Colonoscopy Prep

Miralax and Dulcolax Bowel Prep for Colonoscopy

Oh Joy!

This blog is designed to help anyone going through a colonoscopy prep.  I hope this helps to provide some comfort, information or at least some laughs.  I've had four colonoscopies now, so I consider myself a professional (j/p).  Please note, I am not a doctor, my advise is strictly informational and not medical advice.

For my colonoscopy bowel prep, I was placed on the all liquid (clear) diet with a Miralax, Dulcolax, and Magnesium Citrate prep.  I do have Crohn’s Disease (form of IBD, shout out to all my Chronies out there), therefore when I follow the prep procedures, my bowel clears out pretty easily (okay, the prep is no fun, so use easy loosely).

FYI Only -- Current Chron's Meds: Lialda (Mesalamine), Prednisone (Steroids), Florastors (Probiotic), Prenatal vitamins, DHAs, Calcium

Purpose of Prep

In order for you to have a successful colonoscopy procedure, you must clear your bowel of all solid matter. Please follow YOUR doctor’s instructions.  Note: if you don’t clear yourself out completely, you will have to come back again and depending on how far along you are in the procedure when they discover this, you may be paying for TWO procedures.  Follow the directions!!!

Talk to Your Doctor

Tell your doctor if you have diabetes or take blood thinners. You may need to stop some of your medicine a few days before your test.

Ask your doctor if you should take any of your medicines the morning of your test. If so, take with sips of water only.

Pre-Colonoscopy Prepare

   One Week Before My Test:

• Do not take aspirin products, iron tablets, blood thinners or anti-inflammatory medications; 2 days prior no multivitamins
• Do not take fiber supplements (i.e. Metamucil, etc)
• Do not eat popcorn or any corn
• Arrange to have a driver (adult) that will bring you to your appointment and take you home after.

   I Had to Purchase the Following:

• One, 238 grams bottle of Miralax powder
• Four, 5 milligram tablets of Dulcolax (not suppository or stool softener)
• One, 10-ounce bottle of Magnesium Citrate, Clear (NO red, orange or purple)
• One 64-ounce bottle OR Two 32-ounce bottles of clear, blue, green or yellow sports drink, i.e. Gatorade (no red, orange, purple).
• If you have diabetes, buy a no or low calorie drink such as Crystal Light instead. Do not use carbonated beverages.
• Groceries for your ‘clear liquid’ diet items (see list below)

On the Day Before Your Test

1. I could only drink clear liquids. *No red, orange or purple colored liquids; they look like blood during the procedure.  Clear, green, yellow, blue liquids are appropriate.  Do not eat any solid food or milk products until your test is done.

       Clear Liquids:

• Water
• Popsicles*
• Ice
• Soft drinks*
• Gatorade*
• Clear broth or bouillon
• Jell-O*
• Kool-Aid*
• Black coffee or tea (no milk or cream, dissolved sugar is fine)

    2.   Follow the schedule for your bowel prep. You may need to get to the toilet right away and know that you will have many bowel movements through the day.

MORNING (Day Prior)

_ Got all my goodies together for the day…

8:00 AM - 12:00 PM (Day Prior)

_ I went in to work for a few hours, it helped to get my mind off the all liquid diet and got me out of the house where I would have been stir crazy and would have walked into the kitchen too many times.  I took a little lunch box of liquids and Jell-O with me!

3:00 PM (Day Prior)

_ Back at home, I took 4 Dulcolax tablets with water.

_ Place your Gatorade in the fridge.



I thought about substituting the Dulcolax pills for orange M&M’s, but then I remembered, no food --- awwwww booooo, okay, I’ll take the pills and put the M&M’s back!



4:45 PM (Day Prior)

_ I prepped for my Miralax cocktail (Miralax powder and Gatorade).

_ Mix the Miralax in a 64-ounce bottle of Gatorade OR mix half the Miralax with a 32-ounce bottle of Gatorade.

_ Cap the bottle and shake to dissolve the powder. Most people prefer to drink the liquid chilled so you may want to place it in the refrigerator.

5:00 PM (Day Prior)

_ Start to drink the first 32-ounces of the Miralax cocktail. Drink one glass every 10 to 15 minutes. Drink it quickly rather than sipping small amounts because it does not taste that good. Be sure to drink all of the liquid.

5:00 PM – 8-ounce glass

5:15 PM – 8-ounce glass

5:30 PM – 8-ounce glass

5:45 PM – 8-ounce glass

6:30 PM (Day Prior)

_ Drink the second half of the 32-ounces of Miralax cocktail.  Drink one glass every 10 to 15 minutes. Drink it quickly rather than sipping small amounts because it does not taste that good. Be sure to drink all of the liquid.

_ This is when it gets a little more difficult to drink.  It’s harder, in my opinion, to get the last two glasses down.

6:30 PM – 8-ounce glass

6:45 PM – 8-ounce glass; feeling queasy, two more glasses to go

7:00 PM – 8-ounce glass; was much more difficult to take this one down; only one more to go

7:15 PM – 8-ounce glass; cramping; bowel movements begin!

This time around I considered some different liquids, but once again these liquids were red, awwww booooo!  Okay, I’ll stick to the Gatorade.

10:00 PM (Day Prior)

_ I think I'm pretty clean now.  Although, my liquid is not very yellow yet, more light green.  Probably because I had a lot of blue Gatorade.

12:00 AM (midnight)

_ No more liquids or food (but technically, you couldn’t have food all day, soooooo, nothing new there).

How to Know if You’re Cleaned Out

Your bowel movements will become very watery. The bowels are clear or clean when there is only pale / bright yellow fluid without flecks of stool.

Morning of the Colonoscopy

8:30 AM

_ On the day of the procedure, I had to drink the entire bottle of the Magnesium Citrate.  Luckily I had chilled it in the fridge the night before, but it was still gross.  I put a straw in the bottle and drank it with the straw in the back of my throat and chugged.  It helped a little.

Notes for Morning / Day of Colonoscopy

• Do not eat or drink anything until your test is done.
• Wear leisure clothing.
• If you are to take your morning medicines, take with small sips of water only.
• Bring all medicines you usually take (in the original containers) to the hospital with you or a detailed list of all medications and medication allergies.
• Do not bring any valuables with you.
• You will need to have an adult with you to take you home after your test. You will not be able to leave by yourself and it will not be safe for you to drive because of the medicine you are given at the start of the test.
• You may be told to arrive 1 hour before your test is scheduled so that staff can get you ready. Expect to be here for 2 to 4 hours for your test and recovery time.

12:00 PM (noon)

_ Husband is taking me to the appointment, feeling really weak (probably some what dehydrated).  Wouldn't you know I started my girlie cycle!  Geessshhhh ... this is going to be fun, no meds!!!

12:30 PM

_ Check-in for appointment, feeling pain from my girlie cycle and drained from dehydration, not a great combo.  But the Husband is great encouragement - he keep telling myself, I can do this and it's almost over!

1:30 PM

_ Called back for the procedure, they ask lots of questions "do you have a history of..." "what medication do you take..." "when was the last time you took your medication..."

_ Had to get into the very stylish hospital robes.  I looked goooood! ;)

1:45 PM

_ Given an I.V. - okay so I'm a real baby when it comes to needles and one of the reasons is that I have really 'bad veins' no one can ever find them, add dehydration to the plate and you've got yourself a blind vein finding challenge.  The results, multiple pricks...

2:00 PM

_ Taken back to the procedure room.  Given Propofol to go to sleep - "Propofol is nicknamed "Milk of Amnesia" because of it's milky white color."  I'm out like a light!

2:30 PM

_ Procedure done, get to see my hubby!!!

_ Note: You will have a lot of air coming out of your bottom for the next hour or so.  They have to blow air up your colon to do the colonoscopy.  All glory, grace and class goes right out the window!

_ Met with the doctor, need to get a polyp checked out.  The took a few biopsy's of my ulcers (FYI ulcers are due to my Crohn's).  I still have inflammation in the first 5 inches of my rectum (due to my Crohn's), but the rest of the results were 'good' he said. (yeay)

2:45 PM

_ Debriefed and released!!!!  (FYI - No signing any legal documents today - LOL)

3:00 PM

_ Soooooo ready to eat.  The hubs and I went to Corner Bakery Cafe in the Stone Oak area of San Antonio.  It is the best!!!!  I got the Pesto Cavatappi Pasta and Chocolate Iced Cookie!!!

The Rest of the Day

Feeling okay, nothing too bad.  I've had a few liquid bowel movements still, but they are getting darker!  Enjoyed the rest of the day off from work ... got to watch TV with the Hubs, write this blog and play with my puppy, SoBe. 

My Boston Terrier, SoBe, and her Lion, Larry.  She LOVES Larry!!!

Talk to your doctor or nurse if you have any questions or concerns.

Good luck and just try to tell yourself, it will all be over soon!!!!

Miscarriage at 6 Weeks

Our Misscarriage Story

Below is a timeline of my husband and my miscarriage experience at 6 weeks pregnant.  I am sharing this story for those who have experienced a miscarriage or know someone who has.  My hope is to share the story to ease others anxiety, questions and pain I am not a doctor, the information I share should not be considered for medical treatment.  Please consult a doctor immediately if you are pregnant and see blood or if you think you may be experiencing a miscarriage.

42 Days Prior to MC (Thursday, December 23, 2010)

Date of last menstrual cycle

31 Days Prior to MC (Monday, January 3, 2011)

Possible ovulation date

15 Days Prior to MC / Pgnt: 4 wks 1 day (Wednesday, January 19, 2011)

Date of missed period. Since September 2010, we began using the Natural Family Planning (NFP) tracking technique.  Only because we felt we wanted to know if we did become pregnant.  While tracking I discovered that I was exactly 27 days, clockwork, between periods.  When I missed on the 19^th I knew something was up, but patiently waited a few days before I told the hubby to be sure.

11 Days Prior to MC / Pgnt: 4 wks 4 days (Sunday, January 23, 2011) – Positive Test

Five days past my missed cycle, we decided it was time to take an at home pregnancy test.  We used the First Response at home pregnancy test, consumer reports selected it as number one.  We were ecstatic to find the second pink line, bold as ever, the test was positive.

The next 7 days was our ‘waiting time’ before we told family.  I experienced many normal pregnancy symptoms, but I’d say on a smaller scale than most women: nausea, fatigue, thirsty for water, etc.  We were very excited.

3 Days Prior to MC / Pgnt: 5 wks 4 days (Sunday, January 30, 2011)

9:00pm – I sat on the toilet before bed and when I wiped, there was dark blood on the tissue, nothing in the toilet, tissue only.  Adam and I immediately went online and ‘Goggled’ possible reasons for the blood.  We decided not to panic (or at least he did – lol, I’m a women) and make an appointment in the morning.

2 Days Prior to MC / Pgnt: 5 wks 5 days (Monday, January 31, 2011)

Emotions: helplessness, fear, worrying.  I tried my best to breath slowly and not make myself physically nervous.

7:00am – I woke and immediately called my OBGYN, Dr. Martha Garza.  Dr. Garza is an extremely religious, pro-life leader in the medical community.  She immediately told me to come over for an appointment.

9:00am - Dr. Garza did her normal examination, sent me for blood work and a sonogram.  The sonogram placed us at about 5wks 5d.  I continued to see dark blood and had very light / un-alarming cramping.

7:30pm – Dr. Garza called me with blood results that my HGC were normal and looking good, but that my progesterone levels were very low and that she wanted to put me on supplements immediately.

Here is the only picture we have of baby Anthony - he's a little tiny guy in the black circle:

1 Day Prior to MC / Pgnt:  5 wks 6 days (Tuesday, February 1, 2011)

Light / heavy dark blood and cramping.

10:30am – I went to Oak Hills Pharmacy (located in the Medical Center in SATX).  They had made a compound according to my Dr.’s prescription, 600mg Progesterone supplements a day (One 300mg pills, twice a day).  I took my first pill at this time.

The dark blood continued and my Dr. warned me that my Progesterone was the lowest she had ever seen at this stage and that my chances of a miscarriage were ‘very high.’

I read on the Internet that a sure sign of a miscarriage was bright red blood (enough to soak a pad) and cramping like your period.  I also decided to look at a photo so I could figure out what it looked like.  Many people would say it’s not a good thing to read about / look at, but I’m really glad I did because it helped to prepare me.

Below are a collection of tips for prior to and after the miscarriage

Prior To:

1) Blood: if you have any blood, make an appointment to see your doctor TODAY.  Let them know you are pregnant and you are seeing blood.  They may be able to help before anything gets worse.  I learned that dark blood is better than bright red blood, however, excessive blood of any kind is never good.

2) Talk: let your spouse (of course) and your family know, you will need the support and prayers, even if you are early along in your pregnancy.

3) Prepare Yourself (physically): purchase or find a strainer with very thin holes, some zip lock bags, paper towels, travel wipies and feminine pads.  I carried these around with me especially if I had to leave the house.  The last thing you want to do is flush the miscarriage down the toilet, many women never forgive themselves for not allowing for the proper disposal.

4) Prepare Yourself (emotionally): be positive, but realistic; you need to take this time to calm yourself and do whatever you can to fight for this babies life, but in the same breath realize that there is already a plan that God has laid out, trust Him.

Afterwards:

1) Take Time to Cry: if it happens, mourn.  It is important to mourn the life of the baby, what could have been, etc.  The five stages of grief are:  1-Denial - 2-Anger - 3-Bargaining - 4-Depression  - 5-Acceptance

2) Talk: let your spouse (of course) and your family know, you will need the support, understanding and prayers.

3) Record: it is important to take some time to write out the dates, times, drugs, feelings, etc that you experienced leading up to, during and after the miscarriage.

4) Honor Your Baby: think about naming the baby and having a little ceremony in his / her honor.  Many Catholic cemeteries offer group masses for miscarriages, I’m sure other religions have this as well.  They also have burial sites and there are places that carry baby caskets and burial products (http://www.heavensgain.com/).

Why is this important?  This will help both you and your family bring a little piece of closure and understanding during this difficult time.

5) Guard Yourself: realize people are going to say the wrong thing, and safe guard yourself.  Realize that they don’t exactly know how to react and people say some awkwardly / painful things and they don’t even realize it.  I actually thought this website was really good at summing things up: http://www.grandparents.com/gp/content/expert-advice/family-matters/article/mending-a-broken-heart.html

Day of Miscarriage / Pgnt: 6 wks (Wednesday, February 2, 2011)

Bright red, heavy blood & on / off heavy cramping

7pm – Mass

My sister, Danielle, and her 6 year old son / my nephew, Evan, took my husband and I to mass at St. Anthony that evening.  It was a Wednesday evening and the service was in honor of the presentation of the Christ child in the temple and St. Blaise.  I had a lot of cramping during mass, and the tears kept flowing.  It was like God was preparing me for the miscarriage, I was just glad to be in His home during that time. I sort of felt like the baby was baptized before he/ she left us because the priest blessed the crowd with holy water and I got a huge splat right in the face. After mass, we received a special blessing by the priest.  My sister helped us to grab some holy water to take home, I’m so glad she suggested to.

11pm - Miscarriage

Right before bed, I sat on the toilet with my strainer.  Right when I sat down, there were two bright red blood clots that appeared.  After taking a closer look, and running the ‘clots’ under water, I realized it was a pinkish-grey color, the size of a very large raisin, exactly what the Internet said it would look like.  I called to Adam, ‘We just lost the baby.’  I didn’t cry, I just knew we needed to take a moment to bless the child with the holy water we had picked up at mass that night.  Adam said the blessing.  We decided it was appropriate to name him / her, Anthony, after the church we were in, I believed this was where the baby had passed.  We hugged, placed the baby in a paper towel and then in a zip lock bag with the date / time written on the outside.

Later that night I called my mom and told her.  She was such a great support through the entire process, it’s like mom always knows what to say and do!

1 Day After MC (Thursday, February 3, 2011)

Symptoms: Heavy blood and cramping.

Emotions: crying throughout the day, sort of felt ‘zoned out,’ in general I was really sad and confused.

Activities:

11:30am – Dr. Garza sonogram & blood work, it was certain we lost the baby

1:30pm – lunch with Adam

3:30pm – time with mom and dad

2 Days After MC (Friday, February 4, 2011)

Symptoms: Heavy blood and cramping.

Emotions: crying throughout the day, sporadically and really no rhyme or reason.  My thoughts usually triggered it or comments from others.

Activities: First snow day in San Antonio since 1985, the entire city was shut down for the day.

3 Days After MC (Saturday, February 5, 2011)

Symptoms: Heavy blood and cramping.

Emotions: crying less then the day prior, but still happened a few times throughout the day, really no rhyme or reason.  I did run into a friend at the grocery store who was about 7 months along with her 2 year old.  I did fine when I was talking to them, but once we left and I turned the corner, I broke into tears.

New Medication: Dr. Garza called to check on me.  I told her about the bleeding.  She told me it should be lessening and decided to put me on Methergine (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000072).  Methergine is a blood vessel constrictor and smooth muscle agonist most commonly used to prevent or control excessive bleeding following childbirth.  Dr. Garza also prescribed me pain medication, Acetaminophen Hydrocodone.

Note on Post-Bleeding: I told her that I had read on the Internet that 7 days of bleeding is normal, she said only if it is lessening each day.  If you are bleeding longer than 7 days (some reported that they bled for months), call your doctor immediately!

4 Days After MC (Sunday, February 6, 2011)

Symptoms: Blood and cramping are both lightening up, but have not stopped.

Activities: Super Bowl – Steelers vs. Packers, the commercials always help to lighten my spirits.

9 Days After MC (Friday, February 11, 2011)

Symptoms: Last day of blood and cramping from miscarriage.  Ironically I do have notes that I vomited this day (probably a combination of stress  & Tx allergies)

27 Days After MC (March 1, 2011)

Resumed menstrual cycle – Day 1 of 7

52 Days After MC (March 26, 2011)

Second menstrual cycle – Day 1 of 7

79 Days After MC (April 22, 2011)

Third menstrual cycle – Day 1 of 7

106 Days After MC (May, 19, 2011)

Fourth menstrual cycle – Day 1 of 6

133 Days After MC (June 15, 2011)

Fifth menstrual cycle – Day 1 of 5

160 Days After MC (July 12, 2011)

Sixth menstrual cycle – Day 1 of 5

185 Days After MC (August 6, 2011)

Seventh menstrual cycle – Day 1 of 6

209 Days After MC (August 30, 2011)

Eighth menstrual cycle – Day 1 of 7