Today I am preparing for my seventh Colonoscopy! Yes seventh… at the age of 41 years! How lucky am I to have a bowel that is so well examined and cared for? Ha. This colonoscopy is a routine surveillance procedure which is checking for a reoccurrence of my bowel cancer.
In all honesty, I’m actually (well, sort of) looking forward to it. No, really I am. If you can stay with me for the next 5 or so minutes I will tell you why. I want to share with you how I now approach my colonoscopies. This ‘formula’ works well for me, and I hope that you can pick up some tips for an easier colonoscopy- whether it’s your first or tenth!
I am incredibly fortunate to be able to access my private health cover, which allows me some flexibility in choice of medical specialist and hospital. Because of my private cover, I have opted to have my colonoscopy performed in a different hospital to where my cancer was first diagnosed. I do this because even though it is over three years since my diagnosis, I still find it a little emotionally triggering when I think back to the centre where my cancer was first found. While I reflect on my cancer diagnosis with more ease and resilience today, this residual trauma that I still feel is very common and completely normal.
Many patients share with me that they find returning to the hospital where they received their diagnosis or treatment very physically and emotionally triggering. For some patients, their physical symptoms are hugely debilitating and include sweating, profound anxiety, and even severe nausea. Choosing a different hospital for my follow-up colonoscopies is a simple, yet incredibly meaningful act of kindness that I have allowed myself. Because I can.
If you too experience trauma when you return to hospital for follow-up appointments or treatment, know that you are able to ask if there are other options available to you. One really simple change could be to find a different centre to have your monitoring blood tests or scans. You may be able to get the request slips from your medical specialist and have the tests performed at another location. Your doctor or nurse may also work across other facilities, and you may be able to see them at another venue. This isn’t always possible, but if you don’t ask, you won’t know.
In previous years, regardless of whether the appointment time created more stress for me, I would have requested a procedure time that minimised time away from the office. For some of my previous colonoscopies I worked most of the day of my bowel prep, and even started my prep before I left work. I knew that I had a window of between 1-2 hours before the prep would start to work. What could possibly go wrong there?
For tomorrow’s colonoscopy, I had no appointment time requests. I decided that the time given to me, would be the right time. And most importantly, I decided that I deserved to have a full day off work to drink my bowel prep in peace, rest, read, spend some time relaxing, and just focus on ME! This is something that us mums often put in the category of ‘pure luxury’ or even impossible. It is always important to remember and embrace choice, and even ask ourselves “is there a way to make this easier”?
If you have been following me for a while, or if you have read my book ‘A Woman’s Guide to Navigating the Invisible Cancer Load’, you will know that I always promote that preparation is key to more ease. I highly recommend preparing your fridge and pantry in advance by stocking up on foods and drinks from your approved colonoscopy preparation diet list supplied by your specialist. While there are some minor variations in these lists – we often hear the colonoscopy prep diet referred to as the ‘white diet’ or the low residue diet. Essentially all fibrous and fatty foods are out- no skins, no spices, no nuts, no soup with ‘bits’- you get the idea.
Usually, the white diet starts two days before your colonoscopy, so make sure that you have enough food and drink types that you know you will enjoy for the duration. I always like to choose the healthier options from the list- lean chicken, boiled eggs, cottage cheese, low-fat yogurt, broths, soft/skinned approved fruit/veg. That way I’ve topped up on protein and nutrients leading into my procedure. I’m also not struggling with sugar spikes from the approved processed foods when my body is also trying to process the bowel prep.
Cancer has taught me many amazing lessons, including ‘I am worthy of’- well, lots of wonderful things. So I like to treat myself with a little luxury- the fancier organic teas (I like peppermint, lemon and ginger), the top shelf fizzy water, and the fancy toilet paper! This is such a simple up-level that I have made in my life, and those few extra dollars on groceries for the week will be well worth it! Go on, you deserve it!
Always follow the food list and the instructions that have been provided to you by your specialist. If you are walking through the grocery isles thinking “I wonder if this will be OK”- the answer is No! Stick to the list with military-like discipline.
Likewise, follow the bowel prep times, fluid amounts and fasting times.
You do not want to be sent home without your colonoscopy, because ‘insufficient bowel preparation’ has resulted in an incomplete colonoscopy. Yes it is totally a thing, and it does happen more often then you think. If your specialist can’t see what they need to see in your bowel, they wont be able to complete the procedure with full confidence that every bit of bowel that needs looking at has been looked at. No one wants that, and no one wants to have to complete another round of bowel prep just because the food list or instructions weren’t properly followed. So follow the instructions and set phone reminders if you need to.
Going back to my mantra about being prepared, your bowel prep experience will be a lot easier if you have done a little planning in advance. Simple things like having family meals and school snacks ready in advance, clearing your schedule so that there is nothing on your ‘to do list’, letting your partner or other supportive people in your life know how they can support you, organising play dates (with transport) so that children will be out of the house while your bowels are being cleared out, and letting your children know that “mum needs some rest for the next couple of days” will support you to have an easier experience.
Transport– remember to organise transport to and from your procedure. Most colonoscopies are performed under a light anaesthetic, which means that you wont be able to drive home. All of your procedure instructions will be provided to you in advance. Remember, follow the instructions with military-like discipline.
Follow-up colonoscopies for patients who have a history of bowel cancer can be really scary. There is often a fear of reoccurrence as well as fear of: coping with more illness and treatment, loss of health gains, more family and relationship strain, loss of employment, and financial strain.
By supporting myself with adequate time off work, clearing my schedule, and through a little shopping and meal preparation, I have created more capacity to better prepare my mindset before my colonoscopy. I start by acknowledging that it is completely normal to feel fear after a cancer diagnosis.
My next steps are to 1) spend some quiet time journaling what it is exactly that I am concerned about, and then 2) I visualise my procedure going really well and then receiving ‘good news’. The process of visualisation, although quite simple can take a little practice. If you decide that visualisation is something that you would like to explore, I recommend approaching it with curiosity, rather than something that you must ‘get right’. YouTube is a great place for free visualisation meditations.
I mentioned in my introduction that I am looking forward to my colonoscopy. You may think that I am a little emotionally unstable or possibly high on bowel prep, but it’s true. Recently I have really embraced the art of ‘the reframe’. Reframing is where you take a negative thought and re-frame it in to a more helpful or constructive thought. For me, it doesn’t mean living in a ‘fairyland’, it is about changing the way I choose to see my life or a particular situation.
So, my re-frame for my colonoscopy is: I am really grateful that I have a highly trained specialist who is going to closely examine my bowel, so that if there are any abnormalities they are picked up early. I am also hugely grateful that I am privileged to live in a country where I am able to access surveillance colonoscopies.
This is the way that I move from a place of fear and even the the feeling of being inconvenienced by cancer, into a new and more constructive outlook. This is how I choose to look forward to my colonoscopy and appreciate this second chance that I have been given.
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X The Awakened Mumma, Author of ‘A Woman’s Guide to Navigating the Invisible Cancer Load‘
