This post continues the series of weight progress reports from the previous one.
My weight went up a little in August:
My exercise was down a bit for the month (only averaging 2.25 miles/day of bicycling, down from 3.48 in July and from my normal year-round average of just over 4 miles/day). Non-Californians may find this strange, but I bicycle much more in winter (daily commute to campus) than in summer. It hasn’t helped that we had a heat wave at the end of August—I’m no longer used to afternoons with temperatures over 95°F (35°C), and I just stayed in my nice cool bedroom/office all day.
I had really expected to lose some weight this month (despite the less-than-adequate exercise), because I had a colonoscopy in the first week of August. With 3.5 days of clear liquids only (about 400 Calories a day) and massive doses of laxatives, I expected my weight to plummet, needing some effort to bring back up. Look closely at that weight plot—do you see a drop at the beginning of August? Neither did I. Confounding my expectations, I put on weight during the colonoscopy prep—more liquid went in than came out. My experience should make it very clear that counting on laxatives for weight loss is a really bad idea.
And despite the rather draconian prep protocol I followed, the gastroenterologist pronounced the prep merely adequate, which is still better than the last two times, when a more standard protocol resulted in inadequate prep.
I have a very slow transit time (3–4 days, rather than the usual 1–2 days), so I need to customize the colonoscopy prep protocol. I customized the protocol this time, rather than following the standard one that the gastroenterology office wanted me to follow. Their protocols had failed twice already, because the protocols were based on an average individual, not customized for me.
The protocol I followed this time was
- Day –7:
- Discontinued nuts, whole grains, popcorn, fish oil, aspirin.
Continued multivitamins, atorvastatin, and calcium carbonate.
- Day –3:
- 00:00 Discontinued solid food.
11:30 two Bisacodyl tablets (2× 5mg)
17:30 one dose Purelax (17g PEG 3350) in 300ml apple juice
- Day –2:
- 00:00 Stop all alcohol, red, blue, or purple fluids.
10:30 One bottle magnesium citrate solution (17.45g magnesium citrate)
15:45 One bottle magnesium citrate solution (17.45g magnesium citrate)
- Day –1:
- 08:05-09:30 2L PEG-3350 solution in 8 250ml doses, 10 minutes apart (210g PEG 3350, 2.86g sodium bicarbonate, 5.6g sodium chloride, 0.74g potassium chloride)
- Day 0:
- 07:00 2L of PEG-3350 solution (in 8 250ml doses, 10 minutes apart)
10:40 stop all fluid intake
The Bisacodyl and Purelax had little effect, but the magnesium citrate was very effective. The PEG-3350 was rather slow-acting—very little of the 2L that I took early in the morning of Day 0 had come out six hours later. Drinking 2L in 75 minutes was very hard on my stomach—the first 1L was easy, but my stomach was painfully distended by the end of 2L. (I had deliberately selected a 4L protocol, rather than the 2L Moviprep protocol that I used last time, because I thought that the flushing action of more water would increase effectiveness.)
In five years, when I’m scheduled for the next colonoscopy, I’ll modify the protocol further, discontinuing solid food 12 hours earlier, replacing the Bisacodyl and Purelax with an earlier bottle of magnesium citrate (1 on day –3, 2 on day –2), and doing 3L of the PEG-3350 on Day –1 in 3 1L sessions (8:00, 12:00, 16:00), with only 1L early in the morning of the day of the procedure.