Thursday, April 17, 2008

You Want to Stick That Where?

Today I got a colonoscopy. It's a preventive procedure recommended to people over 50. A gastroenterologist inserts a tube with a camera on the end into the rectum and searches the large intestines for polyps that might become cancerous and any other problem.

To prepare for the procedure you can't eat for a day. You have to take laxatives at certain times to clear out the intestines. The normal dose of Fleet posphosoda is one teaspoon; for colonoscopy prep, you drink two full bottles of the stuff. And yes, it does the job.

The procedure took a little over two hours, including registration, getting an IV inserted, hooking up to a heart monitor and getting an oxygen tube in my nose -- and then lying on a bed waiting. I was told I would get a mild sedative, but I never lost consciousness. During the procedure I watched the whole thing on television. Those were some damn fine looking intestines. Hell, if intestinal fortitude (so to speak) is any measure, I should last another 50 years.

Afterward, the doctor told me to do it again in 10 years. I guess I can wait that long.

The clinic insists you bring a driver, because the so-called sedative is supposed to render one unable to drive. What a crock. I could have driven. But their overcautious rules made me get my Mother to drive and waste her time there. Shouldn't the health care industry worry about health care and leave how adults get to the clinic to their own judgment? Must they act like nannies? Is this the result of our infantilized society or is it some twisted effect of malpractice suits?

We stopped at Coco's for lunch on the drive back, where I attacked a Tuscan ribeye steak with vigor. It got ugly there for a few minutes.

Do I recommend the procedure? Well, I'm no fan of the contemporary trend of celebrities nagging people to do this, that and the other thing. I assume the reader can run his own life. Speaking for myself, I'm glad I did it. The hassle is minimal and it's nice to know nothing is wrong down there.

14 comments:

Anonymous said...

I got one last month. I was very woozy after the procedure. I couldn't have driven home

Myrhaf said...

So much for my anecdotal evidence...

Kendall J said...

When I had mine, I couldn't have driven either.

As to whether to get one, I'm a huge proponent. When you consider that cancer treatment is basically in the dark ages, there is one very basic rule to remember. Your chances of survival still depend wholly on how early cancer is found. Colorectal cancer is one of the big 4 (breast, prostate, and I don't remember the 3rd one) cancer killers. You can't see colorectal polyps growing and by the time external symptoms of excessive growth show, you could easily already be in stage 3. Get the screening after age 50. It's that simple.

Galileo Blogs said...

Myrhaf,

I feel encouraged by your post that it was not a big deal. I have heard the same from others who got the procedure, but I still find the procedure disturbing. I am none too eager to do it, but even though I am only 43 I plan to get it done this year.

It runs in my family on my mother's side. My mother was just diagnosed with it, and had a "carcinoid tumor" removed. Her brother (my uncle) had colon cancer 7 years ago and has survived it. Her mother (my grandmother) died from it.

So, it's Fleet for me in a couple months! Ugh!!

Patrick Joubert Conlon said...

I drove after both of mine. Colonoscopies are easier than endoscopies - down the throat into the stomach and small intestine. They pump air into your guts and it is agony when it passes through the large intestines.

Moriarty said...

Is this the result of our infantilized society or is it some twisted effect of malpractice suits?

It's liability. If someone wracks it up on the way home, the blame will be made to lie squarely at the feet of their physician and the facility. Informed consent, disclaimers and releases aren't worth the paper on which they're printed.

This sort of thing makes for an interesting situation when patients show up at my office in extremis and they want to drive to the ER rather than be taken by ambulance. They have an unquestionable right to exercise their autonomy and may refuse transport and treatment. However, I have an absolute duty to protect the public and can be prosecuted if they cause an accident after leaving my office. Calling the police to report them as an unsafe driver is a nice thought, but that may violate their privacy under HIPAA, also subjecting me to felony prosecution.

So now you know why we have such overcautious rules.

Myrhaf said...

Thanks for explaining that, Moriarty. Health care workers have my sympathy -- just dealing with government required paperwork must be a nightmare.

Moriarty said...

You're welcome. (Now if someone could explain to me how to get Medicare to shake loose of the $25k they've hung on to -- in error -- before we have to make payroll, I'd be appreciative.)

As to colonoscopy: We all know that the plural of anecdote is not "data." That said, I've had two patients die of colon cancer in the last 8 years, both of whom adamantly refused colon cancer screening. It's worth nothing that Versed and fentanyl (the cocktail most often given for conscious sedation) typically causes profound amnesia for the procedure. Most patients remember nothing of their colonoscopy and will tell you that the bowel prep was the worst part of the whole thing.

If you can't afford or refuse to undergo colonoscopy, at least be sure you're getting a yearly fecal occult blood test.

It's cheap, it's a whole lot better than nothing and we have credible evidence that it saves lives.

Moriarty said...

It's worth nothing that Versed...

... and it might even be worth noting.

Sheesh.

Inspector said...

TWO bottles of fleet? I had one of those once.

Once.

It's not an experience I'd care to repeat. But you gotta do what you gotta do, I suppose.

Inspector said...

So, Myrhaf, out of curiosity: which face on the left should I look at when viewing this post?

Myrhaf said...

This is a lighter post, so I would go with the happy face. Perhaps a shot of my backside would be most appropriate, but who wants to see that? Moon River...

Monica said...

I have never had a colonoscopy. I don't plan to get one soon -- I am only 33 -- but I had two grandparents die of colon cancer. So... I should.

Yes, myrhaf, we can all run our own lives but these types of stories are helpful. It is always good to know what other people are doing to improve and maintain their own health. Colonoscopies are one of those obvious things, but there are other things that aren't.

Myrhaf said...

Thanks, Monica. I know that if I had not had the procedure and then got inoperable colon cancer, I would be kicking myself.

My father and my best friend's father both died of heart attacks in their 50's, and both had symptoms of angina that they ignored. People evade going to the doctor because they don't want to hear the bad news -- but in doing so, they make the news worse.