with one day of a liquid diet!) I stuck with plain water and coconut water beyond that. You can drink things like white grape juice, Gatorade, Vitamin Water or clear soda's too if you like. I bought all of that, but in the end water was all I wanted and now I have all these sugary drinks hanging around. I do love the taste of Dragon fruit Vitamin water though, so it gave me something to look forward to🐲🐲🐉🐉
• About 12 hours before the exam you take your first 6 oz dose of the prep. You mix it in 10 oz of water and then have to drink another 32 oz in the next hour after. 
• I used COLD water and tolerated the first dose fine. It's gross..like a mix of Robitussin, Pedi-a-lite and NyQuil...but if you drink it fast it's not terrible. Some people mix it with the other clear liquids above. 
• Someone recommended a straw. That was key! So much easier to get it down.
• Other recommendations were soft toilet paper and baby wipes. 
• You begin to experience chills right away after drinking it. Bundle up and relax. They go away after about an hour
• Your first poop will happen anywhere from 30 minutes after til 3 hours after. Some people it's urgent. I had no moments of panic, but had lots of belly gurgles throughout the whole process. 
• **Gross alert** The medicine is like a power wash for your colon. The goal is to get all the poop out. At first it will be watery and brown. As you progress thru the prep it should turn yellowish and will seem like a LOT of water. It's normal and that helps to do a good test. Credit my friend, Renee Pustizzi, for this gem of knowledge. She's a rock star GI nurse and really calmed my nerves
• Keep sipping water.
• The 2nd 6 oz happens about 6 hours later with the same process. This one hurts. I got halfway thru and nearly puked. It was not as easy to swig down. I think my body remembered the taste. Drinking plain water in between sips helped and I was never so happy to finish a drink!
• If your test is in the morning I'd recommend napping between the first and second drink. It's an interrupted night sleep either way.
• The morning of you need to show up 30-45 minutes ahead of the procedure. You need to stop any food or drink 3 hours before the test. Take a breath..the hard part is over
• You'll be a bit dehydrated so it may be tough to get the IV in. Took them 4 tries and I have some pretty bruises now, but they were gentle. Again, some deep breathing and visualization, and my veins relaxed enough to make it happen.
• They use Propofol to sedate you. It burns for about 10 seconds and then you wake up 45 minutes later in the recovery room feeling well rested. I can see how people have issues with this. That 45 minutes was the best sleep I've had in a long time. What prep was that again?

All kidding about the sleep aside, your doctor will tell you preliminary results right after. If they removed any polyps you'll get results of the biopsy in a few days. You'll need a ride home and you can't drive, workout, do housework or cook for the rest of the day. Some people have mild discomfort in their belly or bum after. Take the time to nap and enjoy the fact that you just took the first step in taking care of your colon health. 

A special shout out to all my friends and family who kept me calm throughout the whole process. Having a conversation about this stuff really does help.

What do you do when your back pain takes your breath away?

1. I can’t shave my legs

2. I can’t drive more than 10 minutes

3. I was told never to lift anything heavier than 10 pounds

4. I can’t walk the golf course or swing a club without pain

5. I was prescribed an opioid (Tramadol/Vicodin/Demerol/Percoce/Roxicet/Fentanyl) (Web MD, 2018) and am afraid I’m going to be hooked

According to the NINDS 80% of people complain of back pain at least once in their lives. (Low Back Pain Fact Sheet, 2018) It is one of the biggest reasons people miss work. (Back pain, 2018)

Some common low back pain symptoms and complaints are:
1. Spasm

2. Shooting

3. Numbness and tingling

4. Stiffness

Most pain will resolve with doing the right movement and with positional changes. You should consult an MD if: 

1. The pain is unrelenting

2. Is worse in the middle of the night

3. If you’ve had recent unexplained weight change

4. If you have weakness in both legs

In 2017 we started to move away from medication and rest as being the first line of treatment for back pain. Now the recommendations are a return to normal movement as soon as possible, manual treatment, acupuncture and yoga. It can take time, but it's been shown that most back pain will resolve over time. (KOLATA, 2017)

Starting to explore 3 directional movement and finding where you are restricted  or have pain can be helpful.  In this video, Gary Ward of Anatomy in Motion (AiM) walks us through 3D mobility and exploring where we have easy or difficult movement. (**If you're experiencing pain, I encourage you to watch this video in full and test the motions. As Gary says you can use the movements for assessment as well as working those motions to find more pain free mobility. If your symptoms persist or worsen, 1st find the pain free motion...then seek out further assessment.

Help prevent ongoing pain by learning to move better to avoid straining your muscles and joints:

1. Hinge at the hips with your knees bent. To practice the hip hinge put a stick against your back with your head and sacrum against the stick. Slowly bend forward from the hips keeping contact the whole time. Knees will bend as you bend forward. Stand back up

2. Push objects vs pull them.

3. Get as close as you can to the object you are moving.

4. Twist in isolation and move your feet vs twisting in combination with bending, extending or side bending

The bottom line is it is not only ok, but it is important to gradually return to normal mobility and  your usual activities, including lifting, driving, sleeping and shaving. You have options for how to manage and can be proactive in seeking help beyond rest and medication.

Back pain. (2018, January 4). Retrieved from Mayo Foundation for Medical Education and Research (MFMER): https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906

KOLATA, G. (2017, February 13). Lower Back Ache? Be Active and Wait It Out, New Guidelines Say. Retrieved from www.nytimes.com: https://www.nytimes.com/2017/02/13/health/lower-back-pain-surgery-guidelines.html

Low Back Pain Fact Sheet. (2018, January 4). Retrieved from National Institute of Neurological Disorders and Stroke: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Web MD. (2018, January 6). Retrieved from Opioid (Narcotic) Pain Medication: https://www.webmd.com/pain-management/guide/narcotic-pain-medications#1

2018: Harmony

In 2017 I didn't make any New Year's resolutions. I was frustrated from the previous year because I didn't meet my goal, again, of becoming a Strong First Instructor. As a result, I feel like I floundered with no real purpose for working out,

I started Move Better, LLC last year, but really started working on growing it around April. I didn't have a true goal or plan for how I intended to make the business work. I'm learning as I go. I think this led to frequently bailing on my own health and wellness and minimal growth of the company.

In mid-November, I got a wicked head cold that limited my activity. On Thanksgiving, my step-mother passed away suddenly. During that time, I lost a lot of sleep worrying for my Dad. I don't handle stress very well and it caught up with me. I ended up with symptoms of vertigo which persisted on and off through Christmas.

This year I missed a bunch of workouts because I just didn't feel good. I gained a lot of weight. My body shape changed  and since November until last week I was struggling to walk upstairs without getting short of breath. I have not felt like myself in quite sometime. All of my talk about staying on top of good movement so that we can do what we want and be healthy doing it as we age seems to be a farce in my own life, and this makes me sad on top of not feeling well.

As I reflected on the last year, I knew I needed to set some resolutions again. I felt the best when I had specific goals in sight. Even if I didn't achieve them, I had something to work toward. Also, in the past few years before 2017 I had started having a word for the year to define what I wanted to achieve. I think it helped me become motivated to do better at my job and to see some excitement in my career again.

So I have revisited my resolve for resolutions. My goal for my health is to be consistent with working out 6 hours per week. I am going to pay attention to what, when and why I'm eating. I'm adding yoga-this month I signed up for an online 31 day challenge.  I am going to meditate for at least 10 minutes daily...even if just before bed.

I am continuing to learn daily on how to build a business. I am spending time getting specific with my goals. I have a lot to learn still, but I believe now, that by setting goals I'll have a better direction to succeed. By setting goals, I help myself to resolve to take of myself in the process. (And if you know anyone in need of meeting their own movement goals thru specific physical therapy or fitness...I would love to talk with them 😁)

My word for this year is harmony. Per Dictionary.com the definition of harmony is a consistent and orderly arrangement of parts. I think this flows with setting goals and making a plan. It's synonyms are peace and understanding. This is something I have always worked to achieve in all of my relationships. If I work toward improved harmony in my life, not only will my own health and well-being be better, but I believe that all of the relationships in my life will improve.

We learn as we go. Sometimes we fail but the beauty is we always have a chance to begin again. I like looking at January to reassess where I'm going, but really we can do this every day. If I allow myself to calmly realize this, I easily achieve that harmony I seek. As a plus, in implementing my plan just today, I actually feel much better overall too.

 Whether you make resolutions or not, take some time to evaluate where you've been and where you're going. We all have room for improvement. Why not take the step and make a change toward being just 1% better every day?

Cheers and a very happy and healthy 2018 to all.