Archive - May 19, 2012

#colonoscopy recap

At quarter of ten on a sunny Friday morning in May, I arrived at the gastrointestinal center in the neighboring town for a colonoscopy. I looked around the room. Except for my wife, and some nervous looking woman sitting alone, I was the youngest person in the room. All of a sudden, I felt old; old enough for an AARP card, old enough to get a colorectal cancer screening.

I've done a lot of reading about colonoscopies, polyps, stages of colon cancer. I had a pretty good idea at the odds. Yes, my odds were perhaps a little higher, due to family history. The occasional aches in the gut, were probably stress, gas, or from pants that were too tight, and not something I normally worried about. I hadn't notice changes in stool size or color, but I must admit, I don't normally look closely at my stools.

The procedures seemed very efficient. 10:02, I was in the first room, where I put on a hospital gown, signed some forms and got hooked up to different machines. Blood pressure was fine. They triple checked the medications I was on, as well as any food allergies that I have. I've heard that a shellfish allergy, like I have, rules out certain medications that somehow have shellfish related to their preparations. I later found out that the anesthesia that I would be having is sometimes prepared with soybean oil and egg emulsifier.

They put in an IV, another first for me, and I admired the curved steel sculpture holding up the the bag of saline solution. 10:14, I signed more forms and waited for the anesthesiologist. 10:22, the anesthesiologist arrived, described the sedative they would use, its effects and warnings. Then, it was time wait to go into the room where they would do the actual colonoscopy. The background music was "Girls just want to have fun".

At around 10:40, I was walked into the colonoscopy room. I laid down on the hospital bed and got my wires reconnected. They hooked up oxygen, another first for me. It had a sweet but metallic smell. My blood pressure was still fine. I rolled over on to my left side, moved my left leg forward, had the blankets arrange and the railings adjusted and it was just about time to start. My blood pressure climbed a little at this point.

There was a safety check to make sure everyone was on the same page, and that I was the patient they though I was. The anesthesiologist injected what looked like a think white syrup into my IV. The propofol, or "milk of amnesia" took effect almost immediately.

I was groggy as I emerged from the propofol fog. I was in a different room and my wife was sitting next to me. She told me the time, and let me know that it was the third or fourth time that I had asked that. We talked a little bit and the doctor came in with the results.

I had one polyp, which they removed. It was around 5 mm. Such polyps are not unusual and are rarely cancerous. I was not surprised to find that I had a polyp, but relieved to hear that it was small. They are doing a biopsy to be sure that it wasn't cancerous. I also have diverticulosis. While I wasn't expecting to hear that, it wasn't surprising. Diverticulosis runs in the family, and is a good explanation of abdominal pains I sometimes experience.

The one unexpected result was erosion of the terminal ileum. That is where the small interesting joins the large intestine. It may well have been caused by the baby aspirin regimen that I've been on for years, and the doctor told me not to resume the baby aspirin for another two weeks. Another possibility is Crohn's disease, which does run in my family, but is fairly unlikely. Again, a biopsy was taken and I'll learn more later.

After I was given the details, along with some patient education materials about diverticulosis, I headed on my way. Kim and I went to a small local restaurant for brunch. I had a turkey burger that tasted really good, and Kim and a mushroom omelette.

So, I've cross the threshold for people over fifty by complete the colonoscopy rite of passage. If there were properly gamified personal health record systems, I could add the IV badge, the anesthesia badge, the colonoscopy badge and the polypectomy badge.

Perhaps, more importantly is returning to Joseph Campbell's monomyth. As I return from my adventure, I need to tell others. So, if you are over fifty and/or have a family history of polyps or colon cancer, go out and get the screening done. The prep work the day before the colonoscopy isn't fun, nor is having the tape that removed the IV, but they are all minor compared to knowing what is going on in your digestive track.

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