The Hardest Part is the Prep

What Took Us So Long?

This past week I had a colonoscopy. It was my first and hopefully my last. I had managed to put it off about ten years longer than the prevailing medical wisdom recommends. I always found an excuse to postpone it. The last time I wiggled out of it was almost two years ago. I had even scheduled it but, at the last moment, I decided that it was too close to the time I had to leave for my work in Germany. I rationalized that there wasn’t enough time to do any follow-up treatment should that become necessary.

This July I ran out of excuses. The German doctor I have is one of those physicians you just inherently trust. He listens. He looks at you as a person, not as a bratwurst on two legs. He asked me if I had ever had a colonoscopy. I sheepishly replied I had not. He didn’t make me feel stupid for not doing it sooner. He just smiled, looked at me kindly and said, “We should schedule that for you.” He reached over to his keyboard and typed in something and asked if the 17th would be OK. What could I say? I was cornered. No excuses possible. “Yes”, the 17th would work I said, as I looked studiously at my appointment book trying not to show my terror.

So the date was set. Actually two dates were set. In Germany, you see the doctor who will be performing the procedure for a consultation. He explains what he will do and asks if you have any questions. My first question was about sedation. The doctor assured me there would be sedation and showed me in the paperwork that I had a choice of three levels from virtually none to totally knocked out. I chose the middle level one with the assurance that I would be in a pleasant twilight state and feel nothing. I filled out a bunch of paper work in German acknowledging there is some risk and giving them permission to snip any bits that don’t look right while they are investigating in my large intestine. Then came the prescription for something called Moviprep.

Moviprep is the aptly named solution that would make sure the doctor had a nice clear view through his colonoscope. It came in two packets: “A” for the day before the procedure and “B” to be swilled starting at 5:00 AM on the day of the procedure. Everyone I knew who had this procedure in the past warned me the taste was nauseating. They didn’t lie. At first it was bearable but with each subsequent cup, it became harder and harder to get down to the point my hand began to shake as I reached for the jar of Moviprep. The doctor had said it would be easier to drink if it were chilled. I hate to think of how it might have tasted if I hadn’t put it in the fridge the night before.

I won’t go into great detail about the effects of Moviprep once it gets in the body except to say it created a storm in me that could only be released in the most forceful and gut wrenching way, repeatedly, all day.

I was only allowed toast, tea and clear juice the first morning for breakfast. After that it would be almost thirty hours before I ate again. When my wife came home with warm quesadillas for her lunch, I alternated between nearly swooning from hunger to contemplating homicide. I retired to the bedroom to avoid injury to either of us.

The morning of the procedure started at 5:00 AM where I was faced with a second chilled liter of Moviprep that I was supposed to chug in an hour and a half. This turned out to be nearly impossible as I found myself racing to the bathroom more and more frequently. I was darn sure I wasn’t going to take my jug of Movi with me. No way was I going to simultaneously drink this cloying, fake citrusy potion and vacate my innards.

The time finally came to go to the hospital. I felt resigned to my fate. The process of eliminating all traces of everything I had eaten in the past several days had left me completely docile.The fear of the actual procedure seemed minor compared to my two day purging ordeal. I wonder if this is part of the medical strategy to make you so grateful for being free of what seemed like a bottomless jug of Moviprep, that you were jelly in the hands of the hospital staff.

While my wife was walking back to the car with the prepaid parking ticket for the dashboard, my cell phone rang. “Herr King”? “Yes”. “You have an eleven o’clock appointment for your colonoscopy”. “Ja”. “You are not here”. “It’s 10:45 now, I’ll be there in five minuten”. “Oh, good bye”. I’ve lived in Germany long enough to not be annoyed by such an interaction. Time has a special place in the German soul and must be honored. Ja!

After a brief wait, fully masked, a stout nurse comes in and motions for me to follow her. She points to a gurney in the hallway in front of the nursing station, saying something in German which I take to mean this is my ride to the operating room and leads me into a dressing room. She starts talking to me in German. I tell her I’m sorry, I don’t speak German. She says rather curtly that she doesn’t speak English. I think I say something like, “Well, we’ll just manage”, to which she gives me a wry smile.

The nurse shows me a pair of black shorts and proceeds to tell me in German how to put them on. I do know enough German to understand that, “der slitten” goes, “auf hintern” or something to that effect which means the opening goes in the back. In a foreign language, as in life in general, context is very important to understanding what one is supposed to do. Ja?

I get undressed and put on the shorts and head out to the hallway. I climb on the gurney doing my best not to flash my mature backside to anyone waiting at the nurses station.

I am first wheeled into a room where the nurse asks me, I think, if I would like a sedative. "Oh, ja”, I reply. A syringe appears and she very expertly injects me with something. As I lie waiting for this supposed sedative to take effect, my mind begins to wander to what I will write about this week.

It may have been the drug or just coincidence, but I begin to think about what is happening in the world and particularly in the U.S. Blame it on the injection, but somehow I begin to think that what is happening there somehow relates to my colonoscopy.

After some undetermined time, the nurse came into the room. I think she asked me how long I’d lived in Germany. At lest that was what I thought she said. In my drugged state, I opted for the simplest response which was, “Ein Jahr”, to which she immediately corrected me with “Eh Jahr”. At least that is what it sounded like. For all I know she could have asked if I liked schnitzel. Without any further conversation she wheeled me into the operating theater. I think she was testing how out of it I was.

I woke up suddenly like a cork flying out of a French champagne bottle. No grogginess. Totally focused. I was dismayed that I would now have to undergo the procedure completely conscious. Drugs, I needed more drugs!

I started looking around the room and noticed I was no longer in the operating theater. It was over! I survived! No sweat!

After my colonoscopy, I met with the doctor who had performed the procedure. He told me that he found no problems. I was relieved. Now I could focus on staying healthy.

As I walked out of the hospital to be picked up by my wife, I thought to myself, “Why did I risk my health waiting so long to get this procedure done? Why was I so afraid?

Maybe it was residual effects of the sedative they gave me, but I found myself again thinking about the current situation in America. America is facing challenges to core beliefs the country has held about its founding and subsequent history. Questions about its history of slavery and racism have risen once again. Questions are being asked about our healthcare system that is heavily weighted in favor of only those who can pay the high price it demands. Questions about how law enforcement and justice can be blinded by biases and privilege. The system, I thought, needs Moviprep. The system needs a purging that allows for a thorough examination of its inner workings.

I delayed my procedure until I couldn’t any longer. I hope the United States is at a point where it can no longer delay its version of a colonoscopy. If it can get over its fear of the political and social preparatory work required, it’s Moviprep, it can say, “What took us so long?”

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Thank you for being one of my readers. If you like what you are reading please forward to others who might be interested and encourage them to subscribe. It’s free. https//:www.bruceking.substack.com I welcome your feedback. Love the ones you’re with. Life is short even in the midst of a pandemic. Be safe. Be well. Get a colonoscopy if you’ve been delaying it. You’ll survive. The prep is the hard part.