GI Prep

My gastroenterology team really thinks I need a colonoscopy now that three years has elapsed since they removed three benign polyps.  Now in my mid-70s, I've accumulated multiple conditions, none an immediate threat, all competing with each other to see which escapes indolent first.  My medical team now expands well beyond GI, which began innocently with normal surveillance colonoscopies at age 50 and 60, an inadequate cleansing at age 70 requiring a do-over, and now concern that something invasive may arise before either my actuarial table catches up with me or some other lingering process needs more than semi-annual lab assessment.  The NP answered all my questions.  The procedure got scheduled far more promptly than the last two times.  And I've been treated better by the office, which I suspect is a regional private equity enterprise that pays the lawyers who compose all their forms to sign more than they pay their endoscopists.  Or they have taken patient feedback more seriously than I remember.

With a failed procedure in the past, I extended my clear liquid restriction, as I did three years ago.  My tolerance has been good.  A little thirst, no hunger.  And no change in my weekly weight measurement from the previous week on an unrestricted diet.  

The cleansing procedure has changed.  Now I mix my own polyethylene glycol in two batches, one of two quarts, the other a half amount of powder and liquid.  I've taken the first capsule laxatives with no notable effect over the first hour.  The laxative powder mixes poorly in the lemonade, but a two hour head start should allow it to dissolve.  The second dose of laxative times to the procedure, so I will need to set an alarm for pre-dawn, but mix the powder after I have a lull from the first ingestion and its effect.  Or my wife can mix it.

As I get older, nearly all personal goals other than my 50th anniversary achieved, feeling pretty decent despite the vagaries and warning flags of the lab, a question of when to stop cannot be avoided.  When indolent moves to aggressive, biopsies, catheterizations, endoscopies, chemotherapy, and surgery remain consent procedures.  Some alleviate suffering, others delay the inevitable.  

Today, I just want to complete the intended colonic inspection and any new biopsies that the doctor does.  A few minutes with propofol will probably offset sleep deprivation of the dawn purging.  Then a summer's respite from medical care.  A chance to travel a little with my wife, share our next anniversary, maybe visit the grandchildren, express myself in cyberspace, entertain a guest perhaps, do something of use at synagogue once or twice.  The purpose of the GI ordeal and other lab surveillance should be to enable those things.  I can cooperate with a few days of deprivation to achieve all those things.