MY FIRST COLONOSCOPY

by Phantomimic All rights reserved RAGG

Preamble
I was trying to beef up my courage to have a colonoscopy. My doctor had told me I should have one because I was over 50 years old and 9 out of 10 people diagnosed with colon cancer are over 50. I knew the statistics, colorectal cancer is the second leading cause of cancer deaths (lung cancer is first) in the United States. Each year about 150,000 Americans are diagnosed with it and 50,000 die. But I had been dragging my feet for several reasons. First, the obvious, people don't like to have a cable inserted up their butts. This is maybe more so in the case of us guys with all the psycho-sociosexual connotations that this has, and especially even more in my case as I come from Latin America. Colonoscopies and proctologic examinations are not words you find in a macho man's dictionary. But these "feelings" were irrational. I knew that I should not let them cloud my judgment and that I had to get my head to think in the right gear and overcome this. Second, I was concerned about the risks of a colonoscopy. According to some quoted figures, the risk of heavy bleeding is 0.2 to 2.67% (1/1,500 to 1/37), the risk of a perforation of the colon during the procedure is about 0.03 to 0.07% (1/3,450 to 1/139), and the risk of death due to a colonoscopy is 0.003 to 0.03% (1/30,000 to 1/3,000). However, I knew there were several things to consider here. One is that these risk figures are compiled from data obtained from 1966 to 2001 and colonoscopies have been getting safer with time. Two, you have to compare the colonoscopy risk to the risk of developing colon cancer, which for a man my age over the next 30 years is

about 4%. (4/100), and three, you need to choose carefully who will do the procedure. In my case the doctors who were going to do mine did this on a regular basis and they had a lot of experience, which greatly decreased my personal risk of any complications. My third and final reason was the hassle/discomfort factor. I would have to take laxatives to cleanse my colon, I would have to take time off from work and I would have to coordinate with my wife drive me home. What finally made me make my decision was the experience of a friend of mine. This person went to the doctor due to difficulty in performing bowel movements. They did a colonoscopy and they found it was colon cancer. It was somewhat advanced but thankfully it was wiped out by the chemo treatment and now my friend is cancer-free. This person was lucky as most of the time colon cancer in the early stages does not produce any symptoms. I knew that when diagnosed and treated early colorectal cancer is 90% curable, but it took someone else's experience to drive the point home. I signed up for the colonoscopy!

Preparations
What is the first thing a sensible man like me does in preparation for his colonoscopy? I went surfing the net looking for colonoscopy jokes! Hey, I was stressed, I needed some humor, but a word of warning, some of these jokes are tasteless and others not politically correct! These are actual things said by mostly male patients to their doctors during the procedure. 1. 'Take it easy, Doc. You're boldly going where no man has gone before!' 2. 'Find Amelia Earhart yet?' 3. 'Can you hear me NOW?' 4. 'Are we there yet? Are we there yet? Are we there yet?' 5. 'You know, in Arkansas, we're now legally married.' 6. 'Any sign of the trapped miners, Chief?' 7. 'You put your left hand in, you take your left hand out...' 8. 'Hey! Now I know how a Muppet feels!' 9. 'If your hand doesn't fit, you must quit!' 10. 'Hey Doc, let me know if you find my dignity.' 11. 'You used to be an executive at Enron, didn't you?' 12. 'God, now I know why I am not gay.'

And the best one of all: 13. 'Could you write a note for my wife saying that my head is not up there?' But perhaps the funniest thing I found was the following YouTube video from an episode of the sitcom "My Wife and Kids" featuring the late singer Lou Rawls and the stand up comedian Damon Wayans (video length 1.33 minutes). http://www.thedocisin.net/?p=13370 Of course, the internet is not only for fun and games, there are educational videos about colonoscopies and what to expect (video length 10.09 minutes). http://www.youtube.com/watch?v=JKfMx06hg7E As well as videos about what a normal colonoscopy should look like (video length 2.52 minutes). http://www.youtube.com/watch?v=6kg5wZQfADQ Anchor Katie Couric, whose husband died of colon cancer, underwent a colonoscopy on the air in 2000 to increase awareness about this procedure. In the following video she guides Early Show anchor Harry Smith through his colonoscopy (video length 19.35 minutes). http://www.youtube.com/watch?v=zLAPQdlXgdU&NR=1&feature=fvwp

But let's get back to me. I scheduled my colonoscopy for 8:45 AM and received a set of instructions. The day before my procedure I could have 2 eggs and white toast with seedless jelly for breakfast but no dairy products. However I could have no lunch or dinner. Instead I could drink fluids like tea, apple or white grape juice, chicken or vegetable consomm (clear broth), or I could eat yellow or green Jell-O. What they don't want you to do is eat solid food or anything with a strong color approaching red that could be misinterpreted as blood during your exam. I employed the energy from the breakfast to shovel my car out from under the snow in the morning, but then I took it easy for the rest of the day. I began my "cleansing" at 5 PM taking 2 tablets of a laxative called Dulcolax and 1 hour later I begun taking the heavy stuff, a total of 5 doses every 20 minutes, each made up of 2 cups of the laxative Miralax dissolved in 8 ounces of the drink Gatorade (lemon: yellow color). I had feared that I would be nauseous and had even purchased some anti-nausea medicine, but the stuff just tasted like the Gatorade and I had no problems. My trips to the potty began about 1-2 hours after the first dose and continued late into the night. I had been concerned about feeling dizziness or weakness but I felt neither. After several "sittings" I said to my family, "Hey look, I'm not full of shit anymore!" My wife rolled her eyes and gave me a skeptical look but my daughter thought it was funny. After my "Niagara" subsided I went to bed but not for long. I had to wake up 5 hours before my arrival time and repeat the above routine. So I just stayed awake all night and read some Scribd documents in between trips to the bathroom.

C-day
My wife dropped me at the clinic where I had to sign a handful of forms and then I was escorted to a locker room where I had to put on one of those hospital gowns that I have never figured how to tie up in the rear. So holding the back of my gown closed with my hand to avoid mooning anyone, I walked over to the preparation room. Here I was asked to lie on a bed and a nice nurse got me ready inserting a cannula into a vein in my arm (an iv drip) and hooking me up to several monitors that began spitting out data about my hearth function, blood pressure and level of blood oxygenation. My bed was then rolled over to the procedure room. Once there the anesthesiologist went over the whole thing with me. They would anesthetize me for the procedure. Some doctors don't do this and some patients request to be awake or mildly sedated, but for the colonoscopy the doctors have to pump air into the colon to inflate it and this can be painful. Looking to my right I was able to see "the tube", the colonoscope, and I started laughing. The thing had marks with numbers at regular intervals like a dipstick. The anesthesiologist explained that those marks were there so the doctor could "gauge" at what level of the colon he was in case they found anything. The marks were spaced out every 10 centimeters. I saw that the one farthest away from the tip read "160". For you metricchallenged people that is a whoping 5 feet with 3 inches. The doctor arrived and asked me how I was and whether I had been briefed on the procedure and so forth. I asked him if he had seen the colonoscopy

spoof video with Lou Rawls that I mentioned before and to my surprise he said he had! Then it was time to get started. The anesthesiologist started injecting some white fluid into me through the iv drip. I remember saying, "I feel funny." and next thing I knew I woke up in the recovery room where through my anesthetic-induced haze I heard the nice nurse say that I should try to pass some gas. "Huh, say what?" I replied. She explained it was to get rid of the air they used to inflate my colon. I said, "Yeah, sure." After I was not drowsy anymore the doctor came over and showed me pictures of my colon. He said everything was normal except for a small polyp that he removed for analysis and that I should call him in 2 weeks to get those results. When I was awake enough to walk I got dressed and my wife drove me home. I took it easy for the rest of the day and apart from some flecks of blood after a bowel movement and some mild intestinal discomfort I had no other problems. After two weeks I contacted the doctor who said the polyp and other random biopsies that they took had been normal. I am now happy to report that I am back to eating and "uneating" normally and regularly. And that was it! The "feared" colonoscopy was no big deal after all. For all you who are 50 or older please consider having this procedure done, and for those of you who are not quite there yet, ask your older relatives if they have had one. Colon cancer is curable if it is detected early and a colonoscopy could save your life.

The image from the National Cancer Institute is in the public domain. Other web-sites Colonoscopy risks: http://coloncancer.about.com/od/screening/a/ColonoscopyRisk.htm Colorectal cancer risks: http://www.cdc.gov/cancer/colorectal/statistics/age.htm

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