The Ins and Outs of A Colonoscopy

Disclaimers: 1) This story is for entertainment purposes only and is not meant to influence anyone’s decision about whether or not to have a colonoscopy. 2) The subject is a bowel procedure so if you find talking about poop offensive, this isn’t the tale for you.

"Hey Frank, how was your colonoscopy?"  "In and out."

At my yearly physical, the doctor reads my records on the computer screen and notices that I’ve turned age 50. He nonchalantly asks, “Have you scheduled a colonoscopy yet?” I answer no and he responds that I should think about doing it.

I know a bit about colonoscopies since friends in my age group have started to talk about the procedure. The same friends, whose shared experiences include bar hopping, job hunting, getting married, and raising children, now discuss things like arthritis, menopause, and colonoscopies. Friends that are with you from your first can of beer to your first bowel procedure are the ones you truly treasure.

After doing my internet research on the subject, I decided to put off having a colonoscopy. The procedure was too invasive, the preparation too unpleasant, and with no family history of colon cancer, risk of bowel perforation outweighed the benefit. In support of my decision, I had a strong negative reaction to anesthesia from an unrelated surgery and wasn’t eager to put myself through it again, especially for a screening test.

When it comes to colonoscopies, I’ve found that health care providers won’t take “no” for an answer. As a few years go by, the doctor’s casual question about having a colonoscopy begins to sound like the sales pitch for an endoscopy center.  One male doctor said, “You go every year for a mammogram, why not get a colonoscopy?” A mammogram consists of taking a shower and slapping my boobs between two plates for a couple of quick pictures. That’s a far cry from not eating for 24 hours, giving myself uncontrollable diarrhea, and getting knocked unconscious while a slightly risky procedure is being performed through my rear end. This retort was expressed by my inner voice while my actual mouth remained politely mute.  

I really began to get annoyed when my primary care doctor’s office started calling on a regular basis. The first few times they fooled me, beginning the call by saying that they are updating their records and want to know if the doctor is still my primary provider, followed by the punch line, “Have you scheduled your colonoscopy yet?” They even left messages asking me to call them back only to hound me about the colonoscopy again. I wondered, somewhat irrationally, if the insistence on getting a “fully covered” colonoscopy was part of some larger conspiracy.

Caught off guard one day, I answered a call from the doctor’s office. The “records manager” asked, if I didn’t want to get a colonoscopy, would I be willing to take a test called a FIT? “What’s a FIT?” you ask. I’ll give you a hint. It has nothing to do with fitness and the “F” stands for fecal. It’s basically a poop test. You take a stool sample at home, package it up neatly in the container provided, and ship it off to a lab for analysis.  I caved on this one.

A couple of weeks later, I am notified by the doctor’s office that I failed my FIT test and they want me to make an appointment to discuss it with the doctor.  During my appointment, he lectures again on the benefits of cancer screening and prevention by removal of potentially cancerous polyps through the colonoscopy procedure.  On the internet, I find that blood in the stool can mean anything from hemorrhoids to colon cancer. I spend the next few days researching local gastroenterology specialists, choosing one based on education, accolades, and patient reviews. Colonoscopy, here I come. Then I spend the next few weeks worrying that I might have colon cancer.

C-Day is rapidly approaching. I have my bowel prep kit from the pharmacy and I’m reading over the instructions and planning my diet. No popcorn, seeds, nuts, fruit skins or “red” or “purple” foods for three days and no solid foods for one day leading up to C-Day. Oh red wine, I’ll miss you the most. Bowel prep also consists of drinking a fairly disgusting solution that gives you diarrhea and you are warned to stay near a bathroom. My concern over this leads me to consider purchasing an adult diaper in case of emergency.  You’ll find these in aisle 12 next to “Incontinence Greeting Cards”.

incontinence-cropped

What does an incontinence greeting card say? I’m sorry for your loss…of control?

Getting through the day before C-Day is as bad as people say. I’m never one to skip a meal, so no solid food leaves me cranky and miserable. Drinking the bowel prep solution plus about a gallon of water is a chore, followed by painful cramps and an infinite number of bathroom runs (pun intended). There is a wise old saying for a time like this that I repeat in my mind like a mantra, “You can never trust a fart, never trust a fart, never trust a fart…” I have thoughts of giving up and backing out of my appointment and wonder how many other people actually do.

Driving to the endoscopy center the following morning, I remind myself that I’m in the home stretch (unless, of course, I have colon cancer and then the battle has just begun). After a short time in the waiting room, I’m brought into an area with an assembly line of curtained cubicles. During a lengthy Q&A with the nurse, I tell him about my stomach upset from my previous anesthesia and he reassures me that I’ll be getting the Michael Jackson drug of choice in a dosage that, in his experience, has never resulted in nausea and vomiting. My inside voice says, “Great! No nausea or vomiting. Just accidental death.”

The nurse finishes checking me over and setting up an IV, leaving me with a magazine. I find that I can’t focus on actual words so I just stare at the pictures. From conversations I overhear, everyone in the assembly line is being prepped for an endoscopy or colonoscopy. It’s one end or the other. One of the criteria in my choice of doctor was finding someone who performed the procedure on a regular basis.  So even if the assembly line seems a bit impersonal, I’m relieved to know the doctor I’ve chosen has had a lot of practice.

When it’s my turn, I’m wheeled into another room where there is a flurry of activity and people coming at me. Rather quickly a needle is emptied into my IV and I’m out for the count. The next thing I know, I’m back in a cubicle where a different nurse checks on me and offers me something to drink. I’m told to get dressed but I must stay in the bed and the thought of me trying to squirm into my pants without getting up makes me laugh. I hope no one was watching the show.

I’m glad to end this story on a positive note. The doctor checked from one end of my bowel to the other and not a polyp or any issue was found. There was no reason why I should have failed the FIT test. Left to draw my own conclusion, it was probably a false positive. I’m somewhat annoyed by that, but also relieved that the colonoscopy is behind me (couldn’t resist a final pun) for another 10 years.

I’m back to living my boozy lifestyle featuring cocktail hour, red wine, and good meals with good friends.

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