The American Cancer Society recommends that people at “average risk” for colon cancer get their first colonoscopies beginning at age 50, but even when we’re younger, we're not all necessarily hearty, strapping young specimens. Sometimes things might look great on the outside, but our insides aren't very good at behaving quite like normal insides should...and sometimes it can leave our doctors scratching their heads.
I was 26 when I began having sporadic and seemingly random bouts of crippling lower back pain. The pain would knock me off my feet for hours at a time as I curled, moaning, in the fetal position. It never mattered how much I rolled over or what position I arranged myself into—there was absolutely no getting comfortable during an attack like this. After hours of pain that usually wouldn’t allow me to fall asleep, I was left groggy, sore, and completely useless the next day.
At first, I thought it was only that my posture sucked and my spine had finally had enough. Well, to be fair, my posture does suck—a lifetime of slouching has done me no favors, a result of always being the tallest girl in my class and a D cup to boot.
“I’ve been slouching all day,” I’d tell my friends, as I contorted into the most bizarre positions in order to attempt to “stretch” my sore back. It never seemed to help much, but it was all I could think to do.
Once, on a trip to New York City, I paid for a cab back to our hotel, even though I usually love walking through the city.
“I just can’t hack it today,” I said to my friend Mike. “Be glad you’re a guy and you don’t have boobs that kill your back.”
After some time had passed, I began to notice secondary symptoms and started to wonder if it really was my muscles or spine that was causing my pain. I seemed to get nauseous and suffer from heartburn frequently as well, and it tended to happen during late nights at work, specifically when the company would provide us with pizza. There were some icky GI issues too.
Wondering if it was a food intolerance of some kind, I got to work dutifully logging my food consumption for three months, cutting things out of my diet and adding other things in, trying to figure out what was causing my pain. I soon realized there did seem to be a connection: if I ate bread more than once a day, the pain would start within 4-8 hours.
This seemed to make sense. After all, when I had gone to the city with Mike, we had each challenged the other to eat a large pizza. (Don’t worry, neither of us succeeded.) When I had experienced pain at college, I had been shunning the weird cafeteria food and instead subsisting mostly on dinner rolls and salad. “Gluten free” hadn’t rose to prominence by this point, but it seemed clear that bread was causing me a problem, so I took steps to cut bread mostly out of my diet, started eating what little gluten-free food I could find on the market, and began feeling better.
After a few months of being relatively happy and mostly symptom-free, I stumbled upon an article online that made me uneasy: It claimed that folks with celiac disease can actually be doing damage to their intestines by continuing to eat gluten—even if they don’t experience any symptoms. The thought of my bowels wasting away inside me skeeved me out completely, so I decided to head to the doctor for a diagnostic blood test, just to be sure.
The antibody test for celiac disease came back negative, but the doctor said that a false-negative result was sometimes common. Since there was clearly still an issue that needed to be diagnosed, he suggested the next step: a colonoscopy and endoscopy.
If you aren't familiar with that particular terminology, allow me to spell it out for you: they were going to stick tubes and little tiny cameras down my throat and in my butt, respectively.
Yep. In my butt.
The procedure sounded scary, but the thought of my insides slowly rotting was scarier, so I gladly signed up, just wanting this whole ordeal over with. If you’re faced with the glory that is a “double dip” as my doctor called it, here’s what you can expect:
Part One: The Prep
I'm going to be real with you here: The colonoscopy itself isn't actually the worst part of the whole ordeal, although most people look horrified at the mere mention of it. In actuality, the two days BEFORE the colonoscopy are the worst part.
Beginning at Midnight two days before the procedure, you have to stop eating. The next day, you are only allowed to consume two things: clear, sugar-free liquids of your choice (as long as they aren’t red or purple—red and purple liquids can stain your colon and might be mistaken for blood), and four liters of the nastiest, saltiest, artificially-sweetened solution I have yet to come across.
There it is, in all its glory. They try to give it what I assume are supposed to be cute and quirky names, like “GoLytely,” but despite that, we were not friends.
They recommended that I add some sugar-free drink powder to the laxative mixture, but that did nothing to make it more palatable. If you ordinarily drink artificially sweetened beverages, you MIGHT be able to stomach this stuff, but if not, fair warning—you might throw up.
I amazingly did not, but a friend of mine did and warned me that it could happen. I certainly did feel extremely nauseous, even though I was also drinking water and clear chicken broth in an attempt to wash away the taste. It only helped momentarily.
You’re really expected to chug this junk. They give you a four-hour window in which to drink it all, but it was recommended that I take the entire day off and spend as much time as possible nursing the bottle. I was supposed to finish the whole thing, but I couldn’t do it. Yes, I was defeated by a beverage. I’m not proud of myself.
I managed to drink a little more than half and hoped that would be enough. I spent the rest of my day on the toilet. Not to put too fine a point on it, but you basically “go” until you think you couldn’t possibly have anything left in your bowels…and then you somehow go some more. Fun. Eventually everything is coming out clear, which is the overall point of this torture—a nice clear intestine means that little camera they stick in can see everything it needs to.
By this point, if you’re anything like me, you're a bundle of nerves. You want to call your doctor and backpedal; assuring them that you're feeling fine now and the procedure is totally unnecessary.
You’re not sure which is scarier: the idea of being put under for the first time (what if you are allergic to the anesthesia? What if you don’t come to again afterward?) or the idea of a room full of strangers gawking at your naked butt. You’re freaking out.
For the rest of the night, you alternate between searching the web for anesthesia horror stories and trying to distract yourself with episodes of 30 Rock on Netflix. You somehow fall asleep despite the butterflies in your stomach.
Part Two: The Process
I had a midday appointment, which meant roughly six more hours of daydreaming about food I wasn’t allowed to eat. Awesome. When I finally arrived at the hospital, there just happened to be a Papa Gino’s in the wing where I was to be seen. The smell of pizza permeated the place. Life is cruel.
I was quickly taken into a private room and given an extremely complicated hospital gown (snaps at the arms in addition to the usual ties at the back) to change into, which my mother had to assist me with.
They took all my vitals and gave me an IV of dextrose and saline. I’d never had an IV before and I’m a huge wuss when it comes to needles, but I managed to act like an adult when they inserted it. The nurse was very nice and accommodating, actually going one step further and taping up the needle in my hand so that I didn't have to look at it.
After thankfully not too much time spent waiting, they wheeled me off into the room where I would have the procedure.
Part Three: The Procedure
My bed was wheeled over to the corner of a large, darkened room. The doctor had barely introduced himself when he said to me in a serious voice, “People your age are hard to sedate.”
I swallowed my fear and responded, "Oh, great!" with a nervous laugh, assuming that he was warning me that sedation was risky—already something I was nervous about.
Actually, he meant to warn me that the sedatives might not work, and I might awake for “all or part of” the procedure. Yikes! I barely had time to panic, as he continued by saying that the scope they were putting down my throat for the endoscopy might cause me to gag, but asked me to please not pull on it, or him. I laughed and asked if they could strap my arms down, just to be on the safe side. Clearly, my fear response is to make stupid jokes. They were good-natured about it, but did not strap me down…at least, not that I know of.
Someone else came in and gave me some clear gel in a small cup, asking me to gargle it and swallow. I did as I was told, and then a voice from somewhere behind me started asking me questions, rapid fire. What was my name? Where was I from? What procedure was I here for? I think it was to see how well the gel was numbing my tongue, but I managed to answer their questions just fine.
They injected some drugs into my IV (something to knock me out, and something else to give me partial amnesia, they said) and told me that the drugs worked fast. There were lots of people in the operating room. One woman was behind my head and she was fastening some kind of white strap. I remember her joking about it being "something to bite down on." They had me lay on my side in the hospital bed, so I assumed they were going to do the colonoscopy first, the endoscopy second...
The next thing I know, I'm “coming to” and there are a number of flat-screen monitors in front of me. The feeling is very odd: I don’t feel as if I have just woken up, and I also can’t remember ever closing my eyes. Have I been alert this entire time, but I just can’t remember it? I can’t trust my brain, and although that freaks me out, I don’t care as much as I should. Clearly, they must have given me some sort of drug to calm me down, too.
(This is the part of the story where people’s eyes go really wide. “Wait,” they say, “You woke up? You were done at this point, right? They were wheeling you back to the next room?” Nope.) I’m still lying sideways on the hospital bed. At least two people are holding me down—one at my legs and one by my head—which makes me wonder if I had been struggling. I hope I haven’t been giving these poor people a hard time, but I honestly can’t remember.
I hear the doctor’s voice behind me and realize that he’s dictating what he sees on the monitors…the inner workings of my intestines. I watch the monitors myself as he goes spelunking.
“All looks good,” he says, but every now and again, the doctor instructs someone else to stop the probe and take a sample of my intestinal lining with a little grabber that reminds me of a claw machine from an arcade. Eesh. I can see small clouds of blood left behind from his efforts, and a secondary tool spritzes the blood away so the camera can continue to have an unobstructed view.
Watching a doctor take biopsies of my insides should probably be terrifying, but (and this could be the drugs talking again) it really wasn’t. How often does someone get a chance to see what their insides look like? Despite considering myself a somewhat squeamish person, I was more interested than anything else. The procedure didn’t hurt at all, and while I did of course feel some pressure downstairs, it was really no big deal.
Throughout the procedure, the medical staff kept telling me what a great job I was doing, which always strikes me as funny. I’m lying on a slab doing nothing—you are doing all the work.
The procedure was over quickly and they wheeled me back out to see my mom. A nurse told me that I was much more alert then patients usually are, which I found funny, since I’m typically the type of person who can sleep through anything…yet I wake up and am highly alert during a medical procedure. Only me!
The doctor came out a short time later and went over some photos with us. (Yep, they take photos of your insides to “prove” that they did the procedure, since most people argue that it was never done!) I felt silly admitting that although I was aware they had done the colonoscopy, were they sure they had done the endoscopy? They assured me that they had, and that I hadn’t pulled on the doctor’s arms.
After sitting for a little while to make sure the drugs had truly worn off, I was allowed to leave. I went straight to Panera and had a long-awaited You Pick Two combo. As you might imagine, food had never tasted so good!
While I was still at the hospital, the doctor told me that everything looked perfectly normal. No Celiac Disease or Colitis here! This was great to hear, of course, but puzzling at the same time. What was wrong with me, then? After 14 days, I got another phone call confirming that the results of the biopsies had come back, and as the doctor had assumed, everything was fine. He told me my GI issues were “probably irritable bowel syndrome,” and that was that.
The Follow Up
Shortly after the procedure, I ended up leaving my stupidly stressful job and my GI issues subsided almost immediately. However, the lower back pain continued to persist, often seeming to strike randomly, when I hadn’t eaten bread. Thinking again that perhaps it was my spine, I tried going to a chiropractor for a few months to no avail.
Eventually, I turned to Facebook of all places. There, a friend of mine who was also a medical student asked if my attacks tended to happen after eating fatty foods. I didn’t think they did, but she suggested I have an ultrasound taken of my gallbladder. After reading up on it a little, I decided it couldn’t hurt to try to rule that out, too.
Lo and behold, I had a very painful ultrasound (they are not supposed to hurt!) and discovered I had several very large gallstones in my gallbladder. Surgery was recommended, but as of yet, I’m holding onto the sucker. I’ve been able to avoid having painful gallbladder attacks (that’s what the back pain was!) by following a high protein, high fat, low-carb diet—totally opposite from the fish-veggies-rice-fruit lifestyle I was living before. It feels counterproductive, but I’ve lost 10 pounds and been attack-free for a long time now, so I must be doing something right!
Throughout the ordeal, I’ve learned one important thing: You have to be your own advocate when it comes to your health, and sometimes that includes getting a second—or even a third—opinion. If something seems “off” about your body, you are the best person to judge that.