I have just had a rather wonderful experience.
For some years now, I have experienced bleeding during bowel movements. It is less likely to occur when I have had an enema, probably because there is less effort involved in evacuating. My doctor has attributed the bleeding during bowel movements to hemorrhoids, which is quite likely given my genetic makeup. But recently it became more severe, and the doctor’s digital test showed internal bleeding also. So, she prescribed a colonoscopy.
A year ago, I had undergone an endoscopy to determine the cause of severe heartburn. That turned out to be a hiatus hernia (I knew that was likely, but the doctor wanted to be sure).
In that experience, I was prepared with a venous drip, which the nurse assured me was only dextrose, but which would make way for other drugs when I needed them. I asked what drugs they had in mind, and was told that there would be drugs to relax my throat muscles, and also to erase memory of the experience afterwards. It was therefore no terrible surprise to me to find myself in the same room where I had started, sort of half wondering why they had brought me back there without having done anything in the room into which I had been wheeled earlier. Suspicions were confirmed when the physician joined me and my significant other and informed me that the problem was, indeed, an inflamed hiatus hernia, which he would prescribe medication for (it didn’t work).
This time, I was given instructions for the days previous to the procedure. No iron supplements for three days before it; on D-day minus one, I was to eat breakfast, but then no solid food until after the procedure for my bleeding during bowel movements.
At noon of D-day minus one, I was to start drinking something called NuLytely, which was supplied in a four-liter container as a powdered mixture. The instructions said to mix it to the full four liters with lukewarm water, but to chill before using for palatability. It was then to be drunk at the rate of one 8-ounce (240 ml) glass every 10 minutes until all gone.
Having been exposed to something called an Evacu-kit some years ago, I wasnÍt looking forward to this stuff. But it turned out to be only slightly salty in taste, and not difficult to take. By the time I was through with it, some two hours later, I had the feeling that I had just taken an oral enema. I was passing fluid at a great rate – but without discomfort. That evening, after the fluid flow had stopped, I took a four-quart enema, which felt real good. The following morning, I took another – this one was specified in the instructions. My SO took me to the hospital – the instructions said that I would definitely NOT be able to drive home after the procedure. We arrived an hour before the appointment time (the instructions had said 45 minutes), and I was ushered into a “recovery” room to prepare. for my bleeding during bowel movements procedure.
Because this section of the hospital was being renovated, space was scarce, and I discovered one other man in the room with me. After I had undressed and put on the hospital gown, another man, fully clothed from the waist down, was wheeled in. He had apparently just had an endoscopy – the nurses were chuckling about the fact that 100 (milligrams?) of Demerol had not fazed the young man, and he was still wide awake. The nurse said that much would have put her out for a week.
He didnÍt seem too upset about the experience, however, and was quite interested about what was going on around him. He asked me what I was there for, and flinched when I told him it was for bleeding during bowel movements. The nurses proceeded to connect the IV tubing to me again. I again asked what it was for, and was told the same thing as I had been the previous time. I objected – told them I did NOT want to be drugged, but wanted to be able to be cooperative and aware of what was going on. They suggested I talk to the doctor about it.
My gurney was wheeled into the Same Day Surgery unit, and the doctor appeared. I expressed my concern about medication, and he wanted to know why I didnÍt want it. I told him I was unhappy about having been drugged on the previous occasion; that I wanted to be aware after the fact of what had happened, and, “well, I just donÍt want it.” He smiled, and said, “Well, weÍll hold down on it.”
The gurney was wheeled between an elaborate cabinet which I would love to have examined more closely, and a rack with electronic equipment on it, including a video display tube about five feet from the floor. Projecting from the cabinet was a black tubular appliance, about 2 or 3 inches across where it attached, and with one or two clear plastic tubes connected to it. It tapered quickly to about five-eighths of an inch, and the rest of it was coiled up on top of the cabinet. Before I was able to grasp any more of the situation, I was told to turn over on my left side, and to pull my legs up somewhat, leaving my butt at about right-angles. From this position, I could see a cabinet on the other side of the room, with a mate to the appliance behind me, not attached to anything, and stretched out to its full length. It looked to be about six feet long. The lights dimmed, and the video display lit up dimly. The gurney was “jacked up” about four or five inches, to get me to a more convenient height. I heard the doctor say, “Give him 50.” I felt the effects of the Demerol immediately, and just as immediately asked them to hold back on it – which they did. I was in a marvelous position to watch the video – they had been considerate enough to let me keep my glasses on – and as I watched it suddenly went from a vague brown color to a red blur. At the same time, I felt the scope tube press gently on my anus. I relaxed to let it in. The red blur continued for a moment, and suddenly materialized into a clear image as I felt air come into my rectum. For a moment, I continued to relax my sphincters, and then realized that I was farting cheerfully, which was probably not polite, to say the least! I tightened up.
The movement of the tube in my anus was delicious. It was cool, but not cold, and was probably covered with some sort of Teflon finish, which made lubrication unnecessary. On the screen, I could see with brilliant clarity the pinkish-white tissues of my rectum as the tube went in. I suspect that there was some mechanism to deflect the end of the scope, so that it didnÍt run into corners – at least, I rarely saw anything that I would have identified as the sigmoid flexure, or the sharp corner where the descending colon suddenly becomes the transverse colon. But the picture was astonishingly clear, and it was fascinating to watch as the colon expanded ahead of the scope, responding to the air injection which I could hear and feel being so deftly administered. Periodically, the progress would stop, as though the doctor wanted to look more closely at something. But the light movement of the tube where it entered my anus kept up, driving me nearly into ecstasy. And the images on the screen continued to intrigue me. Throughout, the doctor and nurses (there were two, I think) kept up a line of inane chit-chat, which had nothing to do with the situation at hand. I would have liked to have had the doctor give me a sort of travelogue – “thatÍs the sigmoid flexure; weÍre now entering the transverse colon,” etc., but I was left to my own imagination and what I knew about the anatomy I was looking at. After some time had passed, the doctor said, “We can give you more medication if you want it.” I immediately shot back, “Oh, no, please donÍt!” He responded, “YouÍre a brave man!” I am still wondering if my long experience with enemas, colon tubes, and the like (of which the doctor had no knowledge), had conditioned me to the point where something which would make an ordinary person very uncomfortable didnÍt bother me at all. But yes, I could feel the movement up through my body, and yes, I could also feel the air expanding my gut – but both sensations were entirely pleasant to me.
At one point, I did feel a strong sudden pressure upward against my diaphragm, although I couldnÍt see anything on the screen nor feel anything at my anus to explain it. The only thing I can surmise is that a bend of the scope was pressing there. Now I know how a pregnant woman must feel when her baby kicks! I was so fascinated that I forgot to breathe, and I guess it must have shown on the monitors they had connected to me. One of the nurses asked me to breathe deeply. At first, I thought she was expecting me to use my diaphragm to massage the bowel – something that any enemaphile is used to doing – but then I realized that her concern was regarding a lack of oxygen, and started breathing normally. The doctor asked me to turn on my back. I did, reflexively letting my legs fall, as I remained transfixed with the image on the screen. This brought laughter, and instructions to “lift your legs back up,” which, of course, I did immediately. After a few minutes, he asked me to turn back on my side, and one of the nurses came around in front of me to press on my abdomen, just below the sternum. After a while, she pressed on the left side, where the descending colon would be. I assumed these to be maneuvers to keep the appropriate portion of the plumbing collapsed to guide the tube of the scope better.
All the while, we were regaled by one of the nurses discussing her time-share on Cape Cod! At this point, I began to see little pockets of fluid collecting in the recesses of my colon on screen. Quickly, there came the sound of suction as they were drained by an intake just out of sight behind the lens of the scope. I muttered something about not having completely drained myself. The doctor said that was perfectly okay, he could take care of it. After I saw the end of the colon – sort of a blind alley – the tube suddenly started retreating rather rapidly. I was a little disappointed that I had not been able to identify the pylorus. I could see the colon collapsing as the air pressure dropped off. When the tube had come almost all the way out – I could feel it in my rectum – it stopped for a moment, to give us a good view of something large and bluish-purple on the wall of the rectum. Then the tube slipped out completely I looked at my watch – the whole thing had taken just exactly half an hour. The gurney was lowered to its original height, and I was told to lie on my back as I was wheeled out of the surgery. Back in the recovery room – which no longer had any other patients in it – the nurse started taking my vital signs, and seemed quite surprised that I was doing so well. When the doctor came in a few minutes later, I asked him if my Significant Other could join us while the doctor gave me his evaluation.
When the two came back a few minutes later, my SO was definitely white in the face. I realized later that he was convinced that the doctor had bad news! Nevertheless, all he could find fault with was the hemorrhoid that we had seen just inside the rectum; he said he would recommend a suppository that my primary doctor could prescribe, to shrink the thing and rid my bleeding during bowel movements.