Hello Everyone! Well, I don’t know about you, but I can’t believe it’s May already. Five months into the year! And as with any year, I spend this month — and most of my spring — catching up with all my doctor appointments. Dental exam and teeth cleaning, full body skin check with my dermatologist, suspicious “spots” frozen off, six month breast exam, bi-annual blood work — AND this year, just for good measure, I decided to throw in a colonoscopy as well! Talk about a spring cleaning!
Now, with my medical history I have a colonoscopy every two to three years. (Indeed, I probably hold the World’s Record of colonoscopies undergone by any one individual over a twenty year period.) This, of course, is based upon the fact that I have already survived one bout of colon cancer and the disease runs in my family. The absolutely great news about colon cancer, however, is that it is nearly one hundred percent preventable! So, let me walk you through my experience and explain.
As anyone who has undergone a colonoscopy will tell you, the procedure itself is nothing — it’s the preparation that presents the challenge. And, the prep begins the day before your procedure when you are required to fast. No solid foods are allowed — only clear liquids may be consumed. Then, sometime in the afternoon usually between 2:00 PM and 6:00 PM, one must begin taking a powerful laxative that will completely flush the intestinal tract.
Years ago, this solution was known as “Go-Litely” — a name the irony of which I’m sure is not lost on anybody — and one was required to drink a half gallon of the foul tasting liquid. In the alternative, some of us preferred instead to drink an ounce and a half of soda phosphate solution or to take several Visicol tablets with plenty of water. While these latter two “methods of evacuation” were easier to stomach, they both were found to be particularly hard on the kidneys — always a possibility when one consumes a laxative and becomes dehydrated. As a result, they were discontinued by their respective manufacturers.
Fortunately, today there are two viable alternatives to this cleansing process. The first is recommended and used by the Sloan Kettering Cancer Center in New York for their colonoscopy patients. It is a user-friendly recipe that utilizes over-the-counter ingredients including good old Gatorade and Miralax. The second is a solution called Prepopik, which also is very user-friendly. One simply takes five ounces of the liquid the day before the procedure followed by five eight ounce drinks of clear liquids (and regardless of what my husband may think this does not include gin) — and another five ounces the morning of the procedure followed by three eight ounce drinks of clear liquids. Although Prepopik requires a doctor’s prescription, it tastes surprisingly good — rather like lemon-lime soda pop — which made it my personal choice.
Rest assured, however, that whatever method is chosen for this preparation the result will be the same. I always say, “Have the running shoes on and be prepared to move quickly.” In addition, make sure there is plenty of toilet tissue — or baby wipes — available in the bathroom. And, it’s always a good idea to keep some petroleum jelly nearby to apply after each bathroom visit. This will help prevent chafing of the sensitive anal tissue as you progress through the cleansing process.
All right — now that that’s behind us 🙂 — the rest is easy! We come to the day of the procedure. One needs a ride to and from the facility or clinic. Upon arrival, the patient fills out a few forms and is taken into a cubicle with a hospital bed and garments to put on. In my case, the garments came with verbal instructions from the nurse which were, “Gown opens to the back, hat goes on the head and socks go on the feet.” I suppose this is necessary. I’m sure some people get nervous and would probably end up putting the socks on their head and the hat on their feet if they weren’t told otherwise. So, I get it. No smirks from me.
Now, once one is cozy in bed (it really is cozy because they bring warm blankets) the nurse hooks up the IV and both the anesthesiologist and your doctor come by to say, “Hi!” Once everyone exchanges greetings you’re wheeled into the examination room, you start to say something — and the next thing you know is that the same nurse you met earlier is now whispering in your ear, “It’s time to wake up.” That’s it. Over. Done. AND, you really can wake right up because the procedure only requires a “twilight” anesthesia, not a general.
All right then — time to get dressed! And to partake in the yummy fruit juice the same nurse now brings you to begin the re-hydration process. This also is the time your doctor will return to discuss the findings of your colonoscopy. My doctor, for instance, takes great pleasure in telling me that I’m a “perfect asshole.” Music to my ears, of course, as he has been my doctor for many years and previous findings — from my first colonoscopy to be exact — were not so welcome.
But, here’s the really great thing about a colonoscopy. The procedure utilizes a specialized endoscope that performs several important functions. First, this flexible tiny tube emits a puff of air that expands the sides of the colon and allows the endoscope to advance and move through the intestinal tract. Second, it contains a computer chip that videotapes the intestinal walls as it moves through the colon. This video (which will never make it to YouTube) is then transmitted to a monitor in the examination room, which allows the examining physician to observe the procedure as it’s conducted.
As a result, any anomaly that appears on the monitor screen — such as a colon polyp — can be removed immediately with an electrical loop that cuts and coagulates the tissue simultaneously. This procedure, known as a polypectomy, can remove any suspicious or pre-cancerous tissue during the colonoscopy which, in most cases, can prevent colon cancer from developing in the first place!! And, to top it all off, this specialized endoscope also comes equipped with a little vacuum cleaner that helps provide better viewing by “cleaning up” any residual material not purged through the preparation process. Boy! Do they think of everything or what!?
Finally, on the advice of my doctor, this year I opted to undergo an upper GI (gastrointestinal) endoscopy at the same time my colonoscopy was conducted. The upper GI tract includes the esophagus, the stomach and the upper part of the small intestine known as the duodenum. Similar to the colonoscopy, the upper GI test utilizes another flexible endoscope with video monitoring that enters through the mouth and travels through these upper body parts taking pictures. Now, I had never had this test before and apparently it has become quite the rage for both procedures to be done at the same time. And, of course, there are advantages to this. The patient is already under anesthesia, the medical team is in place, it only takes a few extra minutes to do both tests AND one can leave knowing her or his ENTIRE digestive tract — literally from top to bottom — has been inspected!
Now remember, most of us only need to undergo a colonoscopy once every five or so years with most having their first between the ages of forty and fifty. For those of us with a higher risk — like myself — the testing will be more frequent and will probably begin at an earlier age. Further, in situations in which the colonoscopy reveals a cancerous condition, the patient can immediately begin treatment. Of course, the purpose of a colonoscopy is to prevent colon cancer in the first place by removing suspicious tissue before it develops into cancer. But in order to do this, colonoscopies must be conducted regularly! So, if you’re due for one, DON’T PUT IT OFF! GET IT DONE! NOW! DON’T BE RE-ACTIVE — BE PRO-ACTIVE!
SO UNTIL NEXT TIME EVERYONE, BOTTOMS UP!
It’s TIME to TAKE THE COURSE and TAKE CHARGE!
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