Wednesday, March 28, 2012

Over 50? You need this.

kw: medicine, medical tests, colon health

OK, this may be TMI for some people: This is how a healthy colon looks from the inside. It is my colon, what there is left of it, looking along the transverse colon toward an anastomosis (surgically fitted joint). At the far end, where the color of the wall darkens, is the ileum, the small intestine.

I had a colonoscopy today, with great results. For the first time there were no polyps. My first colonoscopy, in late 2000, found not polyps but a large cancer. I was 53, and I really should have had a colonoscopy at age 50! Then the removal of a polyp would have prevented all that I went through in late 2000 and early 2001. The good news is, more than eleven years later, I am not a statistic but a cancer survivor.

Many folks are squeamish about having a colonoscopy done. "I don't want anyone running that hose up my butt!" If you see a colon fiberscope, it does look a lot like a six-foot length of black garden hose. Of course, it is a lot more flexible, so it can go through the twists and turns of a normal colon without doing harm.

If I recall right, I've had eight colonoscopies, including that first one in 2000. I had surgery to remove a third or more of my colon a week after that one, and then for five years I had one every year. Five years without a recurrence of cancer is considered a cure, particularly with colon cancer. Those five bring the total to six by the end of 2005. Then I had one in late 2008. Polyps were removed in all of these procedures, so I was scheduled for my next one in late 2011. Scheduling difficulties postponed that to today, only four months "late". My next one is scheduled for early 2015. This will probably continue for the rest of my life.

Most folks need to have a first coloscopy at 50, but if your family has a history of cancer, it is better to start at 40. A friend of ours lost her life to colon cancer at age 49. In my family, my father's side is cancer free, even into their 90s, but my mother's side is more cancer prone, and my mother had cancer three times before dying of ovarian cancer at 81.

Don't be squeamish about it. This test is the only one that can absolutely rule in or rule out cancer of the colon. There is a test for blood in the feces that finds some cancers, but only about half the time. I passed several such tests in my forties! Even at age 51, when I probably already had cancer!!

The test itself is no problem. I've had them with Demerol, with general anesthesia, and this time with a "twilight" treatment where I actually felt the procedure, but felt no pain. The preparation is worse, though that is improving also. In 2000, the preferred "prep" was either a bottle of Fleets Phospho-Soda plus half a gallon of water, all in an hour, or a gallon of Colyte, which is so vile I'd die before I'll ever use it again. I've had both! But since 2002 the preferred bowel cleanser is Senna, a plant derivative that comes in pill form. It is OTC. The usual dose for constipation is one or two pills. The "prep" dose is fifteen pills about noon, and fifteen more in the late evening, with a couple glasses of water each time. Drink more if you get thirsty, and in my case, I did. All this is the day before the test. It cleans you out good, so stay near the bathroom.

This morning, my wife took me to the surgicenter, and an IV was put in for the "twilight" drugs. After a while of sitting and talking with her, I was taken into the 'scope room, where three nurses got me ready while the doctor looked over the photos of past procedures (there are a lot of them at this point). The actual scoping took about ten minutes. As I said, I could feel it this time, and there was no pain. The twilight drugs kept me in a quiet mood (great stuff, if you want a real don't-care attitude for a while). I was expecting more, but the nurse said, "We're done. Let's go," and they rolled me back to the room where my wife was waiting. She was surprised that I was awake and talked to her immediately. A far cry from the times I'd had general anesthesia!

At home, I napped a couple of hours, and now I can at least drive a keyboard and keep my spelling on track. It amounts to a day off work (I worked early on "prep" day, yesterday, and started when I got home); a valuable investment in my own healthy future.

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