How to Have a Colonoscopy at Age 39 in Twenty Easy Steps

1. Go into the hospital for a LONG-awaited knee replacement surgery. Must also have bone spur on side of knee and a Baker's Cyst behind said knee is helpful as well. (Helpful hint: Make sure your insurance has pre-approved the surgery or it could get expensive!)

2. Get crucial dose of antibiotics into your IV before the surgery to fight off any infections lurking in the knee area so you are not as susceptible to infection after the surgery.

3. It is very helpful to have Lupus and a suppressed immune system- the immune system (the white blood cells, the "good guys") must be suppressed because with Lupus, white blood cells overproduce into the billions and then turn on each other and their own Home Sweet Home. Henceforth, the white blood cells will be called Flesh Eating Zombies.

4. Make it out of the surgery with flying colors- anticipating the traditional three-day stay for this procedure. Eat a light Dinner on Day One.

5. On day two, be sure to order a full breakfast and lunch and eat them both. They will be the last meals you eat for a while. Take a leisurely stroll to the nurses station and back. Marvel at your accomplishment. Meanwhile in your body, the proactive dose of antibiotics you were given becomes very confused as it roams around. Who are the good guys? Who are the bad guys? There are so many of the white ones, and they are really quite menacing... the antibiotic decides to take them all out as a precaution. To the Flesh Eating Zombies... something more powerful than they are has entered their turf (a la Crypts vs. Bloods). And it's killing them all. Don't worry, the cost would be too high to have a funeral for each white blood cell (I mean Flesh Eating Zombie) that dies- they'll be taken care of in the next step or two.

6. Around suppertime on Day Two, start to get a stomach ache unlike any other you've ever had before. Watch your abdomen swell as if you were pregnant with an alien baby. Marvel as it becomes more painful than your knee, where bones have been sawed in half in two places- on the shin and the thigh- where the new and improved bionic knee has been placed with lots and lots of screws. You'll be forgetting about your knee for a while. Meanwhile, the antibiotic is doing a little dance in your intestines for killing off all the helpful bacteria that lives in there. It decides the bad bacteria (which everyone has to a small degree) can stay because we all know it's the bad kids that make parties more fun. A lot of the bad bacteria start pairing off like bad kids at an unsupervised party- finding dark corners and empty bedrooms...and they make lots and lots of bad bacteria babies.

7. The evening of day two, begin throwing up. Really do it up right. Un-controllable and projectile are two words that describe what you must aim for. After everything you've eaten for the past four days has been expunged (this will take about three hours), move on to throwing up bright yellow bile (sorry folks, but that's what happens when there's nothing left to puke). Do this for about three hours. By now it's about five in the morning and you can finish up with a couple of hours of dry heaves- you know, the kind where the inside of your belly button almost comes out of your mouth.

8. Day Three Dawns: Don't eat anything today... you don't want to give your body more ammunition. At this point, it helps to think you're just having a bad reaction to the General Anesthesia from the surgery. Realize that your stomach is too tender to move or even touch. Discover that the north end of "Home sweet Home" seems to be spent and you should now start worrying about the south end... better known as "the other side of the tramp stamp (not that I have one!)." Spend day three hobbling back and forth from the bed to the potty with a walker that somebody's grandma used in this room last week, sometimes making it in time, and sometimes not. Allow the humiliation to set in. You are completely weak and dependent. Not to fear, though, bile is still at the party and is ready to Party On, Wayne (Party on, Garth)!

9. Meet the Internist doctor who has been called in to consult. Allow him to prod your stomach like he's kneading a batch of dough. Cry. A lot. Promise to come up out of the hospital bed and personally introduce someone to Jesus if they don't give you more pain medication. Kiss the nurse that brings in the Dilauded drip. As you drift into dreamland, vaguely hear that you've been scheduled for a CAT scan of your stomach.

10. Have your CAT Scan. Allow them to draw gallons of blood for tests. Watch your arms turn a groovy shade of purple and green and yellow (still on Dilauded, remember?) Provide four "separate occurrences" of stool samples so they can count the white blood cells in your stool (I have a new Dirty Job for that guy on TV). Marvel that your body still has anything in it left at all to get rid of... but it does, my friend... it does. Endure another horrible night just like the last.

11. Day Four and Five: Get blood results back and find you've become severely, deathly anemic. Get put on a "NO FOOD OR DRINK diet to give your intestines a break. Have just a sip of water with your oral pills- no more than a couple ounces at a time. Just for fun, for a 24 hour time period lower your blood pressure to 60/30. Run a high fever. Get results of CAT Scan- Colitis. Never heard of it. It means your intestines are severely inflamed. huh. But are they treating you with the right antibiotics? HMMM. How can they find out? Continue diarrhea and next-to-nothing blood pressure. Meet the Gastroentologist called in to find out. Start feeling uneasy knowing something wicked this way comes...

12. Allow the nurses to poke you four times with a heavy grade IV line because your newest drip is going to be thick. In order to achieve this, your whole body must be swollen with all the fluids they've been pumping into you so they can't find your veins. Have your knee doctor tell you that your knee is cleared to go home, but your butt has to stay. Seriously.

13. Just for fun, start your period.

13. Have a blood transfusion. Have another blood transfusion.

14. Get stool results back- Find that you don't have the deathly (literally) wicked bacteria in your colon/intestines- that's the good news- but the bad news is that something is definitely going on in there. And Dr. Gastro is dying to find out what it is. He asks (while you are sitting on the toilet making ungodly noises from all orifices, no less) for consent to do a -gulp- colonoscopy. In your delirium, you agree. Anything to make the poopy stop. Confirm they are going to knock you out.

15. Mentally prepare for medical rape. Not enough time to prepare... they arrive in 15 minutes. Do they really need so many tv screens? Have this conversation with the assistant: (assistant) "So, Angela, do you know what we're going to be doing to you today?" (me) "Yeah, I hear you're going to be sticking something up my butt." (assistant) "Yes, that's about it- minus the medical terminology." Gratefully accept one gram of Dilaudid. Begin procedure. (I'll spare the details here but basically... ick.) Scream, cry, and plead for the doc to stop as he tries to "round a corner of my intestine". Hold procedure. Wait for nurse to bring one more gram of Dilaudid. Wait for a minute for it to kick in, all the while knowing there's a camera up your butt. The procedure goes on and they can go deeper and deeper- finally getting to the infected part- which is covered in ulcers. Watch with druggy fascination. (Again, I won't go into details- but think of the grossest thing you can and multiply that by about 10.) Watch a grabby alligator clip come in and rip off a piece of two separate ulcers. The farther they go, the more there are. Cry with relief when it's over- and feel like you need a scalding hot shower; unfortunately the whole knee surgery thing prevents that. (Oh yeah... I had knee surgery. I forgot.)

16. Day Six: things start to slow down intestinally and your stomach seems to be a tiny bit less tender with decreased stabbing pains. Antibiotics have been changed and increased according to my new diagnosis: Ulcerated Colitis. Start the pills with "good bugs" for your intestines- which have all been killed and flushed... literally. Feel a little perkier from yesterday's blood transfusions. Blood pressure is still low, but not dangerous anymore. Blood work comes back looking good. Get up and walk around a little. Get put on a "Clear Liquid Diet". Drink about a quarter cup of broth, eat some jello (whoever created jello is a GENIUS) and have a Popsicle. Keep it all down (maybe "in" is a better word). Watch the Jerry Springer show and feel better about your own current situation.

17. Day Seven: Get moved up to a liquid diet- eat some unidentifiable soup and keep it where it's supposed to be. Lower your fever to around 99-100*. Raise your blood pressure a little more. Sit through a wound check- which is really swollen but seems to be healing great. Have the Internal medicine doctor come in and tell you he thinks you're on the mend... and that your butt can now go home with your knee. Hooray!

18. Have all IV's disconnected, free yourself from the CPM (Continual Passive Motion) machine, which has now fondly been dubbed the Constant Pain Machine and let your loved ones pack up your stuff. Sign a bunch of papers.

19. Try to fit yourself into a minivan when you cannot lift, bend, or move your giant, pain-filled leg.

20. Make it to home sweet home and sleep on your feather bed with your feather pillow and down comforter. Thank God for His Glorious Protection. Take Valium and Percocet (the dose that was prescribed... don't freak out) and don't wake up until 11am the next day. You don't even have to click your heels three times to know that "There's no place like home!"