Braving My Medical Procedures

The gyn appointment yesterday was interesting; I did well, but need to go back in a month. Maybe my medical team is conspiring and trying to subject me to exposure therapy to shake my phobia. It was very painful, but I was remarkably relaxed, likely due to the calming demeanor of the doctor and the fact that I loved her. She took a lot of time to collect a full history and discuss what would happen and what she anticipated would be the case. She was empathetic, warm, intelligent, and patient. I’m so glad to have found a provider who’s such a good fit. After I was well enough to leave, I found myself slightly less upset than normal that I have to go back yet again!

Afterward, under my own volition (not “forced” by Mom, Ben, or a doctor), I went to do my outstanding lab work for the remainder of the genetic testing, which needed to be redone after my attempt in March. There was a screaming baby spitting up in the waiting room and I got an instant headache, but I was determined to get it done.

When I was called back to get my blood drawn, I saw the room only had the upright chair with the attached arm tray. Because I almost always feel faint or pass out, it’s safest and most successful if I lie down during the blood draw. Instead of just internalizing my disappointment and concern about the position capabilities in the room, I mustered my courage to assert myself and asked if they had a reclining chair, justifying my request with my stories history of passing out. I felt proud for advocating for my needs, especially verbally. Although Ben was with me, I didn’t need to rely on him to speak on my behalf in terms of my needs; this is major progress and displays and significant increase in my self-efficacy to take care of myself, even in times of tremendous stress.

The nurse grumbled a bit about having to shove the big rolling reclining chair into the room, but after that, she was a consummate professional at her job. She used the butterfly needle and it was only a few tubes, so it went fairly quickly. She only had to stick me once and that earns the highest accolades in my book because my veins tend to roll. Per my usual coping strategy to diffuse the anxiety and discomfort of the blood draw, I asked the nurse if she had kids and to tell me about them while she worked on me. I have found it to be a comforting distraction to hear them happily and proudly describe their children.

When we finally got home, I was tired, extremely hungry, and desperately wanting to rest and indulge in comforting food. I did a bit of work, trying to distract myself from the hunger pangs, but my head was thundering and my stomach squeezing as if yelling for food. I started to get dizzy. I had some clear liquids to try and nullify the symptoms, but the results were minimal. I started to get really irritable and told Ben I wanted to postpone the colonoscopy because I just didn’t feel well enough to fast let alone go through with the procedure. I felt a bit of push back from him, rightfully so, after all, I’ve already rescheduled twice and I’m always complaining about my stomach. Ben reminded me how important it was to get it done and started firing questions about why I suddenly felt it wasn’t that urgent. I knew that it was, but the low-blood-sugar-totally-taxed me was trying to mount an argument about why postponing it would be advisable. I left in a huff to take a walk, feeling frustrated that he wasn’t supporting me and being understanding.

In the bright sun and crisp breeze of the noontime air, I started to feel a bit better. I’m less bothered by any vertigo when I’m outside. When I’m staring at my computer screen, it’s more obvious if I’m really dizzy; moving outside makes it less apparent. The fresh air also distracted me from my intense hunger. I considered my irritability and realized that while low blood sugar and stress were the main culprits, Ben’s apparent pressure to go through with the procedure wasn’t the tipping point; I realized it wasn’t sitting well with me that I was trying to justify a decision that wasn’t the one I really wanted to make. I didn’t want to cancel the colonoscopy yet again. The endoscopy is especially critical right now in gaining more information about why my digestion has been so horrendous in the last six months (even more so than normal, that is). As I told Ben, if the procedure was right away (without the fasting and waiting), I’d be first in line. I felt ashamed that I was being weak and trying to convince myself that it wasn’t that important to get it done. I expect myself to be more mature, responsible, and honest. While I’m not trying to make excuses, my body’s proven inability to handle low blood sugar and terrible hunger was absolutely obstructing my ability to silence the demon on my shoulder trying to weasel me out of the hassle and challenge of the colonoscopy prep. The walk gave me clarity about why I was struggling and what I needed to do.

I called Ben and apologize for being crabby. I told him he was right—that I did need to have both the colonoscopy and endoscopy done (and now)—and that I was going to try my hardest to push through the feeling of starvation and hypoglycemia and its symptoms, and undergo the prep so that I could go through with the colonoscopy/endoscopy as planned. I knew it was going to be hard to stave off the hunger and stay distracted, but I wasn’t concerned about the actual drinking of the prep solution since I have chronic diarrhea.

We passed the afternoon taking walks, watching TV, and lying on the rug petting Comet. My mood cleared up and the crabbiness was extinguished as soon as I called Ben on my walk, apologized, and confirmed the decision I knew was the right one in my gut. I feel unworkably upset when I’m not getting the best out of myself or doing the right thing. My conscience has a right hold on my affect and mood and also somatic experience. My headache got slightly less severe with my commitment to go through with things and although I’m sure the fresh air helped alleviate the pain somewhat, I know the removal of the guilt I felt and internal conflict about what to do certainly eased the tension and discomfort as well.

The prep went surprisingly poorly. I was prescribed lemon lime MoviPrep but I opted to do the Miralax laxative prep because it’s much more palatable. I was told to do the split prep preparation, which entails drinking half of the 64 ounces in the evening and half in the morning before heading to the hospital. The Miralax and drink went down relatively easily but I had a paradoxical reaction: instead of causing diarrhea, I got severely constipated. Although this certainly qualifies as oversharing, it’s probably been seven years since I’ve had a solid stool passed; when I say I have chronic diarrhea, I literally mean every time I go every single day. The last time I can ever remember having a formed stool was on the tail end of the norovirus in 2011, a couple of days after the bug blew through me. At that point, I had gone so many days without keeping food down that my bowels slowed down enough to cease diarrhea for a couple of days.

I’m now wondering if a bit of Miralax every day can cure my chronic diarrhea and give me stools that are more formed, less frequent, and far less urgent…I’m partially suggesting this in jest, though it’s an interesting idea. I can’t remember a time I went five hours without a bowel movement, and that’s what happened after drinking the first half. (Well, to be honest, I did go twice in those five hours, but nothing significant, and that’s still far less than normal.) Ben hypothesized that the lack of stool was simply because I hadn’t eaten solid food at that point for 24 hours, but I knew that it was a bigger issue than that: the prep was having the opposite of the desired effect; it was binding me up. All I was going was peeing tons and with such disruptive frequency that by 1am, I had only drifted into one light bout of maybe 30 minutes of sleep.

At that point, I decided I needed to start the MoviPrep or else the gastroenterologist was not going to be able to do the colonoscopy portion despite all my fasting and earnest attempt at the prep. I woke Ben up and he went and mixed up the gallon jug of the vile, greasy, lemon-lime-with-major overtones-of-salt solution. I aimed to drink half and then finish the other half at 5am. I would take a few sips and then chase it with water, but it barely seemed like I was making a dent in reducing the volume in the big jug. I started to get so nauseous and had to get up to throw up. I decided my pace was too aggressive, so I slowed and then took a break and sent Ben and the jug away. I had swallowed about 1/3 of the solution at that point though the goal was 1/2. It was all I could handle though because if it gets vomited up, it’s not going to work anyway.

Ben went back to sleep and I lay down for thirty minutes. Around 2:30am, I went downstairs and stood in the kitchen trying to drink the rest of my first half. Comet kept me company, curiously watching my gulping, wincing, and liquid regurgitation into the sink. I managed to choke down (or spit out) half of the big container and no sooner did I make a bed for myself on the couch, the stomach rumbling and liquid stool began. Frankly, I was so relieved because I knew that was the requirement for a clear procedure (and it’s my norm anyway, so no big deal here!). I ended up only having maybe 2/3 of the entire container because I just couldn’t stomach the second half. I kept throwing up and I had liquid stool anyway, so it didn’t seem mandatory. I was unable to get any more sleep because the drinking took so long, it required lights on (which always wakes me up too much to get back to sleep), and I had to keep running to the bathroom every fifteen minutes or so.

It’s now early morning, around 5:20am, and I’m exhausted. However, this is one of those times where sensory issues are a major drag. My body is on high alert for sensory stimuli and I can’t sleep at this time. Even with an eye mask, it’s too bright, my stomach is too loud, and I’m too queasy. I also have the chills so badly that I’m shivering under too heating pads, two blankets, and a winter hat.

My arrival time is not until 9:30 for an 11am procedure, so I still have four hours here at home. This will be a tough stretch, but I’ll get through it.

Although my wan face and low energy would tell you otherwise, I’m bursting with pride that I went to the gyn, got my blood without any sort of demonstrative anxiety, ignored my hunger and biological insistence that I eat for this medically-necessary procedure, and decided to do the colonoscopy. Maybe these are all low bars of “success” for a “normal” person, but for me, it’s hoist-me-up-on-your-shoulders, rah-rah-rah amazingly brave. I have two last steps—get through the next four hours feeling starving and ill, and do my best to stay calm and stoic during the procedure (I will sedated during the actual colonoscopy and endoscopy so I won’t need to be “brave,” but the whole beforehand (getting an IV, not freaking out about anesthesia, navigating the hospital and check-in process, etc. will be quite trying for me). I’m inclined to think the toughest parts are behind me; however, while this may be a comfort to most neurotypical people, it actually concerns me because it means my tolerance for stress might be nearly exhausted. I’m certainly closer to a meltdown now than I was before this stretch of medical provocations. Hopefully, I can take confidence in the challenging parts I’ve navigated with (mostly) admirable poise and success, and see this procedure through to the end with paralleled grace and bravery. I can guarantee my heart and head are in aligned with that goal; may they remain unwavering and exemplary in their commitment to be the strongest I can be.

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