prepping for your prep

So.  Bowel preps.  They suck.  Thankfully, the prep for the capsule endoscopy wasn’t super aggressive, i.e. I didn’t have to drink 4 liters of foul tasting gunk.

However, with any bowel prep, there is wear and tear, emphasis on tear in my case.  So I thought I’d post a couple of tips – most, unfortunately, learned the hard way.  As a bit of an aside, I think it would increase patient compliance with the prep if these tips or ones like them were discussed in advance rather than relying on the generic instructions given remotely to the patient.  E.g., my prep instructions were communicated to me via a not terribly well written one page instruction sheet sent by snail mail.  They left me with questions like “it says I can have a ‘normal breakfast’ the day before the procedure then switch to clear liquids after breakfast.  But I’ve been instructed not to eat breakfast – I snack starting at about 11:00 AM on things like rice crackers and yogurt.  What actual time does ‘after breakfast’ translate to?”  The last colonoscopy someone tried to schedule for me involved the doctor’s office INSISTING I do the 4 liters of gunk prep.  “But I really don’t handle large volumes of anything in my stomach well.  I’m worried I’m going to puke it up”.  They just gave me a script for two bottles, you know, so I could drink MORE of what made me vomit and told me to try to drink it slower.  Seems it was a one size fits all bowel prep, and the size we were using as the standard was an obese 65 year old man with poor kidney function and a history of heart problems (hence no more of the much more palatable Fleet Phospho-soda prep).

Regardless of what prep you’re given, there are some practical self care tips I wanted to share.

– Prepare your surroundings.
You need access to a clean, well stocked, well working bathroom.   Access means, if your surroundings allow, your own dedicated potty for the duration.  If not, then see “prepare your loved ones” below.  Well stocked means buy extra toilet paper – splurge on the soft stuff; some air freshener (I like the “pure citrus” brand ones); and I also recommend getting some wipes.

picture of a double pack of Charmin flushable wipes from Drugstore.com

Double pack - a good idea.

The wipes to get are usually found next to or near the toilet paper.  Charmin and Cottonelle make them, and there is usually a generic – I go with Charmin because it’s the one that doesn’t have Aloe (which I’m allergic to).  Although the packaging proudly declares that these wipes are flushable, I wouldn’t recommend it.  The last thing you want is a clogged toilet in the middle of your prep. To dispose of these, I recommend either something like the Diaper Genie or (if you don’t have one) a dedicated small trash bag that you will tie off and dispose of promptly when needed.  If you don’t have one already, a night light in the bathroom and en route to the bathroom is key.  You may end up needing to go after bedtime.  If you’re like me, you won’t want to turn on all the lights and wake everyone up if you don’t live alone.  But you’ll be in a hurry and hurrying + unsufficient illumination = fall-down-go-boom.  So get a nightlight (i’s a good idea to have it in general) or keep a flashlight by your bed.

– Prepare yourself.
Mentally and physically, you will need things to get through this intact – and oh yes, I do mean intact.  Mentally:  You’ll need something to keep your mind occupied and it’s best if you have something that is portable since you’ll need to take it on the road so to speak.  If you have an iPad, smart phone, netbook, or other portable device that will allow you to access media, plan to use it.  Stock it up with TV shows, movies, audiobooks, digital books, games, something.  You’ll be using it during your many stays on the toilet.  You can also just go the old fashioned route and get a book, some magazines, or a set of crossword/sudoku/etc. games.

picture of a sitz bath in place on a toilet

you can use the tub instead, but this is quicker.

For physical prep, look into getting a sitz bath. If you don’t use it during, it still might come in handy after if your delicate bits take a beating.

tube of A&D ointment

get some

I also cannot stress enough how important it is to use something like A&D ointment during your prep. I didn’t and ended up having to do sitz baths + vitamin E oil application for a week after on account of a fissure.  Fissures hurt.  A lot.  My post prep care includes sitz baths 2x a day (I’d do more but I really just can’t do this at work) and vitamin E oil (topical).  This has helped considerably, but it would have been better to have not needed to do that.  And this is what I get for being lazy about my prep.

– Prepare your loved ones/cohabitants.
The really nice thing for them to do is to not eat in front of you or cook food while you’re around and prepping.  The night of my most recent prep, as I worked away with resignation at my second clear liquids meal of the day, I asked my husband if he was going to eat anything.  “I did,” he told me.  “I surreptitiously scarfed down a pb&j wrap in the kitchen.”  It was so sweet that I nearly cried.  Unfortunately, he made up for that later by eating nuts in front of me…but truly, I don’t much like cashews so other than the mouth noises (which made my stomach grumble), it was pretty tolerable.  Which brings me to another point.  If you’re the meal planner, then either plan for the rest of the family to eat something you detest or, better yet, to just go out and get pizza.  The only rule is they must eat it all at the restaurant and NOT bring any home.  You don’t need that sort of appetite trauma.  I’m not going to get into what you can and can’t eat – that one seems to be covered relatively well by the standard bowel prep instructions given out by doctor’s offices or endoscopy centers.  I will point out that College Inn makes chicken, turkey, and vegetable broth in a box/carton package now.  This was much more convenient for taking to work to heat up for my clear liquids lunch (microwave in coffee mug).

Another important part of preparing your loved ones and/or people you otherwise live with is to make it very clear that you require “dibs” on the bathroom if there is only one.  They need to check with you before going, and they need to make their use snappy.  No lingering about.  If you have evening showerers in your home, I recommend that they take their showers PRE-prep.  And lastly, while it might seem like a good idea to plan a movie night or to watch shows during your prep (because you’re stuck at home and going for a bike ride or even a walk around the block is not an option), keep in mind that you’re going to be up and down a lot.  My husband and I came up with a sort of protocol about pausing the movie we were watching, but still, it became pretty evident that I just wasn’t going to be able to watch this movie unfragmented.  Accept that in advance, maybe pick something you’ve already seen but don’t mind watching again, and everyone will be happier – believe me.  Lastly, no calls.  If you have the kind of touchy family that I do, maybe let them know that you will be indisposed that night so they either won’t call or won’t be offended if you don’t answer.

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