Friday, September 26, 2008

My Colonoscopy: The Procedure

Well, since I definitely do not want to belabor (at too great a length) a topic like "My Colonoscopy," this will be -- I promise! -- my last post on the topic. Hopefully forever.

When last we left our hapless colonoscopy patient, he had completed his tedious ... but survivable ... colonoscopy preparation regimen, and was headed to the clinic (an hour earlier than originally scheduled!) for the "Big C."

Waiting rooms at colonoscopy clinics are interesting places. I took comfort in the fact that most of the people there looked (more than I felt I looked, anyway) like they SHOULD be there. Grumpy looking old farts who could have been members of the IBS Club, every one of them.

Well, we cling to whatever comfort we can at a time like that.

I was pleased to discover that my health insurance covered (completely!) the cost of this procedure, considered preventative. I was expecting to at least pay a copay. Sweet! Primera, you rock!

After 15 minutes or so, a cheerfully pleasant (for such an early hour on a Monday morning) sounding female nurse called me into an examination room. She instructed me to dress in appropriate garb (two of those open-backed hospital gowns, one for the front and one for the back, assured a certain amount of decorum.) She took my vitals, explained the necessary details, answered questions, and proceeded to look for a good vein to hook into.

I used to get pretty nervous around needles, but thankfully that condition has been cured by the fact that I have forced myself to try and become a county champion blood donor (am headed toward my 2-gallon mark right now), and also my numerous bike accidents. (My first accident, I think they stuck me 7 or 8 times trying to find a good vein. Fortunately, my face hurt so bad at the time from striking the pavement that I barely even noticed.)

So, I could practically sleep while the IV was being hooked up. Which was good, because even with my excellent veins, this time they had a hard time and had to poke me three times (apologetically) before getting what they needed. I think the issue was the fact that I was fairly dehydrated by the prep. I had drunk water for breakfast but only up until a certain point, and I was pretty thirsty by the time the procedure rolled around.

My wife (the RN) has always said I had great veins, which this nurse agreed was the case, she just couldn't get the needle into them quickly.

Anyway, once that was done she took me into the procedure room, which was bustling full of people and equipment. I met several nurses, all very cheerful, and then my physician, relaxed and professional. All very reassuring. They had me lay on my left side and a nurse explained that she was pushing into my IV a cocktail of two drugs, one a painkiller and one a sedative designed to send me into "twilight sleep" -- a state of "conscious sedation" where I would probably remember very little but they could still ask me necessary questions or get my help moving, etc.

At this point I have about 10 or 15 seconds worth of discrete memories left ... I remember (after about 5 seconds), feeling remarkably warm and cozy and exclaiming, "Wow, that feels like one beer."

Another 5 seconds, I felt twice as warm and cozy. I said, "Wow, and that feels like two beers."

I fully remember I intended to say, at one point, "Wow, that feels like three beers ..." but whether I ever actually did or not, only the nurses know for sure.

I don't have any memory of the doctor doing anything behind me, of any cold instruments, or of any other instructions. My only very, very fuzzy memory is that, apparently at some point in the procedure, I felt vaguely uncomfortable (maybe crampy?) in my abdomen. I remember thinking, "I should tell them that feels uncomfortable." I don't know whether I did or not.

They warn you that you can experience cramping, due to the air that is blown into your colon by the instrument in order to open up the various folds so they can see and navigate. Therefore they give you permission and encouragement to expel this air so you can feel more comfortable. (Like, what guy needs permission to do that, anyway?)

My next memory is of my wife standing at my side in the recovery room. I have no idea how I got there. I think the doctor may have been there at first, explaining the results of the procedure. He seemed encouraging. They found two "sessile polyps," he felt they were nothing to be concerned about, but they had removed them for biopsy just to be sure and would have results back within 10 days.

Polyps are fleshy little growths (similar to skin tags, I think) that come out of the sides of your colon. Usually they are benign. Some people (with certain generic predispositions) actually have thousands of them. Most people my age probably have a few. My two were about 6 millimeters in diameter (less than a quarter inch). They remove them with "electrocautery," a little wire loop that is part of the submarine assembly which they tighten around the polyp, then send a current through to burn it off.

I wondered whether this might have been the source of my brief discomfort, but supposedly you can't really feel that happening, so I doubt it.

It was probably the air. I remember feeling slightly balloonish. But I am proud of the fact that I was more discrete than some of the others behind various curtains in the recovery room. I don't remember this, but Darlene said it sounded like some kind of macabre musical symphony in there.

I got a cool souvenir color printout of a couple of photos they took from the inside. How many of you have ever seen what the opening to your appendix looks like? (From the inside?) Been there, done that. Technology is amazing.

Anyway, a little while longer for me to recover my wits and I was able to walk out of there under my own power to resume my day. They said not to drive or return to work, so Darlene drove us both to a nice cafe where we had a lovely breakfast, then I enjoyed the rest of the day off. I went back to work the next morning. I felt like I had a little trouble focusing my eyes on my computer screen, but I suppose that was just a residual effect of the medication.

About a week later my results came in the mail. The polyps were completely harmless, the lab said, and I didn't have to return for another 10 years. Hallelujah!

So, that's it. Nothing to fear. A couple of days thinking about your large colon, and 10 years of freedom. Nice.

So, to the moral of the story: If you are 50+ like I am ... or, if for some reason (such as other members of your family who have experienced colon problems) you are at a higher than normal risk for colon cancer ... you should DEFINITELY get a colonoscopy. Take advantage of this great technology. It will put your mind at ease and safeguard your health. Ask your doctor for a referral. Do it today!

Feel free to comment and to share your own story or ask questions. I'm interested how my experience compares to others.

Thursday, September 25, 2008

My Colonoscopy: The Preparation


OK, the votes are in, and, by a vast margin of 1-0 (see the blog before last), they are in favor of me sharing about my recent colonoscopy experience.

This is not for entertainment purposes, mind you. It is simply to help someone (like me, three weeks ago) looking to see what this routine procedure is like from the patient's perspective.

It started with me overcoming my internal debate and calling the digestive health center to schedule the colonoscopy, after the requisite pressure from my RN wife and me getting a referral from my regular physician. (In my case, my colonoscopy was simply due to my age, now 51, and was meant as a baseline. I haven't had any problems that drove me to get one.)

The clinic staff was very polite and reassuring on the phone. They would send me an important packet with preparation instructions in the mail.

The packet came little more than a week before my procedure was scheduled. The instructions were detailed and clear as regards the prep.

The goal is to arrive at the outpatient clinic for the procedure (in my case, at 9:30 on a Monday morning) as "clean as a whistle." Preparation begins about 3 days before the procedure, by observing a diet mildly restricted -- no seeds or nuts, etc. Things that might get stuck in there and hang around for awhile.

Then, as of breakfast the morning before the day of the procedure, that's when things really get kicked into gear. Liquids only, then you drink the first of two potions ("Fleet Phospho Soda" or the equivalent generic, which costs about $4 or $5 for a 1.5-ounce dose at your drug store), designed to make sure your submarine has good visibility once inside.

I had actually been taking it easy food-wise for the past three days. No red meat, etc., which wasn't hard since I normally only eat red meat once a week anyway. This wasn't part of the instructions, I just thought it would be a good idea. And that wasn't hard, but I was a little nervous, so I went into the weekend fairly hungry anyway.

You have to understand that I am not one of those people who can't fast. I actually enjoy the occasional challenge of going without food for a full day, which I find helpful in getting my mind focused on other things, mostly of a more spiritual nature than my stomach. So, I can deal with being hungry.

My problem was that the day before Monday was Sunday (no duh, huh?), which is typically very busy for me. I was supposed to make some important announcements in front of the entire congregation during worship. One particular part of the instructions caught my eye: "After drinking your first 1.5-ounce dose of Phospho Soda, don't let yourself get too far away from a toilet." The instructions warned that this need could come on you very suddenly. So the thought of that happening while I was standing up in front of 200 people in church was sobering. I hence decided to push the envelope and wait until after church for my first dose. (And, I dutifully skipped the church picnic.)

Basically the prep is a clear liquid that you mix in 8 ounces of something drinkable. Looks like water, tastes like concentrated seawater. My wife, an RN with prior experience, recommended cold fruit juice. The thing to understand about this concoction is that the taste is the worst part. It's basically like drinking sea water, even in the juice. But, you force it down, knowing it's what you need to do, and gratefully it's over as fast as you can drink it, in my case about 2 minutes. You then drink another 8 ounces of juice just to clear the saltwater taste off your tongue. Plus it's recommended to take lots of fluids to replace what you're going to lose shortly.

A normal dose (for laxative purposes) of this stuff is a third of a bottle, half an ounce. So I suspected that a triple dose times two (recommended for just such a cleansing) ought to have dramatic results. I immediately sensed that wasn't far off the mark. The moment the stuff hits your stomach you start to feel some unusual motion. No nausea, or anything like that, just movement. A distant thunder. Storm brewing. Odd.

Instructions say it takes between 30 minutes and 3 hours to have your first BM. (You're supposed to call the doctor if nothing happens after 3 hours. I assume this means you need a plumber in a bad way.)

For me it was 45 minutes. Of course the first time (which I was rather hoping was the last -- foolish boy) is the worst, because that's where the heavy lifting is done. But don't think, "Whew, I'm glad that's over," because believe me, it's not. Your GI system is now revved up and the motor is running. The next few hours you will become well acquainted with your commode.

I had mild cramping (not bad) during this first run. After 3 or 4 hours I felt more or less normal, just a little tired of all the action, and thinking, "Wow, what on earth do you need a second dose for?" I guess it's just insurance.

Now you're on clear liquids only. Jello, broth, things like that. Whatever you put in pretty much comes out, in pretty close to the same state you put it in. The second dose tasted just as bad as the first, and had an almost immediate result. Each time you're a little clearer, until basically it's just a clear yellowish liquid.

The only other annoying thing that, and this was really about the worst of it, was that I began to get a little sore "down there." TP was the enemy. I found a little diaper ointment, discretely applied, helped a lot.

The second dose caused no cramping this time. And of course, if you're like me, by this time you haven't eaten for about 24 hours and you are hungry. But the good news is that I caught up on a lot of reading to try and keep my mind off my stomach.

The next morning, before the procedure, I just drank water, though they allow more (clear liquid, coffee, etc.). I'm not the kind of person who needs coffee, so I didn't bother.

I was glad the clinic called and asked, "We had an appointment cancel ... can you come in an hour earlier?" Rather not waste the time just waiting around.

So, the prep is done. The worst part is over ... and, as I said in response to my one comment, it's really not that bad. You just need to be prepared to do "nothing but" (no pun intended) for 24 hours before your procedure.

Next installment: the colonoscopy itself.

Wednesday, September 24, 2008

Clever Tees

Recently I've enjoyed discovering some of the creative tee shirt designs at SnorgTees.com, and think you'll get a kick out of them ...

























































































Tuesday, September 23, 2008

Just a gut feeling ...

OK, I'm having a huge internal debate. (And that sentence itself will probably sound a little funny if you read on a little bit ...)

Recently (a year and a half ago) I turned 50. One of the lucky things that is supposed to happen to you when you turn 50 is that you're supposed to get a baseline colonoscopy. Doesn't that sound like fun?

Well, it didn't sound like too much fun to me, exactly. My colon has always felt just fine, thank you very much. Most of the time, anyway ... unless I eat one of those little "Madness" habanero sushi things at the Blue Ocean sushi bar. So anyway, my wife (the nurse) convinced me I needed to get it over with. Therefore, one of the things I was interested in was hearing (from someone who had had one already) exactly what it was like. I had questions!

I talked with several 50+ folks who had already experienced the big C. Mostly they agreed that the procedure itself (because of the "conscious sedation") is a piece of cake compared to the prep. But they didn't get too specific about what the supposedly terrible prep was like, so that wasn't the most helpful statement imaginable.

I realize of course that anything that has to do with that particular end of your body is normally kept fairly private and is not (hopefully) a huge topic of conversation. At least not polite conversation.

I actually appreciated Katie Couric's brave "coming out" when she got her colonoscopy on TV, mostly in an effort to encourage more people to have this life-saving procedure.

Anyway, I went looking for blogs on the topic. I wondered, was anyone out there talking about exactly what they experienced in their colonoscopy? I wanted to be prepared.

I found a number of blog entries dealing with colonoscopies. Some were technical in nature (apparently written by med techs giving advice about how to get the scope moving when it's "stuck" in there), and lots were, "Wow, I have to get a colonoscopy, I'm really not looking forward to that ..."

I didn't find any actually describing the procedure (and the preparation) from the patient's perspective.

So, fast forward to today: I had my colonoscopy a few weeks ago, and it really wasn't that bad (either the prep or the procedure). I mean, I've had more fun at a Tupperware party (just kidding, I've never really been to a Tupperware party) ... but it wasn't as bad as I was prepared for. So, I'm thinking about blogging about it. Sharing the gruesome details for someone else who might be considering it.

But I'm still fighting this feeling that talking about one's hiney on the internet may be sharing just a bit "too much information." Can the blogosphere handle a blog with me describing the entire colonoscopy experience, step-by-step?

So I'm tossing a bone out there. Someone please comment and let me know what you think about this. Would this be a benefit to someone out there who is scheduled for a colonoscopy and wondering what to expect, if I shared my experience in detail?

Thursday, September 18, 2008

I Just Might Change My Vote

In a recent lunchtime political debate with a friend, I was listening to the stream of invective about all the horrible things Sarah Palin has supposedly done. I stopped her when she began parroting the line about how Palin was "for the Bridge to Nowhere, before she was against it." 

"Just wait a minute," I said. "Do you mean to tell me that you would vote for a politician who was unwilling to change their position on a project like this even if the circumstances fundamentally changed? Because that's what Palin did."

I realize, of course, that it makes a damaging sound bite to say, "I voted for it, before I voted against it." But the truth is, I wouldn't vote for anyone who was so unthinkingly committed to a proposition that they would refuse to change their position even if the circumstances changed dramatically.

My friend then asked, apparently frustrated, "Are you so committed to Palin that she couldn't do ANYTHING to lose your support?"

Of course not! I'd be happy to work against her, rather than for her, if she fundamentally (through her actions) changed my opinion about her positions and her integrity.

For instance, she might decide to abandon unborn children (the ultimate powerless victims) to those powerful people who were trying to sanction their murder. She could decide to jump onto the embryonic stem cell research bandwagon, even though it's totally unwarranted and unnecessary, simply because it was the politically expedient thing to do. (By the way, McCain's support for embryonic stem cell research is one of the reasons I haven't been real excited about him.)

She could stop thinking logically about America's vast natural resources and decide that, rather than supporting the cautious exploration of the ANWR for oil and gas she would instead seal these remote areas off from exploration and seek to throw even more American energy money to Arab nations who don't deserve it and function as a hotbed for terrorists.

These are just for starters. You see, there's all kinds of things Sarah Palin (and John McCain) could do to lose my vote. I'm not like those who criticize a politician for changing her mind when the circumstances change. If she changes her positions, if she compromises her integrity, I'm sorry, I'm outta here.

However, I would like to turn my friend's own question back on her: "Is there anything at all that Sarah Palin could do that you WOULDN'T criticize her for?"

Like others, I've been following the news about the hacking theft of Sarah Palin's personal e-mail account on Yahoo. The Huffington Post had an interesting article about this. They insinuated that Palin was somehow wrong for having such an e-mail account, that she must have been trying to hide government communications from the Freedom of Information Act.

Comparing Facebook groups 1 million strong for Sarah and 1 Million Against the New Facebook layout
Give me a break! Did you Huffers even watch the news this morning? Even on the Today Show, they said there was nothing in her personal e-mail account but personal e-mail, and that the theft would actually work in her favor because it would show that she had actually done a good job separating the two (keeping her government e-mail on government accounts, and her private e-mail on private accounts).

This is certainly better than I could do. My business life and my private life are so intertwined that I have a tough time keeping personal stuff out of my business e-mails, and keeping business talk out of my personal e-mails. I certainly try, but it's a challenge. (Unless, of course, I'm trying to hide something from the public ... then I put it in my gMail account where it is likely to get HACKED and posted on the Internet! Sorry, that's sarcasm slipping in, isn't it?)

I think this must be true of anyone who loves their job. If you work 60 hours a week, 20 of them at home, how do you keep one sphere from seeping into the other? It's tough. I admire Palin for demonstrating some measure of success at this.

The REAL question is, why aren't we going after the people who (illegally, I might add) hacked into Palin's personal e-mail accounts at Yahoo? That is so wrong it makes me seethe. Can you imagine that happening to you? How angry would you be if someone hacked your most personal e-mails to your friends and displayed their contents on the internet?

Why aren't the "champions of privacy" coming to Palin's defense and pointing out that she is the victim here? Why are her private e-mails instead being splashed in the media? (The same media who are refusing to cooperate with the government investigation of the crime?)

And why isn't the Huffington Post concerned about this aspect of this recent revelation? Oh wait, I guess you can file this under the triumph of ideology, right?

Okay, this is only my second political post in the last 15 years. And my second in the last month. Hmmm. I guess I must be slipping.