A colonoscopy is nothing to get butt-hurt about

                

NOBODY LOOKS FORWARD to a colonoscopy.  Why would anyone?  It’s an inconvenient procedure that puts a person in a vulnerable position to inspect an area of your body nobody wants to even think about—much less talk about.  So, why put yourself through such an experience?  Well, for starters, there are lots of reasons to have a colonoscopy. 

                I’m 43 years old, and I’m having my seventh colonoscopy.  If anyone on the planet has experience on the “receiving end” of a scope, it’s me.  You might be wondering why I’ve had so many scopes for a man under the age of 50; I’ll explain it as this article unfolds. 

If you’re reading this, and someone you know is having doubts about having a colonoscopy, please take the time to share this article with them.  If you’re reading this, and you are the one who is hesitant about the procedure, please take the time to read through this article.  I am sure my story will help ease your fears.

“BUTT” FIRST:  Stupid myths versus hard truths

                Mankind has a way of mystifying uncomfortable subjects.  I don’t know if it is a coping mechanism that is endemic of our species, but sometimes myths make a simple subject more complex than it needs to be.  People fear what they don’t understand.  In order to rationalize colonoscopies, we first have to cut through the crap (pardon the pun).  For facts, I went to the Cleveland Clinic website and the butt seriously blog on stopcoloncancernow.com.

Preparation for the colonoscopy isn't as dreadful as it used to be

• MYTH:  I’m not at risk for colon cancer.
• FACT:  Everyone is at risk; one in eighteen American men and women will get colon cancer in their lifetime.  Adults over the age of 50 need to have a scope because the majority of colorectal polyps (the advance warning of colon cancer) occur after age 50.  REMOVING POLYPS FROM THE COLON COMPLETELY PREVENTS COLON CANCER. 
• MYTH:  If I don’t display any symptoms, then I don’t need a colonoscopy.
• FACT:  In almost all cases, colon cancer begins as a kind of precancerous growth in your colon.  These growths, known as polyps, normally don’t cause any symptoms in the body.  25% of men and 15% of women aged 50 or over who have colonoscopies have polyps removed from their bodies.
• MYTH:  You have to drink gallons of laxative to clear out your bowels to prepare for the colonoscopy!
• FACT:  I will be taking Suprep, a bowel preparation kit that requires two doses of 16-ounces, 10 hours apart.  Of each dose, only six ounces of the 16 is the actual laxative.  The rest of the mixture is water.  In addition, after drinking each dose, I will drink 24 ounces of water (the water helps mobilize the matter in your gut and colon).  To help “ease the chute” during this colon clearing process, I will take Dulcolax.
• MYTH:  You are not allowed to eat for days!
• FACT:  You begin fasting the day before your procedure.  My first dose is at 5:00 PM, and that’s when I cannot eat again.  I plan to eat a bowl of ramen for lunch.  Hey, why not make it easy?  In addition, purple and red foods and drinks should be avoided the day before (since there is a potential for casting misleading colors in your intestines).  My second dose of the bowel prep is at 3:00 AM on the day of the screening.  With an 8:00 AM scope five hours later, I’ll have plenty of time to clear my colon for my examination.
• MYTH:  A colonoscopy isn’t accurate at all.
• FACT:  A recent study reported that experienced specialists, not family physicians or internists, had high success rates for detecting polyps, the precursor to colon cancer.  There are studies out there to the contrary, but look at the case study groups and the level of expertise of those who performed the scope.  Stacking the two studies for comparison, it can be concluded that specialized experience counts in early detection. 
• MYTH:    Colonoscopies hurt!
• FACT:  You won’t be awake for it.  You’ll be under mild sedation.  While it’s true you can wake up during a scope (I did once, and I’ll explain later), it’s highly unlikely that you will.  When you do wake up, you’ll be groggy and full of air, but as for your backside, you probably won’t feel a thing.
• MYTH:  If I have colon cancer, I’m a goner.
• FACT:  Colon cancer, when caught early, is 90% curable.  This is why screenings are so important.  Once the cancer spreads through the body, then the rate of survival decreases significantly.
• Finally, the dumbest MYTH:  I don’t want to go through that experience.  If I had to choose between cancer and having a hose up my ass, I’ll take cancer any day.
• FACT:  Forgive me for this one.  I have had this said to me for years, and this is my response:  I am a father of three children and a devoted husband to a wonderful woman.  I want to be at my kids’ weddings.  I want to dance with my beautiful daughter.  I want to play with my grandchildren and be a mentor to my family for years to come.  Look at your own life.  If you stack up your accomplishments, your loving family, and your future versus a minor procedure that lasts less than an hour, and you choose to sacrifice your family and your future because you cannot bear the inconvenience, then I question your sense of self-worth and what your family members’ lives would be like without you in it.

My story

                Eleven years ago, I was serving overseas on an extended tour of duty in Germany.  Immediately after returning from a war deployment in the Middle East, I was sent to a leadership academy for mid-level non-commissioned officers along with 44 other U.S. military sergeants stationed in Europe.  It seemed all of my classmates were sick, and so was I.  Our teachers called it the crud.  However, there was something peculiar about how I felt.  While many had sinus trouble, I had horrible pains in my stomach.  The pains felt as if my waist was a wet dishcloth being wrung out.  Whenever I felt the pain, a sudden, violent urge to use the bathroom always followed.  Whatever I passed resembled partially-digested food along with bright red fruit punch.  It was blood.  I wasn’t digesting my food properly, and I was passing blood in my stools.  It was a six-week course, and while you might scoff at my words, the military isn’t very forgiving to professional military education school dropouts.  When I woke up, I had to go.  After I ran five miles, I had to go.  During class I would writhe in agony (while popping ibuprofen) as I waited for a break, then I had to go.  Going to the toilet became a mainstay of my life, but the long days of academic instruction had a way of clouding my mind.  Coupling that with military decorum and protocol, and a sergeant’s duty comes before himself.

                Immediately after I returned to my home station after I graduated from the leadership academy, I told my wife about how I felt.  When I was away, I had told her over the phone what I was feeling, but I didn’t go into great detail, and I told her how everyone else was feeling.  In truth, she was more concerned about it than I was.  I had duty to attend to, and nothing could keep me from that.  Fresh from the academy, I was told NATO was coming to inspect our base for compliance with NATO treaties, and I was appointed as part of the headquarters team.  This meant lots of pre-inspection training, prepping, planning, drilling, and studying.  When I wasn’t filling sandbags with my Airmen, I was driving around the fence perimeters to inspect the chain link and barbed wire for tears or voids.  In addition to this, I was passing a lot of blood.  Sometimes, it was all blood.  I was scared, but after weeks of dealing with the pain of it all, it was becoming a new normal for me, and a daily scolding from my wife.  I placed duty above taking care of myself.  It was killing me, and I didn’t know why.

                During a week-long practice drill, we were wearing thick chemical warfare equipment, body armor, gun belts, and gas masks, and I still had to use the toilet nearly every hour.  The frequency of it became noticeable to my commanding officer, but it was largely laughed-off as “Sarge has a bug.”  We pressed on, despite my discomfort.  I tried to keep it quiet, and said very little about my symptoms in a very small circle.

                One day, I couldn’t handle it anymore.  As I stood over a blood-stained toilet, I asked myself if I was going to continue to fool myself into accepting this new normal, and how could I serve my country if I were dead.  I cried—I’ll admit it.  I was awash in fear and I wasn’t thinking clearly.  I was tired all the time, and I had chosen to ignore the strange new color in my eyes and how my skin had lost its elasticity.  I was a walking dead man, and I called the doctor for help.  Unfortunately, I wasn’t given an immediate appointment.  However, my wife had enough.

                She worked for the chief doctor and nurse as their secretary; she dragged me into their offices for an unofficial appointment.  The nurse pinched my skin and looked at my eyes and declared I was severely dehydrated and probably anemic.  As I described my symptoms, a phone call was made to my family care doctor from the chief physician’s office.  I was seen immediately.

                After a whirlwind series of appointments and scoldings (for my delayed reporting of my condition), I was slated for a colonoscopy at Landstuhl Army Hospital in Germany.  I was scared to have this scope done—I was scared about the procedure as well as the preparation, but I was even more scared to learn of my diagnosis and prognosis.  I was convinced I was dying, but I tried to keep that to myself.  My wife, through it all, kept a stiff upper lip and supported me in my sickened, depressed state.

My first colonoscopy

                Because I was going through my own private hell, the bowel prep was actually easy.  It was nice to see pink water instead of deep-red, fruit punch-colored toilet water.  I’ll admit the bowel prep medication in 2007 was much more intense than it is today (I had to drink a half-gallon of what was essentially seawater).  For the first time in months, my body was having a difficult time with passing blood.  I felt empty, and my intestines were too exhausted to clench into its familiar, painful grip.  Amazingly, the procedure was over before I knew it—literally.  I had never worn a hospital gown before, and it wasn’t flattering at all. 

                After putting on what was essentially a paper lampshade with my naked ass hanging out the back, I climbed onto a hospital bed and was given my first-ever IV of saline.  I met the doctor who explained the procedure in detail.  Shortly afterwards, a sedative was introduced to my IV.  I awoke on a low cot in a room full of other men on cots.  I was confused and asked a nurse when my procedure would begin.  I felt inflated, and my guts felt like they were blown dry with a large fan.

                “Your procedure is over now,” the nurse said with a smile.  She must have been asked that question a lot.

                What do you mean it’s ‘over’?  I thought to myself.  It hadn’t begun yet, and I was in a strange room full of men on cots.  These men were making weird noises.  They were farting!

                “Sergeant, I need you to pass gas,” the kindly nurse said.

                What?  I’m hallucinating.  I have to be stoned. 

                “That pain in your gut is air.  The doctor filled your intestines with air.  I promise it’s just air inside you.  You will feel better when you just let it go.”

                My insides painfully agreed with her, but I was groggy and couldn’t fully comprehend.  I’m on a cot, and a nurse—a commissioned officer—was sitting by my side and encouraging me to fart in her presence.  Are you kidding me?  This violates all kinds of courtesy!

                The nurse placed her hands on my stomach and pushed.  The noise that followed can only be described as a large balloon deflating in your hands.  I was still groggy, yet embarrassed at the same time.  The nurse patted my forehead and reassured me it was encouraged to let it go.  To this day, the whole experience was surreal.

                Once I regained most of my faculties and dressed myself, I met my wife outside the recovery room.  She guided me to the doctor’s office.  He had been waiting for me.  The doctor laid my fears to rest; I didn’t have cancer and I wasn’t dying (though I could have if my symptoms had led to sepsis)—I had ulcerative colitis.  It’s as nasty as it sounds:  It’s a series of ulcers that develop in your large intestine (colon), and it’s hard to bring under control in the midst of a flare.  The good news was the disease is treatable, and while it alters your lifestyle, it isn’t fatal in and of itself.  The bad news was the disease was not curable.  When I realized I wasn’t going to die, I accepted the diagnosis I was given, and began a regimen of medications to control the symptoms.  Within a week, I had gone from 25 bloody bowel movements per day to just four.  Within two months, I had no trace of blood in my feces.  My doctors needed to conduct a colonoscopy to find out what was wrong with me, and the delays I placed on my personal health exacerbated the agony I felt as well as the time it took to heal my intestines. 

Why I have had so many scopes

                Patients diagnosed with ulcerative colitis have a higher incident rate of developing colon cancer.  As a result, I have a scope every 18 months to two years.  I had three in the first three years, which seems extreme, but I was undergoing a medical board to determine fitness for continued military service at the time.  In the last eight years, I’ve had three scopes, with my fourth happening in 48 hours.  This is a normal thing for me now, and since I’ve been in remission for the last five years without a symptom, I’ll trade a day of preparation and a few hours of discomfort for the continued feeling of happiness knowing I’m cancer and ulcer-free.

Remember what I said about waking up?

                Yeah, about that.  After Germany, I moved to England as I dealt with bringing my colitis under complete control.  Sadly, I had a flare-up and needed another scope after a hospitalization (most military doctors are poorly prepared to handle gastrointestinal distress) caused concern.  This time, I was sent downtown to a British doctor for a scope.  I completed the usual bowel prep the night before, but what followed could best be described as a Monty Python skit.

                Just like both times before in Germany, I wore one of those stupid gowns.  I was given an IV, and knocked out.  However, this doctor underestimated my sedation dosage.  I awoke to a strange sight and felt incredible pain. 

                There I was on a surgical table, slumped onto my side with my knees bent.  My butt was cold and was precariously close to the edge of the table.  I could feel the horrible sensation of internal inflation.  To be honest, it felt like an air compressor was pumping gallons of air into my intestines (it was).  The colonoscopy hose felt larger than it really was—like a fire hose (it wasn’t).  I was butt-naked and surrounded by student nurses observing the procedure.  Unlike America or the United States military, England makes this a common practice. 

                I must have stunned the doctor, who hadn’t noticed I woke up.  My groggy self reached for the scope hose as I said “I’m naked and surrounded by women.  That’s not weird.  There is an old British man shoving a hose up my butt.  That’s weird.”

                “Oh, dear!” the Englishman said with a start, “our patient is awake.  Please sedate him again.”

                I woke up later.  The pain was gone, but it was clear the doctor was mildly embarrassed that I had awakened during the scope.  He was embarrassed?  I was the one on the table!

                Waking up during a colonoscopy is rare, but it does happen.  Chances are you won’t, but chances were fair that I would at least once (I’ve had so many, it was bound to happen).  I’d also like to point out the British aren’t nearly as adept at these procedures as Americans are.  When we say we’re going to knock you out, we mean it!

My advice after having one

                So, you had your scope and you are back to your normal life.  Not so fast.  Firstly, the sedative you were given prohibits you from driving a car or operating heavy machinery.  So no drag racing, pistol shooting, or woodworking on the day you have your scope.  Save your madcap adventures for tomorrow!  You’ll need a ride home from the hospital (do NOT drive yourself).  Take the rest of the day to recover.  Eat a Big Mac or something.  Relax.  Your doctor will tell you all of these things, but they may not tell you how to ensure you don’t get sick after your procedure. 

                You just had to endure a bowel prep regimen and you had your insides inflated.  In addition, you had a foreign instrument inside you.  Your body is in a state of shock, and there is a chance you can develop an infection.  I actually developed a C. difficile infection after that scope I had in England.  It may not have been because of the scope itself, but it could have been.  It was likely my body was poised for a nasty infection.

                A C. difficile infection happens when your body lacks the ability to fight it off.  Some people carry the bacterium within them for years and never display a symptom.  Your body, specifically your intestines, contains trillions of bacteria—both bad and good bacteria—within them.  The good bacteria help you digest food, fight infection, and help regulate your immune system.  Unfortunately for me, before my third scope, I was hospitalized and given a series of antibiotics.  These antibiotics killed virtually all of my good bacteria (this happens to everyone with many antibiotics).  With no good bacteria to fight the bad, coupled with a hospital stay and subsequent colonoscopy, my body was prime territory to catch C. dif.  I battled the infection for years, which exacerbated my symptoms of ulcerative colitis.  While you may not have colitis, you could get C. difficile after a scope.  To help combat this and reduce the risk of infection, take a probiotic to replenish the good bacteria in your gut.  Yogurt isn’t enough, but it’ll help, too.  There are lots of probiotics out there, and the store brands are just as effective as the big-names.  You need to bombard your innards with probiotics to prevent an infection.

A final word

                This was a long read.  I hope you found it to be encouraging, insightful, and humorous.  I’ve endured a lot of screenings, and I am happy to have done so.  While my case is unique and fraught with pain and grief, the actual colonoscopy itself was the easiest part.  If you are aged 50 or better, or you’re feeling some of the same symptoms I described, don’t delay.  Call your doctor and get referred for a colonoscopy.  The sooner you do, the better you’ll feel.  Get the peace of mind you deserve. 

                Do you have a question or a colonoscopy story to share?  Let me know in the comments below!  I will reply to any comments left on this page!  Please like and share this story on social media.  Spread the word!  We can stop colon cancer before it starts if we just get a scope!  -The Atomic Father