To most who've had a colonoscopy, the prep beforehand is what they say is the hardest part. The night before and the morning of, you take some solution that cleans you out. Then you're good to go for being scoped. The first round of prep didn't do it for me though. The procedure was postponed one day to do another round of prep.
The prep didn't seem like a big deal though. Other than it not clearing things all the way out the first day. Maybe it seemed OK because I was flying a little bit on 5x my normal dose of hydrortisone. Per my endocrinologist, with adrenal insufficiency I need to updose because things like this prep are a strain on the body. I guess that's what the adrenals would normally be told to do by the pituitary gland, but since mine doesn't, I updose instead. In any case I didn't find the prep that bad at all.
Or maybe it also seemed easy because of the apparent slow speed of things moving through my gut. Even the 2 rounds over 2 days got me 80% clear (per my GI doc on follow-up). Not 100% but enough to achieve the main purpose of the lower (and upper) endoscopy, which was to see if there was any inflammation, which adverse effects from immunotherapy could cause.
My GI doc said that about 5% of people require 2 rounds of prep, due to what she called 'slow transit'. There's various terms used, but there's no precise medical term, and it's not considered a problem in and of itself.
My oncologist has been thinking of doing a 'booster dose' of Ipi. But because of some GI symptoms I had over the summer, he wanted to check that out first, which is why I got scoped. As there was no inflammation found, I have the green light to try it out.
I don't know what happened to me GI-wise this summer (June, July and a little of August I think). I went on a one-dose "vacation" from Nivo. Maybe it was some diet changes I made. I'd read articles coming from MD Anderson and the Parker Institute for Immunotherapy suggesting that the effectiveness of immunotherapy might be strongly influenced by diet. Like tons of vegetables, raw being good, fruit, legumes, whole grains only and so on, with a diversity of ingredients. The theory being this affected the diversity of the gut biome, which in turn may affect the success of immunotherapy. They also suggest that probiotics might reduce the effectiveness of immunotherapy because they reduce gut biome diversity. I went almost all the way implementing these suggestions. Along with other changes I subscribed to a food home delivery service called Thistle that delivered meals, salad-like and otherwise, with very diverse raw ingredients.
The more of this change in my dietary style, the worse I felt. It may be coincidence, but among other things I was feeling stress going up and down one of my arms and had an EKG. I started feeing not good in my gut. I also started having a lot of back pain. A PET scan around the same time showed some gastritis. I backed way off the diet. I switched to the kind of diet that people with Crohn's and colitis eat -- low fiber, not legumes and nuts, not raw vegetables, not certain kinds of vegetables at all, and so forth. May be coincidence but my gut and arm discomfort, and back pain eased off.
The colonoscopy was a few months after all this. I'm eating like I used to before trying the "maybe good for immunotherapy" diet and my gut feels fine. Like I said it may have nothing to do with those symptoms at all. But I'm not likely to be gung-ho with diet changes like that again. With the "all clear" my oncologist is planning to do the booster dose of Ipi after the holidays.
I'll have an MRI next week and a PET/CT the week following.
The prep didn't seem like a big deal though. Other than it not clearing things all the way out the first day. Maybe it seemed OK because I was flying a little bit on 5x my normal dose of hydrortisone. Per my endocrinologist, with adrenal insufficiency I need to updose because things like this prep are a strain on the body. I guess that's what the adrenals would normally be told to do by the pituitary gland, but since mine doesn't, I updose instead. In any case I didn't find the prep that bad at all.
Or maybe it also seemed easy because of the apparent slow speed of things moving through my gut. Even the 2 rounds over 2 days got me 80% clear (per my GI doc on follow-up). Not 100% but enough to achieve the main purpose of the lower (and upper) endoscopy, which was to see if there was any inflammation, which adverse effects from immunotherapy could cause.
My GI doc said that about 5% of people require 2 rounds of prep, due to what she called 'slow transit'. There's various terms used, but there's no precise medical term, and it's not considered a problem in and of itself.
I don't know what happened to me GI-wise this summer (June, July and a little of August I think). I went on a one-dose "vacation" from Nivo. Maybe it was some diet changes I made. I'd read articles coming from MD Anderson and the Parker Institute for Immunotherapy suggesting that the effectiveness of immunotherapy might be strongly influenced by diet. Like tons of vegetables, raw being good, fruit, legumes, whole grains only and so on, with a diversity of ingredients. The theory being this affected the diversity of the gut biome, which in turn may affect the success of immunotherapy. They also suggest that probiotics might reduce the effectiveness of immunotherapy because they reduce gut biome diversity. I went almost all the way implementing these suggestions. Along with other changes I subscribed to a food home delivery service called Thistle that delivered meals, salad-like and otherwise, with very diverse raw ingredients.
The more of this change in my dietary style, the worse I felt. It may be coincidence, but among other things I was feeling stress going up and down one of my arms and had an EKG. I started feeing not good in my gut. I also started having a lot of back pain. A PET scan around the same time showed some gastritis. I backed way off the diet. I switched to the kind of diet that people with Crohn's and colitis eat -- low fiber, not legumes and nuts, not raw vegetables, not certain kinds of vegetables at all, and so forth. May be coincidence but my gut and arm discomfort, and back pain eased off.
The colonoscopy was a few months after all this. I'm eating like I used to before trying the "maybe good for immunotherapy" diet and my gut feels fine. Like I said it may have nothing to do with those symptoms at all. But I'm not likely to be gung-ho with diet changes like that again. With the "all clear" my oncologist is planning to do the booster dose of Ipi after the holidays.
I'll have an MRI next week and a PET/CT the week following.
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